It is possible to compensate for the effects of a disadvantaged family background by giving children from those families access to high-quality childcare and supporting their parents to provide a nurturing home environment
(pages 19-25 of printed journal)
The Early Years Education Program (EYEP) is a new program being offered by the Children's Protection Society (CPS), a not-for-profit child welfare organisation based in the north-east of Melbourne. EYEP is targeted at children aged up to three years, who have been or are at risk of being abused or neglected. Children who participate in EYEP receive five days per week of high-quality education and care totalling at least 25 hours. Particular features of the program are high staff/child ratios, qualified staff, attachment-based care, a child-centred curriculum based on the new National Early Years Learning Framework, integration with family support services, and a focus on building alliances with parents to sustain their children's participation in the program. This participation lasts for three years, or until a child reaches school age.
The objective of EYEP is to ensure that children who participate realise their full potential and arrive at school developmentally and educationally equal to their peers. It is now well-established that children's social, emotional and mental development in their early years is a major predictor of their subsequent life course. From Neurons to Neighbourhoods, a review of research on early childhood development by the US National Research Council and Institute of Medicine concluded that: 'virtually every aspect of early human development, from the brain's evolving circuitry to the child's capacity for empathy, is affected by the environment and experiences that are encountered in a cumulative fashion, beginning in the parental period and extending throughout the early childhood years'. Early mastery of a range of cognitive, social and emotional competencies lays the foundation for young children's achievements as learners in school and beyond.
Children with deficiencies in their cognitive and non-cognitive skills before the age of five are likely to have these deficiencies persist into later life, forming the basis of problems such as low education attainment, unemployment, teenage pregnancy, and involvement in crime. The skills children acquire before the age of five years depend strongly on family environment and socio-economic background – for example, such factors as the mother's marital status, level of education, and health.
So it is children from disadvantaged backgrounds who are most likely to fall behind in skill acquisition in their early years, and experience financial and social problems as a result. Those effects are even more pronounced for children who are abused and neglected. For many children living in vulnerable families, multiple risks converge to compromise safety and development. Exposure to trauma such as abuse, neglect or violence affects every dimension of an infant's psychological and behavioural functioning. CPS's experience is that these children typically enrol in their prep year with skills two years behind their classmates', and that they never catch up.
Some good news, however, is that it does seem possible to compensate for the effects of disadvantaged family backgrounds by giving children from those families access to high-quality childcare, and by supporting their parents to provide a nurturing home environment. In the US, programs such as the Abecedarian and Perry preschool programs, which have combined intensive preschool education and care with parental mentoring, have found significant improvements in children's performance on intellectual aptitude tests, their likelihood of requiring special education services, and long-term employment and earnings outcomes. Findings from the Effective Provision of Pre-School Education study in the UK (the largest European longitudinal study of development and learning in children aged from three to seven years) indicate that what parents do is more important than who they are. So, while it may not be possible to change family circumstances such as unemployment and poverty, improved outcomes for children can nevertheless be achieved by supporting families to do things differently.
While the benefits of early and sustained education for vulnerable children may be well-established, at-risk children who would benefit the most are least likely to have access to appropriate education and childcare. In Victoria, over 90 per cent of pre-school children are enrolled in government-funded kindergarten programs. However, analysis of the CPS 2007 Family Support program found that, of children aged up to five years, only 16 per cent had experienced some form of early childhood education and care services, and only 50 per cent of four-year olds were enrolled in kindergarten programs.
CPS has designed EYEP to address both the apparent lack of access to early education by vulnerable children, and evidence of the benefits of intensive childcare and early education for those children.
Particular features of EYEP are high staff/child ratios (1:3 for children under three years, and 1:6 for children over three years), qualified staff, a rigorously developed curriculum, and the use of relationship-based pedagogy. The program involves direct intervention with children to address their identified needs, reverse developmental delays, and reduce the impact of risk factors and adverse events. An innovative feature of the program is a trans-disciplinary model with an in-house infant mental health consultant, family-support specialist, and early-childhood curriculum consultant. Integration between EYEP and family support services is emphasised, and the program has an active focus on building alliances with parents to sustain their children's participation in the program.
The education model in EYEP is a pedagogically-driven reflective teaching model that is child-focused and built on the National Early Years Learning Framework of 'Belonging, Being and Becoming'. Each child has individual learning goals that are defined by the parents in partner-ship with the educators. The educators plan a curriculum using play-based approaches and intentional teaching to support each child's learning and development across learning outcomes in the Early Years Learning Framework. Play-based approaches and intentional teaching support children to develop a positive sense of identity as they explore, create, imagine, solve problems, learn communication skills, and develop friendships. It is understood that how children learn is just as important as what they learn. Reflection on practice guides the ongoing planning cycle. Educators document, monitor and assess each child's learning over time.
Central to the program is an attachment-focused, trauma informed, primary-care model which recognises the significance of respectful, responsive relationships for every child's learning and development. Every child is allocated a key worker who is that child's primary carer for the purposes of the program. Purposeful, warm greetings and clear ideas of the routines and opportunities of the day are essential components of the model, which help to give children a sense of security, predictability and consistency. The purpose of the primary care model is to encourage the fostering of significant attachments for children who are likely to be experiencing attachment disorders in their home-care environments.
To provide a more concrete feel for what EYEP is doing, what follows is a case study about a boy called Will, who is four years old. He has been excluded from two childcare services because of his challenging behaviour – which includes biting, swearing, spitting and urinating in the playroom. These behaviours may well be viewed as challenging but they also provide great insight into just how insecure and unsettled Will feels.
Will's mother survived three violent relationships and has three children under four years of age, Will being the eldest. Her frustrations with Will's behaviour lead her to harsh discipline: she regularly smacks him, locks him outside and yells at him. Will was sexually abused by one of his mother's partners when he was just three years old. He still wears nappies because he is frightened to use the toilet.
Will's behaviour is the result of trauma and fear, and the way he behaves is entirely understandable given his feelings and what he has experienced. But in less than six months Will is going to have to start school.
Will joined EYEP last year as part of the pilot phase of the program. Since then he has experienced the primary carer model and been welcomed into the Centre along with his mother and his brothers. He has been referred to the local child and adolescent mental health service, and together with them a care plan has been designed that involves 25 hours participation in EYEP each week.
It took Will three months to settle into the program and to begin to trust staff; the same with his mother. He has a good routine and eats three meals a day at the Centre. He has been put in charge of caring for the chickens and collecting the eggs each morning. He has a routine of helping prepare breakfast for himself and the rest of the children and he has flourished in this responsibility of providing.
Will now understands that his primary carer at the Centre is a consistent figure who accepts him and cares about him and he has built a safe relationship with her. As a result Will has become ready to learn. He explores and experiments and has started to interact with his peers in play activities such as drama, art and music. He can pretend and imagine. He can ask for help and he can tell us when he feels angry and upset. This is the beginning of his recovery. He has a long way to go and is unlikely to be as 'school ready' as most of his peers, but with the small amount of time he has had to recover from the trauma of infancy, he is doing well.
Research is currently underway to evaluate the program. From the outset, the CPS Board was concerned not just to introduce EYEP, but also to know whether it worked, and whether it should be extended to similar at-risk children throughout Australia. They decided to test the effects of EYEP using a randomised trial.
To implement the trial, CPS have put together a multi-disciplinary team. It includes researchers with expertise in infant mental health and social work, early childhood education, and program evaluation and statistical methods; and staff from the CPS responsible for implementing the program. This multi-disciplinary team has been essential to getting the research project off the ground. Having experts in child health and education has been critical for allowing effective communication with the educationalists who are implementing the program – to understand what their model is and what they are trying to achieve. Having both academics and clinicians involved in the research ensures that it will have academic validity, but also that it works at a practical level.
The trial of EYEP will ultimately involve 45 children who will participate in the program, and another 45 who will be non-participants. By comparing outcomes for these groups it will be possible to estimate how participation in EYEP affects children and their parents. These numbers have been chosen to fit with the capacity of the CPS childcare centre, as well as delivering statistically valid estimates of the effects of EYEP.
To be eligible to participate in EYEP a family must meet several criteria. Most importantly they must have two or more risk factors on the Department of Human Service Best Interest guidelines. Examples of risk factors include: a history of family violence; alcohol or substance abuse problems; or harsh, inconsistent discipline, neglect or abuse in treatment of the child.
Eligible families in the north-east of Melbourne are being informed by their Family Support case managers of the opportunity to participate in EYEP. Those who express interest proceed to an enrolment interview with CPS where EYEP and the research project are explained. Families that consent to participate are randomly assigned between the 'treatment' group that will receive a place in EYEP and the 'control' group which will not receive a place and, hence, will have 'usual care' arrangements.
A pilot of the EYEP project was conducted in 2010, supported by funding from the Commonwealth Department of Education, Employment and Workplace Relations, in order to hone the service model, the survey and measurement methods, and the research process.
Recruitment of participants for the full three-year EYEP trial is now proceeding, with the first 30 children currently being recruited to the trial (of whom 15 will participate in EYEP, and 15 will constitute the control group). The next 30 children will be recruited in the second half of 2011, and then the final 30 in the first half of 2012. Funding for the trial has come from the Victorian Department of Human Services, and from philanthropic sources, including the Sidney Myer Fund, the Ian Potter Foundation and the RE Ross Trust. Results from a one-year impact evaluation should be available in 2013, with a complete cost-benefit-analysis likely to be finished by 2015.
There will be three main parts to the analysis of EYEP. The first is the process evaluation, involving the description and evaluation of how the program was implemented. Second, a variety of impact evaluations will be conducted throughout the research project. These will examine questions such as how participation in EYEP affects children's ability to sustain their participation in early childhood care and education, their levels of socio-emotional, cognitive and language development, whether they have more secure attachment relationships with their primary care givers, and have better physical and mental health. As a basis for the impact analysis, extensive data is being collected on the children's cognitive, speech, language and emotional development, their physical and mental health, parent-child attachment relationships, and on the parent's health and community participation at their time of entry to the trial. This data will also be collected at one-year intervals during the trial.
Third, a cost-benefit analysis will quantify the costs and benefits of EYEP to society. This part of the analysis involves translating the net impact of the intervention into an estimated monetary value for each specific benefit and cost, and then aggregating these estimates to calculate the overall benefit/cost ratio.
As well as comparing the treatment and control groups of children in the trial, the children will be compared against children with similar characteristics from the Longitudinal Survey of Australian Children (LSAC). In the first instance, this will show where the children in the trial fit into the general population of children in Australia. Ultimately, it will also provide an alternative control group for evaluating the effect of EYEP – which may be important as the control group in the trial may end up accessing more services than would be the case for a similar group not involved in the trial. A reason for this is that the researchers have an ethical obligation to provide information on their children's development to parents in the control group, and to advise them to discuss any problems with their GPs or Family Support caseworkers.
So, why bother to evaluate EYEP, when there have already been evaluations undertaken of similar programs in other countries? This research project is important because the findings from international research cannot automatically be applied to Australia. First, differences in the cultural context, family risk factors, and the family support service system between Australia and other countries may affect how the program works. Second, the best-known programs enrolled participants a long time ago, in the 1960s and 1970s, and were conducted in small cities. The current study will provide up-to-date evidence that is relevant to Australia's urban environment. Finally, many policy-makers in Australia are sceptical about the efficacy of programs targeted at high-need children beyond existing universal services. The research study will measure the benefits and costs of EYEP to the children who participate, and to the community as a whole.
A condensed version of a presentation to the Social Justice Seminar held at the University of Melbourne on 3 May 2011.