BABYTALK VISITS FOR CHILDRENS CENTRES A PRIMARY PREVENTION COLLABORATION

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BABYTALK VISITS FOR CHILDRENS CENTRES A
PRIMARY PREVENTION COLLABORATION

• Deborah Gibbard, Clare Smith Louise Higgins
• Portsmouth City teaching PCT

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Rationale

• Increased risk of speech and language
  difficulties in areas of economic deprivation
• Risk factors for poor outcomes in later life
  include speech language delay and SES
• Impact on educational outcomes, social
  development, emotional behavioural
  difficulties, and employment prospects

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Rationale

• Facilitative parenting may protect against
  negative impact of low SES
• Important features
• -Parenting quality (caregiver-child
• engagement)
• -Parenting activities (learning at home, e.g.
  
• book reading)
• -Learning materials (e.g. age-appropriate
• books toys)

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Development of the Babytalk Service (BTS)

• Challenge of addressing speech and language needs
  of children
• Sure Start Somerstown speech language programme
• High social deprivation
• Primary prevention service, targeting multiple
  aspects of the language and literacy environment
  early in a childs development

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Babytalk service
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Babytalk Visit

• Home visit
• Parents/carers of babies (approx 6 months)
• Advice on
• Language milestones
• Effect of main carer
• Ways to encourage language development

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Babytalk visit
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Babytalk- effectiveness evaluation(Smith
Gibbard, paper in preparation)

• Originally delivered by SLT service
• Evaluated by parent questionnaire Sure Start
  Language Measure (SSLM)

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Evaluation of Babytalk visits parents ideas to
encourage language

• Parents who had received the BTS able to give
  more appropriate ideas on how to promote language
  development at home
• (ANCOVA significance p0.005)

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Evaluation of Babytalk VisitsChildrens spoken
language

• SSLM mean word count at 2 years 21 higher where
  families had received the BTS
• (ANCOVA significance p0.023)

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Extending the Babytalk service - Why?

• Sure Start mainstreaming strategy
• National local drivers
• Childrens Centres agenda
• Joint service level agreements
• Shared goals targets
• Operational plans, goals reviews
• Clear evidence on effectiveness

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Extending the Babytalk service multi-agency
proposal

• Develop expand the BTS across
• the City of Portsmouth
• 17 newly established Childrens
• Centres with a population of 10619
• 0-5 year olds
• Key Aim to extend the service
• whilst maintaining its quality and
• effectiveness

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Extending the Babytalk service -how?
Multi agency proposal
Identify BTS staff
Create protocol and knowledge skills
framework BTS staff to develop portfolio
evidencing skills
Deliver Babytalk training day
BTS staff to shadow minimum of 2 shadowed
visits
Monthly group supervision
BTS staff observed by SLT after 6 months and
signed off
Ongoing termly group supervision
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Participants

• 5 childrens centre staff identified as potential
  BTS staff
• Existing Strengths
• -knowledge and skills in child development
• -experience of working in a nursery setting
• - experience of outreach work and home
  visiting

Multi agency proposal
Identify BTS staff
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Developing materials

• SLT service developed
• Protocol for delivering Babytalk visits
• Babytalk knowledge and skills framework detailing
  key competencies needed to deliver quality
  assured babytalk visits
• BTS staff created portfolio demonstrating
  evidence of their skills in each competency

• Create protocol and knowledge skills
• framework. BTS staff to develop
• portfolio evidencing skills

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Babytalk training

• SLT service devised a whole day training course
  to help fill gaps identified in Babytalk staffs
  knowledge
• Shadowing reflective practice record sheet

• Deliver Babytalk training day

BTS staff to shadow minimum of 2 shadowed
visits
BTS staff observed by SLT after 6 months and
signed off
Monthly group supervision
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Group supervision

• Supervision is a key factor in delivering a
  quality speech and language therapy service
• (Communicating Quality 3, 2006.)
• Ongoing group supervision

Monthly group supervision

• Ongoing termly group supervision

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Extending the Babytalk service -how?
Multi agency proposal
Identify BTS staff
Create protocol and knowledge skills
framework BTS staff to develop portfolio
evidencing skills
Deliver Babytalk training day
BTS staff to shadow minimum of 2 shadowed
visits
Monthly group supervision
BTS staff observed by SLT after 6 months and
signed off
Ongoing termly group supervision
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Method monitoring and evaluation of Babytalk
service extension

• How much has the service been extended?
• Increase in availability population data from
  Portsmouth City Council
• Increase in actual contacts 2008 monitoring
  figures for whole city compared with Sure Start
  area
• Increase in actual contacts for last quarter of
  2008

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Method monitoring and evaluation of Babytalk
service extension

• Has the quality of the service been maintained?
• Assessment of Babytalk staff competencies by
  Speech and Language Therapy service using
• Competencies profiles
• Shadowed visits
• Analysis of parent feedback forms

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Method monitoring and evaluation of Babytalk
service extension

• Analysis of parent feedback forms
• Compared forms from visits given by speech and
  language therapy assistants and Babytalk staff
• Responses compared
• Will you do anything differently as a result of
  the visit?
• What will you do differently? (beneficial
  versus non-beneficial responses)

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Analysis of parent feedback forms What will you
do differently?
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Results of evaluation service availability

• Any parent in the City of Portsmouth can now
  request and receive a Babytalk Visit
• Any Health Visitor can now make a referral
• Availability ?965.2

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Results of evaluation contact monitoring

• Contacts for 2008
• ?272 in actual delivery
• ?396 in quarter 4
• upward trend in increase
• expected to continue with increased staff levels
  and increased information sharing with Health
  Visitors

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Results of evaluation quality of service

• Babytalk staff achieved same competencies as a
  result of training and development
• Babytalk staff able to demonstrate satisfactory
  performance on shadowed visits
• Babytalk staff showed development of knowledge
  within monthly supervision meetings

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Results of evaluation Analysis of parent
feedback forms

• Will you do anything differently?
• Yes responses Sure Start Somerstown compared
  with other Children's Centres
• Somerstown 73.3 (253/345)
• Childrens Centres 76.5 (192/251)
• No significant difference (p0.297)

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Results of evaluation Analysis of parent
feedback forms

• beneficial comments, Sure Start Somerstown
  compared with other Childrens Centres
• Somerstown 84.8 (184/217)
• Childrens Centres 86.2 (150/174)
• No significant difference (p0.694)

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Discussion multiagency working
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Discussion future developments

• Service delivery
• Health Visitor liaison (e.g. professional forum)
• Combination of group (e.g. first time mums) and
  home visits in order to maximise reach
• Evaluation
• effectiveness (child language levels)
• long term benefits

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Conclusion

• Babytalk service now available to any parent in
  Portsmouth City on request
• Initial analysis indicates that service delivered
  by Babytalk staff is equal in quality to original
  service

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Babytalk service questions?