Winning the battle of words

By Hannah Richardson
BBC News education reporter

One in 10 children has a speech disorder

Many children are arriving at primary school without adequate speech and language skills, suggests research. How can nurseries help?

They may just be blowing bubbles and tapping out rhythms on a tambourine, but the children at Mulgrave Early Years Centre are also fine-tuning one of life's most vital skills - communication.

"Everybody in a circle doing good sitting and good looking," says nursery nurse Jo to a group of six jolly three-year-olds perched on tiny chairs.

And once the fidgeting has stopped, the children are gently asked to say hello to each other in turn. The syllables of each name are tapped out on the tambourine and every child is prompted to say their own name.

Some struggle even to do this, with one or two clearly unable to manage more than a few sounds.

All of these children have been identified by health professionals as having problems with their speech development.

They have been referred to the early years centre in Woolwich, south-east London, where nursery nurses trained by children's communication charity I CAN give them a bit of extra help.

This gentle, but intensive "circle time" aims to show the youngsters how to learn by looking.

Playing alone

One child in the group, Rebecca - not her real name - barely knew any words when she began a placement at Mulgrave six months ago.

At the age of three, she would have been expected to know around 300 words and be able to put them together in short sentences of a few words.

Dawn France, the centre's lead I CAN teacher, says: "She knows that you want something from her, but she doesn't quite know what it is.

Nursery nurses provide a running commentary as a child plays

"Out of the most common 40 words for a child her age, she could say two - duck and elephant, and comprehend about 20.

"Yesterday, she said about 30 words when I was reading a story to her."

Rebecca has been attending the sessions for 13 weeks and, in general terms, although she is still well behind for her age, she has advanced around 18 months in speech development to the level of a two-year-old in just a few weeks.

Although speech delayed, arguably Rebecca is one of the lucky ones, as her problems have been picked up by a health visitor.

Many parents would not even know if their child was falling behind speech-wise.

Campaign manager for I CAN's Make Chatter Matter campaign, Laura Smith, says a mother approached her at a recent outreach event and asked if she should be worried that her three-and-a-half-year-old child was not yet speaking.

Yes, was the very clear answer.

"We know there is a 'golden time' from 0-5 where if problems with speech and language are picked up, there is a much greater chance of solutions being found," she added.

SPEECH LANDMARKS 0-1 - Makes simple sounds and copies facial expressions 1-2 - Understands key works such as 'clap' or 'biscuit' 2-3 - Says basic sentences, such as 'Mummy, look dog' 3-4 - Asks questions like 'Can I have some milk please?'

So why are so many children's language problems slipping through the net?

I CAN's director of operations Clare Geldard acknowledges that the language milestones for typical development can be confusing for parents as they cover quite a few months or even a year.

"Also there is a trend that health visitors are becoming less involved in developmental checks - there are less of them and some are even taking place over the phone."

But Ms France argues it is very easy to spot a child with delayed speech and language abilities just by looking at how they play.

"The children that come to us have very delayed play skills.

"With your average three-year-old, they might go into the home corner and play at getting food or make a cup of tea. There's a certain amount of role play or symbolic play."

Those with speech delay will be playing on their own or not at all, she adds.

Frustration

Ms Smith says she can often tell which children have problems, when they first arrive, as they are often the ones playing alone or acting out their frustration.

And further down the line, if the language problems are not corrected, these sort of frustrations can lead children to be labelled as having other problems.

"Behavioural difficulties are often a symptom of someone with a language disorder. Or they may become withdrawn," says Ms France.

Ms Geldard says that an unchecked communication disorder can ultimately feed negatively into a child's personality.

Most speech delays can be corrected if caught early, says Ms France

"They get angry or they say to themselves, I can't get my message across, so I am going to stop trying and then they withdraw.

"It can follow them throughout their whole educational career," she said.

And yet the answer seems so simple.

The nursery nurses at Mulgrave Early Years centre stand alongside children as they play, providing a commentary on what they are doing, building their vocabulary as they go.

And they work with parents on the best way to play with their child at home to promote language growth.

Ms France says: "For instance, they might start by pushing a car around. The parent might come in and say what about this other toy?

"Instead of trying to change it, we should follow the child's lead and maybe start talking about the car going up, up, up the road

"By the end of the session they might learn the word 'up'."

For nursery nurse Jo the rewards come when a child makes even the smallest break-through.

"It's lovely when a child really gets it. It's what we do the job for after all."