One in four children starting school has a language delay

Children are missing out on early intervention for speech or language delays due to a shortage of speech pathologists.

One in four children arrive at school with communication skills that are not what they should be, according to the Australian Early Development Census.

Medical factors that can affect a child’s language development include hearing issues, neurological conditions and intellectual disability.

Environmental factors include limited interaction with adults, excessive screen time, insufficient exposure to varied and complex language, and poor access to quality early childhood education.

That’s not helped by the fact that Australia currently has a shortage of speech pathologists.

Many have moved into private practice and in some areas waitlists for appointments in the public system can be up to two years.

President of Speech Pathology Australia, Kathryn McKinley, said many parents do not know how to identify whether their child has a speech delay or how to get help.

“And then they might have issues in accessing a speech pathologist … There’s not always services available for people where they live, and there’s limited funding,” she said.

Ms McKinley said without early intervention speech and language difficulties affect a child’s literacy, learning, social interactions and mental health.

“These challenges can continue on into adolescence and adulthood,” she said.

Calls for a national approach

Ms McKinley said a child’s early communication development was influenced by biological, social and environmental factors.

Some children have profound conditions that will require intensive support for many years, while others may only need a few therapy sessions to get them back on track.

Ms McKinley said that wasn’t always happening due to long wait lists, limited services in some areas and poor understanding about speech therapy and language milestones.

“All too often, children and families are not getting the support that they need,” she said.

She wants to see a national approach to addressing speech delays during those critical early years of brain development.

“It doesn’t need to be provided one-on-one,” she said.

“Part of what speech pathologists do is work with early educators and teachers to support their work in their classroom.”

Ms McKinley said once a child fell behind with their communication skills, they often stayed behind, but with early intervention the trajectory of their life could be changed.

It’s a view Minister for Health, Disability and Aging, Mark Butler, recently echoed when he announced the creation of Thriving Kids, a new federal program to support children with mild to moderate developmental delay or autism.

“Everything we do must aim to identify needs as early as possible in a child’s life and get them and their parents the intervention that will work best for them.”

Mark Butler, Minister for Health, Disability and Aging,

Details about how Thriving Kids, which is due to start next year, will operate, are yet to be worked out, but Mr Butler said one of the initiatives under consideration was the creation of a new Medicare item for speech pathology “to support kids to communicate and build relationships”.

One school’s resounding success

Riley speech was not what it should have been when he started kindy in the regional Victorian town of Morwell.

His father, Ash, said it was as if his brain was working faster than his mouth.

Instead of being able to express himself, or ask for something he needed, Riley would get frustrated when his speech came out as gibberish, Ash said.

That affected his behaviour.

“He would throw things, walk around, stomp his feet, slam doors,” Ash said.

A few years before Riley joined Morwell Park Primary School, staff noticed a lot of children joining the junior classes had speech and language skills that were not up to the mark.

To address the issue, the then principal put in place a speech therapy program.

Improving a child’s ability to understand oral language helps them understand what’s being asked of them and the content of lessons.

The school’s oral language program teaches enunciation, fluency, vocabulary and comprehension. Children participating in the program are taught to express themselves and to understand language.

When a child’s speech is on track, they are able to ask questions to better understand classes and to clarify what their teacher expects from them.

Simone Richardson, the school’s current principal, said many families would find accessing specialist services like speech therapy financially challenging.

She said even if they could afford private services, children often ended up on a waiting list for six months to a year because so few speech therapists operated in their regional area.

“Without us offering [speech therapy] or providing it within the school, the children may not have access to it,” she said.

Riley participated in the program in his Kinder year and as a result he started Prep able to engage with lessons and better equipped to express himself.

Ash said Riley now articulates his thoughts better than his older sibling, who didn’t go through the program, and he is less frustrated.

“You can see in his brain, in his eyes, that he’s really thinking about what he wants to say,” Ash said.

“Once he realised strategies to get them words out, it hasn’t stopped.”

The difference Ash has seen in his son’s behaviour is similar to what Ms Richardson and her staff have observed across the school.

In years gone by, staff were dealing with a lot of students who had emotional outbursts.

But recently, they’ve seen a noticeable reduction in poor behaviour.

Ms Richardson said this is because more students are able to verbalise their needs and ask for help.

Ms Richardson has a strong sense that teaching students to express themselves thoughtfully will help them cope with hurdles later in life.

“They’re going to have challenges and things are going to be hard,” she said.

“If they can verbalise their needs and express themselves, those things get easier for them.”

Catherine Lambert, one of the two speech pathologists who guide the program, said when children’s oral language development is on track, they feel connected to their learning environment and build robust friendships.

That could explain why attendance at the school has improved since the program started.

Ms Richardson said parents were strong supporters of the classes and were making sure their kids turned up.

She also thinks the program has lifted the school’s results.

Over the past three years, the school’s Grade 3 and Grade 5 NAPLAN results have steadily improved.

This year’s Grade 5 mean scale score for numeracy was slightly above Victoria’s mean score, and 78 per cent of Grade 3 achieved strong or exceeding scores in reading, compared with 69 per cent of the state.

“For an area such as Morwell, where a lot of our families have real disadvantage, that’s huge,” Ms Richardson said.

Patchwork approach

Australia does not currently have a national policy regarding early intervention for children with speech or language delays.

WA’s education system includes five specialist Language Development Centres and a Language Outreach Service which employ speech specialists.

In New South Wales, schools can use funding they receive through the Resource Allocation Model to pay for a speech pathologist.

The education departments in Queensland, Victoria, South Australia and Tasmania all employ speech pathologists to work with teachers and students in public schools.

Ms Richardson said it was usually only the children with the most complex needs who received that level of support so her school used its own funding to ensure as many as possible got the help they needed.

The program is supervised by two speech pathologists and delivered by teachers and teaching assistants so that as many as 30 children can participate a term.  

Catherine Lambert said this meant children didn’t have to miss class and many more could get help.

“We have far more children who are able to access that really structured evidence-based therapy without having to have a speech pathologist here five days a week,”

Catherine Lambert, Speech Pathologist

The two speech pathologists track students’ progress and can refer children to private practitioners, if they think they need more intensive therapy.

This article originally appeared on ABC News – Word don’t come easy

This story also featured on the ABC Listen’s The World Today current affairs program – One in four kids start school with speech delay