Home visits pilot moves to next phase

By Ann McGauran | 09 July 2019

The Institute for Fiscal Studies (IfS) and Peterborough City Council have partnered to develop and pilot a home visiting intervention to support the home learning environment of very young children in disadvantaged families.

Focused on child development, the pilot scheme in Peterborough has received ‘overwhelming positive feedback,’ according to the feasibility study published today by the Institute for Fiscal Studies (IFS).

The pilot study aimed to test the local acceptability of a new parenting programme for disadvantaged families. While the full programme would run for about two years – starting from around six months and overlapping with free childcare for disadvantaged two-year-olds – the pilot involved 20 families in a short five-week intervention, only one of whom dropped out by choice.

The study said that even though the pilot ‘only involved up to five visits’, the feedback is ‘evidence that the intervention holds potential to benefit children’s cognitive and behavioural development’.

The next step is to evaluate the intervention through a randomised controlled trial in Peterborough. The trial will involve around 600 children, split between an ‘intervention’ group who receive the programme and a control group who do not.

The strong support of Peterborough City Council has been critical to the success of the feasibility study, and will continue to be essential to developing and trialling the programme, the report said.

Feedback from the pilot suggests the delivery model developed is well accepted among families and home visitors, and because it involves partnering with well-established charities providing early years and education services it has the potential to be scaled up beyond Peterborough.

The team of IfS researchers said their study has laid the groundwork for adapting and evaluating the Reach Up and Learn early intervention programme in England – and has found evidence of a gap in services in England that a home visiting programme targeted at very young children’s development might help to fill.

Early years services in England are mainly targeted at children aged three and older, ‘while inequalities in child development open up earlier’, said the report.

The intervention took as its starting point the curriculum from the Reach Up programme. The report said the programme has been extensively evaluated, with multiple trials in Jamaica, Colombia and Bangladesh finding ‘significant – and often long-lasting benefits for children’s development’.

The programme supports stronger parent-child interactions and a more stimulating home environment by building the parent’s knowledge of child development and confidence in playing and interacting with the child – ‘which in turn promote children’s intellectual and social development’.

The curriculum is delivered by trained home visitors through regular visits to children under the age of two and lasts for around two years.

The home visitor introduces a new toy or puzzle at each visit and teaches the parent activities that make use of it. Books and songs are also shared with parents and parents are encouraged to use everyday interactions and experiences as a chance for learning.

According to the report, Peterborough is a ‘particularly appropriate setting to develop and test the programme’, as it faces many of the socio-economic risks such as poverty and low pay that threaten children’s healthy development in disadvantaged communities all around the UK, said the report. The city has an ethnically diverse population, and in the development phase, the IfS will determine how best to adapt the curriculum for such communities.

Sarah Cattan is an associate director at the IFS, responsible for its education and skills work – and one of the report’s authors. She tells The MJ: ‘We’ve worked in very strong partnership with Peterborough City Council, and they are convinced that there is a need for such an intervention. It is crucial that we establish scientific evidence about whether and how the intervention benefits children and their families.

‘Our plan is to run a randomised controlled trial, whereby some children would receive the programme and some would not, and to follow these children over time. By comparing their outcomes we will be able to measure the impact of the intervention on their development.

‘We also want to look at how such intervention affects the public purse – through for example a reduction in need for remedial education and social care, services that cost local government a lot of money.’

The IFS team is now looking for funding to implement and evaluate the randomised controlled trial in Peterborough. The team also wants to share the learning so far with practitioners and is interested in working with other local authorities who may consider developing the intervention in their areas and participating in its evaluation.

Inviting other interested local authorities to contact her, Ms Cattan adds: ‘We have a strong blueprint for this programme. Now we would like to take it to the next phase.’

Opinion: Intelligent Intervention

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