1 December 2020

Over the past few years, the RCSLT has been working with Public Health England (PHE) and the Department for Education to develop guidance to support the commissioning of early years speech, language and communication (SLC) pathways. We are delighted that this guidance – Best start in speech, language and communication – has now been published.

The guidance makes clear the critical role that speech and language therapists play at a universal, targeted and specialist level in improving outcomes for children.

One element of the pathway is the Healthy Child Programme and the role of health visitors in the identification of children with speech, language and communication needs (SLCN). The current measure used by health visitors is the ages and stages questionnaire (ASQ). However, feedback from professionals, including from SLTs, is that the ASQ is not sensitive enough to pick up all children with SLCN. In fact, the ASQ is intended to be a population measure rather than a screening tool.

As a result, in partnership with the Department for Education, Public Health England commissioned Newcastle University, led by Professor James Law, to research and develop a more sensitive measure.

The measure that has been developed is called the Early language identification measure (ELIM) and intervention. The measure uses existing evidence and was piloted and evaluated in five areas in England. The ELIM is intended to support early identification and intervention of SLCN, resulting in more timely and appropriate referrals to SLT. Services and professionals will determine applicability for local use.

Alongside the tool, Public Health England is rolling out training to support health visitors to use the ELIM and intervention with children aged two to two and a half alongside the ASQ, within the Healthy Child Programme. The approach being used by Public Health England is to engage the health visitors who have already been trained as part of the early SLC training programme – this was commissioned by PHE and developed by the Institute of Health Visiting following a procurement process, with input from RCSLT and a wider expert advisory group.

The ELIM is an evidence-based assessment and intervention tool that above all is intended to support children and families, in addition to supporting professional practice and service development. Work is underway to allocate a SNOMED code to the ELIM which it’s hoped would enable data collection in the future.

Find out more about the ELIM and read the guidance

The Best start in speech, language and communication guidance was published on 30 October 2020 and is available to download on the gov.uk website.