Written evidence submitted by Royal College of Speech and Language Therapists (RCSLT)
The impact of COVID-19 on education and children’s services
Evidence from the Royal College of Speech and Language Therapists (RCSLT)
The RCSLT welcomes the inquiry into the impact of COVID-19 on education and children’s services. While much of the media attention and parliamentary scrutiny has understandably been on the adults who have been directly impacted by coronavirus, the RCSLT has remained equally concerned about the indirect impact on children and young people.
We hope that the committee will take a broad view of education and children’s services within the scope of this inquiry, to include not just schools, nurseries and social care, but also the wider system that supports children’s education and some of our most vulnerable young people, including speech and language therapy. Our response is based on early comments from our members on how speech and language therapy services for children and young people have been affected by the pandemic.
2.1 Impact on communication and language development
We are concerned about the impact of provider closure in the early years sector on children’s early communication and language development.
During the pandemic, many young children will have experienced a stimulating home learning environment that has supported the development of their early communication and language skills, with increased time for parent-child interactions, play and book sharing. However, some children will not have benefited from this environment during their time at home, and their communication and language development is likely to be negatively impacted as a result. The effect may be greatest in areas of socio-economic disadvantage; research tells us that children from disadvantaged backgrounds are already at increased risk of delayed language development, and receive particular benefit from attending pre-school education settings.,
Unless steps are taken to address this, the impact could be long lasting: the first months and years of a child’s life are particularly crucial for language development and if a child’s language is not supported, their development may be permanently affected. It is well established, and recognised by government, that a child’s early communication and language skills are crucial for school readiness, emotional wellbeing, educational attainment, and their later life chances.
2.2 Impact on early identification and intervention
The potential negative impact for these children will be amplified by the fact that during the pandemic there have been fewer opportunities for these delays in development to be picked up. Early years practitioners who would usually be amongst the first to spot if a child is not meeting developmental milestones are no longer in regular contact with these children and families. Similarly, children with long term speech, language and communication needs which may start to become apparent during the early years, are less likely to be identified at an early stage if children are not in regular contact with professionals.
Other changes during the pandemic are also likely to impact on early identification of children with delayed language and other speech, language and communication needs, most notably the changes to health visiting which mean that some children will not receive their 2 to 2-and-a-half year development review at the right time – or at all.
Speech and language therapy services are reporting a significant reduction in referrals received during the lockdown period, which is likely to result in pent-up demand for speech and language therapy assessments and intervention when education settings re-open and health visitor checks resume. This may include children who have developed more significant needs due to delays in identification and support.
On 19 March NHS England wrote to commissioners and providers of community health services advising that community paediatric speech and language therapy services should undertake segmentation to prioritise urgent care needs, with medium and lower priority work stopped. In response, managers of services undertook reviews of caseloads to prioritise which work was critical and must continue at all costs, and which work would have to be paused. High priority work commonly included:
In line with Government guidance, most children’s speech and language therapists were asked to work from home. Many NHS speech and language therapy service managers were asked to consider which staff could be redeployed to other roles and made plans for service continuity should that be the case.
As we have moved beyond the initial phase of the response, services have started to develop new ways of working to enable them to support children and young people whilst maintaining social distancing during the lockdown period. In normal times, children’s speech and language therapists work closely with other agencies such as schools and childcare settings. The closure of most of such settings as a result of the pandemic has necessitated a rethink in how services are delivered.
Activities which have been provided by services during the pandemic have included:
However, the speech and language therapy offer has varied from area to area, depending on a variety of factors including IT infrastructure, local policies around telehealth, and the level of staff redeployment. This has created a further postcode lottery, which is likely to widen the gaps in therapy provision which the Education Select Committee identified in their report on Special Educational Needs and Disabilities (October 2019).
The impact of COVID-19 on speech and language therapy service delivery
Between 23 and 29 April, the RCSLT conducted a survey of speech and language therapists in the UK to find out how coronavirus was impacting on services. Of the speech and language therapists who work in mainstream schools:
As education and childcare settings begin the process of opening more widely, it is anticipated that speech and language therapy services will receive a sharp increase in referrals and requests to provide advice for education, health and care needs assessments and plans.
So while we are keen for education and childcare settings to open more widely once evidence shows it is safe for them to do so, planning for re-opening of schools needs to take into account the ability of health services to interact with settings, including the availability of personal protective equipment (PPE).
We are concerned that the impact of the changes to provision which have been necessitated by coronavirus will be greatest on those from disadvantaged groups. The new ways of working are less accessible to some children and young people from disadvantaged group. For example, families who have literacy difficulties, who speak English as an additional language, or who do not have access to technology or broadband may be unable to access support which is delivered remotely.
We are also concerned about children and young people with swallowing difficulties (dysphagia) and complex health conditions. Our members have reported that some children who would benefit from a face-to-face assessment have not received it due to understandable parental concerns about the risk of their child being exposed to coronavirus.
4.1 Long term impact
In addition to the disadvantaged groups mentioned above, speech and language therapists report particular concerns about the long-term impact of the lockdown on:
There is a risk that a significant cohort of children will not have their needs identified and supported in a timely way, with long term impact not only on their speech, language and communication, but also on their educational attainment, mental health, employment prospects9 and possible involvement in the justice system.
These risks will be increased if redeployed children’s speech and language therapists are not returned to their permanent roles as soon as possible after the initial crisis period is over, and if services are not resourced sufficiently to identify the missing children and tackle the long waiting lists that will follow when education and childcare settings re-open.
It is important that any contingency planning to ensure the resilience of the education and children’s care sector by the Department for Education is done jointly with the Department of Health and Social Care, to ensure that the health services which support children’s education and development are included. Consideration might usefully be given to:
The Royal College of Speech and Language Therapists (RCSLT) is the professional body for speech and language therapists, speech and language therapy students and support workers in the UK. We have more than 17,000 members. We promote excellence in practice and influence health, education, employment, social care and justice policies.
Speech and language therapists assess and develop interventions to support children and young people with speech, language and communication needs (SLCN) to maximise their communication potential. They work directly with children, their families, and other professionals to develop personalised strategies which support each child or young person’s needs.
Speech and language therapists also provide training to the wider workforce, including early years settings and schools, so that they can identify the signs of speech, language and communication needs and where appropriate, deliver interventions (with appropriate supervision).
For further information please contact: Caroline Wright, RCSLT Policy Adviser
 Law, J., McBean, K and Rush, R. (2011) Communication skills in a population of primary school‑aged children raised in an area of pronounced social disadvantage International Journal of Language and Communication Disorders, 46, (6) pp 657–664
 Taggart, B., Sylva, K., Melhuish E., Sammons,P. and Siraj, I. (2015). How pre-school influences children and young people's attainment and developmental outcomes over time. [Online]: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/455670/RB455_Effective_pre-school_primary_and_secondary_education_project.pdf.pdf
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 Law J., Rush R., Schoon I. and Parsons S. (2009) Modelling developmental language difficulties from school entry into adulthood: literacy, mental health, and employment outcomes. Journal of Speech, Language and Hearing Research, 52(6): 1401-16
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