Early Intervention In
Childhood Setting
Clare Messenger
Implementation Advisor, The Early Intervention Foundation
What I will talk about
• The Early Intervention Foundation
• The importance of early intervention in early years
• Integrated systems for early years
WHO WE ARE…
EIF launched on 4th July 2013 as a charity and a What Works Centre
We promote Early Intervention to:
• Tackle the root causes of social problems
• Improve children’s life-chances, breaking the often intergenerational
cycle of disadvantage
• Reduce the cost of failure to the taxpayer
WHAT WE DO….
Assess - what works – to determine both the best early interventions available and
their relative value for money
Advice - to commissioners, providers and investors on the best practical,
evidence-based measures, enabling them to make the best choices to support
children and families
Advocate - for early intervention as a serious alternative to the more widespread
expensive and ineffective late intervention
WHAT IS EARLY INTERVENTION
• Early Intervention is about getting additional,
timely and effective support to children who need
it – enabling children to flourish and preventing
costly, long-term and damaging outcomes
• Programmes, Practices and Systems to prevent
social cost and personal harm for children and
young people, from conception to early adulthood.
• Early Years AND “Early” activity
WHY IS EARLY INTERVENTION IMPORTANT
 £70,000 – the cost of each child with untreated behavioural
problems, 10 times the cost of children without behavioural problems
 £59,000 - the average annual cost for a young person to be placed in
a young offenders institution
 £10m a day - the productivity loss to the state as a result of youth
unemployment
 £2.9bn – the current total cost of children in care, half of which is
spent with dealing with children who have been abused
 Source: Early Intervention: The Next Steps, report by Graham Allen MP, January 2011
Early Brain Development
• Compelling evidence
• Emotional brain largely created in the first 18 months
• At birth: 10 trillion synapses - 200 trillion by age 3 (implies rapid learning
via early life experience)
• Experience – hard wiring
• Embryo is affected by what the mother experiences eg DV
• Child’s development is affected by the responsiveness of their mother
• Parenting
• Attachment and attunement
Why intervene at a young age?
– A child’s development score at just 22 months can serve as an accurate
predictor of education outcomes at 26 years
– Vocabulary at age 5 has been found to be the best predictor of whether
children who experienced social deprivation in childhood were able to escape
poverty in later adult life.
– A study of boys assessed by nurses at age 3 as being ‘at risk’ found that they
had two and a half times as many criminal convictions as the group deemed
not to be at risk at age 21.
– Some 54% of the incidence of depression in women and 58% of suicide
attempts by women have been attributed to adverse childhood experiences,
according to a US study
Poor communication skills impact on...
Mental health
Educational achievement
•Vocabulary at 5 a
powerful predictor of
GCSE achievement
Behaviour/vulnerability
2/3 of 7-14 year olds with
serious behaviour
problems have language
impairment
Criminality
40% of 7 to 14 year olds
referred to child psychiatric
services had a language
impairment that had never
been suspected
Disadvantage Cycle
Employability
47% of employers say they can’t
get recruits with the
communication skills they need
65% of young people in
young offender
institutions have
communication
difficulties
Children from low income
families lag behind high
income counterparts by
sixteen months in vocabulary
at school entry
What Helps?
• From birth, children’s learning results from their interaction with
people around them, significantly affecting their later educational
outcomes (Roulstone, 2011)
• Good quality early relationships and secure attachment enable a
growing brain to become efficient, enhancing cognitive abilities
(National Scientific Council on the Developing Child, 2011)
• The developing brain of the baby adapts itself to the quality of the
relationship with parents, creating neural circuits that mirror his or
her experiences (Belsky et al., 2011)
THE STILL FACE EXPERIMENT
What can we do?
• Universal preventive services
• Targeted EI for those families that need it, understand risk factors and
route causes
• Evidence based programmes
• Think EI! , improving social and emotional development and
communication skills
• Antenatal
• Universal health services, health visiting programme
• Children centres
• Early years practitioners
• Integrated approach
Family Nurse Partnership
US evaluations have found:
•48% reduction in verified cases of child abuse and neglect by the time
the children were aged 15
•56% reduction in A&E attendances for injuries and ingestions during
child’s second year of life
•28% relative reduction in all types of health care encounters during
child’s first two years of life
•79% relative reduction in the number of days that children were
hospitalised with injuries or ingestions in child’s first two years of life
Incredible Years
• to help their babies feel loved,
safe, and secure and encourage
their babies’ physical and language
development.
• The parenting group format fosters
peer support networks and shared
learning.
• Trained Incredible Years facilitators
use video clips of real-life
situational vignettes to support the
training and stimulate parenting
group discussions and practice
exercises with their babies.
• Providing Incredible Years to the 150 or o
3-year-olds at risk of conduct disorder
would cost roughly £780,000 per year
• Most of those 150 children at risk of a
conduct disorder in their third year of life
will be calling on child protection, special
education, foster care and youth justice
provisions.
• Equivalent cost of taking 20 children into
foster care for 1 year.
• If Incredible Years ensures that 21 of the
150 children do not require foster care it
pays for itself, before taking account of
any other improved outcomes.
20 PIONEERING PLACES
Blackpool
Blackburn with Darwen
Cheshire West & Chester
Croydon
Dorset
Essex
Gateshead
Greater Manchester
Newcastle
Nottingham
Poole
Plymouth
Solihull
Staffordshire
Hertfordshire
London Tri-borough
Islington
Wiltshire & Swindon
Lancashire
Worcestershire
SYSTEMS, PROGRAMMES & PRACTICE
Incredible
Years
Big
Brothers
Big Sisters
Good
Behaviour
Game
Multisystemic
Therapy
Family
Nurse
Partnership
Functional
Family
Therapy
Guiding
Good
Choices
Integrated Systems in Early Years
• Commissioning
• Governance
• Strategic and operational targeting
• Integrated assessments and delivery
• Information sharing
• Evidence based programmes
• Best and promising practice for integrated structures
• Single front door
• Integrated MA teams
• Single management structure / professional supervision
Early Intervention in Action