Could the success of The King's Speech boost efforts to help children with communication difficulties?
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King's Speech boost efforts

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She was a quiet baby, and a quiet child. But it was not to an extent that was particularly alarming. I remember sitting in the garden with my husband, saying: 'This time next year, we won't be able to shut her up.'"

When Laura first noticed that her two-year-old daughter, Eleanor, was quieter than other children, she assumed it was only a matter of time before she caught up with her peers. Yet Laura has spent the past five years trying to provide the support Eleanor needs to cope with complex communication problems that, to the untrained eye, were completely hidden.

Realising that a child is struggling to communicate, and trying to find them the right help, may seem a far cry from the drama of a grown monarch's attempts to overcome his stammer. But a coalition of organisations that help children with communication difficulties hopes that the box-office success of The King's Speech – in which Colin Firth portrays King George V and his friendship with a speech therapist – will boost its campaign to raise awareness about the 1.2 million children in Britain who struggle to communicate. The Communication Trust, a body representing more than 35 charities and non-profit organisations, is launching the Hello 2011 Year of Communication campaign at the end of the month.

The trust plans to target parents, education and healthcare professionals, and those who buy and provide services for children and young people, with information about identifying and supporting children with communication problems. The campaign has received the backing of more than 50 organisations, including the departments of education and health, and from BT. "What The King's Speech brings home is that it is really hurtful to have difficulties communicating," said the Government's communication champion, Jean Gross, who is helping to lead the campaign. "The extent of that is visible in the film. They may not have stammers but the effect is the same. The film can only help awareness, as long as we understand that there are these more subtle kinds of speech and language difficulties."

According to the trust, as many as one in ten children suffer from some form of long-term and persistent difficulty in communicating, ranging from an inability to say words or construct sentences, to problems understanding instructions and lessons. These problems often go undiagnosed, and one of the Hello campaign's key aims is to make the public aware that children can experience a diverse range of difficulties that are far harder to identify than a stammer or poor pronunciation.

"You are desperately wanting to find out what is wrong. But without a label, without knowing what is wrong, it is very difficult to know what direction to take," said Laura. "If I'd known more about speech and language at that stage, it would have given me another option to explore."

The Communication Trust hopes the Hello campaign will help to improve the level of information given to parents, in particular guidance on recognising the stages of language development. The trust also hopes to make communication difficulties a priority among frontline staff dealing with children, many of whom have little knowledge about speech and language problems in children. The trust's aim is to make sure that by the end of the year, children with communication difficulties are receiving help more quickly.

The year of communication was originally proposed by John Bercow MP, now the Speaker of the House of Commons, following his 2008 review of services for children with speech, language and communication needs. The review found that 77 per cent of parents who wanted help dealing with a child's communication difficulties did not get the support and information they needed. When Tracy King realised her twin 18-month-old daughters, Rachel and Sarah, were developing communication skills more slowly than her son had, it was the beginning of a draining 10-year struggle to provide them with the support they needed.

Though she managed to get her daughters into a special-needs school, where they made progress using a communication system incorporating gestures and facial expressions called Makaton, eventually the girls were forced to go to a mainstream primary. With large, noisy classrooms and scant additional support, they found it difficult to keep up. "No one ever believed that I knew my children better than they did," Tracy said. "It felt like complete repression and control. They would come home and not want to read, yet the school would pressure me and I would feel guilty."

Tracy's Local Education Authority (LEA) would not provide expert help for Rachel, who had more severe problems than her sister. The family racked up large credit-card bills paying specialists to assess Rachel in a bid to force the authority to pay for a speech therapist. The LEA agreed to come up with the funding only when her case was on the verge of going to court.

"A key issues for children with communications difficulties is they fall through the gaps between health and education," said Gross. "That is because the budget is with health organisations but the responsibility for children is with the local authority."

Poor language and speech abilities are often linked to poverty, and as many as half of children from deprived areas can have delayed communication skills. According to Gross, many of these children have less severe difficulties which can be dealt with effectively by parents and teachers in a natural environment.

Schools can help children with communication problems by providing "communication friendly" classrooms, with low noise levels and limited visual distractions. Teachers can also use visual tools such as illustrated timetables and puppets to ensure children with communication difficulties are not excluded. Gross also believes that teaching assistants could be used more effectively to tackle communication difficulties by taking small groups of children out of the classroom for regular short sessions.

"If you can reduce the number of children with the less serious difficulties, then you can focus language therapists on children with the more long-term biological impairments," she said. "At the moment, waiting lists get clogged up with children who could be helped more effectively by those who are with them round the clock."

For children with severe problems, Gross says that funding must be directed more carefully to ensure the costs of failing to tackle communication problems are not felt later on. She points out that ability to communicate effectively is one of the strongest determinants of a child's educational attainment and employment prospects in later life. It can also have a significant impact on behaviour, and at least 60 per cent of young offenders have communication problems.

Despite difficulties, both Tracy and Laura eventually managed to find the right support for their children. Eleanor was assessed as having complex speech, language and communication needs at the age of two-and-a-half. However, two years in a mainstream school caused her to regress and become less communicative, despite the efforts of the school's speech and language unit. Now seven, Eleanor has spent the past 18 months at the I CAN Meath school in Surrey which specialises in helping children with severe and complex speech, language and communication needs. Laura says that at Meath, Eleanor is "confident and happy and surrounded by people who support her way of communicating".

After a difficult time at primary school, Rachel and Sarah moved to a more accommodating secondary. Staff rapidly learned from the speech therapist grudgingly provided by the LEA and worked hard to make the girls feel comfortable. The 17-year-olds are now both at college, where Sarah is studying for an A-level equivalent diploma in performing arts and Rachel is doing a first diploma in art.

For Tracy, the most satisfying aspect of her daughters' progress is they are socially active. "They have really good relationships because of their language skills," she said. "From being children who were not able to communicate, they have had their confidence and self-esteem raised, which has enabled them to be where they are today."


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