Warning over speech therapy cuts

Cuts to speech therapy services could force thousands of children with problems to wait for months for support, the Government’s communication champion warns ministers today.

The Government’s proposed NHS reforms to allow GPs to commission services could also make it harder for children with speech problems to get help, according to Jean Gross, whose role as communication champion finished at the end of last month.

Ms Gross calls for the Health and Social Care Bill, currently going through Parliament, to be amended to make it compulsory for children’s community health services to be commissioned jointly by the NHS and local authorities.

In an exclusive interview with The Independent , Ms Gross said parents needed more information about children’s speech development arguing that many families were still unaware how to help their youngsters.

She called for parents to be offered information via smart phones and social networking sites, saying parents were willing to make dramatic changes to their lifestyles once the dangers of their children’s excessive television viewing or dummy use were explained to them.

In her final report, Two Years On, Ms Gross warns that the improvements made in children’s speech during 2011, the national year of communication, risk being overturned because of the “significant cuts” to front-line services. The cuts come as levels of communication problems identified in children continue to rise, with a 58 per cent growth in numbers of pupils with communication as their primary special need over the last five years.

Ms Gross told The Independent her visits to 105 out of 152 local authorities during her two years in the job had made her “very worried” about the effect of the cuts on children with communication problems.

Ms Gross said she feared that children would face significantly longer waits to see speech and language therapists for assessment. She said: “If you are three and have to wait around 18 months to be seen then it is going to be much harder to catch up. If children can have help and catch up by the time they are five and a half then there progress should be normal from then on. But research shows that a child whose problem persists after five and a half will struggle.”

Ms Gross was appointed the Government’s communication champion in January 2010 in order to boost awareness of the importance of developing children’s communication skills.

She immediately sparked a national debate with a poll suggesting that nearly a quarter of boys - and one in seven girls - are struggling to learn to talk because their parents let them watch too much television.

The new report suggests there is still widespread lack of knowledge about speech development among parents. A survey by the National Literacy Trust last year found that one in five parents-to-be believed it is only beneficial to communicate with their baby from the age of three months and one in 20 believed that communicating with their baby is only necessary when they are six months or older. Meanwhile one in eight parents believed the primary responsibility for developing their child’s communication skills lies outside the home.

A survey of 3000 parents commissioned by Ms Gross last year found that only one in four parents knew when a child might be expected to say its first word (between 12 and 18 months). 82 per cent of parents told this same survey that they needed more information on speech development.

The national year and Ms Gross’s role were both originally proposed by John Bercow MP, now Speaker of The House of Commons, in his review of speech and language provision in 2008 which concluded that there was “grossly inadequate recognition across society of the importance of communication development”.

The report says that good progress has been made in the number of five year olds achieving a “good level of development” in spoken language. 82 per cent achieved this level in 2009 rising to 86 per cent this year. The number of children with very poor language skills at the age of five has dropped from four per cent in 2009 to three per cent this year.

Mrs Gross told The Independent: “I think the message from my report is that there are some measures that are fantastic and others that aren’t great. The question is how do we maintain the gains we have made when we are now seeing the real loss of front line services. All of these gains were achieved before the cuts. Everybody has to accept the current economic situation but I am concerned that speech and language services started from such a very low position that the cuts will really bite.

“To have cuts to front line services in something that was already so patchy and such a postcode lottery really worries me. I do think that the cuts have now begun and that next year they will really bite.”

Research suggests that around ten per cent of children have a speech and language difficulty. In deprived areas, more than 50 per cent of children start school with delayed language skills.

An evaluation report commissioned by the Royal College of Speech and Language Therapists has found that speech and language therapy delivers a net benefit to the UK economy of £742m, through bringing people back into work and helping children into school, with every £1 spent generating £6.43 in enhanced lifetime earnings.

Meanwhile, a recent RCSLT survey found that 84.4% of therapists had experienced cuts to services.

One local authority visited by Mrs Gross had employed a team of 14 speech and language therapists to work in children’s centres as part of a drive to identify youngsters’ difficulties as early as possible. The funding was cut in April and all 14 therapists were made redundant.

Ms Gross welcomed the Government’s plans for all two year olds to have a development check including an assessment of their language skills and its focus on recruiting an extra 4200 health visitors by 2014 to carry them out. But she warned that cuts elsewhere would mean that there were not enough speech therapists to support the children identified as needing help by the new checks.

She said: “There is no point identifying children as needing help unless you are in a position to do something about it. The situation does worry me.”

Derek Munn, Director of Policy and Public Affairs at the Royal College of Speech and Language Therapists (RCSLT), said: “The appointment of the Communication Champion, has raised awareness of how a child’s ability to communicate dramatically impacts on their life skills. Jean’s work has also highlighted the link between language problems and social and economic deprivation. However, there is a danger that slash-and-burn cuts and poorly implemented reforms will put this progress at risk.”

Case Study

Kathryn Middleweek, 33, loves her job as a speech and language therapist in Hackney, east London. She works with children aged between three and 16 with communication problems such as language delay, stammering or dyspraxia. But she fears that cuts will make it harder to provide vital services for vulnerable children.

She said: “There have already been cuts and that places increased pressure on those already in post to provide a full service.

“In Hackney we have already had cuts to health and education and we did lose a speech and language therapist. We’ve also had a recruitment freeze so when people left they weren’t replaced. Recently we did recruit some people which was a positive sign but I think that across the country speech and language therapy is facing cuts.

“This is having an impact on universities which are reducing their training courses because there are fewer clinical placements on offer. At the moment there is an excess of graduates.

“I think when I qualified in 2008 my cohort was just about okay – within 12 months of graduating just about everyone had a job. But after that I think it has become much more difficult to find a post.

“We got hundreds of application when we recently recruited for three speech and language assistant posts – including graduates. Some people who applied had also applied when we had recruited a year previously – which suggests they had been out of work all that time.

“Our work is vitally important. Speech and language therapists fill all sorts of gaps and provide services that no one else would. I love how broad my remit is. I work with children and young people all the way from nursery age to school leaving age as well as their parents, carers and education staff. A key element of my role is working across health and education to help young people access learning in order to achieve their full potential.

“I am passionate about communication and the impact it has on children’s emotional and social well being, their life skills and life chances. It really is important stuff.”