Early Speech, Language and Communication Development: Which Factors are Associated with Better or Poorer Outcomes?: Early SLC development in Scotland
The importance of the first 1000 days, from conception to the end of a child’s second year, has been recognised as having the greatest impact on subsequent wellbeing and health across the individual’s life course (World Health Organisation’s Commission on Social Determinants of Health, 2008).
The evidence regarding the lifelong impact of SLC concerns is clear, particularly in relation to the connection with learning and attainment, wellbeing and mental health, poverty, employment, justice and behaviour (as described below):
Learning and Attainment - Early language emerges as the most important factor in influencing literacy levels at age eleven.
Wellbeing and Mental Health - Children with SLC needs are at increased risk of developing mental health problems.
Poverty - Children from socially disadvantaged families are more than twice as likely to be identified with an SLC concern.
Employment - 88% of long term unemployed young men were found to have an SLC need.
Justice - Over 60% of young people who come into contact with the justice system are found to have SLC needs.
Behaviour - Studies consistently observe higher levels of behaviour challenges among people identified with SLC needs.
The importance of children’s communication rights is recognised following the incorporation of the United Nations Convention on the Rights of the Child (UNCRC) into the law within Scotland. UNCRC ensures that children’s communication rights are specifically enshrined within Article 12 and 13, relating to freedom of expression and opinion.
The value of prevention and early intervention principles is equally recognised within Scotland, where there is a national commitment to giving every child the best start as an essential approach to reducing health inequalities across the life course.
The Scottish Government Early Child Development Transformational Change Programme emphasises the importance of a preventative approach from pre-birth across all developmental domains, including SLC. (Children and Young People (Scotland) Act 2014 GIRFEC, Child Poverty (Scotland) Act 2017, UNCRC (Incorporation) (Scotland) Act 2024, The Promise Scotland, Early Child Development Transformational Change Programme)
Across Scotland, early child development is monitored via a Universal Health Visiting Pathway with recorded concerns at the 27- 30 month Child Health Review (CHR) reported in the National Performance Framework.
Since the COVID-19 pandemic, there has been an increase in reported developmental concerns at the 27–30 month CHR. The highest increase in reported concerns is evident in the developmental domain of SLC (as shown in the image below). This national data set reveals an increased likelihood of SLC concerns in areas of multiple deprivation (Public Health Scotland, Early Child Development Dashboard).
This resource draws from the literature and explores the factors associated with better and poorer SLC outcomes and aims to identify opportunities for prevention and early intervention. There may be persisting and distinct SLC differences associated with biomedical conditions (such as deafness or genetic conditions) or neurodevelopmental differences. However, social and environmental factors associated with poorer SLC outcomes may be responsive to primary or secondary prevention approaches (Appendix LINK).
This resource describes some of the factors that are associated with better outcomes for SLC development, including responsive adult interactions and positive maternal mental health.
Finally, the resource will consider how The National Practice Model can be applied to identify and strengthen protective factors and support vulnerabilities for SLC development. This model recognises children’s wellbeing is shaped by individual developmental factors interacting with family and/or care factors, with support from local services and communities. The National Practice Model forms part of the wider Getting it Right for Every Child (GIRFEC) approach used across Scotland.
