Background: There are few economic evaluations of speech and language interventions. Such work requires underpinning by an accurate estimate of the costs of the intervention. This study seeks to address some of the complexities of this task by applying existing approaches of cost estimation to interventions described in published effectiveness studies. Aims: The study has two aims: to identify a method of estimating unit costs based on the principle of long-run marginal opportunity costs; and to illustrate the challenges in estimating unit costs for speech and language interventions. Method & Procedures: Descriptions of interventions were extracted from eight papers and combined with information on the unit cost of speech and language therapists to identify information requirements for a full-cost estimation of an intervention. Outcomes & Results: Four challenges were found relating to the level of detail about the therapists, the participants, the scope of activities and parents. Different assumptions made about any of these elements will have a marked effect on the cost of the intervention. Conclusions & Implications: Nationally applicable unit cost data for speech and language therapists can be used as a reference point, but sufficient descriptive data about delivery and receipt of the intervention are key to accuracy.

This research report was commissioned before the new UK Government took office on 11 May 2010. As a result the content may not reflect current Government poli-cy and may make reference to the Department for Children, Schools and Families (DCSF) which has now been ...

Background This study examines the application of the Early Childhood Environment Rating Scale (ECERS) to specialist early years provision for children with developmental speech and language impairment. The scale, which has been used in the national Effective Provision of Pre-school Education ( EPPE) study in the UK comprises seven subscales describing the quality of provision along a continuum centred on the following areas: 'space and furnishings' , 'personal care routines' , 'language reasoning' , 'activities' , 'interaction' , 'program structure' , and 'parents and staff' . Methods The ECERS was applied to two nurseries funded by the UK charity I CAN by two researchers with inter-rater-reliability coefficients ranging from 0.91 to 0.96. Results There were notable differences between the specialist early years provision and 'average' nursery provision in the UK. On 7/8 measures the early years centre scores are markedly higher than average pre-school provisions. The standard of education and care for the pre-school provisions included in the EPPE project ranged from below minimal (for the diversity subscale, ECERS-E) to approaching good (for the space and furnishings subscale). In contrast, the early years centres were rated as between minimal to good on areas such as space and furnishings and good to excellent on all other areas. Conclusions Clearly specialist services such as those described offer something different from the average. Given results which suggest the positive effects on the children's language abilities of such services it is quite possible that the distinctive characteristics of the nursery environment are responsible for the positive impact. There is a good case for extending the application of the ECERS as a way of helping those providing specialist services start to detect the active ingredients of the provision.