The Best for Every Child A report on the potential to transform disadvantaged communities in Lisburn through early intervention Researched and written by Barnardo’s NI, commissioned by Resurgam Trust Dr Roger Courtney Public Health Agency Contents Page i. Executive Summary 2 1. Introduction 6 2. The Needs of Disadvantaged Communities in Lisburn 10 3. Why Early Intervention? 37 4. Public Policy Context 46 5. Theory of Change 75 6. Operating Model 95 7. Implementation Plan 102 8. Bibliography 108 Appendices 1. Terms of Reference 114 2. Membership of the Early Intervention Steering Group 116 3. Summaries of proven early intervention programmes 117 4. Early Intervention Sites & programmes in the UK and Ireland 198 (Nottingham, youngballymun and West Tallaght CDI) The title of this report, “The best for every child” is a quote from one of the parents who participated in the consultations during the research phase in developing this report Page 1 Executive Summary 1. Introduction This feasibility study and consultation was commissioned from Barnardo’s with funding from the Public Health Agency, by Resurgam Development Trust representing community and youth organisations in disadvantaged communities in the City of Lisburn, including Old Warren, Hilden, Hillhall, Tonagh, Knockmore and Lagan Valley. It involved consultations with a very wide range of community organisations, schools and professional agencies working in Lisburn. It also included research into: the needs of the target areas; the desired outcomes for children and young people; the evidence and arguments for taking an early intervention approach to the issues; the public policy context and the extent that it might support an early intervention approach; and the evidence of the potential impact of delivering particular proven programmes in the target areas of Lisburn. 2. The needs of disadvantaged communities in Lisburn Research into the needs of disadvantaged areas of Lisburn complemented by consultations with local community groups and professionals working in the target areas identified very significant issues concerning the health, wellbeing, safety and security of the population in these areas, which have a very detrimental effect on the lives of many families. Concerns about parenting were also very prominent in most of the consultations. These findings are consistent with the international literature on inequality and deprivation on a range of wellbeing indicators. What was more shocking was the very poor educational outcomes of the children and young people, right from primary school. Of those attending the three post- primary controlled and integrated secondary schools in Lisburn, three-quarters leave school without 5+ GCSEs with English and Maths and very few go on to university or college. There was significant evidence of educational under- achievement being replicated down the generations. The nature of employment in the 21st Century would suggest that, as a result of poor educational achievement, the level of deprivation, and the extent of poor health and wellbeing, in these areas will, if not arrested by a major intervention, increase further in future years. It was clear from the research that tinkering at the edges of the problem will not be enough to tackle this chronic problem: a substantial and comprehensive initiative is urgently required if the next generation of lives of children and young people is not to be blighted. 3. Why Early Intervention? A consensus has development amongst neuro-scientists, psychologists, economists and others concerned with the development of children and young people that: ■ 80% of brain development happens before a child is three years old and so these are the most critical years to invest in the development of the child; Page 2 ■ investing in these early years and in the early stages when challenges in a child’s life are becoming evident are both more effective than investing in dealing with the chronic later phases of these problems; ■ investing in the early years of a child’s life and the early stages of social problems before they become chronic can produce very substantial savings to the public purse in later years; ■ prevention science is critically important in demonstrating, through robust research, usually involving random control trials, what interventions actually work; and ■ being clear about the specific outcomes that any intervention is designed to impact on is vitally important. 4. Public Policy Context Although the concepts around an early intervention approach have only become commonly discussed internationally in the last decade, they have now had a significant impact on the strategic thinking of a range of government departments and agencies in Northern Ireland, which now emphasise prevention, early intervention and evidence-based practice, although actual implementation of the approach is still at a very early stage. It requires a longer-term perspective in realising the savings to the public purse of such an approach and the breaking down of departmental silos, as the positive outcomes of an investment from one department may accrue to another department. 5. Theory of Change The report outlines a logic model which demonstrates the links between the investment of resources; the programmes to be delivered; the outputs from these programmes; the outcomes in terms of changed lives; and how each of these can be measured. The logic model suggests that the following outcomes should be addressed: ■ Reduced number of teenage pregnancies ■ Reduced level of smoking during pregnancy ■ Improved parenting skills and confidence ■ Improved parent-child attachment for 0-2 year olds ■ Improved school readiness amongst 3 & 4 year olds ■ Improved literacy and numeracy in children aged 4-11 ■ Improved social and emotional skills and resilience of 4-11 year olds ■ Improved school attendance ■ Improved educational aspirations and attainment on leaving school ■ Reduced behavioural/conduct problems ■ Reduced smoking, alcohol and drug consumption amongst young people ■ Reduced crime and anti-social behaviour amongst young people Page 3 Executive Summary Effective interventions need to commence with a family before a child is born and continue at least through primary school age. They need to include universal programmes as well as targeted services. In order to address this, the approach proposed has two key elements: 1) Although Lisburn is under-served in relation to support for children and families, as it does not receive regeneration funding such as Neighbourhood Renewal, despite having areas within the 10% most deprived in the 2010 MDM figures and has much worse educational outcomes than areas within the worst 10%, there is still a need improve the co-ordination, effectiveness and integration of existing services for children, young people and families in the Lisburn area by developing a common outcomes framework (which will enable impact to be measured), creating a shared focus on quality achieved through joint reflective practice, training and peer learning, whereby different organisations can learn from one another. In addition, all existing organisations will need to work together to transform the culture within the City of Lisburn, especially within areas of deprivation, to emphasise aspiration and achievement (particularly in relation to education). 2) The scale of the problem in Lisburn, whereby 75% of pupils from all of the three controlled / integrated schools leave without the minimum 5 CGSE with Maths and English, is such that significant new sustainable investment is needed in new interventions to break the cycle of poor outcomes, which is likely to only get worse. These new or enhanced interventions must compliment and work alongside existing community services within Lisburn so that all services are working together under a common outcomes framework. The new or enhanced interventions should also have clearly demonstrated effectiveness so that confidence can be gained that they will deliver the level of improvement required. Specific interventions will be identified by the multi-agency Early Intervention Lisburn Consortium once funding is in place, but are likely to include interventions based on: ■ intensive home visiting; ■ parenting training; ■ pre-school early years child development; ■ additional literacy support in the primary years; ■ social and emotional development; and ■ mentoring support. Page 4 6. Operating Model The report outlines an operating model for delivering the recommended programmes in Lisburn which will be both owned by the local community; fully engage all the key stakeholders who have an interest in outcomes for children and young people in the target areas in a collaborative approach; and be delivered by an agency with strong experience in delivering early intervention programmes for children and families. There are also considerable advantages in developing a close relationship with other areas that have developed an Early Intervention approach. A partnership with the Early Intervention initiative in Derry-Londonderry, which is at a similar stage would have particular advantages. 7. Implementation Plan The report outlines a medium-term implementation plan in phases for taking forward the recommendations in the report. The phased approached allows for the potential findings from the large number of RCT evaluations that will report over the next four years in future phases to be taken on board. Page 5 CHAPTER ONE Introduction 14 16 11 7 10 15 17 12 13 5 3 6 1 2 8 4 18 9 1 Knockmore