Experienced West Midlands based speech & language therapy

Tuesday, March 31, 2020

Objective-setting learning and where it fits

Theme III [at the end of part I] mentioned SEND – with particular reference to speech, language & communication difficulties [SLCN].  The key points here are that these children will have been identified as either already behind, or at risk of falling behind.  We know there is a problem.  We also know, as research projects continue to confirm, that early identification and intervention is absolutely crucial.  There are many, many references to this in recent and not so recent literature. 

Best practice in any setting is to have a tried and tested way of keeping track of children’s progress – screening for speech, language and communication development is no different.  For a number of years now Soundswell has endorsed the value of the Wellcomm Early Years speech and language screening and intervention toolkit:  it’s easy to use and it does what it ‘says on the tin’.  However, whatever you choose to use should lead you to the best way to support those children who are not keeping pace with their peers.  It should also allow you to measure progress.

Interventions need to take account of a number of different things [let’s call them ‘variables’].  Children with SLCN very often have additional needs: it’s important to know that as it will help you set objectives and also influence whether grouping certain children together will work.

You will notice that the language used to talk about activities has changed: there are references to ‘interventions’, ‘objectives’ & outcomes.

It is not impossible to adopt an ITM approach to deliver targeted interventions.  As a therapist I could give it a try but it certainly wouldn’t be the first choice!  There are some good reasons for this.

To be successful, ITM is challenging enough when supporting and enhancing normal development.  The reasons for this have been thoroughly discussed in parts I & II of this article.  In part II we have said that ‘staff would need the various targets for individuals at their fingertips so they can exploit the child’s choice of activity as a way to facilitate whatever it is that the child needs to improve/develop’.  Therapists would find that pretty testing!

I absolutely understand that very strong advocates of ITM may take some convincing that there is another [possibly more effective] way of supporting SLCN.  But – here goes anyway…..!


There are articles who debate the merits of both approaches.  We asked our team of therapists to peruse some of the literature and provide a balanced view.  Here are some examples:


Here the author/s are saying that both of these approaches are effective, ‘in the moment’ more so, for children without identified needs. These approaches will follow the child’s lead and incorporate the principles of good adult child interaction strategies [ACI].  However, as therapists, we know that this is not enough for children aged 3 & 4 who present with language difficulties.



The authors here acknowledge that ITM has much to recommend it- but again not in isolation and not for all children.  They mention the need for some adult-lead activities and trying to get a balance between adult and child led.


This article provides an accessible easy read with lots of practical pointers.  We are asking practitioners to consider the ‘what to do’ within the context of what is known about SLCN and how to deliver successful interventions.

Undisputedly ‘Good observations of the child and following the child’s interests’ is important however this alone may not lend itself to the adult being able to incorporate the necessary language targets into the chosen activity [we have talked about this earlier].  The approach is less about planning and more about ‘enhancement’ and, within the context of the Soundswell Pyramid would feature at tier 1 (universal).  Therapy appears in tiers 2 [&/or 3] – interventions targeted at an identified problem.

Here are some key strategies with some additional therapist explanation:

  • Observe and listen closely to every child that you are focusing on’ – yes absolutely!
  • Ask open-ended questions. These are usually ‘How’ or ‘Why’ questions, and they should never have a yes or no answer.

Blank hierarchy of questions (Dr Marian Blank https://wisewordsaustralia.com.au/levels-of-questioning) research shows that 60% of 3-year olds understand level 1 and 2 questions, 65% of 5-year olds understand level 3 and 4 questions. The example questions suggested here are level 4 questions.  Many nursery-aged children will not be understanding at this level, children who have been identified as moderately and significantly behind their peers may well be struggling with blank 1 and 2.  Staff will need training to understand the development of questions to ensure questions can be targeted to the children’s language level.

  • If you’re not able to dedicate the time to each child, consider having focus children each week who you give your full attention to. This could be as little as 10% of your cohort.

Again, for the moderately and significantly behind groups, once a week will not impact sufficiently to make a sustainable difference.

  • Always go to the child. By asking them to come to you, you are disrupting the flow of their play.

Agreed, for many children who are developing as expected.  The child with SEND/SLCN will also benefit from adult-lead activities [to broaden horizons, reduce any repetitive narrow-interest focus and demonstrate what else could be done with the chosen toys].

I wonder, is there any evidence that shows that children will learn more/ make more positive gains through ‘in the moment’ vs withdrawal/ more targeted input?  The rationale for withdrawal for some children would be an assumption that they will achieve more progress……this would be an excellent opportunity for some kind of a comparison study!

Every setting is different, and you need to experiment to find out what works for you. Don’t be disheartened if it doesn’t feel right from day one, these things take time.

Absolutely – but do take account of what is already out there in terms of knowledge and skills and knowing what works well and when. 

  • Be clear about what practitioners need to deliver ITM effectively and make sure they are equipped
  • Ensure practitioner knowledge about normal development is robust [if not, spotting the problems and doing something about them can be hit and miss]
  • Learn how to both identify and support SLCN – embrace an objective-lead approach to deliver effectively
  • Be brave enough to advocate an eclectic approach!  This certainly isn’t the easiest route – but has the potential to be by far the most effective if done properly
  • Visit the Soundswell nursery model (click here) where there are toolboxes at all three levels, identifying strategies and interventions to support speech, language and communication development.  ITM has an important place at universal level – its effective deployment delivering the very best of adult child interaction strategies [ACI].