NEW EVIDENCE PROVES EARLY CHILDHOOD SUPPORT WORKS

- NO LONGER A HUNCH, BUT A CERTAINTY

Gillian Cumiskey, Shane Kearney and daughter Mia. 

Photos by Preparing for Life staff.

Breaking scientific news from the world of community development: An early childhood intervention programme in north Dublin has made proven that early childhood supports truly do work. 

The team behind ‘Preparing for Life’ worked away beneath the radar for years, like many community workers do. However, they agreed to talk to 'Changing Ireland' and now feature as the lead in our Spring edition.
Alongside Ben Panter's feature, we've added news here from Northside Partnership. Three upcoming events were today announced to further explain the findings. We also include here an interview with family mentor Sarah Jane Leonard who has been involved in 'Preparing for Life' from the beginning. 

Making history with children in north Dublin

Editorial by Allen Meagher

Allen Meagher, 'Changing Ireland'

‘Preparing for Life’ is a community initiative conducted by the Northside Partnership and funded by the Department of Children and Youth Affairs and Atlantic Philanthropies. What makes it different is that, every step of the way, the work is being evaluated by a team from UCD’s Geary Institute.

And they have proven beyond doubt that early childhood support is worth its weight in gold.

For anyone working in early childhood care or development, they have scientifically measured the impact of your work. If you had a feeling you were having an impact but couldn’t swear on it before, now you have the proof. Presuming you’re doing the kind of things they do in north Dublin.

Tremendous detail is provided in analysing the results and everything is rigorously backed up by science.

The findings to date should be of interest to everyone, from parents to national policy-makers, programme-designers, trainers and lecturers, and community-based projects seeking evidence to support grant applications. They are of interest to students and indeed anyone wishing to better understand children’s development.

The material is all available online. It’s dense, yet insightful, and supported by data throughout. It will be immensely important in guiding us in the long-term.

The project focuses, for instance, on cognitive development and how best they can nurture their children in a challenging environment.

The programme recognises that, “Disadvantage is often associated with lower cognitive resources which can be a difficult intergenerational cycle to break.”

On this issue, the team have made a breakthrough. Their interventions are working. Children receiving support show better cognitive outcomes and this is but one example.

Early childhood interventions can be better targetted as proof emerges about what works best. It should now also be easier to campaign for increased funding to help young children grow and develop to their full potential.

PROOF THAT EARLY CHILDHOOD INTERVENTION WORKS

- Study has “important policy consequences”

Ben Panter, journalist

BY BEN PANTER

A pioneering project - conducted by the Northside Partnership in Dublin and evaluated by UCD - is Ireland’s biggest random control study into the effects of intervention in early childhood. It involves 200 families, has been running for nine years and supports social, emotional and behavioural development, literacy, physical health and cognitive health.

It has also produced evidence that early intervention works. The latest research  - published in January - documents outcomes for children who have participated in the programme from birth up to age four..

The need locally for early childhood intervention was first identified after a 2004 study (Murphy et al) in the Northside area found that half the children starting school lacked skills considered essential for education. The target area includes all of Dublin 17 and parts of Dublin 5.

The study revealed that language, communication, cognitive development and general knowledge were all areas that needed to be addressed.

As fortune would have it, around this time Atlantic Philanthropies (AP) had expressed a desire to invest in programmes for children and youths in Ireland.

The Northside Partnership was asked to submit a proposal and focused on early childhood.

“There is now a lot of evidence to suggest that intervention is better than crisis management later on,” programme manager Noel Kelly told ‘Changing Ireland’.

“Children are more likely to be ready when they go to school, this results in higher educational attainment and a decreased likelihood that they will suffer from addiction, mental health issues and anti-social behaviour.”

Much of his team’s initial work was informed by the research of Prof. James Heckman, a Nobel winner from the USA. He was among the first to provide evidence that investing in early childhood care was a most productive use of resources.

The Department of Children and Youth Affairs got behind the Northside Partnership in supporting the programme alongside AP with five years of funding (through the Area-Based Childhood Programme).

Above: Amber Ward.

In a project that will have such a long term impact on the lives of its participants, mistakes were not an option. Preparation was essential.     

It was not until 2007 that the programme began in earnest and even then it was a further two years until fieldwork began. Why did it take so long?

Noel said, “We had to be absolutely sure we were not doing harm, yet we had to be sure it worked. The debate raged long and hard and now we can say that this study can stand up to international scrutiny.”

There were huge ethical concerns. The programme involved Randomised Control Trials (RCT) which meant splitting volunteer parents into two groups, all with different levels of intervention.

This presented a dilemma for those involved with the project.

As mentor team leader, Val Smith recalled: “There were concerns, we had two groups of families and all of them would be needy, one group would get the services (but not the other) and we thought that clearly that can’t be right.

“The answer to that was; we actually don’t know whether the programme is going to be doing any good or not, so we are not actually (knowingly) denying anyone anything.”

Orla Doyle, economics lecturer in UCD and the principal investigator on the ‘Preparing for Life’ research team emphasised the importance of the control group: “The study was unique in an Irish setting because most evaluations of early childhood intervention were not tested rigorously.

“The RCT evaluation design ensures that any impact we identify has been generated by the programme, we can definitively say that any outcomes are a result of this intervention.”

With these concerns addressed to the satisfaction of the team, they began the arduous search for willing participants.

“We didn’t have a mandate, we are not TUSLA and we had to win over parents’ trust,” said Noel.

“Parents volunteered, we had to meet them in the maternity hospital which was very time-consuming. We had to do all the footwork and physically meet them. It was successful though, 52% of parents joined,” he said.

David Burns, Gemma Dwyer and daughter Ava.

It was not all plain sailing. Since the programme is voluntary, parents are under no obligation to see it through to the end, according to Val Smith.

“Five years is an awful long time and it can be difficult to keep people actively engaged. There were incentives to get people to sign up and people were joining because of that and it is difficult to keep them engaged.”

A cost benefit analysis is currently underway and the results should be known in September.

Meanwhile, the programme has secured a second phase of funding and over 140 parents have already signed up.

The programme recognises that, “Disadvantage is often associated with lower cognitive resources which can be a difficult intergenerational cycle to break.”

“Regarding child development, the programme was most beneficial for the children of first time mothers and the children of mothers with lower cognitive resources,” state the researchers.

“This is a positive development for the programme with important policy consequences,” they humbly point out.

For more info, contact Melanie Murphy.

E: melanie.murphy@nspartnership.ie

T: 01-8771509.

W: preparingforlife.ie

Sample findings 

BY ALLEN MEAGHER

Each family was part of a group receiving either high or low levels of support and after an 18-month period, researchers made the following discoveries:

·       Children in the high treatment group displayed a higher level of gross motor skills.

·       They were less likely to be at risk of socio-emotional and cognitive delay compared to those in the low treatment group.

·       They had more appropriate eating patterns, were less likely to be hospitalised and had better mother-reported health.

·       Mothers in the high treatment group were more likely to have positive interactions with their children.

·       The home environment was more likely to be appropriate and safe for those in the high treatment group, most notably in the realms of appropriate behaviours toward children, overall health and safety of the environment and the availability of age-appropriate learning materials.

·       Download the 18 months report, a PDF, here: http://bit.ly/1VJEtZU

So, what kind of support is provided?

For example, children internalise and externalise problems. As well as measuring this, the team provided parents with ‘Tip Sheets’ to help them encourage their children to express emotions. This aimed “to offset children’s communication problems which, if left unchecked, could lead to clinical levels of internalising or externalising behaviours.”

At 48 months, results generally - from 217 interviews - were less stark than before.

Children in the high level support group did nonetheless clearly demonstrate “positive programme effects in the areas of cognitive development, behaviour, and fine motor skills”.

There was “some evidence of consistency over time, particularly in the areas of cognitive development, behaviour and age-appropriate skills”, the researchers said.

However, some of the positive effects on children’s behaviour observed at both 24 and 36 months were no longer evident at 48 months.

The research team partly attributed this to flagging interest and involvement in the fourth year of engagement by some parents. The studies continue.

For this, and so much more, visit the website. W: geary.ucd.ie/preparingforlife/

‘Preparing for Life’ events to share their good news

In the coming months, Preparing for Life will host a series of events to share the findings from the random control trial research project by the UCD Geary Institute which has followed the journey of the original 200 Preparing for Life families since 2008. The research project set out to determine whether the programme's approaches have helped to improve children's school readiness. 

- The following three updates were first published on April 13, 2016, in Northside Partnership’s newsletter.

1. Research Seminars at the Mansion House, May 17th:

A series of short seminars will provide an overview of specific aspects of the Preparing for Life study beginning with "Preparing for Life - Results for Children at 48 Months" on Tuesday, 17th May from 11am to 1pm. A second seminar will focus on the "Children's Profile at School Entry Study & Child Health Results" and will take place on Wednesday, 22nd June from 11am to 1pm. To register, email melanie.murphy@nspartnership.ie.

2. Academic Conference at UCD, Aug 31st:

"Preparing for Life - The Results" is a one-day academic conference that will provide a more detailed insight into all aspects of the Preparing for Life study since 2008 together with keynote addresses from Professor Richard Tremblay of the University of Montreal / UCD and Professor Hirokazu Yoshikawa of New York University. It will take place on Wednesday, 31st August from 9am to 3.30pm. Click here to register.

3. Community Celebration in Darndale, 1^st week in September:

The research launch calendar will culminate with a special community event in the first week of September in Darndale Community Hall (a final date is yet to be confirmed). This event will focus on thanking the 200 families who took part in the study together with all of the project's partners and supporters within the community.

1-to-1 INTERVIEW

- with Sarah Jane Leonard, Family Mentor (pictured)

Sarah Jane Leonard is a Family Mentor with Preparing for Life's Home Visiting programme. She has worked with Northside Partnership for 20 years and with Preparing for Life since 2008. Mentors work alongside families from pregnancy to when the child starts school. They provide information on child development and parenting, with the aim of improving school readiness. Below, she describes what this role entails.

- This interview was originally published on April 13, 2016, in Northside Partnership’s newsletter.

Describe an average day?

Most days are 8.30am – 4.30pm. I divide my time between our Darndale and Coolock office, but primarily my work is in the family's home. On a typical day I have up to four appointments with my families who are mostly pregnant women and mothers with young children. Depending on their preferences, we meet in their home or a neutral spot like a coffee shop. I also sometimes meet clients in the evening, if they work during the day

The aim of the home visits is to support the parents to be proactive in their parenting role and in meeting the needs of their child. Key child development and parenting issues are addressed using a set of PFL-developed Tip Sheets. We have developed these based on current research and guidelines and we hand them to the parents at each visit. Parents can ask me anything about parenting and child development but I remind them that they are the expert. Boundaries are essential to this role. I also deliver the Triple P programme which helps parents with positive parenting strategies. 

There is also paperwork involved in my role so when I go back to the office I need to maintain case files on our database. On occasion, I also link in with other services working with a family to ensure that all agencies are working together and that everything is transparent.

What do you enjoy most about your role?  

I am very passionate and committed to what I do. I love my job, every day is different. The best part is when I see parents making changes and acknowledging that change. 

A fundamental part of my job is building relationships based on mutual respect and confidentiality. As mentors, we never tell them what to do. We give parents information so that they can make more informed choices and decisions about their children. We like to encourage parents to enjoy their children and to talk to them. 

What personal characteristics should a family mentor have?

I listen and never judge, which helps build relationships. One thing I know is important and that works well is prompting parents to come up with solutions for themselves. Also to give praise and feedback, if necessary. I ask questions like what do you think you could have done differently there? That’s part of our training. One size doesn’t fit all, in helping a family to reach their own solution.