1. Early Intervention In Childhood Setting
Clare Messenger
Implementation Advisor, The Early Intervention Foundation
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2. What I will talk about The Early Intervention Foundation
The importance of early intervention in early years
Integrated systems for early years

3. 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

4. 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

5. 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
So what do we see as EI – there are many definitions and this is something that you will need to agree with yourselves and across partners
We see Ei as ……..
What we are going to talk about today is the importance of early intervention at an early age
This of course also means supporting the parents and parents to be – so instantly we are talking over generations
What we focus on…..
Social and emotional well being
Language and communication skills
Self-management and control
Mental health

6. 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
So to remind ourselves of why EI is so important - these show some financial costs that are a result of not intervening early – much if these costs can be prevented

7. Early Brain Development
Compelling evidence
Emotional brain largely created in the first 18 months
At birth: 10 trillion synapses 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
Works via neurons (brain cells) & synapses (connections)
We know a lot more about the brain development now
Compelling evidence of how important the eely years are in terms of maximising development

8. 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
Many of the costly and damaging social problems in society are created because we are not giving children the right type of support in their earliest years and as they grow up and become parents themselves -
Here are some things that we know happen if we don’t get the right support at the right time – many studies to show how important it is to get the right support for very young children and that if we don’t get this right then the implications are huge
………..

9. Poor communication skills impact on...
Mental health
Behaviour/vulnerability
Educational achievement
40% of 7 to 14 year olds referred to child psychiatric services had a language impairment that had never been suspected
Vocabulary at 5 a powerful predictor of GCSE achievement
2/3 of 7-14 year olds with serious behaviour problems have language impairment
Criminality
Disadvantage Cycle
Employability
Children from low income families lag behind high income counterparts by sixteen months in vocabulary at school entry
65% of young people in young offender institutions have communication difficulties
47% of employers say they can’t get recruits with the communication skills they need

10. 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)

11. THE STILL FACE EXPERIMENT

12. What can we do? Integrated approach 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

13. 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
FNP –just one example of an evidence based programme – uk studies are underway to look at the impact here and early results are reflective of the US studies

14. Incredible Years
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.
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.

15. 20 PIONEERING PLACES Blackpool Greater Manchester
Blackburn with Darwen
Cheshire West & Chester
Croydon
Dorset
Essex
Gateshead
Hertfordshire
Islington
Lancashire
Greater Manchester
Newcastle
Nottingham
Poole
Plymouth
Solihull
Staffordshire
London Tri-borough
Wiltshire & Swindon
Worcestershire 
We work with and through our 20 pioneer places – to learn, share good practice, encourage innovative ideas and test new ideas
In addition to this we are developing a national programme of support – to enable the spread of learning and share evidence and reviews and tools as they are developed

16. SYSTEMS, PROGRAMMES & PRACTICE
Family Nurse Partnership
Multi-systemic Therapy
Big Brothers Big Sisters
Good Behaviour Game
Incredible Years
Functional Family Therapy
Guiding Good Choices
This emphasises that we are about all three PPS – that effective programmes should sit within an effective system in order to be most beneficial
Our Places have put a great emphasis on finding how best to deliver in an effective system – this includes governance, commissioning and delivery

17. 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

18. Early Intervention in Action