Greater Manchester Early Outcomes FundPathways to Talking

Learning Event 2nd December 2019

Chris McLoughlin Lead DCS for GM School Readiness Programme

GM Early Years/School Readiness Vision

We want every child in Greater Manchester (GM) to have the best start in life. This means that every child grows up in an

environment that nurtures their development, derives safety and security from their parents / care givers, accesses high

quality early years services and has a belief in their goals and their ability to achieve them.

Our ambition is that every child in GM is acquires the skills necessary to negotiate early childhood, primary and secondary school and education and employment.

What is the GM Model?

1. 8-stage New Delivery Model assessment pathway

2. A range of multi-agency pathways

3. A suite of evidence based assessment tools and targeted interventions.

School readiness: The Greater Manchester Approach

Andy Burnham Mayor of Greater Manchester

Good Level of Development 2013 - 2019• In 2015 62.4% children in GM achieved a good level of development (GLD) at the end of

Reception Year, aged 5 years, this represents a significant increase on the equivalent figure of 47.3% in 2013

• In 2019 GLD as increased to 68.2%

• GM remains below the England average of 71.8%

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

2012/13 2013/14 2014/15 2015/16 2016/17 2017/18 2018/19

Per

cen

tage

ach

ievi

ng

GLD

GLD Results 2013-2019

GM

National

We’re seeing positive improvements in outcomes for our disadvantaged children

Outcomes for pupils eligible for Free School Meals have improved consistently since 2015.

Provisional 18/19 data shows we have caught up with the England average.

48.0%

50.0%

52.0%

54.0%

56.0%

58.0%

60.0%

2015/16 2016/17 2017/18 2018/19

Pupils Eligible for Free School Meals 2016-2019

GM England

Why does early speech, language and communication matter?

• The ability to communicate is recognised as the most fundamental life skill for children

• It directly impacts on their ability to learn, to develop friendships and on their future life chances.

• In areas of poverty over 50% of children are starting school with delayed communication skills.

• When language difficulties are resolved by the age of 5, children are more likely to develop good reading and spelling skills and when leaving high school they achieve as well as their peers.

What are we doing about it

Speech, Language and Communication:Foundation Skills for Life

Michelle Morris, Consultant SLT / Lead for GM Early Years SLC Pathway

Michelle.morris@srft.nhs.uk@ speechiemsm

In the next 30 mins I will

•Describe the conditions commonly referred toas Speech,Language and Communication Needs

•Explain why developing these skills is so important

•Identify the potential impact on life chances if these skills are notdeveloped

•Explain why the early years should be the focus of our efforts•Describe what we are doing in GM to maximize opportunities for

children and young people to develop effective communication skills

Speech, Language and Communication Skills?

• Being able to attend and listen

• Understanding (Receptive Language)

What do we mean by Speech, Language and Communication Skills?

• Being able to attend and listen• Understanding (Receptive Language)• Expressive Language • Speech production • Social use of language using language for different purposes adapting language to meet the needs of the listener/situation following the unspoken rules of communication

Speech, Language and Communication Needs

Language Delay Under 5 years

resulting from insufficient exposure to a broad range of vocabulary &language

models

Speech &Language Disorders

Developmental Language Disorder

Language Disorder associated with a

bio-medical condition

Language Disorders

Refers to speech, language and communication difficulties that create obstacles to interaction or learning in everyday life and where they are not likely to catch up i.e. the condition has not resolved by 5yrs old

Approximately 10% of children and young people. 3/class

Pathway will identify these children who will need universal, targeted interventions & specialist interventions

Two Types – Developmental Language Disorder & Language Disorder associated with a condition

• 7.58% of children have DLD, a language disorder that is unexplained by any

other condition (Norbury 2016)

• DLD has been described as the “most common disability that no one has ever

heard of”

• This makes it the most prevalent neuro-disability. More common than Autism

(1.1%) or stammering (1%) which everyone knows

• In addition another 2.34% of children have a language disorder that is associated

with another condition e.g. ASC, hearing impairment

What the research tells us

Speech, Language and Communication Needs

Language Delay Under 5 years

resulting from insufficient exposure to a broad range of vocabulary &language

models

Speech &Language Disorders

Developmental Language Disorder

Language Disorder associated with a

bio-medical condition

In areas of high socio-economic needs up to 50% of children

who are aged 5 years and under, experience a delay in

language and communication i.e. their language skills are

significantly behind that of their more advantaged peers

The early years GM pathway is designed to identify and

support these children as well as identifying children with

SLC disorders

Speech and Language Delay

0

20

1

0

Chi lds age

in months

30

Million

Word

Gap

Number of words heard by children in

different income groups

Professional

Hart & Risley 1995

En

hanced c

um

ula

tive w

ord

s a

ddre

ssed t

o c

hild

.

By 4 years of age, there is a 30 million word gap betweenchildren from the wealthiest and poorest families.

By 18 months, children in different socio-economic groupsdisplay dramatic differences in their vocabularies.By 2 years, the disparity in vocabulary development has grownsignificantly (Fernald, Marchman, & Weisleder 2013).

Lack of exposure to sufficient quantity and quality of language may result in language delays for many children

Children living in middle and higher income homes have more opportunities to practice language skills and experience language-rich environments in comparison to children living in low income homes.

Family income does not directly cause language delays.

It is not who you are, but what you do that matters

0.9

0.8

0.7

0.6

0.5

0.4

0.3

0.2

0.1

0

1900 1950 2000

Manual Labour

Communication

Ruben (2000): Redefining the survival of the fittest Communication disorders in

the 21st Century

Changes in Occupation in the USA

2Years

Why are the Early Years so important?

Timeline illustrating different rates of rapid synapse development

Attunement :synchronised interaction between parent and baby

GM Communication and Language Pathway (Update Feb 19)

Difficulties such as fluency, feeding and specific medial conditions should be considered separately

ASQ3

ASQ 3 (SE)

Green score on Well Comm

SLC Tool Kit

Amber score on Well

Comm SLC Tool Kit

Red Score on WellComm

SLC Tool Kit

Communication with SALT

team

Universal language promoting

advice;

Universal key messages e.g. five to

thrive, social baby.

WellComm Activities;

Parent Child interaction group;

Targeted intervention in settings

e.g. early language group, attention

group (play plan where

appropriate).

SALT referral/intervention

1:1 Parent Child Interaction

intervention (Communication

Development Worker)

ASQ3: communication and

language falls in white area

and no concerns re HLE

EYFS tracker

ASQ3: communication and language falls into Grey

and/or concerns re HLE:

carry out WellComm

Assessment

Parental concerns

Professional

judgement (skills

developed following

training and

experience)

Underpinned by skills and knowledge of workforce and work with other EY

pathways e.g. parenting.

Home Learning

Environment indicators

Refer to language falls into

black :

apply professional

Judgement whether to

carry out WellComm

assessment

specialist services SALT

depending on level/area of

need. (SEN)

Communication and

language risks shown on

EYFS tracker :

Carry out WellComm

Assessment

Parent: use GM

recommended

tools to measure of

change in use of

PCI strategies

(group or 1:1);

Child: Use

WellComm tool 3

months post initial

screen/interventio

n to assess where

further

interventions are

needed;

EYFS tracker.

Early identification

and intervention

Central role of families & the

importance of HLE

A multi sectorial, multi

professional response .

Everyone’s contribution is

recognized

Linked to other

pathways e.g. PIMH

Awareness of the

importance of SLC by

the citizens of GM

Workforce

developmentIterative

process

Using the evidence to inform

actions and practice

A flexible approach

to respond to diverse

SLC needs

Using local

innovation

Pathway

Principles

Early Chat Matters

Becky Bibby - Jan RobinsonDeborah James

GM Pathways to Talking Project Team

GM Early Outcomes Fund

• DfE Programme established the Early Outcomes Fund in November 2018 worth approx £6.5m

• Overall ambition of the fund is to increase the number of LAs starting a transformation journey to improve the collective operation of local services in securing good early language outcomes for children

• The fund has 3 key aims:• To increase leadership focus at LA level on the key issue or early

language• To enable LAs to undertake work to improve their services and how

they are delivered• To resource evaluation and partnership working amongst LAs that

will spread innovation around the wider system

GM Early Outcomes Project

• GM Pathways to Talking

• Shared bid submitted by Salford in partnership with 10 localities and the Greater Manchester Combined Authority

• Theory of change: We have an existing SLC pathway - why are Communication and Language Outcomes age 5 years not improving more rapidly in GM?

• Awarded £1.5 million for 2 priorities: • To evaluate implementation of the existing GM SLC pathway • To increase the scale and pace of SLC pathway implementation

Working across 10 GM localities

• Funded project leadership roles in each locality to ensure capacity to identify locality strengths, priorities and develop and implement a locality plan

• Every locality multi-agency team has completed a self assessment – GM Pathways to Talking Stocktake

• Each locality project lead has developed their own Theory of Change to address locality priorities and allocated funding linked to a locality implementation plan

• Building on existing relationships within GM with a strong focus on peer support and challenge

Sharing the learning across GM• 10 locality stock-takes – identified areas of strength as well as gaps.

• Recognised the learning that we want to share and celebrate within and outside GM.

• Best practice themes:• Strong Leadership and Commissioning of the SLC pathway at scale

• Engagement of early years settings and schools

• Implementation and impact of GM stage 4b assessment at 18 months and use of WellComm to identify speech, language and communication needs and provide early interventions

• Working with families and communities with English as an Additional Language

• A coordinated programme of workforce development for SLC

• Supporting improved parent: child interactions through early communication groups

Working from the inside out Lister is going on inside something – that’s where transformational change is craftedJohn Shotter – practical philosopher in organisational change says we need to ask, what are people going on inside of?

Halve the word gap

4-Pillar delivery

Broadcast, marketing and

messaging

bbc.co.uk/tinyhappypeople

@bbctinyhappypeople

Frontline professionals

Community activation

Digital

www

Content categories

Hook ActivitiesScience

Entice, engage curiosity

Wow the audience

Practical, easy things to do

Bradford

Pilots 1 & 2 GM and across the UK

Testing tone and feel of content, and routes to market

Parents, front line professionals, community groups

Website and Instagram channel

Manchester

Stockport

Salford

Bolton

Wigan

PILOT 1

Swindon

Inverness

Nottingham

NI - Traveller Community

Bridgend

Where we are now

Oct 2019 Soft launch

Greater Manchester / GMCA

Blueprint for rest of UK

Endorsements

Working towards full launch March 2020

Full launch ambitions

Gtr Manchester

Coastal Cornwall

Belfast

Glasgow

5 hyper local hubs across the UK

Big commercial collaborations

400+ films and 30+ articles

Additional website sections –professional area, wellbeing

Wider BBC

Merthyr Tydfil

Ella’s experience

Ella’s experience

Ella’s experience

Ella’s experience

Ella’s experience

Ella’s experience

GM Pathways to Talking

Next Steps

What are our GM priorities?

• Digitisation of early years data and shared access across multi-agency services

• Strategic engagement of all sectors of the early years workforce

• Aligning the SLC pathway with other pathways to ensure a joined up offer for GM families