How can we collaborate to develop services for children and young people who have SEMH & SLCN?

An issue we continually revisit, both at Course Beetle courses and at the Social Emotional Mental Health (SEMH) Clinical Excellence Network (SEMH CEN) is how can speech and language therapists (SLTs) collaborate with others to develop services for children and young people who have SEMH & Speech Language and Communication Needs? This is an issue many us have been thinking about for a long while. I have worked alongside education colleagues for many years, through many iterations of Ofsted expectations, each time thinking about how we can align our aims. One head teacher said to me, ‘I don’t care about SEN, just attainment’, so my focus for influencing was that by working on developing language and communication skills we could impact literacy and thereby attainment. Eventually she recognised that working on language and communication was vital for those with SEMH, and to gaining ‘outstanding’ status. I know that similar conversations are happening as regards social care and in child and adolescent mental health and forensic services.

This can be onerous work, but we mustn’t give up as communication is a human right1, the impact of SLCN is serious and should not be ignored, especially as it is an important factor in the development of behavioural problems2 and the link between communication and behaviour is still not well recognised3.

I’m not keen on not reinventing the wheel, and I know there are many creative and collaborative people working on this, so the SEMH CEN has collated some information on how SLTs work collaboratively in schools and this is in part of the Royal College of Speech and Language Therapists (RCSLT) SEMH clinical guidelines4. We need to gather similar information on our work in other settings and to share this, which SLTs can do via the SEMH Basecamp site and though SEMH CEN meetings.

What does the research tell us?

It’s useful to look at what the research tells us about how we can collaborate effectively5.

We need

  • Time together to think and plan
  • An understanding of each other’s jargon, roles, responsibilities and priorities
  • Shared beliefs and goals
  • An ability/willingness to adapt, take responsibility and to contribute
  • Systems and policies which support collaboration

Some of these requirements are easier to achieve than others and I’ve come to the conclusion that trying to influence the whole ’system’ whatever it is, is most effective. If a manager or head teacher is ‘on board’ things can really change. I think it’s also necessary to ’pick the low hanging fruit’ and work with those who have the time space and capacity to change.

Results from Glover et al (2015), consistent with previous research suggests that teachers do not feel they have the necessary skills or knowledge to support children with SLCN, similarly SLTs also need knowledge of the curriculum and classroom management. So obviously good evidence-based training and coaching is very important6 and can be effective7.

Five Good Communication Standards for SEMH

Recently the RCSLT published ‘Five Good Communication Standards’ (5GCS) for best practice for children and young people with SEMH8. They summarise relevant research and aim to ensure reasonable adjustments are made to meet the speech, language and communication needs of individuals with SEMH in any setting.

The 5GCS for SEMH provide a useful framework for an organisation to develop a collaborative plan. There are also 5GCS for Looked After Children which I have used with a foster care agency to enable them to meet the new Communication Access standard9.

The standards are

  • Standard 1: There is a detailed description of how best to communicate with
    individuals.
  • Standard 2: Services demonstrate how they support individuals with communication needs to be involved with decisions about their care and their services.
  • Standard 3: Staff value and use competently the best approaches to communication with each individual they support.
  • Standard 4: Services create opportunities, relationships and environments that make individuals want to communicate.
  • Standard 5: Individuals are supported to understand and express their needs in relation to their health and wellbeing.

The RCSLT fact sheet gives examples of how these standards might be met which include;

  • Standard 1: A speech and language therapy assessment, recommendations and systems for sharing this information.
  • Standard 2: Evidence that the child or young person’s understanding has been actively checked (for example, ‘Tell me what that means to you’, not ‘Do you understand?’) and that information has been adapted accordingly to ensure understanding.
  • Standard 3: Evidence that training is working, from the impact it has on young people and their progress.
  • Standard 4: Staff communicating in a positive, enabling, effective and facilitative way with children and young people and their families based on individuals’ communication needs
  • Standard 5: The active involvement of young people in evaluating services.

The 5GCS can provide a basis for rich discussion and thinking as staff collaborate to decide what these standards mean for them in their setting, what is already in place and what could be developed.

What next?

Find out more about children and young people who have both SEMH and SLCN and how we can develop services to support them at the  An introduction to working with children and young people who have Social, Emotional and Mental Health Needs (SEMH) and Speech, Language and Communication Needs (SLCN) course. We’ll consider the research and take the opportunity to think with colleagues about how to use these ideas to effectively support our clients.

Join the conversation about how we can work together online #howwedothe5GCS

Join the RCSLT SEMH Basecamp site (by emailing info@rcslt.org) so you can stay in touch with other SLTs and local SEMH CENs and share ideas.

Show references

[1] https://internationalcommunicationproject.com/profile/communication-basic-human-right/

[2] Chow, J. C., Ekholm, E., & Coleman, H. (2018). Does oral language underpin the development of later behavior problems? A longitudinal meta-analysis. School Psychology Quarterly, 33(3), 337–349. https://doi.org/10.1037/spq0000255

[3] Ramsay, J., Cowell, N., & Gersch, I. (2018). How school staff understand the relationship between problem behaviours and language difficulties. Educational Psychology in Practice, 34(1). https://doi.org/10.1080/02667363.2017.1367647

[4] https://www.rcslt.org/members/clinical-guidance/social-emotional-mental-health/social-emotional-and-mental-health-guidance

[5] Glover, A., McCormack, J., & Smith-Tamaray, M. (2015). Collaboration between teachers and speech and language therapists: Services for primary school children with speech, language and communication needs. Child Language Teaching and Therapy, 31(3). https://doi.org/10.1177/0265659015603779

[6] Kraft, M. A., Blazar, D., & Hogan, D. (2018). The Effect of Teacher Coaching on Instruction and Achievement: A Meta-Analysis of the Causal Evidence. Review of Educational Research, 88(4), 547–588. https://doi.org/10.3102/0034654318759268

[7] Starling, J., Munro, N., Togher, L., & Arciuli, J. (2012). Training Secondary School Teachers in Instructional Language Modification Techniques to Support Adolescents With Language Impairment: A Randomized Controlled Trial. Language Speech and Hearing Services in Schools, 43(4), 474. https://doi.org/10.1044/0161-1461(2012/11-0066)

[8] https://www.rcslt.org/-/media/docs/FGCS-and-SEMH.pdf?la=en&hash=C014E3A15B766411ABE626153538DF022A8A81A1

[9] https://www.rcslt.org/home/policy/communication-access-uk