Effectiveness Of The Early Intervention Approach

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23 Mar 2015 03 May 2017

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Within this essay I am not going to list the reasons to believe in the effectiveness of the early intervention approach. The usefulness of early intervention itself is not in dispute. I will, however, be discussing the strengths and weaknesses of different types of early intervention. I will discuss the reasons to believe that some intervention schemes are better than others concerning ways to handle social issues. This essay will discuss the definitions of the terms used in the title. I will look at the motivations behind the schemes and discuss ways of analysing their effectiveness. In relation to the importance of child participation and the amplification of children's voices, I would also like to look at children's views on their own situations and why they feel like they should engage in acts that would qualify as a social issue.

Defining the key words

Using the term 'social issue' in reference to children and families tends to suggest childhood delinquency, drug abuse, violence, teenage pregnancy, crime and etcetera. The word 'issue' implies that there is a problem that should be dealt with; an issue is not an acceptable or desired means of behaviour and it opposes the social ideal. However, many questions arise concerning who has created the definition of this ideal. The language used in the title suggests that the ideal consists of the eradication of all social issues. (which the Government has highlighted.) Used in CTC??

Effectiveness is an expression that is used by the Government when evaluating early intervention. In the UK, The government drives forward the need for evaluation and assessment of early years practices (Lewis & Utting, 2001). It is a commonly held assumption that to achieve the goals of evidence-based practice and cost-effectiveness, "evaluation is a necessity, not a luxury" (Ghate, 2001, p23).

Preventative early intervention initiatives have become more common since the arrival of the New Labour government in the late 1990s (Ghate, 2001). Whether they are led by the government or by other organisations, an early intervention programme generally has the aim of reducing negative social outcomes the children may contribute to when they grow up. Within this essay, I will be using examples of two different types of early intervention scheme: government-led and community-led.

Different types of intervention

Government-led

Throughout the 1990s, there was a growing recognition that wider social, political and economic factors were negatively influencing the families and communities that children grew up in (Hannon & Fox, 2005; Glass, 2001). Shortly after New Labour was elected to power in 1997, Tony Blair stated that by 2010, the number of children living in poverty within the UK would be halved and by 2020 it would be eradicated ( ). As a result of this, the New Labour government introduced a number of early intervention initiatives with the aim of reducing social exclusion due to poverty (Clarke, 2007).

The New Labour government has shown a serious commitment to the early intervention approach, having invested hundreds of millions of pounds into one initiative in particular: Sure Start (Hannon & Fox, 2005). To begin with, Sure Start was targeted primarily at working with parents of young children from the most socio-economically deprived areas in the UK. By doing this, therefore, the government aimed to potentially tackle future 'issues' that their children might create. One statement of Sure Start's intentions is described by Clarke (2007); "(Sure Start aims to avoid) social exclusion in adulthood, primarily by enabling children to realise their potential within the education system‟ (p.699). Sure Start reflects its aim by working both directly and indirectly with the child; directly by providing such things as pre-school childcare; and indirectly by providing services for parents and the wider community (Belsky & Melhuish, 2007).

Other government early intervention approaches that have been introduced since 1997 with the aim to break the cycle of poverty include: child tax credits, working tax credits and child benefits. Government policies and green papers such as Every Child Matters (2003) support the early intervention approaches by outlining the standards for child well-being and suggesting guidelines to help professionals reach these standards. The 2007 Children's Plan recognises the importance of providing support for parents, in order to gain their enthusiasm for their child's education. Parental enthusiasm and involvement is a key factor when trying to initiate an intervention scheme ( ).

Government programmes and large scale intervention programmes such as Communities That Care (CTC) are not the only types of early intervention. Communities themselves have long developed programmes that tackle issues important to them. "Sure Start was to be focussed on relatively small areas of need, reflecting... the desirability of action at the level of communities" (Hannon & Fox, 2005, p3)

Community-led

Non-government led organisations have been set up all over the country in response to different communities' needs. One example is 'Kids Company', a charity which aims to "provide practical, emotional and educational support to vulnerable inner-city children and young people" (Kids Company Website, 2008). This statement seems very similar to the one Sure Start uses. Kids Company's methods of early intervention, however, differ significantly from those of Sure Start.

"Kids Company's effectiveness lies in its provision of innovative, flexible and child-centred services. Kids Company provides targeted therapeutic and social work interventions, and universal class and group access to the arts." (Gaskell, 2008, p4)

Personal relationships with people they are reaching.

Self-referal.

Accessibility is an important factor for intervention schemes. If parents or children do not access intervention (whether it be through choice or lack of knowledge)

"The assumption is that behind every child is a responsible adult, who will navigate the path to services" (Camilla Batmanghelidjh, 2006, p15). Sadly, the truth for many children who would benefit most from intervention services is that their main carers are not willing or cannot be bothered (uninterested?) to allow their child to attend (Batmanghelidjh, 2006).

Motivations behind intervention schemes

Politics

Children's welfare?

Money

The intention for the Sure Start initiative was that it "should be based on the best evidence of what works" (Glass, 2001, p14).

Lack of funds can mean that some children get overlooked by local authorities and social services. In her book, Camilla Batmanghelidjh (2006) describes coming into contact with children who were suffering from lack of food and neglect, referring these children to social services, but discovering that they were not eligible for help due to lack of resources and too many cases of sexual and physical abuse.

Many children drop out of the education system and are never pursued by the 'system' because the behavioural and emotional difficulties of the children are too much of a burden to school staff (Batmanghelidjh, 2006).

Many interrelated factors place children 'at risk' of adopting behaviour that could be seen as a social issue. Many children who already practice such behaviour are likely to have been conditioned by their family's socio-economic circumstances. Socially unacceptable behaviours can lead to social exclusion, which can, in turn, result in the next generation's social exclusion (Clarke, 2007).

Children's attitudes, achievements and behaviour are shown to be linked to the environment in which they grow up in. The largest influence is shown to be that of the family (Parton, 2007). Talk about EPPE. The key, when looking at dealing with social issues, lies in tackling the underlying factors. This could be by the means of providing services and/or resources.

These factors include poverty, poor nutrition, emotional neglect and underachievement. There is an overall understanding that these factors cannot be isolated from one another (find evidence).

Intervention is a term that suggests that an outside source will come 'in' to intervene with whatever is going on and disappear again once too 'issue' is fixed or eradicated.

Analysing effectiveness (research)

Evaluating larger scale early intervention programmes

Early Effects of CTC (Hawkins et al, 2008)

Reports positive effects, but the results are quantitative - looking at if the children have taken drugs or shown signs of 'delinquent' behaviour.

Not looking at the children's views of how the project may have changed their lives - issues such as being listened to, valued and feeling part of the community.

"if services cannot specify what changes they expect to see for `successful' users, evaluators certainly cannot measure them, let alone pass judgement on whether the service has proved effective." (Ghate, 2001, p25)

Strengths of early intervention approaches imply that these are the reasons for perceived effectiveness. Contrary to the strengths of early intervention projects, their weaknesses reveal the space for improvement within the services.

The New Labour government has introduced several interventions that aim to benefit families. Much research would support the idea that early intervention schemes such as Sure Start have a positive benefit on children's well-being ( ), but how far can research reflect the true picture of what is happening to under-privileged children in this country?

This pressure to measure a setting's effectiveness can detract from the amount of time practitioners can spend with the children: "Time and energy is, therefore, increasingly sapped from those providing services to fill in forms for external purposes, rather than supporting children." (Lewis and Utting, 2001, p4). Ironically, this could negatively affect the 'effectiveness' of the intervention.

Accessibility- If many people are accessing services, then the likelihood of them having an impact is increased. Alternatively, if there are not enough staff members to meet the needs of the attendees, then the likelihood of effectiveness is inevitably decreased.

"Before an educational outcome there needs to be an emotional one" (Batmanghelidjh, 2006, p23). Successful outcomes or effectiveness of an intervention service are not instantly noticeable. It may take years for disturbed children to engage in behaviour they were previously unable to. "Their outcomes are personal, and their successes are often individual and emotional first, before they become visible in the world of academia and work." (Batmanghelidjh, 2006, p 22)

"The problem with presenting outcomes in the way that they are being demanded is that clinicians try and exclude children from their services who are likely not to provide positive outcomes." p.23 - This is not through cruelty, though, but because the clinician relies on the money they earn for doing their job 'effectively'. Money is essentially the reason why so many children do not receive the services they should. Children are being dehumanised by being treated as statistics that keep adults in their jobs.

"So many of our current interventions with vulnerable children come from the perspective of the well-adjusted adult, needing to preserve our own sense of safety." (p 153)

Short-term initiatives, where the practitioner enters the child's situation, offers a 'quick-fix' cure and then disappears again, are merely cosmetic. This kind of intervention offers no real solution to the issues that disadvantaged children face. The government thrive on statistics that have been distorted to reflect their political goal (find some). The public want statistics to show them that issues are being resolved.

It is to do with how committed people are to seeing change. Short-term initiatives are ineffective, due to the fact that people are complex beings. Effective early intervention programmes have recognised the need to build relationships with the people behind the 'issues'.

Conclusion

Children who carry out anti-social behaviour are sometimes referred to as being 'delinquent' (Hawkins, 2008). This reflects the medical model of disability, that which implies that the fault lies within the child and needs to be fixed.

The aim of some early intervention programmes can be to benefit wider society rather than the child. Blair (2008) spoke of a new political initiative that would identify those most at risk of offending at birth. This kind of intervention would not be beneficial to the child. Being labelled from birth as a potential offender could produce a self-fulfilling prophesy.

The most effective early intervention programmes are those that make a commitment to the children themselves; that aim to make them feel valued as members of society and offer them the best opportunities.

Many of the 'early intervention' programmes explored, such as Communities That Care (CTC) concentrate on notions of bringing the community together and building social capital from within the community. We cannot expect children to act as responsible members of the community unless they are treated as such. Not just gathering their views but involving them, involving them in planning and developing of programmes - as will see constant criticism from the children is 'nothing actually happens'

Disenchantment

The 'delinquent' child (Hawkins, 2008)

Looking at how the child is framed within early intervention programmes. Is it to make them feel valued, important and give them the best opportunities? Or is it to sort them out for the sake of wider society?

Government initiatives: Identifying those at risk of offending at birth (Blair, 2008). Fits with governments crack-down on anti-social behaviour and ASBO's.

More positive: Sure Start, parenting programmes.

Want to prevent the problems before they start, but such approaches label the child before they have even offended. This is likely to alienate them further from society. Not helpful!

Distribution of power

CTC

Programme is systematically applied from the outside

Community driven and the community identifies problems they believe need addressing

But, research by (Brown et al 2007) into the 'Community Youth Development Study:'

Leaders were those who already held leadership positions i.e. mayors, city managers, police chiefs, school superintendents. These were the people who were interviewed, alongside five 'referred leaders'

No effort to break down power relationships. Study itself is not representative. We do not hear the views of different community members.

'Older respondents and those from law enforcement were more likely to report higher baseline levels of collaboration' than younger respondents or those from other community sectors' (Brown et al 2007). So again criminal justice system taking the lead.

Ultimately, people sacrificing their time and finances can do such impressive things for the need of their communities....

"And I think that's what our world is desperately in need of - lovers, people who are building deep, genuine relationships with fellow strugglers along the way, and who actually know the faces of the people behind the issues they are concerned about." - Shane Claiborne (The Irresistible Revolution, 2006)

Define what can be meant by social issues in this essay.

What does it mean to 'deal' with social issues?

What is effectiveness? How can we measure such a relative/ idiosyncratic thing?

What types of early intervention are there?

Government programs - Surestart

Voluntary sector- charity work/ people choosing to live in disadvantaged community to help change for the better.

Education?

Therapists?

Health? - NHS, midwives, health visitors etc.

What reasons are there to believe that these methods work?

CTC data (large no.s of opinion surveys - do these fully reflect true picture?)

Case studies?

Government studies (truly reliable? Short term? Who are they financed by and for what purpose?)

What alternative approaches are there to early intervention?! (What are we comparing early intervention to to make the assumption that it is the most effective approach to deal with social issues?

Other countries (Norway and Sweden)

Are families engaging with intervention projects?

Non-engagement (Anning and Ball 2008)

Intervention or need of resources??

Arnold et al (2003):

Specific needs of communities and the individuals themselves within such communities need to be addressed. Great diversity of needs

It is the environment that needs changing not the individual.

Brown et al (2007) 'CTC organizes the adoption of a science-based approach to prevention into five stages that correspond to Rogers' (1995) stages of innovation diffusion. Each stage is guided by a set of "milestones" and benchmarks" that are used to monitor CTC implementation' p181

Diffusion is the process through which (1) an innovation (2) is communicated through certain channels (3) over time (4) among the members of a social system (Rogers, 1995).

Most individuals evaluate an innovation, not on the basis of scientific research by experts, but through the subjective evaluations of near-peers who have already adopted the innovation. Diffusion is essentially a social process through which people talking to people spread an innovation.



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