Off to a better start: what we know about early intervention services.

Author:Sykora, Joan
 
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Abstract

In New Zealand and elsewhere, evaluations of early intervention programmes indicate that long-term, positive outcomes can be achieved and sustained by children participating in high-quality early care and education. Recognising the importance of getting children off to a good start in life, the Ministry of Social Development is building capacity throughout New Zealand to provide a variety of early intervention services to families. A review of the international literature on best practices and programme quality revealed that there is much to learn from the experiences of programmes that have been rigorously studied. This paper reports on that review, emphasising eight key elements of early intervention services that can be provided to families to help strengthen the long-term development and wellbeing of children. These factors are programme quality, personnel and staffing issues, range of services, timing of service provision, duration of service delivery, intensity of services, location of services, and engagement and retention of families in services.

INTRODUCTION

The recent advancement of research on childhood development and intervention strategies that support healthy development has been remarkable and enlightening. The earliest years of life are now recognised as a critical time in human development, and government policies and services are reflecting this knowledge.

The "nature vs. nurture" debate can be put to rest as a result of this research. We now know that as development unfolds it is influenced by both genetic make-up and human experience and, in particular, by the interplay between the two (Shonkoff and Phillips 2000). The debate about the value and effectiveness of early childhood interventions can be put to rest as well. We now have overwhelmingly clear evidence about what children need for healthy development, what puts them at risk for poor life outcomes, and what protects them and helps build resiliency (Buddulph et al. 2003, Currie 2000, Gray 2001, 2003, Kali12003, Karoly 1998, Masten and Powell 2003, NICHD 2001, Ramey and Ramey 1998, Reynolds 2000, Shonkoff and Phillips, 2000, 2003, Shonkoff and Meisels 2003, Smith 2000, Yoshikawa 1995). We move now to the question of how to assure that all children have opportunities for healthy growth and development from conception onward (Grunewald and Rolnick 2005, Ramey and Ramey 1998, Shonkoff and Phillips 2000).

The bulk of the research on early intervention services has focused on vulnerable families who are less likely to have the opportunities to ensure their children get off to a good start in life. Early intervention services have the potential to turn this around and get those children off to a better start in life, and on a better path to a better future (Gray 2003, Karoly et al. 1998, Ramey and Ramey 1998, Seibenbruner 2002, Shonkoff and Meisels 2003).

Supporting vulnerable families to obtain what is necessary for their children will ultimately benefit these individuals and the wider society as well. In addition to improving the lives of children over time,

research suggests that early intervention programmes for vulnerable children have the potential to yield at least four types of savings to government and society:

* greater tax revenues from an increase in participants' earnings and rates of employment later in life

* lower welfare outlays

* reduced expenditure for social services, health and other services--later in life when services are typically more expensive

* lower criminal justice system costs (Karoly et al. 1998).

Decisions regarding where to invest limited public resources confront policy makers on a daily basis. It is their job to ensure that those endeavours have adequate pay-offs and yield high public returns. Taking an economic perspective on the contribution that early childhood interventions can make to a society, Rolnick and Grunewald (2003, Grunewald and Rolnick 2005) report that for the long-term betterment of a society there are few economic development strategies that can yield a higher level of benefit than investing in getting children off to a good start in life.

The Ministry of Social Development is concerned with the process of getting and keeping all New Zealand children on positive developmental trajectories. A critical review of the early intervention literature was completed for the purpose of identifying what has worked in New Zealand and elsewhere to create and sustain improved life outcomes for vulnerable children. This article presents some of the highlights of that review, particularly those that are relevant to public policies linked to improved outcomes for vulnerable children.

BACKGROUND

Early intervention services include a range of care, support and educational services for infants and young children, in tandem with education and support for parents. The theory behind early intervention programmes is that by providing certain services and supports, the outcomes children achieve over their life course can be significantly improved. The more the "odds are stacked against" a child, the more important interventions become. By helping these children build resiliency, avoid risky behaviours and link to protective supports, the research shows that we are able to support them getting off to a better start in life, and ultimately to better life experiences (Masten and Powell 2003, Seibenbruner 2002).

In New Zealand, Parents as First Teachers is an early intervention programme based on the belief that parents are their children's first and most important teachers. Support is provided to children from birth to three years of age and their families. Workers provide support and guidance to parents individually and in groups. In the New Zealand Family Start programme, early intervention services are targeted to "at risk" families in urban locations throughout the country. Home visits are made by a family/whanau worker who helps both parents and children. The family/whanau worker also serves the family as a coordinator between the other agencies with which the family might be involved.

This literature review concentrated on early intervention services specifically for vulnerable children and their families. "Vulnerable" is defined as those who face greater risk for poor outcomes than the general population. The literature is scattered with various terms such as "at risk", "disadvantaged" and "fragile". The term "vulnerable" was chosen for this literature review, although the review covers literature that includes all of these terms (Barrett 2003, Brooks-Gunn 2000).

Method

The foundation of this literature review was the collection and review of literature from a variety of peer-reviewed journals, along with other high-quality academic publications and government documents. Selection of the literature was based on methodological quality and credibility, which was reviewed for each study, document or institution. As such, only well-designed and implemented research was selected for review. This included qualitative, quantitative and mixed-method research designs. Longitudinal studies were favoured as providing more substantive information on long-term outcomes. Studies of early interventions for young children track various outcome domains, such as increased cognitive ability or reduced...

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