The session was chaired by EIF trustee Jean Gross, CBE, and featuring contributions from David Hoare, Chair at Ofsted, Professor Kathy Sylva of Oxford University, Dr Kirsten Asmussen, Evidence Analyst at EIF, and Candida Brudenell, Assistant Chief Executive at Nottingham Council.

Ailsa Swarbrick, Director, Family Nurse Partnership National Unit

I recently watched ‘The Arc of History’, the final episode of Inside Obama’s White House. The series has been an eye-opening catalogue of frustrations, breakthroughs, triumphs and the challenges of making decisions when there is simply no easy answer.

I was reminded of this at last week’s EIF conference workshop: How can we support struggling parents in the early years? I wondered if it was not parents struggling but us – practitioners, policy makers, researchers and others – as we strive to make sense of the range of perspectives, evidence and history so that we can recognise and support the parent’s powerful role in early intervention.

The workshop drew out some clear learning:

• Most parents are ok – and generally doing just fine. But some periods are trickier than others, and focusing on specific risky times can be particularly effective.
• The evidence base is growing and we should use it. But there are not always clear yes or no answers in the messy real world  – evidence helps us improve but it may not always prove.
• Collaboration should be in the DNA of our work – rather than developing solutions for them, we should ask parents and communities how we can help.
• Innovation means looking at things differently – this could mean engaging different local community players – Candida Brudenell from Nottingham City Council gave a great example of how the local radio station had helped with a campaign to improve school attendance.

These messages resonate with me as the FNP National Unit embarks on an exciting improvement programme FNP Next Steps.

Finally, back to Obama, by way of Jean Gross who started the workshop with a race through the recent history of parenting policy. It has changed along the way. Different approaches have been taken, some successful, some less so. The course has shifted in the light of new evidence, new social and financial pressures, technologies and social behaviours no-one dreamed of 20 years ago. But the overall direction has been overwhelmingly positive, or, as Obama reflected: “My view of human progress has stayed surprisingly constant…. [If] you were asked what moment in human history would you like to be born, you’d choose right now.”

That feels a good way to view progress in early intervention and parenting policy. And if this is how far things have come, we have great foundations to build on for the future.

Louisa Reeves, Lead Communication Advisor, I CAN

I was very much looking forward to attending this session at EIF’s National Conference at the Royal College of Physicians. As a speech and language therapist working for the children’s communication charity I CAN I am very much aware of the crucial role parents play in their child’s development especially in the first years of life.

Initial scene-setting from Jean Gross focussed on helping us to recognise that all parents struggle, and raised the question of whether parents should be left to ‘get on with it’. This was a great pre-cursor to the fascinating summary of research findings around parent interaction that were highlighted by Kirsten Asmussen. This was particularly useful in identifying the important role parents play in influencing children’s development across a number of domains, and the impact on young children when parents struggle.

I was interested to then hear Kathy Sylva’s reflections from her research in children’s centres, as it resonated with the challenges we face at I CAN – how to rigorously evaluate a service or intervention whilst at the same time making it flexible enough to be altered to suit individual parents or groups and keeping within ethical boundaries. One of the most interesting findings for me was that the children’s cognition and language was not affected by the Centre’s work but was by the formal learning opportunities they had. This reinforces the approach I CAN has taken in working with early years practitioners to improve their practice and give them interventions to use to support children’s language and communication skills.

All of this we need to do in the context of truly working ‘with’ parents – a challenge laid down by Candida Brudenell in her presentation – and the changing landscapes of local authorities, and the crucial role early years services play in supporting and improving the life chances of children explained to us by David Hoare.

So, how will this session impact on our work at I CAN? We already have a very successful Enquiry Service which is used by concerned parents on a daily basis but we know that more families struggle with speech, language and communication difficulties than contact us. We need to look at what messages we are giving to parents and how we deliver those messages and in what format. We will take up Jean’s challenge to look at how we can harness the information revolution to reach and support more parents. We already have successful interventions for children aged 3-4 yrs; 4-7 yrs and 7-10 yrs. Our next step is to look at how to support children’s language and communication development at 2yrs and we will work closely with parents to develop something which is effective and usable for them.

Dr Ann Hoskins, MB MCh BAO, MCommH, FFPH, Independent Public Health consultant

This was a useful session which gave interesting insights into the history of service delivery for early years over the last 10-15 years; an update on the research/evidence of what works at an organisational and individual level; some new innovative approaches to working with parents; and finally, ideas on a change of focus for Ofsted.

Some of the key messages from this session have implications for how we continue to improve and enhance outcomes for children both in the short and long-term, let us delve into some of them below.

Firstly, politics matter! The importance of early intervention in the early years is recognised and new research continues to reinforce the importance and potential of interventions to improve outcomes for parents and children. However, as new leaders come into post in government and public services, it is important that advocates for early intervention continually remind our leaders of the importance of early years: that services can make a difference, investment in early years can reduce future costs and this can have a positive impact on future generations.

We need to be mindful of the history of services for children. Over the last 10-15 years we have moved from very targeted interventions to universal approaches. The impact of austerity is pushing some local councils to move again to more targeted approaches, however the evidence is clear on the importance of both universal and targeted approaches working together (‘Fair society, healthier lives’, The Marmot review, 2008) There is a real opportunity with the transfer of commissioning of the health visiting programme to councils to develop integrated approaches across the public health, education and social care workforce. Developing services that are based on universal prevention, which leads to early identification and opportunities to intervene and prevent further deterioration.

It was good to be reminded that most parents are good at supporting their children’s early development. Parents particularly struggle when certain risks are present e.g. parental mental health problems, economic hardship, relationship problems; however, a range of effective interventions are available. Several challenges were highlighted in this session, the most important being that the service needs to be able to reach the families needing extra support. Other issues included the need to ensure professionals are well trained and supported to enable the delivery of evidence based interventions at the appropriate time and the importance of working with parents who often have solutions to their own problems.

Finally, the importance of implementation at scale: this can only happen if the staff are available, have reasonable workloads and can work with and identify the parents who need extra support.”