A collaborative graduated approach to supporting speech, language and communication needs (SLCN) in the Early Years: Does it work?

In the United Kingdom, education settings are encouraged to implement a graduated approach to support children's early speech, language and communication development. Whilst there is evidence of effectiveness for some universal and targeted interventions, there is little evidence related to the whole graduated model. This study focuses on the impact of implementing a Speech and Language Therapist (SLT) supported multi-tiered system of support (MTSS) on the language skills (specifically receptive vocabulary) of 409 children aged 3 to 5 years, in comparison to a business-as-usual (BAU) model over 2 years of Early Years Foundation Stage (EYFS) education. Longitudinal multi-level modelling was used to examine progress over time and showed that inclusion in this MTSS for three terms resulted in statistically significant improvements in receptive vocabulary compared to BAU (monthly improvement of .82 standard score points, p<0.001). After just one term, children with the lowest receptive vocabulary scores showed significant improvements of 2.10 (p < 0.05) standard score points per month compared to control children (BAU), steadily closing the vocabulary gap. The universal tier of the MTSS facilitates greater receptive vocabulary improvement than the control condition, providing strong evidence of the importance of the universal tier as more than simply ‘business-as-usual’. This highlights the importance of SLTs working in collaboration with EYFS staff to actively support the implementation and normalisation of changed classroom practice at the universal tier and the embedding of appropriate targeted tier interventions.