The Science and Technology Committee examine the strength of the evidence linking adverse childhood experiences with long-term negative outcomes, the evidence base for related interventions, whether evidence is being used effectively in policy-making, and the support and oversight for research into this area.
In our response, we will primarily be focusing on the association between social disadvantage and speech, language and communications needs (SLCN) and the long term negative outcomes that this can result in, particularly when taken into consideration alongside adverse childhood experiences (ACEs).
There is a strong link between SLCN and social disadvantage. In many areas of deprivation, more than 50% of children start school with delayed language skills[1]. Children from low income families lag behind their peers by nearly one year in vocabulary at school entry, with gaps in language much larger than gaps in other cognitive skills.[2] In addition, children eligible for free school meals and living in a deprived neighbourhood are 2.3 times more likely to be identified as having SLCN.[3]
Although there is not necessarily a causal link between social disadvantage and ACEs, there can be an association between the two. A recent report from Public Health Wales highlighted that although no communities should be considered free from ACEs, families living in areas of deprivation were at a greater risk of experiencing multiple ACEs, and that such experiences in families were exacerbated by their experience of disadvantages like homelessness, poverty, and involvement in the justice system.[4] Other commentators have noted that because of the close association between ACEs and social disadvantage, arguably ACE effects should‘include socioeconomic disadvantage as an additional form of adversity’.[5]
Where a child has to deal with adverse experiences, good language and communication skills might operate as a protective factor. In a recent Public Health England Report, good communication skills were identified as supporting resilience, which reduces the likelihood of later social, mental and emotional health difficulties[6]. The reverse has also been proven to be true, with SLCN being a risk factor for more negative outcomes in terms of social, mental and emotional health difficulties.[7]Having a strong focus on children’s speech, language and communication skills, can be viewed as providing them with the tools to better face ACEs, thereby reducing the likelihood of long-term negative outcomes. Additionally, a focus on speech, language and communication can support early identification of children with SLCN, therefore leading to timely support being put in place and more positive outcomes for children.
There are strong links between unidentified speech, language and communication needs and young people within the youth justice system. The Centre for Youth & Criminal Justice recently undertook research into the childhood experiences of young people who had been referred to their Interventions for Vulnerable Youth (IVY) service. In doing so, they foundan elevated exposure to adversity of those who were referred compared to the general population.[8] In addition to this, research shows that at least 60% of young people in the youth justice system have speech, language and communication needs, which have often gone unidentified. When this number is compared with the figure that within the general population, around 10% of children and young people have long term SLCN;it is possible that poor communication skills may further exacerbate the long term difficulties of those who have experienced ACEs.[9]
In terms of providing support to address ACEs through specific early-years interventions in order to minimise their long term negative outcomes, in a 2015 Early Intervention Foundation pilot, Blackburn with Darwen Borough Council had success using the Nurse Family Partnership / Early Start intervention.[10] The intervention was delivered by family support workers with nursing or social work backgrounds, who assessed vulnerable families’ needs, providing support and mentoring through the child’s preschool years.The interventions aimed to give young children an educational head start and provided training to parents on child development, non-violent discipline and problem-solving skills.
By using these interventions toidentify parents in need of additional support, a whole system response was developed across agencies rather than referral to individual services that address single issues.Partners such as health, social care, education and criminal justice also became more ‘ACE aware’ and have started to integrate this approach into their long term vision, strategies and training.[11]
In addition to this, we would also recommend using The Communication Trust’s What Works[12] database. The database is a free, online resource, providing a comprehensive set of evidence-based speech, language and communication interventions. Of the60 interventions currently listed on the site, 44 are applicable for children in the early years.
Speech, language and communication difficulties can have a hugely detrimental impact on children’s long term life chances, particularly when combined with ACEs. However, these long term consequences are not inevitable, and there is much that can be done to help buck the trend; if the right support is given at the earliest possible opportunity, many children with SLCN are able to experience improved outcomes and greater wellbeing later in life. These consequences are not inevitable; many children, given the right support at the right time will catch up, but it is essential that meaningful steps are taken to improve early identification of SLCN as well as providing sufficient support and intervention to improve educational outcomes and wellbeing.
[1] 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: 657-664.doi:10.1111/j.1460-6984.2011.00036.x
[2]Waldfogel, J., & Washbrook, E. V. (2010). Low income and early cognitive development in the UK: A report for the Sutton Trust. London: Sutton Trust
[3] 6 Dockrell, J., Ricketts,J. & Lindsay, G. (2012) Understanding speech, language and communication needs: Profiles of need and provision BCRP 4
[4] Public Health Wales, Adverse Childhood Experiences (ACEs) in Wales and their Impact on Health in the Adult Population (2016)
[5]Nurius et al, ACEs within a Social Disadvantage Framework: Distinguishing Unique, Cumulative, and Moderated Contributions to Adult Mental Health(2013)
[6]Public Health England, The mental health of children and young people in England(2016)
[7] Snow et al, Youth (in)justice: Oral language competence in early life and risk for engagement in antisocial behaviour in adolescence (2012)
[8]Centre for Youth & Criminal Justice, An ACE up your sleeve? (2017)
[9] Bryan et al (2007)
[10]Blackburn with Darwen: ACE (Adverse Childhood Experiences) Screening Pilot (2015)
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