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Hertfordshire Community NHS Trust's Speech and Language Therapy Early Years team have been awarded the Early Intervention and Prevention for Children, Young People and Families Award at the HSJ Award 2025 for its 'FOLLOW' initiative. Here the team explain how FOLLOW works to improve outcomes for babies and children by empowering parents and professionals to support children's communication skills. 

Communication is a fundamental life skill. We know that 1.9 million children have speech and language needs with up to 1 in 5 starting school without adequate language skills. When children don’t have access to the right support, this has a huge impact on their education, their ability to make friends, their mental health and their future employment.

Looking at our local Hertfordshire data, 30% of children are starting school not achieving a ‘good level of development’ and we’ve seen a 60% rise in speech and language therapy referrals in the last three years. This data was both concerning and challenging, but we know the research shows us that many language difficulties can be prevented, so we took action. 

We developed the FOLLOW initiative so that families and early years professionals can start supporting a child's communication skills immediately, which we know makes a positive difference to a child's development and outcomes. 

What is FOLLOW and how does it work?

FOLLOW is an acronym for six key evidence based strategies that parents, carers and early years professionals can use with children to help support and develop their language skills. It stands for:

• Face to face - Get down to your child's level
• Observe - Observe what your child is playing with and following their lead
• Label — Label what your child is playing with using single words and phrase
• Limit questions - Limit the number of questions you ask your child — use comments instead
• Opportunities - Create natural communication opportunities with everyday acivities
• Wait — Wait and pause to give your child the time and chance to communicate

These simple strategies can be used anywhere, anytime and in any situation. We wanted to make them as accessible and easy to implement as possible, so we created an engaging webinar and an eye-catching postcard to share the message. 

FOLLOW is embedded across all three tiers of our speech and language therapy (SLT) service model in Hertfordshire:

Universal Level

All parents, carers and early years professionals can instantly access our FOLLOW postcard and short webinar.

Early Years Professionals can learn how to use FOLLOW with all children in their settings through our ‘Talking With Children’ training which includes access to adult-child interaction video coaching with a therapist.

Targeted Level 

The Speech and Language Therapy team devised and set up Early Talk language groups which are delivered by Hertfordshire One YMCA family support centre staff. FOLLOW is the key message shared during Early Talk which is for children aged 20 months to 3 years who are at risk of or who have language difficulties. 

Specialist Level

For children who require specialist support, an enhanced version of FOLLOW is the foundation of adult-child interaction coaching sessions.

How it’s been shared

We have collaborated with our stakeholders to get the FOLLOW message out to as many families and settings as possible. Health visitors and public health nurses now share FOLLOW with parents and carers during 2 year development checks. We deliver training on FOLLOW to pre-schools, nurseries, schools and GPs.

We are part of Hertfordshire County Council’s FOLLOW campaign with education, libraries, Herts Parent/Carer Involvement group, our public health nursing team and Herts for Learning. Within this campaign every child going into reception was given a FOLLOW bookmark and a digital FOLLOW resource was created.

Nationally, we shared the FOLLOW message at a Royal College of Speech and Language Therapists' Clinical Excellence Network, a BBC Tiny Happy People event and at the Institute for Health Visiting Conference.

Outcomes

A major outcome is that no-one has to wait to see a therapist to start supporting their child’s communication as families can access immediate advice.

Outcomes from Early Talk (gathered via parent feedback surveys in the past year) demonstrate the positive impact of the FOLLOW initiative:

• 100% of families reported they feel confident in using FOLLOW
• 91% reported progress in their child's language skills after just 6 weeks
• Only 13% of children who attended Early Talk needed a referral for specialist SLT assessment

Early Talk is enabling over 700 children a year to quickly receive language intervention.

What next?

Having created the FOLLOW resources to support early language development, we have replicated this format and now have webinars and postcards with strategies to support social interaction, communication and speech sound development.

We are continuing to work on projects incorporating FOLLOW with our stakeholders with the ultimate goal of increasing the ‘good level of development’ for children in Hertfordshire.

We hope to work with our wider network to help improve language outcomes for babies and children by making the FOLLOW strategies accessible to more families and professionals across the UK.

For more information please contact Cathy Gough and Becky Robinson, Early Years Lead Speech and Language Therapists at Hertfordshire Community NHS Trust on hct.sltearlyyears@nhs.net