Spending on speech and language therapy has fallen in many areas of the country and children in need of SLT are subject to a postcode lottery of provision because of huge disparities across England, research has found.

The study by the children’s commissioner for England, Anne Longfield, says that too many vulnerable young children are missing out on vital support in their earliest years, with far-reaching implications for their progress and life chances.

It is the first time data has been brought together from councils and clinical commissioning groups (CCGs), who jointly commission SLT services, to show how much different regions spend.

Taking into account population growth and inflation, the report finds that real-terms spending on speech and language services has decreased in three out of five areas of the country.

While the top 25% of spending areas in England invest more than £16 per child, the lowest 25% spend just 58p or less. For children with an identified speech and language need, some areas spend £300 per pupil, compared with just £30 in others.

“In this report, I found that there is enormous variation in spending around the country on speech and language services,” the commissioner said. “I am concerned that this means a postcode lottery for children who need this vital help.”

She said some children had been waiting months for support. “We should be very concerned that almost one in five children aged five is behind in speech and language development, and yet more than half of areas in England have seen a real-terms fall in spending on speech and language therapy in recent years.

“Those who fail to receive help are at greater risk of falling behind in education, or developing behavioural problems. There are far too many children who have ended up in youth custody who had speech and language problems at school.”

According to the report, entitled “We need to talk: access to speech and language therapy”, the total spend on SLT services for 2018-19 is estimated at £166m, equivalent to just over £10 per child. Only 23% of areas had a real-terms increase in spend per child, while 57% of areas saw a reduction.

Urban areas tend to spend more than rural areas. Local authority spend per child is highest in London, at just over £7 per pupil, with the south-east just behind at a little under £6. It is lowest in the east Midlands, which spends 34p, and the West Midlands (90p).

Generally, CCGs fund the bulk of spending on SLT. The north of England has the highest CCG spend per child at just under £18, followed by London, at just over £17. The lowest CCG spend per child is in the Midlands and East NHS region (just over £10) followed by the south of England (just under £14).

A government spokesperson said: “As part of the NHS’s long-term plan, we are working to improve support for children and young people, including considering how to ensure we have the right numbers of speech and language therapists to meet demand.

“We are boosting local early-years services with £8.5m to help establish best practice and are providing £50m to develop more high-quality school-based nursery provision for disadvantaged children, £26m to set up a network of English hubs and a national training centre, and £20m on the professional development of early-years practitioners – ensuring every child can thrive.”

James Bowen, director of policy at the National Association of Head Teachers, said: “Children’s early speech and language skills are the foundations upon which all future learning is built. If children fall behind in the early years, it can prove difficult, often impossible, for them to catch up later, even with additional help.

“Early intervention is key, but schools are finding it harder and harder to access specialist help from speech and language therapists, as both school budgets and local authority budgets are cut.”