Early Years Centres for pre-school children with primary language difficulties: what do they cost, and are they cost-effective?

Abstract

Background: High levels of early language difficulties raise practical issues about the efficient and effective means of meeting children’s needs. Persistent language difficulties place significant financial pressures on health and education services. This has led to large investment in intervention in the early years; yet, little is known about the actual and relative costs of early years provision. Aims: To profile the different costs incurred by two Early Years Centres (EYCs) partially funded by the charity I CAN and children receiving what might be termed ‘routine’ NHS speech therapy to provide an analysis of cost efficiency and equity. Methods & Procedures: Costings for service provision for 91 children (mean age 2;9) were collected. The activity of staff at each site and the cost of staff allocated to services were computed. Data on other resources were also collected. Outcomes & Results: The cost per child per session was on average £12. Despite the longer course of intervention in the first centre (10 compared with 6 weeks), the cost of the course per child was of the same order (£245 compared with £253). The annual cost of the early years provision per child was higher relative to the costs of the NHS provision, £645 compared with £181 in one EYC (A) and £462 compared with £173 in the other (B). When the cost of standard nursery provision was factored in, the difference in annual costs was rather less, with £5298 for the early years provision (EYC A) relative to £4276 in the comparison group. By contrast, the annual cost of early provision rises to £5926 relative to £8861 in the comparison group (EYC B).