Latest publications:
Equity for All: Children's Speech and Language Therapy Services in Scotland

Download the Equity For All report
We are delighted to publish Equity for All: Children's Speech and Language Therapy Services in Scotland, a thematic report commissioned by the Scottish Government to provide a comprehensive understanding of the speech, language and communication needs of children and young people in Scotland and the speech and language therapy provision to meet this need. The report summarises data collected within the Balanced System® Framework in an iterative process engaging with all 14 Health Board areas and therefore presents a complete picture for Scotland.
Four key themes are considered in the report:
- The need for to address inconsistency of support relative to need from one area to another
- The need to measure the impact of service provision
- The need for integration of systems for children and young people across health, education and social care
- The need to develop the workforce to meet need with flexible skills and competences
We want to thank the speech and language therapy services for their participation which facilitated the collection of this national dataset. We are aware that the process of supporting services to better understand the needs of their population and systems to maximise impact has already affected change in a number of Health Board areas.
We are delighted that the recommendations will inform the newly established Interim Speech and Language Communication Response Group, a short life working group within the Directorate for Children and Families at Scottish Government.
We should also like to thank Carolyn McDonald, Chief Allied Health Professions Officer for her foreword introducing the report and Pauline Beirne, National Lead Allied Health Professional for Children and Young People, for her support and facilitation of engagement with services across Scotland.
Carolyn said: “For me, the evidence around predicted need shines a light on what we intrinsically know through implementation of our Ready to Act Strategy; the value of targeted support for those most in need, joint partnership working and improved outcomes-based service planning have all been associated with improved outcomes for children with communication needs.”
Glenn Carter, Royal College of Speech and Language Therapists’ Head of Scotland office, says: “We welcome the report and its recommendations and we look forward to working with the Scottish Government and local services across the country to tackle these issues together. Real action is needed to address major health inequalities and improve the outcomes for children and young people with communication needs.”
The report is authored by Better Communication CIC Director, Marie Gascoigne. Thanks also to Claire Welburn, Data Analyst, and Victoria Riley-Hill, Senior Associate, for their work supporting services to capture their data.

Welcome to Better Communication CIC
Supporting change in systems so that children and young people, and their families, are helped by the right people, in the right place at the right time.
Better Communication is a Community Interest Company - a not-for-profit organisation which was initially formed to support the implementation of change in the commissioning and provision of services for children and young people with speech, language and communication needs (SLCN) but has evolved to also work across other areas of need that benefit from the Balanced System® approach. Better Communication CIC is committed to enhancing the evidence base around the factors which really make a difference in terms of impact for children and young people.
Our aim is simple: to make the best use of resources to ensure that the right people work with the right children in the right place and at the right time.
Better Communication CIC was established by Marie Gascoigne in 2011 in order to provide a focus to bring together a team of associates with a wide range of expertise and backgrounds in order to provide, commissioners, provider organisations, leaders and practitioners with access to training, advice and support to implement change.
The work of Better Communication CIC uses the Balanced System® Framework. The Balanced System® is an outcomes-based, whole system approach to the delivery of integrated services developed by Marie Gascoigne over the past twenty years. The core concepts remain true but the framework and supporting resources have continued to develop in response to the changing context and requests to consider new applications.
The Balanced System® Schools and Settings accreditation scheme was established in 2014 in partnership with NAPLIC and Afasic. In 2020, the Balanced System® Pathway Tool was developed as part of the Early Outcomes Fund project in the East Midlands with Nottingham, Derby and Leicester Cities. This has since expanded to include Worcestershire and further areas are in the process of moving to using the Pathway as a means of supporting parents and practitioners to find the resources and advice most relevant to them. Work is currently underway to develop a platform to support services, schools, settings, parents and carers to capture impact of support across the integrated system - Prove it! will be available in the autumn of 2022.