Interacting with and providing stimulating environments for young children helps to put in place the building blocks for their growth and development. Communication is crucial to speech and language development, as is early reading to children and encouraging their engagement with books and reading.
Before formal education can begin, children must learn to:
- play
- talk
- listen
- understand, and
- attend
Speech, language and communication development (SL&CD) and health inequalities from 3-5 years
While the first twelve months of life are crucial for establishing the foundations of language and communication development, appropriate supports for children and parents can improve outcomes at later stages.
Inequalities experienced by parents and children can affect speech, language and communication development and lead to further health inequalities later in life.
Quick links:
- What are health inequalities?
- Policy context
- What do we mean by SL&CD in 3-5 year olds?
- How do inequalities relate to speech, language and communication development in 3-5s?
- Identifying those at risk
- Communication support needs (CSN) of parents
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-centred services - Getting it Right for Every Child (all external links).
The Education (Additional Support for Learning) (Scotland) Acts 2004 & 2009 entitles children with support needs - including delayed communication development - to extra support for learning.
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 3-5 year olds?
By the age of 5 years, children should be able to use sentences with a developing grammar, take part in conversations, talk about past events and ask questions.
For a fuller discussion, see Speech and language development - what to expect 3 - 5 years.
How do inequalities relate to speech, language and communication development in 3-5s?
According to the Royal College of Speech and Language Therapists’ Communicating Quality 3 (external link) the accepted prevalence in 2006 was that 10 per cent of the school aged population had a speech, language or communication difficulty which could potentially affect their educational attainment.
The prevalence was higher in areas of social deprivation and where there are vulnerable populations (high rates of drug or alcohol abuse and or looked after children).
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.
At any age, the following should be a cause for concern and for referral to Speech and Language Therapy services:
- Parental concern about child’s speech and language.
- Child is heard to stammer or if parent reports hearing this.
- Child has difficulty chewing and swallowing.
- Child has a hoarse voice or abnormal voice quality.
- Child whose play or social interaction seems inappropriate.
For a fuller list of indicators for concern, please consult Speech and language development - what to expect 3-5 years.
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 to tired or unwell to learn and develop at the usual rate.
For a comprehensive list of age-specific indicators, please see the NHS Lothian guidelines for referral to SLT (MSWord Download - 116Kb).
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.
