‘I wonder if it is possible to write some basic principles or ground rules that would guide early intervention in all countries and all situations’
In my country, early childhood intervention for babies and young children who have disabilities and special needs has been around since black and white television converted to colour. So, it is a relatively new phenomenon in the world and we are really at the beginning of its evolution.
The problem is that, while television and related technology have developed dramatically since those days, early childhood intervention has not. We have expanding populations of babies and infants with various complex needs and we do not yet have established integrated systems to provide them and their families with effective support. Early childhood intervention is firmly stuck in the middle of the last century.
Effective early childhood intervention is supported by three major pillars – health, education and family support. There has been much progress in the first, helping children survive and keeping them as healthy and free from pain as possible. But education and family support are both suffering serious developmental delay.
There are pockets of good practice led by good people in many countries but we are a million miles away from knowing how to provide timely and relevant support to every child and family who needs it.
Where are the children and families who are being badly let down? They are in countries with rich economies, mine and perhaps yours. They are in countries with poor economies – sometimes wrongly designated as ‘developing’. Endless hundreds of thousands of them are in newly displaced populations (in your country and mine) and countless more are in refugee camps now and will probably still be in them in twenty years’ time.
That is the problem we are facing. It means that whenever we establish or modify an early intervention service, we must consider how effective it can be in providing timely and relevant support to all the children and families in the region who need it – and anticipating those who will need it in the future.
I wonder if it is possible to write some common basic principles or ground rules that would guide early intervention in all countries and all situations. This is much the same as imagining what universal early intervention might look like in thirty or forty years’ time. Perhaps these ground rules could be in the form of a statement or charter of child and family rights. It would take a better brain than mine to establish these principles, but I would start with the following:
1. When we discuss ‘early childhood intervention’ we should keep in mind another phrase ‘early child and family support’ because this makes it clear that families are involved. It also perhaps helps us move from interventions that are outdated and institutional.
2. There must be respectful acknowledgement that it is the right of parents to bring up their children. It is the responsibility of professionals to support them in this when they ask for help. Help should never come as interference.
3. Interventions must respect parents’ skills and abilities. The intervention process is then to combine these with professionals’ skills and abilities to achieve collective competence around each child.
4. A system for a locality, camp or region must be created by all relevant local agencies bringing health, education and social care into a well-organised, seamless and harmonious whole with a single point of entry.
5. There will be three major considerations woven into all interventions:
a: attachment between child and parent(s) or between child and other primary carers
b: the quality of life of the child and the potential for a decent childhood
c: the quality of life of the family and its growing capacity to meet future challenges.
6. Because early child and family support professionals are in short supply in every country, there must be a commitment and creative endeavour to provide effective support with the fewest possible professionals. One successful model is transdisciplinary teamwork within the TAC approach in which everyone’s expertise is channelled to the child and parent through a primary interventionist.
7. Interventions can focus on the same natural activities in which all children gain their first skills and understanding – playing, moving around the house, eating, drinking, socialising, managing clothes, bedtime, etc.
8. While it is very hard to imagine a ‘jack of all trades’ in early child and family support, professionals from different disciplines should be enabled to learn from each other to enhance their whole-child skills. Softening professional boundaries brings clear advantages to children, families and professionals.
9. In any locality or situation developing early child and family support, the views of professionals are important as are the views of academics. But of equal importance are the collective views of local parents and other family members.
10. Early child and family support systems must have built-in feedback mechanisms so that families and professionals can report their experiences for future service development.
These are my first ten suggested ground rules. Do they seem relevant to you?
The ideas are further developed in Bringing up babies and young children who have very special needs: A 21st century guide for parents, students and new practitioners (2019)
and in the earlier book: An integrated pathway for assessment and support: For children with complex needs and their families
I would value comments and suggestions for other
basic principles or ground rules.