Speech, language and communication development

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?

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.

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Articles in this topic


  • External Resource

    Curriculum for Excellence

    Improving education for children and young people by putting their learning experiences at the heart of education.

    • When was this published? 8/17/2010

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

    National Autistic Society Scotland

    This is the largest UK charity dedicated to sufferers of autism and aspergers syndrome, and their families.

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

    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