Early Voices

How health visitors can support children’s speech, language and communication


About the programme

Early Voices was a national professional development and training programme for Health Visitors funded by Big Change, designed to impact the families that Health Visitors work with. It increased their knowledge in speech language and communication development, helped them share that knowledge as Communication Leaders and led to change in their local areas.


Stories of Change


Read about and hear our Communication Leaders’ successes and challenges below

  • Working with parents


    Health visiting is a universal service and often the first point of contact new parents have for support and advice around their child’s speech, language and communication development. In many areas however, the level of need amongst families for the service is not uniform and some need more support than others.

    Working with families with more than one language in the home

    Vicky talked to us about her work with families with English as an Additional Language (EAL) and where children were cared for by other family members because of parents’ need to work. She described how an Early Voices resource had a huge positive impact on both a young baby and her mother during a routine 8-12 month review. Listen to Vicky's experience here:

    Listening carefully and completing a more rounded assessment

    Nina described her work with a mum, anxious about her child’s communication skills. Uncertain whether the case required it, Nina made a referral to Speech & Language Therapy which was rejected for not being specific enough. The mother’s concerns remained however. As a result of Early Voices training, Nina completed further assessments which informed a new referral to speech and language therapy. Watch her describe her learning here:

    Understanding the importance of the home learning environment

    Fawn was concerned about some home learning environments that she sees. She reflected that parents often do not realise, perhaps because of their own early play experiences, that even short periods of parent and child playing together make a significant difference to their speech, language and communication development.

    Engaging hard-to-reach families

    Working with families who are harder to reach is part of the everyday work of health visitors and other professionals within the network of early years. For parents, the realisation that their children may have Speech, Language or Communication Needs can be difficult to process, especially when there are needs across the whole family. Building relationships and trust slowly with these families is critically important to the success of interventions.

    Read the full 'working with parents' case study here.
  • Embedding speech, language and communication in your practice


    The work of a health visitor is critical, not just because they are often the first early years professional a parent encounters but because their work is so multi-faceted. 

    As Public Health England consider their review of the Healthy Child Programme, stories from Early Voices Communication Leaders illustrate the need and benefit of having speech, language and communication knowledge and practice embedded as a golden thread throughout public health messaging.

    Making every contact count 

    Caroline completed her Health Visitor training relatively recently, but she felt that the information she was given on speech, language and communication was limited. Feeling instinctively that these skills were central to a child’s overall development and readiness to learn, it was this knowledge gap that prompted her to undertake the Early Voices training, so she could improve her own practice and develop that of her colleagues. Watch Caroline describe her work here:

    Getting everyone talking, about talking!









    Getting everyone talking, about talking!

    Following multiple cascades of the Early Voices training and through regular planned and incidental conversations with colleagues, there has been much enthusiasm for this project in Newham!

    For example, whilst the burgh distributes a new birth pack with a plastic wallet for information leaflets across a range of topics pertinent to new parents, there isn’t currently a communication leaflet in it! The inclusion of the Early Voices key strategies leaflet will change that and conversations about speech, language and communication development can be facilitated more easily as a result.

    Embracing the power of social media

    Clare, a Communication Leader in Gateshead described how a colleague had developed a Facebook page for Gateshead Health 

    With her new knowledge about speech, language and communication, she agreed to develop a weekly post for the Facebook page. She reflects here, that although it was more time consuming than expected, and a journey of discovery as a non-Facebook user, she considered it a success!










    Read the full 'embedding speech, language and communication knowledge in your practice' case study here
  • Enabling cross-service collaboration


    Organisational structures within health and education services for children and families in the early years are complex and often siloed. Communication is not owned by any one professional or group however; everyone can and should champion it. Sensitivity and respect for the knowledge base and expertise of different groups is essential for collaborative practice.

    Early Voices: opening up conversations

    Many Communication Leaders spoke about how the opportunity to cascade Early Voices training across local early years services had provided a mandate that facilitated conversations across different early years stakeholder groups - groups which had previously operated in silos as they were employed and commissioned via different routes.

    Going beyond the core health visiting team

    In Leeds, Early Voices messages are being delivered through the Pregnancy, Birth and Beyond programme. These training and support sessions are delivered at Children’s Centres mostly by health visitors, but often with some input from midwives, early start practitioners and family outreach workers.  Kirsten used the Early Voices materials in her delivery to this group who were eager to deal with parents’ growing concerns around speech, language and communication:

    The training was well received: the staff understood the benefits of children having good speech and language, but knew little of how to deliver those outcomes.

    Communication is not owned by any one profession or group, everyone can champion it

    Nina described having some mixed responses from nursery nurses when delivering her cascade trainings. Although most practitioners wanted to get involved, there were some Nursery Nurses who understandably felt that ‘this is what we do already’. In hindsight, Nina reflected that she needed to work more closely with the Nursery Nurses in order to ensure the cascade training complimented their already strong knowledge base:


    Nina reflected that a potential solution was to allocate more Communication Champions across professions. She hypothesised that this revised approach could help keep communication on the agenda across large teams by promoting it within individuals’ practice, whilst reducing the perceived expertise hierarchy between early years professionals.

    Read the full 'enabling cross-service collaboration' case study here.
  • Leading change in the workplace


    Not all parents and professionals feel confident about how to support language development and how to spot when there are concerns. Some early health structures are set up in ways that are challenging for some families to access. Systems change is needed in the early years workforce and workplaces so that more children get the right kind of support at the right time.

    Building on strengths in local practice

    After Yvonne, the Communication Leader in Redcar and Cleveland, received her Early Voices training, she was eager to cascade the learnings to her team. But before jumping in, she first reflected: how would it strengthen existing workstreams of staff development and dissemination? This contemplation revealed valuable synergies from the work they were already doing in early baby brain development, perinatal mental health and children’s readiness for school, for example. She felt that the speech, language and communication messages within Early Voices could be the common thread pulling together the good work they were already doing:

    She reflected that “[The training] has done what we set out to do, which is to try and pull this team together. But, also there is a sense of purpose now  in terms of every contact we have with families”. The strategies weren’t so much about providing key messages at one time point, but reinforcing key messages at all time points from ante-natal through the early childhood journey.

    Improving services for vulnerable families

    Clare, the Communication Leader in Gateshead, described how the Early Voices training sparked conversations around the lack of specific work targeted at vulnerable families. The authority wanted to develop pathways where they could offer additional resources and programmes of work for the early years practitioners.  This prompted the Communication Champion to be invited to deliver the Early Voices training for the Early Help under-fives team:

    The three planned sessions will equip the 45 Early Help team members with the tools to support vulnerable families in speech, language and communication.

    Read the full 'leading change in the workplace' case study here.
  • SLC Changing Practice

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