1. What age can I use the ELIM-I measure with?

The ELIM-I measure is for use with children aged 24-30 months (2 -2 1/2 years). The measure has been standardised on children in this age range therefore is inappropriate for use with children outside this age range. 

2. Which children can I use the ELIM-I measure with? 

The ELIM-I measure is a universal assessment and can be used with all children age 24-30 months.

3. If a child uses a different word from that specified on the word list, but with the same meaning, for example, instead of 'setee/sofa' may say 'couch'- is this marked as correct? 

Yes. Children do not need to say the exact word on the word list but the meaning must be the same, therefore local dialect words with the same meaning can be marked as correct. However, if the child says a completely different word for the same item (that is, ‘cup’ for ‘juice’, ‘motor’ or ‘brum’ for ‘car’, ‘dog’ for ‘cat’) do not mark it as correct. 

4. Are children expected to know all 50 words on the word list?

No. The 50-word list is a range of words that children 24-30 months may or may not say. This means some words are those that children will be more likely to say, whereas other words are those that only a few children may say. ELIM-I is aiming to capture the range in individual differences in how children learn words. It is important for practitioners to reassure parents that its very unlikely a child will know all of these words, and there is a big range in children's language at this age. Practitioners should look at the ELIM-I Practitioner Guide and guidance videos for ideas about how to phrase this for families.

5. How should the word list be used with children who speak more than 1 language?

If a child speaks more than 1 language at home, please tick the word if they say it in either of their languages. If English is the child's additional language, the word list should be completed in their primary home language using a translator or local translation services where possible. We advise that practitioners do not use 'Google translate' as many words do not translate directly across languages. 

6. What am I looking for to answer the observation question 'Does the child understand what is being said to him/her when their parent/carer asks them something which is NOT obvious from the context?' ?

Many children will appear to understand what is being said to them by making connections between object cues and routines in their immediate environment, for example, a child may appear to understand the instruction 'put your shoes on to go outside' when their shoes are by the front door and/or this is part of a daily routine, the shoes and door are supporting cues to understanding the instruction. In this question we are exploring whether the child is able to understand what is being said to them when they don't have these cues. For example, a parent may say 'can you get mummy's shoes from the bedroom', 'go find your teddy (when teddy is out of sight)'.  

1. How do I decide between the self-directed or coaching approach to intervention?

The decision between a self-directed or coaching approach to intervention is based on practitioner judgement and expertise, knoweldge of the family context, and barriers and enablers for the family to deliver responsive interaction. The majority of children who are indicated by the ELIM-I measure and/or parent concerns as in need of support will be suited to a self-directed approach to intervention, however the decision between the two approaches should be shared between practitioner and parent/carer.

2. Do I need to decide on the approach to support (self-directed Vs coaching) and complete the parent/carer's goal-setting during the Healthy Child Review? 

No, the decision about the approach to support, and intial goal-setting with parents/carers may be completed either within the 2-2 1/2 year review if there is time, or at a follow up visit with the parent/carer; this separate visit will be particularly important for families who may benefit more from a coaching approach, allowing more time for discussing support, goal-setting, modelling behaviours, and answering any questions families may have. 

3. How many additional visits or telephone contacts are required for each intervention approach? 

For the self-directed approach it is recommended that pracititoners carry out one additional visit after goal setting, and consider optional text reminders and/or a telephone review of progress. For the Coaching approach it is recommended that pracititoners carry out between 2 and 4 additional visits, and consider optional text reminders and/or telephone or face-to-face review of progress.  

4. How do I decide when to stop intervention support? 

Some children who are indicated by the ELIM-I measure will already have been referred to SLT, in which case it is likely that one block of intervention will be sufficient support. For those children who are only being seen by the health visiting team, after pracittioners have delivered their intended number of contacts, pause and see how the child progresses and review around 2 months later - at this point whether or not practitioners offer additional support, or refer onto SLT, depends on local pathway criteria.