This paper reports the results of a one year regional pilot research project based in the North East of England. The research, funded by the Nuffield Foundation, provides detailed information about the subject knowledge, pedagogical understanding and confidence of early years professionals in relation to the development of speech and language in children under five. Our analysis of questionnaire and interview data explores whether professionals' different backgrounds, training and working contexts affect their confidence and competence in relation to speech and language development. Practitioners' needs and desires in terms of additional training and support are placed in the context of the importance of early identification of difficulties in speech, language and communication in securing the best outcomes for children and the increased emphasis on assessment in the professional role of early years practitioners, for example in terms of the new Special Needs Code of Practice.