Identifying speech, language and communication needs among children and young people in residential care

There are claims that elevated levels of speech, language and communication needs (SLCN) exist among looked-after children and young people, and that their needs remain largely undetected and unmet. Scarce empirical evidence exists to support these assertions.

To investigate whether elevated levels of communication impairment exist among children and young people in residential care; to begin to explore the nature of any communication impairment indicated, including social and pragmatic difficulties; to consider the extent to which communication impairment may be undetected and unmet; and to consider the suitability of the Children's Communication Checklist 2 (CCC-2) as a screening tool in this context.

In four local authority areas in Scotland residential care workers completed the CCC-2 on children and young people well known to them, and provided information about previous concerns and/or referrals regarding communication.

Results are presented for 30 children and young people ranging in age from 11;01 to 17;01 years (133-205 months, mean = 172.57, SD = 19.97 months). CCC-2 scores indicated impairment in 19 out of 30 cases. In eight of those 19 cases profiles were suggestive of autistic spectrum disorder (ASD), while for the remaining eleven cases impairment was indicated in other aspects of speech, language or communication. The general trend was towards greater severity of impairment in both ASD and non-ASD profiles. Information regarding previous concerns and/or referrals was available for ten of the 19 cases whose profiles indicated impairment: in nine out of these ten cases there had been no concerns, and in the final case no referrals had been made despite concerns.

This study indicates the presence of high levels of SLCN among individuals in residential care, much of it severe and pervasive in nature, and in large part unsuspected. The CCC-2 has the potential for use as a screening tool for this population. There is a compelling case for speech and language therapy services to address issues of awareness and access with regard to this population. This preliminary research supports the need for further investigation on a larger and wider scale.