Speech, language and communication development

Infants emerge from the womb as multi talented and communicative individuals. New born infants have a whole host of communicative aptitudes. These include musical and literacy preferences, the ability to identify their mother’s voice, copy facial expressions and express contentment and displeasure.

Speech, language and communication development (SL&CD) and health inequalities from 0-3 years

The development of good speech, language and communication abilities in infants rests upon positive interactions with parents, especially during the first year of life.

Health and social inequalities experienced by families can affect positive interaction and speech, language and communication development and lead to further inequalities later in life.

Quick links:

What are health inequalities?

The WHO defines health inequalities as "differences in health status or in the distribution of health determinants between different population groups."

For a general discussion of health inequalities and the early years, please see Inequalities in the early years.

Policy context

Activity in this area is consistent with commitments and priorities detailed in the Early Years Framework and the National Parenting Strategy, Equally Well, Achieving our Potential, a range of NHS Scotland's Quality Indicators and is relevant to Scotland's national practice model for child-centered services - Getting it Right for Every Child (all external links).

Under the terms of the Disability Discrimination Act, public sector service providers must discharge their Disability Equality Duty to promote equality of opportunity for people with disabilities, including those with communication support needs or communication disabilities.

What do we mean by SL&CD in 0-3 year olds?

It's important that parents (and other adults) speak to their babies as soon as they are born in order that they gain familiarity with speech sounds and begin to learn words and language patterns.

See Developing communication skills in infants.

How much a child is spoken to (Hart and Risely, 1995) and the number of different words a child hears (Pan et al. 2005) directly affects its speech and language development.

Before they can speak, babies are still able to communicate their needs and feelings and respond to what goes on around them.

Positive responses by adults to these cues - e.g. offering food when the 'hungry' cry is heard - build connections in the brain that are the foundations for more complex communication in future.

As speech begins to emerge, parents and other adults can support further development by continued positive, sensitive and consistent responses, through play, and by reading and giving access to books.

A 2011 longitudinal study for the Department for Education in England, Investigating the role of language in children’s early educational outcomes (external link), found that children's language development at two years predicts their performance on entry to primary school and:

"The children’s communication environment influences language development. The number of books available to the child, the frequency of visits to the library, parents teaching a range of activities and the number of toys available are all important predictors of the child’s expressive vocabulary at 2 years.

The amount of television on in the home is also a predictor; as this time increased, so the child’s score* at school entry decreased." (Page 3).

Both the above report and a review of evidence by NHS Health Scotland found that the home learning environment is of more importance for intellectual and social development than parental occupation, education or income (p27, Evidence summary: Interventions to support parents, their infants and children in the early years (pregnancy to 5 years (external link)).

*Defined as early language skills, reading, writing, and maths that they need to help them in school.

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How do inequalities relate to speech, language and communication development in 0-3s?

Anything which diminishes the ability of parents to communicate with and bond with babies and young children may affect their development of speech, language and communication abilities.

Emotional availability is required if parents are to respond to their child in positive ways. This can all be affected by health and other inequalities.

For factors associated with an increased risk of experiencing difficulties in social, emotional and cognitive development, please see Evidence Summary: Interventions to support parents, their infants and children in the early years (pregnancy to 5 years) (page 32) (exernal link).

Not speaking English as a first language is not in itself a risk associated with delayed speech, language and communication development.

Children who develop good communication skills via any language are generally able to transfer those abilities to other languages and those living in bi-lingual homes may find it easier to learn new languages.

Communication support needs (CSN) of parents

Communication Support Needs include learning disability, sensory impairments and English not being spoken as the first language.

Parents with CSN may be less able to access additional supports and information that could assist with their child's development.

For a detailed discussion on issues around assisting parents with communication support needs, please see Communication Support Needs (CSN) and inequalities in pregnancy.

Identifying those at risk

Because those at risk can be difficult to identify, it's important to link with other professionals who may know more about the family and their circumstances, e.g. Speech and Language Therapists, carers, GPs, social workers, health visitors, nursery school and other childcare staff, and voluntary sector agencies.

Specific factors relating to physical health should also be taken into account, including:

  • Frequent catarrhal colds - child may experience undiagnosed but repeated, transient conductive hearing loss due to blockage of the Eustachian tube, leading to developmental delay.
  • Frequent illness or hospital admission - child may be too tired or unwell to learn and develop at the usual rate.

For a fuller discussion of inequalities risk factors, see Inequalities in the early years.

A Pathway of Care for Vulnerable Families (0-3) (external link) sets out key contact points and interactions for those working with vulnerable families.

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Indicators of problematic speech, language and communications development

For a checklist of normal interaction development indicators for infants 0-12 months (including summary guidance for carers) please see Development of Interaction Checklist 0-12 Months (PDF Download - 66Kb).

The following are indicators of potential problems any age:

  • Parental concern about child’s speech and language
  • Child whose play or social interaction seems inappropriate
  • Child has difficulty chewing and swallowing
  • Child is heard to stammer or if parent reports hearing this
  • Child has a hoarse voice or abnormal voice quality.

For further, age-specific indicators, please see:

Lothian guidelines for referral to SLT (MSWord Download - 116Kb) or, for this age group alone, Speech and language development - what to expect 1-3 years.

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Articles in this topic

Policy

Evidence

  • External Resource

    The connected baby

    This DVD, developed by Dr. Suzanne Zeedyk, observes and analyses the interaction between baby and parent, sibling or grandmother in a familiar domestic situation, in order to highlight the extraordinary abilities of the young baby to communicate and enter into conversation with a partner.

    • When was this published? 7/17/2012
  • External Resource

    The Third Implementation of the Sure Start Language Measure

    Sure Start, a UK government programme, provides services for pre-school children and their families. It works to bring together early education, childcare, health and family support. The Sure Start Language Measure is a parental report tool to measure change in the language skills of 2 year olds.

Professional support materials

Information for the public

  • External Resource

    AFASIC unlocking speech and language

    The Association For All Speech Impared Children (AFASIC) is a charity that works with young people who have difficulties with speech, language and communication.

    • When was this published? 8/17/2010
  • External Resource

    Before words [266KB]

    A cartoon-based resource with the key messages for parents to support speech and language development before words. 0-12 months. Developed by Gretel McEwan, Lynn Jones & Foundrymedia

    • When was this published? 11/23/2010
  • External Resource

    First words - first steps to conversation [333KB]

    A cartoon-based resource with the key messages for parents to support speech and language development. Developed by Gretel McEwan, Lynn Jones and Foundry Media.

    • When was this published? 11/23/2010
  • External Resource

    National deaf children’s society scotland

    This charity campaigns for education, health and family support services for deaf children.

    • When was this published? 8/17/2010
  • External Resource

    National Literacy Trust: Quick Tips to Talk to your Baby

    Talk To Your Baby has produced a series of quick tips for parents and practitioners to help children develop good talking and listening skills. Each sheet is available bilingually in thirteen languages. Copies can be downloaded from the website.

    • When was this published? 4/15/2013
  • External Resource

    Play, Talk, Read website

    Information, tips and resources for introducing Play, Talk and Read to babies and young children.

    • When was this published? 5/6/2013
  • External Resource

    Ready Steady Baby!

    A website for the public providing information and advice through pregnancy and the baby's first days.

    • When was this published? 8/18/2010
  • External Resource

    Ready Steady Toddler!

    A website for the public with information, tips and advice for bringing up toddlers.

    • When was this published? 9/30/2010
  • External Resource

    Royal National Institute of Blind People (RNIB) Scotland

    Royal National Institute of Blind People (RNIB) is the UK's leading charity offering information, support and advice to almost two million people with sight loss.

    • When was this published? 8/17/2010
  • External Resource

    Scottish Autism

    The Society has been supporting families in Scotland affected by autism for over 40 years.

    • When was this published? 8/17/2010
  • External Resource

    Top tips for growing up with more than one language

    Information on speech and language development in a bilingual setting.

  • External Resource

    You and your baby

    A book for new parents with learning disabilities. This book is available free of charge to Early Years professionals in Scotland as an alternative to Ready Steady Baby! To order contact nhs.HealthScotland-EarlyYears@nhs.net.

    • When was this published? 2/15/2011
  • External Resource

    You and your little child

    Book for parents with learning disabilities with children aged 1 - 5 years. This book is available free of charge to Early Years professionals in Scotland from NHS Health Scotland as an alternative to Ready Steady Toddler! To order contact nhs.HealthScotland-EarlyYears@nhs.net.

    • When was this published? 2/15/2011