Exciting News!

The Select Standing Committee on Finance and Government Services just released their Report on the Budget 2018 Consultation. We are thrilled to let you know that speech-language pathology (SLP) services for young children have been clearly identified as a priority in their recommendations. The importance of these services is mentioned under Themes 1 and 3.

Theme 1: Health Care

Speech-Language Pathology or Therapy

Recommendation #20. Prioritize and increase funding for speech-language pathology services for children to address the urgent need for access to timely and effective services, and to ensure an appropriate number of speech-language pathologists are available to assist young children prior to starting kindergarten.

Theme 3: Social Services

Child Care and Early Childhood Development

Recommendation #37. Increase access to early childhood identification and intervention services, including occupational therapy, physiotherapy and speech and language pathology, with a focus on addressing urgent recruitment and retention challenges of professionals in this sector.

Special thanks to all of the parents, caregivers, grandparents, concerned citizens, communication health assistants, and speech-language pathologists who took the time to share their stories and get our message to policymakers. This historic step forward would not have happened without you!

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Consultations closed & Thank you

The public consultations by the Select Standing Committee on Finance and Government Services closed yesterday evening. The Committee’s report will be released by November 15, 2017.

Thank you to everyone who participated in our 2017 Call to Action. If you haven’t already, please fill out this short poll to let us know if, and how, you participated.

Our hearts are full with gratitude to everyone who supported this initiative.

The Ask, 2017

When we started Communication Matters, an SLP Advocacy Group for Young Children, in 2014, one of the first things we did was to decide on our Vision. Since January 14, 2015, our Vision has been, “We believe it is important for all preschool-age children in British Columbia to receive the speech-language pathology services they need.” We acknowledge that this view is shared by many other speech-language pathologists (SLPs), other professionals who work with preschoolers, as well as other members of the public at large.

This year is the first time we have encouraged people to participate in the Select Standing Committee on Finance & Government Services public consultations to advocate for young children with speech-language needs. Based on feedback from our volunteers and other interested speech-language pathologists, we want to share a specific ask so that everyone can feel comfortable answering these questions and understanding what we are truly advocating for. Therefore we have provided the following as our official ask for 2017 that you can feel free to quote, use as your own ask, or modify to use as your own ask.

Our Ask for 2017 directly relates to the Communication Matters Vision:

What are we asking for?

Communication Matters, an SLP Advocacy Group for Young Children, is asking that all children in British Columbia (BC) who need speech-language pathology (SLP) support have access to timely and effective service. This means additional SLPs immediately, and a mandate to collect more data to determine the further need.

How many SLPs are needed?

Based on our province-wide survey results and population estimates, Communication Matters has estimated that funding for at least 200 additional SLPs is needed immediately. The number of additional SLPs needed is actually higher than this, but this would be a start.

Where will the SLPs come from?

Some may be recruited back from private practice, others would come as new graduates, others may move from other provinces with the appeal of working with more manageable caseloads, others may be privately contracted similar to those contracted through At-Home or Autism funding.

How would data be collected to determine exact need?

First, ensure all publicly funded SLP programs for young children in BC are using the same records management and data collection system to track demand/need (e.g., NucleusLabs, which is already in use by several Ministry of Children & Family Development funded agencies). Then, use evidence-based practice guidelines to determine the exact need. This could be accomplished by an expert working group comprised of representatives for all stakeholders.

This is a learning process for us, and it is possible that based on the outcome of the 2107 public consultations, we may need to revise our ask for 2018. Thank you to everyone who has provided us with input, including our 2015 survey respondents, and supported this initiative. This is for you!

For more information, please refer to our current call to action and key messages.

Why is it important to treat speech and language delays as soon as possible?

Speech and language treatment is more effective and less costly to the public system when children receive it earlier in life. 1 2 5 6 9 10

Many decades of research have proven that an investment in early intervention for speech, language and other developmental delays pays dividends many times over. By investing in the health and well-being of young children, a tremendous amount of money can be saved over time in the public school system, health care, and legal system. Investment in early speech and language services is an investment in the health of the child, the family, and the community.

Children’s brains are geared to learn quickly in early childhood. 2 3 4 5 6 7 10

The first six years of life is an important time in a child’s life for learning the basics of speech, language and other important foundational skills. After age six, neuroplasticity is reduced and it becomes more difficult (but not impossible) for the human brain to learn speech and language. Many decades of research has proven without a doubt that early intervention brings about the best results.

Severely impaired communication skills are a barrier to normal human relationships. 10

It can be difficult for children with significant speech and language delays to build and maintain normal relationships with important adults in their lives such as caregivers, teachers or extended family members. Children with severely delayed communication skills may also have difficulty building friendships with other children. Poor communication skills can restrict a child’s ability to play and socialize with other children. A child needs adequate speech and language skills, as well as communication confidence, to introduce him or herself to other children, ask to join in play, and negotiate the rules of the game. As children grow older, normal play and socializing include activities in which more sophisticated communication skills are necessary.  

Language and intelligence support each other in early development. 2 3 4 5 10

Starting in very early childhood, communication skills and intelligence support each other and grow together. Children learn best by communicating with caring adults in social relationships. When they are able to use their communication skills to make connections with adults, those adults tend to spend more time talking with these children. These conversations are important learning opportunities for a child. When an adult talks with a child, the child can then use his or her language and speech skills to ask the adult for even more information. As the conversation flows back and forth, the child’s mind receives the stimulation and information it needs to grow and flourish. Celebrate the curiosity of a preschool child when he or she asks, “Why?” “Who?” “Where?” Give thoughtful answers to those questions. You are giving information to feed a growing mind!

Children with speech and language delays are at risk for developing anxiety about communicating. 4 10

Speech-language pathologists and other early childhood development professionals have recently noticed an increase in the number of children who show signs of anxiety. Many children with significant speech and language difficulties lose their confidence about their ability to communicate with other people when they experience many failed attempts at communication. As a result, they sometimes shy away from interacting with others. When an anxious child withdraws from others, the child misses out on opportunities to learn, participate in the community, make new friends, and share their own ideas and stories. Children who can successfully communicate with others enjoy a healthy amount of control in their lives. This helps to build a child’s self-confidence.

Children who have difficulty communicating sometimes develop unwanted behaviours as a way to cope with their frustration. 1 6 10

If a child’s speech and language difficulties are not resolved early, unwanted behaviours may develop due to extreme frustration. These behaviours may include biting, hitting, pinching, or pushing others. If the child turns his or her frustrations inward, they may harm themselves in physical, emotional or psychological ways. This does not mean that a child is “bad”; it’s just that they have no other way to communicate. These behaviours are simply forms of self-expression. But these unwanted behaviours can become habits, and these habits can lead to social, emotional and psychological problems over time.

Children with good speech and language skills at the start of kindergarten are more likely to succeed at school. 2 3 4 8 9 10

Children who have any type of developmental delay, including speech and language delays, are at risk of falling behind at school. An important part of being “kindergarten ready” is having adequate communication skills to participate in the classroom and be ready to learn. Children need to understand spoken language well enough to understand new information and to follow instructions. Children also need adequate speech and language skills to ask and answer questions, successfully interact with others, and communicate their thoughts and ideas clearly. Kindergarten readiness is an important measure of success to those who are responsible for the public health system.

Good speech and language skills are the foundations for learning to read and write. 3 4 8 10

When children learn how to read and write, they use their knowledge of spoken speech and language to help them understand how words and sentences are written. If a child’s knowledge of spoken language is delayed (for example, they have many speech sound errors well into their first years of school, or their spoken language sounds immature compared to other children their age), their foundation for reading and writing is weaker. Children with speech and language delays are more likely to struggle in learning to read and write. Educators often say that children learn to read until Grade 3, and read to learn after Grade 3. This means that if a child has not learned to read well enough by Grade 3, he or she will find it more and more difficult to be successful in higher grades.

Children with poor speech and language skills face many risks throughout life. 1 2 4 5 7 9 10

Poor communication skills are closely linked to poor life chances. Children with delayed speech and language skills are at risk for failure at school, problems connecting with others, fewer educational opportunities, and poorer professional opportunities. Children with poor communication skills are also at risk for lower self-esteem, poor self-confidence and higher risks for mental health issues as they get older. Studies have shown a close link between poor communication skills and increased chances of being jailed.


References

  1. Canadian Paediatric Society and Canadian Academy of Child and Adolescent Psychiatry. “The promise of the early years: How long should children wait?” Paediatric Child Health 2012, Vol 17 No 10: 535-536.
  2. Centre on the Developing Child, Harvard University; NGA Center for Best Practices; and National Conference of State Legislatures. “In Brief: The science of early childhood development.” www.developingchild.harvard.edu. Accessed September 2017.
  3. Head Zauche et al. “Influence of language nutrition on children’s language and cognitive development: An integrated review.” Early Childhood Research Quarterly 2016, 36: 318-333.
  4. Head Zauche et al. “The power of language nutrition for children’s brain development, health, and future academic achievement.” Journal of Pediatric Health Care 2017 Vol 31 No 4: 493-503.
  5. Heckman, J.J. “Skill formation and the economics of investing in disadvantaged children.” Science 2006 Vol 312: 1900-1902.
  6. Hertzman, C. “The significance of early childhood adversity.” Paediatric Child Health 2013 Vol 18 No 3: 127-128.
  7. Human Early Learning Partnership. The importance of early child development, 2014: 1-3.
  8. Inclusion BC et al. Kids Can’t Wait: The case for investing in early childhood intervention programs in British Columbia. Report on the 2016 Provincial Early Childhood Intervention Summit, 2016.
  9. Kershaw, P., et al. “The Economic Costs of Early Vulnerability in Canada.” Canadian Journal of Public Health 2010; 101 (Suppl. 3): S8-S12.
  10. Law, J. and Charlton, J. Language as a child wellbeing indicator. Early Intervention Foundation, 2017.

#CommunicationMattersBC

2017 Call to Action (Round 2)

Each year, the Select Standing Committee on Finance and Government Services (SSCFGS) holds province-wide consultations so the public can provide input on their priorities for the upcoming provincial budget.

Earlier this year Communication Matters put out a call to action for speech-language pathologists (SLPs) interested in speaking at the public consultations held by the SSCFGS. We are extremely grateful to every volunteer who came forward to express their interest in participating in these public consultations.

On September 20th, the SSCFGS released the schedule for their public consultations across the province and registration opened up on the 21st. Our volunteers found that the spaces to speak at the in-person consultations were filling up fast. However, this year the Committee has also included two additional ways for British Columbians to participate in the public consultations: submit a written or recorded statement and/or complete an online survey. All three participation options are available on their Consultation Portal site.

Now, we are putting out our second call to action for this year and this time we are calling on everyone in BC:

If you would like the next budget to prioritize early and effective speech-language therapy services for young children, then please provide input to the Committee by completing the short online survey and/or submitting a written or recorded statement. The more people they hear from, the more likely they will be to realize that this is important to so many British Columbians.

We are aiming to have 100 people provide input to the SSCFGS. If you have participated to express a concern about speech and language services for young children, please let us know by completing this short form.

The consultation process closes on October 16, 2017, at 5:00 pm. Between now and then, let’s do everything we can to create awareness about why it is important to treat speech and language delays as soon as possible. Over the next couple weeks, we will be sharing these key messages and other links of interest via Twitter and Facebook. Please help support this initiative by sharing these links, and your personal stories of why this is important to you, with your friends and family using the hashtag #CommunicationMattersBC.

Thank you!

Speech-Language Services for Young Children in BC: Key Messages

Current Situation in British Columbia

British Columbia (BC) has the second lowest number of speech-language pathologists (SLPs) per 100,000 people in Canada.
Source: Speech-Language and Audiology Canada. (n.d.). Speech-language pathologists and audiologists per 100,000 people in Canada. Retrieved from http://www.sac-oac.ca/sites/default/files/resources/Stats%20Map%20Canada_EN.pdf.

“More than 85% of [BC preschool] SLPs reported caseloads that exceed the recommended caseload size of between 25 and 40 children (per: Therapy BC)… The most commonly reported caseload size was 60-80 children with some caseloads exceeding 160 children (when scaled for 1.0 Full Time Equivalent (FTE)).”
Source: Communication Matters, Speech-Language Pathology Service Provision for Young Children in British Columbia Survey Results, December 2015.

“Only 5% of [BC preschool] SLPs said they were able to provide a level of service they would recommend to the majority of their caseload.”
Source: Communication Matters, Speech-Language Pathology Service Provision for Young Children in British Columbia Survey Results, December 2015.

“85% of [BC preschool] SLPs reported some sort of waitlist to access SLP services. This area requires further investigation.”
Source: Communication Matters, Speech-Language Pathology Service Provision for Young Children in British Columbia Survey Results, December 2015.

“…wait times for supports and services are impacting the ability for families to receive the assistance from Government programs that will support them through this critical period in their children’s lives. The majority of survey respondents, approximately 64%, had to wait more than 3 months to access a program/service. 20% of respondents waited more than 6 months and 10% more than one year. The wait times for speech-language pathology and for respite services are particularly lengthy, with many families waiting more than 2 years for these services. In some cases, families never received the service they were referred for due to the excessive wait. Many families ended up paying to access services in the private sector.”
Source: Family Support Institute of BC. (2016). Parent Feedback Project Results. Retrieved from http://familysupportbc.com/wp-content/uploads/Parent-Feedback-Project-Report.pdf.

At least 9.4% of kindergarten students in BC demonstrated vulnerability for language and cognitive development (i.e., interest in books, reading, language skills, literacy and math-related activities).
Source: Human Early Learning Partnership. EDI [Early Years Development Instrument] British Columbia Provincial Report, 2016. Vancouver, BC: University of British Columbia, School of Population and Public Health; October 2016.

At least 14.2% of BC kindergarten students are vulnerable in the area of communication skills and general knowledge (i.e., ability to clearly communicate one’s own needs, participate in story-telling, and general interest in the world).
Source: Human Early Learning Partnership. EDI [Early Years Development Instrument] British Columbia Provincial Report, 2016. Vancouver, BC: University of British Columbia, School of Population and Public Health; October 2016.

Investing Early Helps Children Beginning in the School Years

“The ability to communicate through speech and language is fundamental to a child’s literacy development. Children are more likely to benefit from treatment when communication disorders are identified early on.”
Source: Speech-Language and Audiology Canada. (n.d.). Language and literacy skills are just the beginning. Retrieved from http://www.sac-oac.ca/sites/default/files/resources/literacy_poster_letter_en.pdf?_ga=2.226671384.469567464.1506657399-888862476.1505835416.

“Children with language impairments are 4 to 5 times more likely to have reading difficulties while in school.”
Source: Speech-Language and Audiology Canada. (n.d.). Language and Literacy Skills, Speech-language pathologists can help. Retrieved from http://www.sac-oac.ca/sites/default/files/resources/literacy_info_sheet_en.pdf?_ga=2.233534235.469567464.1506657399-888862476.1505835416.

“Up to 30% of children with speech disorders also have a reading disability.”
Source: Speech-Language and Audiology Canada. (n.d.). Language and Literacy Skills, Speech-language pathologists can help. Retrieved from http://www.sac-oac.ca/sites/default/files/resources/literacy_info_sheet_en.pdf?_ga=2.233534235.469567464.1506657399-888862476.1505835416.

“Recent research indicates that reading difficulties are primarily language-based.”
Source: Speech-Language and Audiology Canada. (n.d.). Language and Literacy Skills, Speech-language pathologists can help. Retrieved from http://www.sac-oac.ca/sites/default/files/resources/literacy_info_sheet_en.pdf?_ga=2.233534235.469567464.1506657399-888862476.1505835416.

A UK study found that approximately 36% of 11-year-olds with specific language impairment (SLI) were at risk of being bullied.
Source: Knox E and Conti-Ramsden G (2003) Bullying risks of 11-year-old children with specific language impairment (SLI): Does school placement matter? International Journal of Language and Communication Disorders 38: 1–12.

“Early experiences and the environments in which children develop in their earliest years can have lasting impact on later success in school and life. Barriers to children’s educational achievement start early, and continue to grow without intervention.”
Source: Center on the Developing Child (2009). Five Numbers to Remember About Early Childhood Development (Brief). Retrieved from www.developingchild.harvard.edu.

Investing Early Will Help in the Long Run

Every $1 spent on early childhood health and development saves up to $9 in future health, social and justice services.
Source: Canadian Public Health Association (2013, June 18) Public Health: a Return on Investment [Video file]. Retrieved from https://www.youtube.com/watch?v=TVZxtuZhN_M.

“Providing young children with a healthy environment in which to learn and grow is not only good for their development—economists have also shown that high-quality early childhood programs bring impressive returns on investment to the public. Three of the most rigorous long-term studies found a range of returns between $4 and $9 for every dollar invested in early learning programs for low-income children. Program participants followed into adulthood benefited from increased earnings while the public saw returns in the form of reduced special education, welfare, and crime costs, and increased tax revenues from program participants later in life.”
Source: Center on the Developing Child (2009). Five Numbers to Remember About Early Childhood Development (Brief). Retrieved from www.developingchild.harvard.edu.

In Canada, boys with language impairment have higher rates of arrests and convictions than boys who do not.
Source: Brownlie E.B., Beitchman J.H., Escobar M., Young, A., Atkinson, L., Johnson, C., Wilson, B., and Lori, D. (2004) Early language impairment and young adult delinquent and aggressive behavior. Journal of Abnormal Child Psychology, 32, 453–67.

A Canadian study found that young adults (between the ages of 18 and 24 years old) who had a history of language impairment had one of the highest rates of psychiatric disorders in the community: 37%
Source: Beitchman, J.H., Wilson, B., Johnson, C.J., Atkinson, L., Young, A., Adlaf, E., Escobar, M., and Douglas, L. (2000). Fourteen-Year Follow-up of Speech/Language-Impaired and Control Children: Psychiatric Outcome. Journal of the American Academy of Child and Adolescent Psychiatry, 75-82.

Children’s Rights

Article 23 You have the right to special education and care if you have a disability, as well as all the rights in this Convention, so that you can live a full life.
Source: United Nations (n.d.). Convention on the Rights of the Child In Child Friendly Language. Retrieved from https://www.unicef.org/rightsite/files/uncrcchilldfriendlylanguage.pdf.

Article 24 You have the right to the best health-care possible, safe water to drink, nutritious food, a clean and safe environment, and information to help you stay well.
Source: United Nations (n.d.). Convention on the Rights of the Child In Child Friendly Language. Retrieved from https://www.unicef.org/rightsite/files/uncrcchilldfriendlylanguage.pdf.

Article 28 You have the right to a good quality education. You should be encouraged to go to school to the highest level you can.
Source: United Nations (n.d.). Convention on the Rights of the Child In Child Friendly Language. Retrieved from https://www.unicef.org/rightsite/files/uncrcchilldfriendlylanguage.pdf.

#CommunicationMattersBC

Download a PDF version of this post here.

Edited on October 11, 2017 to include additional information.

Announcing Our New Website

Communication Matters, An SLP Advocacy Group for Young Children, is excited to announce the official launch of our new website. From here we can share our vision and plans with both professionals and the public. We are particularly excited about our Parent/Caregiver Resources page which provides information for families about what they can do as well as links to resources within BC. Stay tuned for future blog posts.

#CommunicationMattersBC