Wider wellbeing issuesThe report also identified broader challenges linked to communication needs:Nine in ten practitioners reported children struggling with friendships, social engagement and experiencing tantrums at school. Three-quarters reported children showing anxiety about speaking, while more than half worked with children who were refusing school. Pandemic impactPractitioners widely attributed many of these difficulties to the pandemic, particularly the loss of crucial early social interaction during lockdowns. Increased anxiety about the outside world and reduced parental capacity during home-working were also seen as contributing factors. Teachers, classroom assistants and ALNCos were more likely than speech and language therapists (SLTs) to report insufficient training and to flag staff shortages as a barrier.