In England 14% of two-year-old children are failing to meet the communication level expected for their age. In disadvantaged communities this rises to 40%. Problems have been made worse by the restrictions on family life and educational experiences during the COVID-19 pandemic. At the same time, many children’s speech and language therapy services are in crisis. They have the largest waiting lists of any NHS community service. More than 74,000 children are waiting for support in England alone.

Many Local Authorities and NHS services are working together to provide early support for children’s language and communication development, to prevent problems developing and reduce the numbers of children referred to speech and language therapy. But needs far outstrip the supply of help. Around 50% of children with language and communication needs are never referred for help. Socially disadvantaged and minority ethnic families are least likely to access support.

Lots of things influence children’s early language development and children’s needs vary, so no one intervention suits everyone. This study will find out if we can adapt approaches that have been shown to work in research to fit the needs of different communities.