All children should start school with the speech and language skills necessary to access, benefit from and enjoy the learning experiences they encounter, and to develop as happy, well-adjusted and valued members of society. This is my mission for the Sure Start children I work with; a tall order isn't it, but should it be?

In March 2001, I carried out a study in the Bilston and Ettingshall Sure Start (BESS) area of Wolverhampton. This showed that 58 per cent of the four-year-olds assessed had speech and language (S&L) skills below both the national average and the norms expected for their age. The majority exhibited poor attention and listening skills as well as difficulties understanding the spoken word. It is likely that, by the end of Reception, these children will not have achieved the early learning goals, particularly in communication, language and literacy.

It was not just levels of skills which were low: the study found low expectations and levels of awareness amongst service providers. Less than 50 per cent of the nursery staff interviewed identified S&L impairment as impacting negatively on a child's educational attainment, whereas all staff identified the impact on social and emotional development. The majority also reported being under-confident in identifying children with impairments and supporting them in the nursery environment.

Nursery staff are now trained to screen children on entry, referring those they are concerned about to our S&L team for intervention. Staff and parents are provided with advice, and direct individual or small group intervention is offered where appropriate. As a result, parents have reported being able to communicate better with their children.

Prevention, the second strand to speech and language therapy, is key. We tackle it both indirectly through the provision of quality resources and directly through parent and baby/child groups.

For the first two years of the programme every family in the area received a 'speech and language' calendar with a top tip every month. Goodie-bags are another successful method of reaching and engaging with families while providing quality materials to stimulate children's speech and language development. Our baby bag includes a touchy-feelie book introducing babies to nursery rhymes; our toddler bag includes a hardboard book of first word vocabulary and brightly coloured photographs; older and more able children receive a book with an extended vocabulary including adjectives and verbs. Often these are the only books these children will be exposed to until they start nursery.

The toddler bag also contains a nursery rhyme tape and booklet. Nursery rhymes are an essential part of building positive parent-child interaction and S&L skills, as well as being crucial for the development of literacy. Many of the commercially available tapes are too fast for little ones to join in and the words are often drowned out by the music, so we have devised our own which is sung by local school children at a slow pace. This tape has been very popular with parents, children and Sure Start projects throughout the country.

It is not sufficient to tell parents to play, talk and interact with their babies and young children; many of them need to be shown. Parents often do not know what toys are suitable for their children's ages. They have limited knowledge of nursery rhymes, do not talk to their young babies, or appear never to have sat or lay on the floor with their baby to play with them. This is what our parent and baby/child groups are all about.

Our six-week 'Look Who's Talking' baby group is offered to all parents with babies between the ages of six and 12 months. Parents learn how to promote their baby's early communication skills such as looking, listening, turn-taking, imitation and play skills. They also learn nursery rhymes, simple toy-making and have access to a toy loan scheme. Families are also then offered a nine-week programme, 'You Make The Difference' (Hanen), an internationally recognised preventative approach. This uses videoing of parent/child interaction to enhance existing skills. We offer many enticements to encourage parental attendance including free drinking cups, nursery rhyme tapes and booklets and crèche vouchers. Evaluations so far have shown that both parents and babies/young children have enjoyed the groups as well as acquiring new skills and knowledge.

Developing children's communication skills is key to developing their life chances and parents are paramount to this process. It is very satisfying seeing how quickly young children can develop with the appropriate intervention. There are high levels of need in our area but collaborative working practices between different agencies makes the job easier, more effective and very rewarding.

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