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Coronavirus and early intervention: Confronting a new world for families, children and vital services


25 Mar 2020

EIF chief executive Dr Jo Casebourne surveys the new world we all find ourselves in, the profound changes experienced by families and services alike, and our next steps here at EIF.

For all of us, our personal and professional lives have been changed by the Covid-19 outbreak in ways that are hard to measure or even, at this early stage, to fully comprehend. At EIF, the past fortnight has seen some big changes, as our offices have closed and our fantastic team have embraced a working life that’s moved entirely online. At the same time, practicalities aside, we have wrestled with some fundamental and urgent questions about EIF’s role and objectives in the midst of so much upheaval.

First, our primary focus remains on improving the lives of children and families. While so much about that mission has changed in its details, it remains the reason that EIF exists, and we will continue to work as hard as ever to provide the research, information and support that critical decision-makers, practitioners and others need.

In some ways, this may look and feel like business as usual. We will continue to deliver many of our planned projects – the questions we set out to answer through our research, on issues such as conflict in the home, childhood adversity or adolescent mental health, haven’t suddenly gone away. We will continue to produce the reports, guides, blogposts and other materials that we always have – these things will be there for anyone who needs them now, and when life returns to normal, our library of resources will be richer, ready and waiting. We will stay in touch with our networks and contacts, albeit through calls and virtual meetings in place of the more familiar roundtables and workshops. And we will continue to focus on the evidence for effective approaches to supporting children and families – now, more than ever, good decision-making depends on high-quality information and a clear view of what’s been shown to work, under what conditions.

Clearly, though, life has changed, at least for a time. This is a crisis for families, and vulnerable families in particular: staying at home all day isn’t easy, health and money concerns will add to the strain, and a whole set of valued services and trusted individuals, like teachers and schools, are now missing from parents’ and children’s lives.

Although the impact of these contextual changes on our work is still to become clear, we can make some early assumptions. A number of existing wider societal challenges are likely to become even more acute: child poverty is likely to rise, as is stress and conflict within families, and the incidence of mental health problems among children and adolescents. People across the early intervention field, from policymakers to frontline professionals, are rightly refocusing their attention on new and urgent problems. Many of the traditional routes by which early intervention is actually delivered have suddenly ceased to exist or substantially shrunk: schools have shut for most children, health services are understandably prioritising acute health concerns, and local authorities will be forced into difficult decisions about their provision of statutory and other services. And the serious scaling-back of face-to-face services, such as health visiting or social worker contact, will reduce the opportunities to identify children and families at risk or to provide much-needed support.

The government has announced a number of measures designed to support family incomes and to keep schools open for vulnerable children. However, it is likely that the gaps between the most disadvantaged children and others will widen in this period of face-to-face services not being available to vulnerable families. This national emergency also comes on top of long-term trends that have seen increasing numbers of children living in poverty, which will make it very hard for many families to manage in ‘lockdown’ and through any long period of social distancing that follows.

To ensure EIF continues to provide useful information and support in this challenging new environment, we will be reaching out to the local areas we already know and work with, and others who know us less well, to find out how we can be most useful in the immediate future. We will work with other organisations to understand the immediate impacts on early help and early intervention, and to identify the questions or challenges that are uppermost in service leaders’ minds at this time. And we will try to think ahead as well, to provide strategic and planning support for local areas as this early phase of widespread disruption progresses and a return to ‘the new normal’ comes into view.

Beyond EIF, certainly, it will not be business as usual for early intervention itself. The kinds of changes I’ve already described to the way in which early intervention and public services for children and families operate, pose some significant challenges to the goal of providing effective support that brings sustainable, long-term benefits. Interventions that have demonstrated this kind of positive impact in the past tend to share some important characteristics: many are delivered over a sustained period, with a high ‘intensity’ of provision, founded on high-quality relationships between providers and recipients, with a through-line of regular contact, trust and open communication. Moreover, the kinds of alternative interventions that might look like good substitutes in the short term – particularly online or digital services, or other light-touch or one-off interventions – tend to have much weaker evidence of working, or no evidence at all.

For some period of time, then, it may simply be extremely difficult to provide the kind of early intervention that the evidence suggests is more likely to be effective. The disruption to normal services is essential and entirely understandable. Nonetheless, we must keep a wary eye on the quality and likely effectiveness of the interventions that are being provided. At EIF, we’ll be looking urgently at the current evidence on some of these other approaches to delivering early intervention, to clarify what we know and, just as importantly, what we don’t know about their likely effectiveness. And as part of our outreach to local areas, we’ll be offering support and guidance to help evaluate some of these new or newly significant approaches, so that together we’re preserving some of the lessons that will be learned through this wholesale, rapid transformation in services.

Lastly, however unclear the specifics might be right now, this new world we all find ourselves in is likely to bring about important changes in the demand for early intervention. Just as significant as the precipitous drop in access to education settings, social services and out-patient healthcare, is the corresponding jump in the importance of the home, and of the relationships between family members, between parent couples, and between parents and children. Suddenly, the home is the sole locus for supporting most children’s education and personal development, all while parents contend with the loss of jobs or income, or trying to balancing working at home with parenting and schooling, the uncertainty of day-to-day practicalities, and the simple and understandable stresses of spending so much more time together in close quarters.

The evidence is clear on the link between stress at home, parenting, and the potential for negative impacts on children’s long-term outcomes. Here, as in other areas of home and family life, children’s development and wellbeing, we have high-quality information and resources to share. We will continue to work responsively with government departments and other agencies and organisations to fulfil requests for evidence and advice. And we will look urgently at how our existing resources can best be adapted and made available to decision-makers, service leaders and frontline professionals looking for reliable answers on new and critical questions.

We are all being confronted every day with new questions and uncertainties. At EIF, we will continue to focus on generating and providing high-quality information to improve the lives of children and families.

About the author

Dr Jo Casebourne

Jo is CEO at What Works for Early Intervention and Children's Social Care.