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The Politics of Prevention and Early (Years) Intervention: Why is acting early so hard? [email protected] Twitter: @AnneHollonds

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Page 1: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

The Politics of Preventionand Early (Years) Intervention:

Why is acting early so hard?

[email protected]: @AnneHollonds

The Politics of Preventionand Early (Years) Intervention:

Why is acting early so hard?

[email protected]: @AnneHollonds

Page 2: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

“Head Start” “Sure Start” “Better Start”“Early Start” “Equal Start” “Good Start”

………Where to start?

Page 3: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

“prevention is about preventing aproblem before it occurs

early intervention is aboutresponding to the first signs of aproblem”

“prevention is about preventing aproblem before it occurs

early intervention is aboutresponding to the first signs of aproblem”

ARACY

Page 4: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

1. Where to start? The politics and the policies

2. Integration – contradictions andopportunities

3. Building a system with childrenat the centre.

1. Where to start? The politics and the policies

2. Integration – contradictions andopportunities

3. Building a system with childrenat the centre.

Page 5: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

What Hockey is going on about…

25

30

35

40

25

30

35

40millionmillion

Working age population (15-64)

Child population (0-14)

Aged population (65 and over)

Total Population

Employed Persons

Age Pensioners

Projection

0

5

10

15

20

0

5

10

15

20

1978-79 1988-89 1998-99 2008-09 2018-19 2028-29 2038-39 2048-49

Source: 2010 Intergenerational report

Page 6: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

2012-13

• $3.2b on child protection

• $664m on prevention or early intervention

• 7.5% pa increase in child protection costssince 2007

The Forrest Review 2014

• $3.2b on child protection

• $664m on prevention or early intervention

• 7.5% pa increase in child protection costssince 2007

The Forrest Review 2014

Page 7: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Productivity Commission Report on Childcareand Early Learning

Page 8: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later
Page 9: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later
Page 10: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later
Page 11: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later
Page 12: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later
Page 13: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later
Page 14: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later
Page 15: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later
Page 16: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later
Page 17: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later
Page 18: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

‘Sensitive periods’ in earlybrain development

Binocular vision

High

Habitual ways of respondingLanguage

Emotional controlSymbol

Peer social skillsRelative quantity

Central auditory system

0 1 2 3 7654Low

Years

Page 19: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later
Page 20: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Centre forCommunityChild Health:

Collaboratefor Children

Centre forCommunityChild Health:

Collaboratefor Children

Page 21: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

2. Integration – contradictions andopportunities

Page 22: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Feeding Families at Forbes Children’ sCentre SA

Page 23: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Figure 4: A child-centred approach for social system support of the Five by Five.Adapted from the UCL Institute of Health Equity report “An Equal Start: improving outcomes in Children’s

Centres”. BetterStart 2014

Page 24: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

School Readiness

Australian Early Development Census (AEDC)

• Physical health and wellbeing• Social competence• Emotional maturity• Language and cognitive skills• Communication skills and general knowledge

2012: 22% vulnerable in one or more domains / Indigenouschildren 43%)

• Physical health and wellbeing• Social competence• Emotional maturity• Language and cognitive skills• Communication skills and general knowledge

2012: 22% vulnerable in one or more domains / Indigenouschildren 43%)

Page 25: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

400

600

800

1000N

umer

acy

NAP

LAN

scor

e

Vulnerable student

Non-vulnerablestudent

Telethon Kids Institute 2015

0

200

Year 3 Year 5 Year 7 Year 9

Num

erac

y N

APLA

N sc

ore

Non-vulnerablestudent

Page 26: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Indigenous Affairs priorities of theAustralian Government:

• Getting children to school• Getting adults to work• Building safer Indigenous communities

• Getting children to school• Getting adults to work• Building safer Indigenous communities

Page 27: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Multi-generational approach

Page 28: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Early InterventionFoundation UK

2015

Page 29: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

“A focus on supporting parents reinforces …..that early intervention and prevention is aboutempowering parents, not State interference infamily life”.

UK Early Intervention Foundation 2015

“A focus on supporting parents reinforces …..that early intervention and prevention is aboutempowering parents, not State interference infamily life”.

UK Early Intervention Foundation 2015

Page 30: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

3 Domains of Parental Wellbeing

Executive functionMental healthEconomic security

3 Domains of Parental Wellbeing

Executive functionMental healthEconomic security

Shonkoff and Fisher 2013

Page 31: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Infant mortality 20131.8 per 1000 births

Page 32: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Baby Basket:Cape York 2014

$874 per person

Baby Basket:Cape York 2014

$874 per person

Page 33: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Finland’s Maternity Package 2014

Page 34: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

3. Building a system with children atthe centre

Page 35: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

“Improvingchildren’slater lifeoutcomes”

UCL Instituteof Health Equity

2013

“Improvingchildren’slater lifeoutcomes”

UCL Instituteof Health Equity

2013

Page 36: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later
Page 37: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

System Elements

• National Outcomes Framework• Integrated evidence-informed policy• Inter-professional practice and progressive

universalism platforms• Enablers: Implementation support, outcomes

measurement, data linkage• Evidence-informed interventions: children,

parents, family relationships.

• National Outcomes Framework• Integrated evidence-informed policy• Inter-professional practice and progressive

universalism platforms• Enablers: Implementation support, outcomes

measurement, data linkage• Evidence-informed interventions: children,

parents, family relationships.

Page 38: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

We need…..

• Longer term planning – 10 and 20 year plans

• Investment in prevention and early yearsintervention

• Transition plans from late reactionexpenditure to investment much earlier

• Longer term planning – 10 and 20 year plans

• Investment in prevention and early yearsintervention

• Transition plans from late reactionexpenditure to investment much earlier

Page 39: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

[email protected] @AnneHollonds

Page 40: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

DV video

Page 41: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Talking Families Qld 45 sec ad

Page 42: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Toosmalltofail.com

Page 43: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

NET Important

88

91

89

88

88

Support for Investment in Early Action

57%

59%

58%

60%

58%

32%

32%

31%

28%

90%

7%

6%

7%

4%

8%

2%

2%

2%

7%

2%

3%

2%

2%

1%

2%

Total

Blue Collar

White Collar

<$20K

$20K- $39K

Very Important Quite Important Not Very Important Not at all Important Not sure

88

89

90

91

91

Q1. Overall, how important do you feel it is for Governments to invest more in acting early to support familieswith young children as a way to help prevent problems and save money in the long term?Base: All respondents (n=1000)The Benevolent Society 2013 43

58%

89%

60%

58%

53%

90%

30%

30%

33%

38%

8%

9%

7%

8%

2%

2%

2%

1%

1%

3%

2%

1%

2%

5%

0% 20% 40% 60% 80% 100%

$20K- $39K

$40K- $59K

$60K- $99K

$100K- $149K

$150K+

Page 44: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Murdoch Children’s Research Institute

Page 45: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

The enduring legacy of the EarlyYears

Page 46: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

BetterStart 5x5

5 dimensions of healthy development:1. Physical2. Language3. Attachment4. Social emotional5. Cognitive

5 stages of healthy development:1. Pregnancy2. Post-natal3. Infancy4. Toddlerhood5. Early childhood

5 dimensions of healthy development:1. Physical2. Language3. Attachment4. Social emotional5. Cognitive

5 stages of healthy development:1. Pregnancy2. Post-natal3. Infancy4. Toddlerhood5. Early childhood

Page 47: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Benefits of prevention and early intervention

benevolent.org.au

Page 48: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Page 49: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

The enduring legacy of the EarlyYears

Page 50: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

http://www.youtube.com/watch?v=lANkrXcEjMc&feature=em-

share_video_user

http://www.youtube.com/watch?v=lANkrXcEjMc&feature=em-

share_video_user

Page 51: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Perinatal deaths 1975–2012Source: THL, Nordic perinatal statistics

Page 52: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

Maternal mortality

Page 53: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later
Page 54: The Politics of Prevention and Early (Y ears) Intervention ... · Finland’s Maternity Package 2014. 3. Building a system with children at the centre “Improving children’s later

1. Where to start? The politics and thepolicies

What do we know?What do we have?What can we do with what we have?

1. Where to start? The politics and thepolicies

What do we know?What do we have?What can we do with what we have?