Poor language is linked to poor behaviour even in very young children. 2 in 3 language delayed 3 year olds have behaviour problems

Randomised Controlled Trial



As a result of the encouraging findings from the ToTT pilot study, The Communication Trust was awarded a grant from the Education Endowment Foundation (EEF) to conduct a further comprehensive research study into the ToTT school-wide approach to improving speech, language and communication support.

The EEF grant funded a randomised controlled trial of ToTT between September 2013 and July 2015, to provide evidence supporting the link between speech, language and communication and educational attainment in primary school children. The primary aim of the project was to ascertain the link between ToTT and changes in literacy levels, and was independently evaluated by Queens University Belfast (QUB).

Alongside exploring the wider benefits of the approach for schools the secondary research focused on further evaluating the impact of ToTT against its' four core aims:

  • Improved speech, language and communication skills of children
  • Increased early identification of children with speech, language and communication needs
  • Increased joint working between partners across health and education
  • A sustainable approach, so that policy and practice continue to support positive outcomes

What is a randomised controlled trial?

A randomised controlled trial is thought to be one of the best ways of determining whether an intervention is working. A randomised controlled trial is different from other types of evaluation as it uses a randomly assigned control or 'business as usual' group who are matched closely to the intervention group. This enables evaluation of the effectiveness of the intervention by comparing the two groups, where one group receives the intervention and the other group does not.

What happened during the ToTT randomised controlled trial?

  • The Communication Trust successfully recruited 64 primary schools across three local authorities - Wigan, Hull and Stevenage/North Hertfordshire.
  • The language and literacy skills of pupils in all schools were independently measured in September/October 2013 by QUB
  • Schools were then randomly allocated to either the 'intervention' group or the 'control' group, with 32 schools in each group.
  • Between October 2013 and July 2015 the groups participated in the project as follows:
    • Control group schools continue 'business as usual', receiving a free targeted language intervention at the end of the project (in September 2015)
    • Intervention group schools were provided with the full ToTT whole school approach to improving speech, language and communication support including;
      • Weekly access to a ToTT speech and language therapist
      • Initial assessment, observation and analysis to look at current school approaches and strategies for supporting speech, language and communication skills
      • A bespoke package of intervention and support designed to build on current practice
      • Staff training and development sessions focusing on supporting speech, language and communication in the classroom
      • A range of targeted interventions across all key stages to facilitate improvements in children's ability to use and understand spoken language
  • Language and literacy skills of pupils in all schools were measured again by QUB in June 2015 to evaluate the link between ToTT and changes in literacy levels

What did the findings show?

The primary evaluation focusing on the impact of the ToTT RCT on reading was released by the EEF in May 2016 and is available here on the EEF website. Although there was no overall impact on reading comprehension during the four terms of the project, teachers were clear that they hoped to see improvements in reading and writing in the longer term. Teachers and senior leaders also reported positively on the wider benefits of the programme, with 88% of staff confirming that ToTT was an important addition to the provision in their school.

The independent secondary evaluation exploring the wider benefits and impact of the ToTT approach is now available here. It brings together findings from the EEF evaluation, information from an in-depth process evaluation undertaken by the University of Manchester, and data collected by schools involved in the RCT.

Most notably, the secondary evaluation research, completed by education and youth think tank LKM Co highlights that;

  • ToTT was successfully embedded into whole school structures and systems across a variety of schools, irrespective of their starting points and contexts.
  • Expert training sessions, alongside flexible and practical support provided by the speech and language therapists ensured statistically significant increases in staff's self-reported confidence in a number of areas of SLC practice.
  • The prevalence of SLC supporting practice increased in class, and practitioners reported improved confidence in supporting SLC development.
  • Teacher and TA assessments of pupils' speech and language skills became more informed and accurate; practitioners reported statistically significant increases in their confidence in a number of areas.
  • Senior leaders played a crucial role in prioritising and driving forward the programme in school; with support from senior leadership Communication Leads developed skills and expertise in SLC.   
  • TA's were instrumental in helping to embed ToTT universal and targeted approaches to SLC support across the curriculum.
  • Wide ranging benefits and improvements for all children's SLC; this included better listening, stronger vocabulary and improvements in confidence and behaviour.
  • There were statistically significant increases in the SLC skills of pupils with language delay who took part in ToTTs targeted interventions, as measured by the Progression Tools.

We're delighted that the independent secondary evaluation demonstrates so clearly and robustly that the ToTT universal and targeted approach to SLC suppoty offers an effective approach to workforce development, and leads to positive outcomes for pupils SLC. Alongside this, it presents a number of lessons we can learn to further develop our understanding of how to effectively support children and young people's language and communication.

Trust Director Octavia Holland stated, "As an organisation we know how important good quality evidence is for ensuring speech, language and communication remain a focus within the broader political and educational agenda. Through our wider work, we will aim to ensure that the evidence from Talk of the Town is translated into meaningful, practical approaches and resources for the schools workforce to maximise outcomes for children and young people."

If you'd like more information about ToTT or if you have any queries, please contact Theresa Redmond, TCT Professional Advisor (tredmond@thecommunicationtrust.org.uk). More information about the Talk of the Town model and approach can also be found here

The EEF is a major grant-making charity dedicated to raising the attainment of disadvantaged pupils in English primary and secondary schools. Their vision is to break the link between family background and educational achievement, ensuring that pupils from all backgrounds have the opportunity to fulfil their aspirations and make the most of their talents.