Trouble talking: changing policy and practice for the language delayed child
Submitting InstitutionNewcastle University
Unit of AssessmentModern Languages and Linguistics
Summary Impact TypeSocietal
Research Subject Area(s)
Psychology and Cognitive Sciences: Psychology
Summary of the impact
Research at Newcastle on speech language and communication needs (SLCN)
has significantly extended the range and quality of evidence in this
field. The research is significantly informing high level policy makers,
and has been used to set up an accessible database which is having impact
on the practice of a range of different professionals. It has contributed
to a new programme of work which has produced positive outcomes for
schools, children and young people and has been used as an evidence base
to secure charity funding for a third sector organisation.
Delayed language development is common in young children, affecting up to
20% of children at school entry, rising to a figure of 40% in the most
disadvantaged populations (1). Many of these children go on to
struggle with reading and writing and consequently other academic
subjects. As a result, many underachieve throughout their schooling and
into the work force.
Since joining Newcastle, James Law (Professor of Speech and Language
Science, 2010-present) has built on his ESRC funded project work (funding
but not publications outwith the current REF period) which looked at adult
outcomes for school entry language delays (1). This project was
among the first to confirm the long term consequences of such early delays
in a very large populations over a long period of time (18,000 between 5
and 34 years in the British Cohort Study 1970) (2). Social
disadvantage is one of the main predictors of change in the early years
from an analysis of the Millennium Cohort Study (3), although
comparable work on Avon Longitudinal Study of Parents and Children showed
that for very young children what parents do to promote their child's
readiness for school is more important that social disadvantage per se (4).
With the exception of (4) Law led each of these studies, writing
the original proposals, contributing to the analyses and authoring reports
Equally important is the development of well evaluated interventions.
Before being employed at Newcastle, Law was the first author of an
internationally recognised review of speech and language therapy
interventions published by the Cochrane Collaboration, which can be
accessed at http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004110/pdf.
It is very widely cited and contributed to Law's role as PI in a major
£1.5m research programme funded by the Department for Education in
England, called the Better Communication Research Programme (BCRP),
2009-2012 and commissioned as a response to the Bercow review of services
for children with speech, language and communication needs (SLCN). One
aspect of this work was identifying the `best evidence' for oral language
programmes. The research examined the intervention literature related to
children with primary speech and language difficulties. The evidence was
drawn together and led to the production of the report, What works:
Interventions for Children with Speech Language and Communication Needs,
one of a number of reports from the BCRP project (5). The main
findings were that whilst over 60 evidence-based interventions are
available to practitioners, many are not being used in the UK, with some
practitioners commonly relying on interventions with little underpinning
evidence. Independently Law has also been contributing to the development
of the primary evidence base both in the UK and in Australia (6).
References to the research
1. Law, J., McBean, K. & Rush, R. (2011) Communication skills in a
population of primary school-aged children raised in an area of
pronounced social disadvantage. International Journal of Language and
Communication Disorders 46(6): 657-664. DOI:
2. Law, J. Rush, R, Parsons, S. & Schoon, I. (2009) Modeling
developmental language difficulties from school entry into adulthood:
Literacy, mental health and employment outcomes. Journal of Speech,
Language and Hearing Research 52, 1401-1416. REF2 Output: 156264.
3. Law, J., Rush, R., Anandan, C., Cox, M. & Wood, R. (2012)
Predicting language change between three and five years and its
implications for early identification: findings from the Millennium Cohort
Study. Pediatrics. 130:1 e132-e137. REF2 Output: 177144.
5. Law, J., Roulstone, S., Lee, W., Wren, Y., Zeng, B. & Lindsay, G.
(2012) What works: Interventions for Children with Speech Language and
Communication Needs. Nottingham: DfE. Available at: http://www.education.gov.uk/researchandstatistics/research/better.
6. Wake, M. Levickis, P. Tobin, S., Zens, N., Law, J., Gold, L.,
Ukoumunne, O. C., Goldfeld, S., Le H.N.D., Skeat,J. &
Reilly, S. (2012). Improving outcomes of preschool language delay in the
community: Protocol for the Language for Learning randomised
controlled trial BMC Pediatrics 12:96. Available at: http://www.biomedcentral.com/1471-2431/12/96.
All the papers cited have substantive international reach. (2) and (3)
are being submitted in REF2; (1) and (6) are in important professional
journals; and (4) and (5) are reports which have received government
scrutiny and are published on government websites.
Key Grant information:
||Value to Newcastle
||Better Communication Research Programme (BCRP)
||Department for Education
||Centre of Research Excellence in Childhood Language
||National Health and Medical Research Council (Australia)
||Early Language Delays in the UK
||Save the Children
Details of the impact
The research has informed the direction and focus of a parliamentary
inquiry, the All Party Parliamentary Group (APPG) on Speech and Language,
chaired by Lord Ramsbotham. Lord Ramsbotham who led a parliamentary
discussion on the issue on January 29th 2013, also confirmed: "In
addition to his willingness to advise, based on his deep knowledge and
understanding of the subject, he (Law) was able to suggest people from
whom we ought to seek evidence, and topics that we could pursue with
advantage. We could not have completed our work without him...I can
think of no better example of how research can be used to impact on
policy" (IMP1). Law presented research evidence to the APPG
and he was identified as a key contributor by the Royal College of Speech
and Language Therapists (RCSLT). As a result, the underpinning research is
cited multiple times in the final report (IMP2). The underpinning
research output (2) was also cited in the RCSLT's response to the
House of Commons Education Committee in October 2012, to highlight the
relationship between language delays in children and social disadvantage (IMP3).
The significance of the RCRP and APPG reports are highlighted by Lord
Ramsbotham: "[the reports] were published in time to inform debate on
the Children and Families Bill...if successfully enacted, these will
change the life prospects of many young people, for which there is no
doubt that much of the credit will be due to Professor Law for educating
members of both Houses of Parliament" (IMP1).
The Communication Trust, an umbrella organisation representing more than
40 charities which have speech and language as a focus of their
activities, drew directly on the BCRP evidence to develop an interactive
online database, `What Works'
The Director of The Communication Trust, said; "This landmark research
is to be welcomed by all those committed to supporting children and
young people who struggle with communication...The Trust and our
Communication Consortium is fully committed to ensuring all those who
work with children and young people with SLCN know how to support them
and have practical tools to do this... We're working with the Department
and the research team to disseminate the resources and outcomes of the
research, including an online database of evidenced interventions to
support children's communication" (IMP4).
The database has also been endorsed by the RCSLT and the organisation's
Chief Executive was quoted in a Communication Trust Newsletter as saying:
"The RCSLT is delighted to have had the opportunity to work with
partners at The Communication Trust to support the evaluation and
development of the What Works website. At a time when commissioning of
services is becoming more complex, any resource that supports this
process is going to be vital" (IMP5). Indicating the
significance of the database, RCSLT's Chief Executive has also confirmed
that feedback from the membership (12,201 people in the UK) has been
positive and that "we believe that the database, to which James Law has
been so instrumental, has the potential to make a major contribution to
the development of evidence based services across the UK and beyond"
The online database aims to support a range of users, including speech
and language therapists (SLTs), commissioners, teachers, practitioners and
other specialist staff and draws together the best available evidence in
an accessible form. It was launched March 2013 and by the 31st
of July 2013, it had been accessed by a total of 22,700 visitors, with
49,500 page views (IMP7). 4,200 professionals are already
registered to use the database. The Professional Director of the
Communication Trust states that "The data base is a direct result of
the research and we have worked closely [with Law] to ensure the
research information is accessible to the widest audience while not
losing the robust nature of the content. The data base has been
important to our sector in providing up to date information on evidenced
interventions that can apply positively on outcomes for children and
young people with speech, language and communication needs...the what
works data base has been incredibly well received across our sector"
(IMP7). Feedback from users is positive, and comments left by
professionals who have accessed the database include:
"I've already used information I have found on the database to discuss
interventions with parents, schools and speech and language therapists.
I have also found the links to various websites extremely useful and
have recommended some to parents and EY [early years] practitioners.
Thank you!" (Educational Psychologist)
"[The database] helps influence our service delivery design; supports
advocating to commissioners/our managers for evidence of why we need
Speech Language Therapy" (SLT)
"Although we have always strived to be evidence based as a profession,
in the day to day job of a Speech & Language Therapist, there is not
often time to find this research. Having a database will be a fantastic
resource when sharing with parents and professionals why we have chosen
an intervention (or why we have chosen NOT to use something!)" (SLT)
Significantly the database is funded by the Department of Education
through to 2017 and the moderating group of which Law is a key member will
continue to monitor its quality.
The Communication Trust also cited the research findings as corroborating
evidence in their case for support for an Early Endowment Foundation grant
of £967,780, which is funding a new trial based on their programme, Talk
of the Town (IMP8). The programme "was developed with the aim
of providing a framework where evidenced approaches and interventions
could be dropped into place within the early years, primary and
secondary school in one community...We were able to take this approach
and the What Works data base as a foundation to seek further funding to
test out the approach more robustly and have recently secured a
significant grant from the Educational Endowment Foundation to run a
randomised control trial on the approach in 64 primary schools across
three areas of the country" (IMP7). In the `Latest News'
section of their website the Communication Trust noted that: "the
underlying interventions supported as part of Talk of the Town are those
that have been identified through the Better Communication Research
Programme as having good evidence of impact" (IMP9).
The comprehensive review of the relevant research literature in the BCRP
research also produced a `Communication Supporting Classrooms (CsC)
Observation Tool' (with supporting guidance) — one of few such tools that
are evidence-based (IMP10). The Tool provides professionals with
the means of profiling the ways in which oral language is supported in
Reception and Key Stage 1 and 2 classrooms. It has been published on The
Communication Trust website `Resources for Practitioners'.
In summary, the underpinning research has significantly informed and
influenced high level policy makers and professional organisations. In
particular, the BCRP research was (i) instrumental in placing SLCN on the
political and policy agenda, and (ii) led directly to the introduction of
a database of evidenced interventions, aimed at supporting practitioners,
and a new programme which has produced positive outcomes for schools,
children and young people.
Sources to corroborate the impact
(IMP1) Factual statement from Lord Ramsbotham, Chair of the APPG for
Speech & Language.
(IMP2) APPG on Speech and Language Difficulties (2013) The Links
Between Speech, Language and Communication Needs and Social
Disadvantage. London: RCSLT (pages 8-13, 15-16, 18-19, 21, 27, 32,
34-37). Available at:
(IMP3) RCSLT (2012) Evidence to the House of Commons Education
Committee on the Government's Proposed Reform of SEN Provision (page
2). Available at:
(IMP4) The Communication Trust, Press Release (December 2012). Available
(IMP5) The Communication Trust, Newsletter — March 2013. Available at:
(IMP6) Factual statement from Chief Executive, RCSLT.
(IMP7) Factual statement from Professional Director, The Communication
(IMP8) Education Endowment Foundation Projects (Talk of the Town).
(IMP9) The Communication Trust, News Item `The Education Endowment
Foundation award a grant to The Communication Trust to test a school-wide
approach to improving speech, language and communication support'.
(IMP10) BCRP (2012) Communication Supporting Classrooms Observation Tool.