Summary of the impact

Professor Sue Roulstone's research has contributed significantly and widely to a growing political appreciation of the crucial role that language plays in children's development, socially, emotionally and educationally. The research has contributed evidence to underpin policy initiatives to monitor language as an indicator of successful child development, to support the importance of children's early language development and to ensure services for those with impairments are evidence-based. These initiatives have in turn impacted upon the development of services and the use of parent and child perspectives in service design and development.

Underpinning research

Language plays a crucial role in children's development. Approximately 7% of primary aged children will have a speech, language and communication impairment (SLCI). The research focused on the perspectives of these children and their families, and on evidence about what works to support children's language development. It was undertaken at UWE by Sue Roulstone (Underwood Trust Professor of Language and Communication Impairment 2004-2013), Dr Yvonne Wren (Honorary Research Fellow, from 2006), Rosalind Merrick (PhD student, 2006-9) and Dr Jane Coad (2006-2011).

Perspectives of parents and children

In 2004, Roulstone and Merrick worked with local practitioners to evaluate speech and language therapy services [R1]. This was one of the first evaluations to include the perspectives of children with SLCI and their parents. Subsequently, they demonstrated that, using well-designed materials to support communication, children could successfully participate in the research and communicate their perspectives, despite their communication impairments. Children's discourses about their communication impairments thus became explicit for the first time, showing that, although they used a discourse of impairment, they also accepted their developing speech and language as part of their everyday learning and development [R2].

Following this, Roulstone was commissioned to complete the independent consultation of parents and children as part of the Bercow Review of Services for Children and Young People with Speech, Language and Communication Needs, commissioned by the (then) Department for Children Schools and Families in 2008. Roulstone's team, including external collaborators, found that parents saw communication as central to their child's development and learning, a `key to life'; parents were looking for well-signposted services with access to specialist resources, with a timely diagnostic process where professionals worked in partnership with parents.

In response to the Bercow Review, the UK government set out their `Better Communication Action Plan' and commissioned the `Better Communication Research Programme' (BCRP) from 2009-2012. Roulstone, as one of the four national researchers that won the bid, led the investigation of outcomes valued by children with SLCI and their parents. She found that parents perceived communication as the life skill that underpins other key life outcomes such as independence and social inclusion. Parents and children also provided stories of the lack of awareness about SLCI among both professionals and the public [R3].

Factors and interventions supporting speech and language development

Roulstone is an advisor to Avon Longitudinal Study of Parents and Children (ALSPAC) (the large population study hosted by the University of Bristol), setting up the direct assessment of children's speech and language at 2, 5 and 8 years [R4]. Roulstone has continued to analyse these data since joining UWE and Roulstone et al. (2011) [R5] found important associations between parents' activities with their children before the age of two and children's language at two years. This in turn was significantly associated with their performance on school entry assessments, suggesting that children who develop their language early are at an important advantage. Furthermore the research established that parents' activities were more important predictors of children's early language than the parents' social background.

A survey of current practice regarding children's communication development, led by Roulstone and Wren (part of the BCRP) found over 150 programmes in current use [R6]. Roulstone and Wren (with James Law from Newcastle University) then reviewed the evidence relating to 50 of the most popular, the first systematic review of current practice. The review revealed that only 5% of programmes had strong evidence; 56% had evidence from at least one trial and 39% had only face validity or case-study evidence.

References to the research

Related grant: Roulstone (PI) & Merrick. Children's views and speech and language therapy. £34,000 Remedi, July 2006-June 2008

Related grant: Lindsay (PI), Dockrell, Law & Roulstone. Better Communication Research Programme — Speech, Language and Communication Needs (SLCN) Cost-Effectiveness Research Programme. £1.2M. Department for Children Schools and Families, June 2009 — May 2012.

Related grant: Roulstone (PI), Wren, Emond, Peters. The origins and outcomes of persisting phonological impairment. £181,624, Medical Research Council. December 2007 — May 2008

Related grant: Roulstone (PI), Law, Clegg, Peters. Investigating the role of language in children's educational and social outcomes. £60,000, Department for Children Schools and Families. October 2009-September 2010

Related grant: see grant 3 above.

Details of the impact

Topic guides and picture materials developed by Roulstone et al. [R1, R2] to investigate the perspectives of children with speech, language and communication impairments (SLCI) and their families have been used to support user consultation. For example, the national Commissioning Support Programme (also part of the Better Communication Action Plan in 2008) was tasked with providing support for commissioning of services for children with SLCI. The final guidance [S1], published in 2011 contains the topic guides and picture materials developed as part of Roulstone's research.

The consultation with parents and children, led by Roulstone for the Bercow Review (2008), presented parents' views regarding their ideal world. In such a world, communication was seen as fundamental, diagnosis was timely, services were signposted with easy access, people work in partnership, specialist resources are appropriate and available, and speech, language and communication needs are recognised by the public. The influence of these findings can be clearly seen in the groupings of four of Bercow's five recommendations: communication is crucial; early identification and intervention are essential; a continuum of services around the family is needed; joint working is critical [S2]. Roulstone's research is acknowledged in Bercow's report [S2] which uses quotes and illustrations directly from Roulstone's data. For example, the opening quotation for Bercow's review on p16 "Speech language and communication is the most important thing in all our children — it's their key to life" is a quotation from a parent taken directly from Roulstone's research.

Roulstone's research into the perspectives of children and young people regarding their SLCI has prompted practitioners to search out these perspectives within their own services. An example is given [T1] by a speech and language therapy team leader from Wiltshire who describes the influence, in 2004, 2011 and 2012, of Roulstone's research on the practice of her service. She describes the introduction of children's views into their auditing process and how this helped her team to understand the value that children placed on activities within therapy.

Roulstone's findings emphasised the central role of communication in children's lives and the perceived lack of awareness of this in professionals and the public. Bercow's report picked up this finding and recommended a national campaign year to promote awareness of the role that communication plays in children's lives and the damaging effects of SLCI. The government accepted this recommendation and announced the National Year of Communication in 2011 — a campaign to increase understanding of the importance of communication to children's and young people's welfare and development. During the National Year (2011), Roulstone's research findings from the ALSPAC data were used to support the campaign, that is, the finding that parents' activities in the first two years of life were associated with increased vocabulary in their children at the age of two years and improved school readiness. Roulstone was invited to present her findings in seminars for early years practitioners, museum curators and therapists (for example, in London and Manchester) that were staged as part of the national year. Speech and language therapists have described the research as invaluable [T2] in their work with children's centres and families supporting the need to develop environments to support children's language development.

Roulstone's research, based on the data from ALSPAC and the investigation of the evidence base underpinning current practice, has been referenced in a number of recent policy documents that argue for the development of services for the early identification of and intervention for children with SLCI. For example, Roulstone's research is widely referenced in the All Party Parliamentary Group on Speech and Language Difficulties recent report (February, 2013) on the links between SLCI and social disadvantage [S3] and in the 2012 Nutbrown Review [S4] which referred to the `overwhelming evidence for the strong support of young children's early language development' from Roulstone's research. The research is also being picked up at a local level where it is cited to support the development of services which promote support for children's early language development, for example [S5], a speech and language therapy team in South Wales cite Roulstone's research to support their `Strategy for the Prevention, Early Identification and Intervention for Speech, Language and Communication Needs for Children '.

Finally, Roulstone's research [R6] to identify the evidence underpinning current practice is having an impact on the use of evidence-based practice. In 2012, the Communication Trust used the research to generate a searchable web-site [S6, S7]. This has stimulated developers of intervention programmes to investigate the evidence supporting their intervention and The Communication Trust has commissioned Roulstone to provide support for its membership to develop their evidence base [T3]. It is also the case that commissioners, managers and practitioners see it as a source of information so that they can select interventions that have some level of underpinning research evidence [T4]. The website was launched in March 2013; over 4000 users have signed up to use the site with over 27,000 page visits in the first six months.

Sources to corroborate the impact

Sources:

S1. Commissioning Support Programme (2011) "Speech, language and communication needs; user involvement and consultation". Appendix [pages 24-29] contains tools developed in Roulstone and Merrick's research. http://www.thecommunicationtrust.org.uk/media/12889/slcn_tools_user-involvement1_1_.pdf

S2. The Bercow Report: A review of services for children and young people (0-19) with speech, language and communication needs. (2008) Nottingham: DCSF. Explicit acknowledgements: footnotes on pages 17, 18; quotes and illustrations taken directly from Roulstone's research on pages 16, 17, 19, 25).
http://webarchive.nationalarchives.gov.uk/20130401151715/https://www.education.gov.uk/publications/eOrderingDownload/Bercow-Report.pdf

S3. Report of the All Party Parliamentary Group on Speech and Language Difficulties (2013) The links between speech, language and communication needs and social disadvantage. Roulstone's research is referenced on pages.8, 9, 11, 13, 16, 18, 19, 21, and 27). http://www.speech-therapy.org.uk/sites/default/files/APPG%20on%20Speech%20and%20Language%20Difficulties%20inquiry%20report%20-%20February%202013.pdf).

S4. The Nutbrown review (2012). Foundations for quality: the independent review of early education and childcare qualifications. Roulstone's research cited on page 19.
http://media.education.gov.uk/MediaFiles/A/0/9/%7BA098ADE7-BA9A-4E18-8802-D8D4B060858D%7DNUTBROWN%20FINAL%20REPORT%20-%20final.pdf

S5. Aneurin Bevan Health Board, Flying Start, Speech, Language and Communication Development Service. Strategy for the Prevention, Early Identification and Intervention for Speech, Language and Communication Needs for Children 0 - 3:11 Roulstone research referenced. (document available from UWE)

S6. Law, J., Lee, W., Roulstone, S., Wren, Y., Zeng, B., & Lindsay, G. (2012). "What Works": Interventions for children and young people with speech, language and communication needs. London: Department for Education. Research Report underpinning the development of the "What Works" website Available at:
https://www.education.gov.uk/publications/standard/publicationDetail/Page1/DFE-RR247-BCRP10

S7.The Communication Trust. "What Works" website:
http://www.thecommunicationtrust.org.uk/schools/what-works-database.aspx

Testimonials:

T1. Testimonial from Wiltshire Speech and language therapy team leader regarding her successive use of Roulstone's research

T2. Testimonial — spontaneous email from a practitioner who attended one of these sessions and who uses the research; programmes from seminars held during 2011 with arts practitioners — `CultureBaby' (museums workshop) and with nursery practitioners (`Talk to your baby' — National Literacy Trust conference).

T3. Testimonial from The Communication Trust corroborates UWE's research contribution to the "What Works" website and its benefits.

T4. Testimonial from speech and language therapy team leader in Birmingham regarding the value of the "What Works" website