Growing together in early childhood intervention

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My visit to Chisinau in Moldova for the Growing Together conference http://easpd.eu/en/growing-together-moldova was both inspiring and thought provoking.  The aim of my involvement in the conference was to share my experiences at the Champion Centre as part of my WCMT Fellowship and to meet with fellow Board members of EURLYAID http://www.eurlyaid.eu/.

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The central aim of the conference was to bring together various stakeholders in the ECI field, such as family organisations, organisations of persons with disabilities, disability service providers, researchers and policy makers at national and international level in order to take a critical look at the development of national strategies needed to set up quality community-based ECI services both in Western and Central and Eastern European countries. The overall objectives of the conference were:

  • Mutual learning and transnational exchange between various stakeholders working in ECI;
  • Sharing of innovative methods and models to strengthen the development of sustainable community-based ECI services;
  • Identifying barriers in legislation, training of professionals, funding systems and other challenges hindering the provision of quality support in the ECI field.

Before visiting Chisinau I had been unaware of the poverty levels that still remain in some Eastern European countries (upto 25% child poverty overall in Moldova with upto 80% in some areas).  Yet there was a sense of hope and willingness amongst the audience. Key messages from speakers were:

  • The need to deinstitutionalise ECI services and provide services that are child and family-centred, it is crucial that children remain in their own homes;
  • Teams that work in a transciplinary manner are crucial for effective ECI services;
  • Provision of ECI services is a basic human right and services should be provided for children with disabilities free of charge, in a location near to their home and in a manner that is relational and reflective;
  • Goverments and policy makers have a duty of care to ensure quality and safeguarding regulation;
  • Inclusion starts with ECI services;
  • Barriers to successful ECI provision include lack of funding, lack of Government acknowledgement of the need for services, societal denial and stigma, lack of information about services for parents, and lack of professional training;
  • Professionals who work in ECI services should have the highlest level qualifications (preferably M level), however, they should train and collaborate with paraprofessionals to increase reach of services;
  • ECI services should be personalised and relevant to the social-cultural-historical contexts in which children grow and develop;
  • International collaboraiton is key.

I am looking forward to building upon my experiences in Chisinau and hope to return one day to be part of the change.

 

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Supporting children born prematurely

Children born prematurely are at risk of a variety of neurological impairments which can mean they are more likely to need special educational support when they reach school age (Wolke, D. http://www2.warwick.ac.uk/newsandevents/pressreleases/sensitive_parenting_can).  Evidence shows that sensitive parenting can emeliorate these risks. At the Champion Centre in New Zealand children born prematurely attend integrated relationship-based early intervention services with their families where the parent-child relationship is promoted throughout therapy sessions. When I visited the Centre last year, the concepts of relational pedagogy and professional love were observable in therapy sessions:

EI Model

Following on from my Travelling Fellowship funded by WCMT http://www.wcmt.org.uk/users/carolynblackburn2015 Dr. Susan Foster-Cohen from the Champion Centre in NZ http://www.championcentre.org.nz/ will be visiting Birmingham City University to deliver an International Guest Lecture in June, 2016.  Her talk is entitled:

Bio-psycho-social consequences of premature birth: family and professional partnerships in early intervention

The short, medium and long-term impacts of premature birth on the infant, the mother, the family and their educational and social communities are the active subjects of research in a number of academic fields. Such research is revealing trends and likelihoods of developmental, educational, mental health and social consequences of prematurity that can, and must, be addressed in early intervention. Particularly difficult, however, is predicting which children will have which, or any, lasting consequences of their prematurity. This presents a challenge for health, education and social welfare practitioners to translate the research evidence into the best support for each child, the families that raise them, and the teachers that educate them. This talk will review the bio-psycho-social consequences of premature birth and then describe the multi-disciplinary support provided to children born prematurely, their families and their teachers at The Champion Centre in Christchurch, New Zealand. It will focus on the challenges encountered in assessment, monitoring, and intervention; and the importance of developing families as ‘advocates for life’ for their children.

Dr. Susan Foster-Cohen is the Director of the Champion Centre and Adjunct Associate Professor at the University of Canterbury. She is engaged in active research into the outcomes of parent-partnership interventions at the Centre. She has also been a member of a research team at the University of Canterbury exploring the long-term outcomes of prematurity, with a particular focus on communication and language development. She has held academic positions in universities in the UK, USA, France and New Zealand and has published widely on language development in both pure and applied journals and books.

Places can be booked here https://www.eventbrite.co.uk/e/bio-psycho-social-consequences-of-premature-birth

 

 

 

Young children’s musical activities in the home

Communicative Musicality PodcastChildren playing with musical toys. Isolated on white background

 

Summary findings of an internally funded project (Blackburn, 2016)

Background

The English Early Years Foundation Stage (DfE, 2014) places music as an activity to be promoted under expressive arts and design as a ‘specific’ area of learning, whilst communication and literacy is a ‘prime’ area of learning, even though early sound discrimination promoted by music activities is a foundational step for phonic and vocabulary development. Furthermore as noted by Young (2007), the emphasis on language acquisition in early childhood as well as the basic skills of literacy and numeracy means that practitioners and researchers are required to explicitly demonstrate the efficacy of music in supporting children’s wider learning rather than appreciating children’s creative competencies. There is also concern that the quality and appropriateness of music activities offered to young children and their parents are given due consideration (Young, 2007). Papousek (1996: 108) stressed the importance of informal musical stimulation for very young children, illustrating the importance of children’s spontaneous and natural rhythmic patterns:

‘For the infancy period, it may be advisable not to disturb the earliest forms of intuitive musical stimulation by rationally guided artificial manipulations and formal educational interventions, but to keep them concealed as a precious part of early parent-infant relationships.’

Given the established association between music and human communication (see Malloch and Trevarthen, 2009; Ockleford, 2001; Ockleford, 2010), this project seeks to identify how young children across the age range included in the EYFS are involved in musical activities in home and out-of-home early years settings starting with an initial survey and interviews with families to establish children’s participation in musical activities in the home. Research questions included:

  • What are the views, perceptions and reported practices of interested stakeholders in young children’s musical activities?
  • What musical activities are young children involved in within home settings?

This is seen as a scoping study for further research into how the association between music and communication development can be promoted amongst stakeholders interested in young children’s well-being, learning and development. Children’s experiences in the home contribute to their overall learning and development. Therefore, involving parents in an initial survey and interviews has provided insight into children’s earliest experiences.

Summary of findings:

From the survey, twenty participants reported that they had a musical background or that the family was musical. There were no significant differences in the frequency or type of musical activity reported by this group of participants. There were also no significant differences between their perceptions of the benefits of musical activities for children and the remaining participants. Grandparents were joining in with young children’s musical activities and emphasised how much they enjoyed and anticipated visits from their grandchildren stressing the intergenerational benefits of shared musical activities identified by de Vries (2012). Only two parents that were interviewed had musical backgrounds. In interviews parents’ reports of the benefits of children’s participation in musical activities in the home varied widely from inclusion and participation to calming and soothing.

In contrast to previous studies (for example de Vries, 2009) young children in this study were participating in musical activities daily in most cases and in almost all cases at least weekly. The range of musical activities was wide and adults were joining in with children’s musical activities. Given the associations between the frequency of shared musical activities and children’s later prosocial skills, vocabulary, numeracy and attentional and emotional regulation identified by Williams et al., (2015), this is an important finding. The role of technology in children’s musical activities is an interesting finding. In common with Denac’s (2008) findings about children’s preferences, children were participating mostly in listening to music and singing songs followed by activities that involved movement and instruments, although children’s preferences were not gathered in this study.

Participants in this study appeared to recognise the value and importance of children’s spontaneous musical activities and to encourage it describing the benefit for children’s holistic development and the role of music in attachment and bonding. However, in common with de Vries’s study, they also appear to have identified benefits for children in attending organised, structured musical activities both within the home, but more substantially outside the home. In interviews it appeared that this was related to children’s musical development and building parents’ and children’s confidence to participate. It was interesting that only one parent in interview expressed concern about the nature and quality of professional qualifications needed to organise musical activities for young children and parents as this was a matter of concern raised by Young (2007) and one participant in this study.

From his study, de vries (2009) suggested that initiatives that encourage parental engagement in literacy programmes be extended or adapted for parents to encourage creative musical activities in the home. However, it is clear from this study, that as far as this (admittedly narrow) sample is concerned, participation in musical activities occurs regularly for young children, their parents, foster carers and grandparents. However, the high number of organised, structured activities that children participate in outside the home is an area worthy of further investigation to ensure that experiences offered to young children do not serve to formalise their innate musicality thereby ‘disturbing the earliest forms of intuitive musical stimulation by rationally guided artificial manipulations and formal educational interventions’ Papousek (1996: 108).

 

 

 

Identifying, assessing and supporting young children’s speech, language and communication in early years settings

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A landmark government commissioned review of Services for Children and Young People with Speech, Language and Communication Needs [SLCN] (Bercow Report, 2008) signalled the centrality of SLC in children’s development, learning and later academic and life-long success. It further stimulated increased attention and interest in SLC from government and led to a significant government-funded research programme (Better Communication Research Programme, 2012) and a ‘Year of Communication’ (2011) that aimed to raise awareness of the needs of children with SLCN. Furthermore, this established a national prevalence of SLCN of 7 % of all children in England, 1% of children having severe or complex SLCN needing long-term specialist provision, and a further 50% of five-year-old children living in the most disadvantaged areas of England having speech and language skills that were significantly lower than those of their peers. The effectiveness of Early Intervention [EI] was a key theme resulting from the Bercow Report (2008) and subsequent independent reviews. Most significantly, Bercow (2008) was confident that the majority of difficulties and delays in the acquisition of SLC could be identified as early as the second year of life and emphasised the role of early years practitioners in the early identification, assessment and support of young children’s SLCN.

The Bercow Report (2008) stressed the role of early years practitioners with regard to the early identification of problems with children’s SLC development so that the number of children reaching compulsory school age identified with SLCN and SEND could be reduced through universal, targeted and specialist EI. Nutbrown (2012: 19-20) noted that for early years practitioners a “key part of understanding how and when children typically developed was being able to notice signs of slower, or different development and whether or not an apparent delay in development was an indication of other SEND”. She was particularly concerned that early years practitioners should be equipped with the knowledge about:

  • what to look for in this regard;
  • how to respond to it;
  • how to interact with parents and the multi-agency professionals who may play a part in supporting a child with SEND, with EI.

My PhD therefore aimed to explore the policy-to-practice context to the delays and difficulties in the acquisition of SLC in the first five years using a mixed-methods interpretive case study design. Nine children were observed in 11 different early years settings (some children attended combined placements), eleven early years practitioners and nine parents were interviewed in addition to an initial survey.

Using a bioecological model as person-process-context-time model to understand the phenomenon of early identification, assessment and support of SLCN revealed that the processes and structures within early years settings such as the size of settings, age ranges of children, grouping of children, activities provided for them and adult pedagogical interactions impacted on children’s communicative interactions with others, adults and peers. Children’s use of solitary self-talk was an interesting finding given its reported usefulness for children in forming a bridge between social speech and inner speech, keeping track of their thoughts and regulating their emotions.

At the microcontext of the home environment, parents appeared to be supportive, were realistic in their expectations for children and sought professional help for their children when needed. However, it had been easier for some parents to secure professional help than others. Parents were content that their child had made progress in SLC in their early years setting and appreciated the benefit for their child of attending early care and education settings.

At the microcontext of early years settings, early years practitioners were observed to be fulfilling their role of assessing, monitoring and identifying problems with children SLC competently. However, the majority of children identified with SLCN from survey responses were aged twenty-four to sixty months with few in the twelve to twenty-four month age band suggested by Bercow (2008). Specialist settings were using a wider range of tools for assessment and monitoring than mainstream settings which helped them to monitor progress in finer detail. The majority of practitioners reported that their initial training had not equipped them adequately to identify problems with SLC, work with parents and other professionals or support children with EAL. Whilst all practitioners had attended post-experience training related to SLCN and SEND, only one had attended training related to supporting children with EAL.

Specialist and mainstream placements were found to complement one another, although the wide variation in adult-led/child-initiated play within and across groups was surprising since this was found to have a strong influence on the amount and quality of adult and child-initiated talk. This served to reinforce the view that children with delays and deviance need time in a social context to rehearse speech as well as to observe, listen to and imitate known figures in familiar contexts.

Specialist settings were able to plan very intensive and closely matched tasks that can become de-contextualised and thus become skill-and-drill in nature. Mainstream settings were able to build on incidental activities and familiar social contexts providing contextualised SLC and behavioural models. Language learning for young children is not a skill but a culturally learned behaviour created through patterns of action and interaction in a specific social context. Talking to young children, about the things that the caregiver and child do together with objects (to create joint attention), simplifying sequences of actions that can be talked about and later repeated by the child is a foundational step in language development.

Mainstream practitioners would benefit from gaining a more detailed knowledge of normal or typical patterns of language development, especially the early stages related to attunement, relationship-building and turn-taking which were shown to be fundamental to SLC development. Specialist practitioners might benefit from considering building and developing a social contextual dimension into planned intensive one-to-one SLC activities so children have the opportunity not only practise new skills, but also to apply them in a socially appropriate situation with the benefit of adult scaffolding. Children learn language through incidental rather than didactic learning opportunities.

Both specialist and mainstream practitioners would benefit from developing a wider range of strategies and support resources for EAL, especially with regard to Assistive and Augmentative Communication (for example signs and widgets), for parents and children. These could profitably be used more extensively in mainstream settings.

At the exo level of LA influence, the study suggests that whilst children with severe and complex SLCN received specialist early years provision and considerable support from Speech and Language Therapists, this was not the case for children with mild to moderate and therefore less easily recognisable SLCN. Although children with mild to moderate SLCN and EAL had some access to specialist services, it was not comparable to that offered to children with severe and complex SLCN. Although this seemed appropriate, it raised the question of how those children at risk from developing SEND might have their developmental trajectory optimised given the importance of development in the first three years of life stressed by Government policy reports such as the Bercow Review (2008).

SLCN as observed in this study varied in nature, intensity and onset. Most children had been identified by professionals or parents as having a difficulty by the age of two years, six months. This suggests that the education and health check required to take place at approximately two to two years six months is appropriate. The Children and Families Act will serve to strengthen support for children with more severe difficulties. However, the reduction in LA services following austerity measures may threaten the prescribed and important extra support by Area SENCOS, Educational Psychologists and SLTs for mainstream practitioners who support children with mild to moderate SLCN.

The study has highlighted the difficult and subjective nature of early identification and assessment and the wide variation in children’s early experiences, social interaction, SLC, socio-economic and socio-cultural environments. The appropriateness of requiring generalist practitioners to undertake specialist roles with reported reductions in support from other professionals due to austerity measures remains an overarching challenge for policy makers to address. However, if problems are not identified early then later problems with communication, language and literacy skills and other areas of the curriculum, accompanied by poor self-esteem and motivation to learn were anticipated by practitioners in this study and other research (for example, Bercow Report, 2008). Whilst the study has focused on learning and competence in SLC, it has been beyond its scope to extend to consideration of broader literacy development.

Early identification of problems requires observation over time with children with milder delays being identified later than the second year of life suggested by Bercow Report (2008). Children can make satisfactory progress when provided with the right specialist support and resources in mainstream early care and education alongside their typically developing peers. All children could benefit from:

… an unbreakable determination to seize the opportunity that this review offers to help some of our most vulnerable children and young people. (Bercow Report, 2008: 64)

Agreement as to how to achieve the aims established within the Bercow Report (2008) to ensure effective EI for all children needs to be fully understood and acted upon. A shared understanding of early SLC development across professional groups is a necessary pre-requisite to achieving this.

How to cite this study:  Blackburn, C. (2014) The Policy-to-practice context to the delays and difficulties in the acquisition of speech, language and communication in the first five years.  Unpublished PhD thesis, Birmingham: Birmingham City University

References:

Bercow, J. (2008) The Bercow Report. A Review of Services for Children and Young People (0-19) with Speech, Language and Communication Needs. Nottingham: Department of Children, Schools and Families

Nutbrown, C. (2012) Review of Early Education and Childcare Qualifications: Final Report. London: Department for Education

Relationships are at the core of successful early intervention services

Research located in the scientific disciplines of early childhood intervention and psychology demonstrate the potential for change in children’s development when Early Intervention programmes promote the participation of an active child in meaningful ways that respect and values the family interactions and practices that they grow and develop in. In the UK the nature and structure of services run the risk of devaluing families’ contribution to children’s learning and development as well as children’s varying competencies and strengths. Services are not always integrated and sometimes contribute to family stressors rather than reducing them. I travelled to New Zealand to explore the world-leading Champion Centre where relationship-based EI services are provided for children aged birth to six who have at least two areas of developmental delay/disability. The programme is offered in a centre-based model of service, in partnership with parents, and in accordance with international best practice.

I found that observable physical and social processes and structures within the delivery of the model include a number of dimensions that can contribute to parents feeling empowered and having high aspirations for their children as well as children’s progress over time. This includes: respectful professional interactions and relationships with children and families, integrated professional working, effective and timely communication between professionals and families, pedagogy of listening, waiting and personalization, engaged families and actively participating children. Parents’ high aspirations for children reflected professional aspirations for children of inclusion for children in education and society as well as meaningful employment and achievement in life. Professional aspirations also extended to successful parent-child relationships. At the most profound level, there was the aspiration that the Champion Centre EI service could “change brains for parent and child.” (Champion Centre Director)

I will be presenting the findings at BCU internal research conferences and cluster events as well as at the International Society on Early Intervention Conference on Children’s Rights and Early Intervention in Stockholm, June 2016 and other international conferences. The findings will also inform undergraduate and post-graduate teaching within the University.

Interim reflections on a Travelling Fellowship

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The report from my Travelling Fellowship to NZ is due by December.  On typing up the interview transcripts I found myself reflecting on my overall impressions of the Champion Centre and the people who had worked so hard to welcome me in New Zealand but also on the usefulness of travelling to the other side of the world.  These are my reflections.

First of all sincere thanks to Dr. Susan Foster-Cohen for organising a comprehensive research programme, to all of the staff for welcoming me and accommodating me, to parents and children for allowing me to observe their sessions.  I thoroughly enjoyed my visit to the Champion Centre (and Christchurch) and was really well looked after. Also sincere thanks to Jane Thistlethwaite of Positive Path International for showing me some of the amazing special schools in NZ.

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The Champion Centre

The evidence and argument for relational pedagogy is robust internationally, especially in early childhood. The relational approach in the Champion Centre Model is the most consistent thread throughout the programme and observable in therapy sessions, in conversations between professionals, between professionals and families, professionals and children and extends to visiting researchers. Outstanding and distinctive features (that are different to previously observed early childhood education/intervention models and worth travelling to the other side of the world to see) include:

  • The range of therapeutic /educational approaches (the inclusion of music and intensive computer time especially) and the delivery of these all under one roof with parents as full and equal participants, sometimes following therapists, sometimes leading therapists alongside their child;
  • The integration of these different approaches to the extent that sometimes they are jointly delivered where this is perceived to be beneficial for the child/family/particular target, This means that there is a consistent approach whereby there is a common culture/language whilst individual specialisms are respected and maintained;
  • The natural conversations during everyday communications and interactions between staff of different disciplines and with families that are beneficial for consistency of delivery and continuation of the programme within the home setting;
  • The respectful and reflective approaches from professionals towards each other, to children, families;
  • The time given in therapy/education sessions for parents to talk and be listened to, this was especially important in the monitoring programme for children born prematurely where the Psychologist intuitively knew to allow silent moments and time for parents to think about what they wanted to say;
  • Dedication and enthusiasm of staff for the programme that goes beyond a desire to work with young children and extends to caring about the long term sustainability of family structures and processes;
  • Feedback from parents in interview has been extremely positive and reflects all of the above comments as well as respect for the highly skilled professionals who have shared their journey/about to share their journey, the baby programme that helps parents start their journey and the transition programme are especially valued by parents.

Overall, an adventure that I enjoyed, and as many people have said before me, an inspirational experience.

Seminars, sunsets and Sodom and Gomorrah

My time in Aukland/Hamilton so far has been mainly occupied with visits to Special Schools and Early Childhood Intervention Conductive Education units as well as speaking at two seminars on FASD for Positive Path International.

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Over 200 people attended the seminars which took place over two days and feedback from delegates has been really positive reinforcing the need for more information for educators and other professionals about FASD.

Following this some relaxation was in order with fish and chips and a beautiful sunset at Raglan Bay

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And a visit to Rotorua with Red Wood forests and Hells Gate Geothermal Park and Mud Spa where for more than 700 years the Ngati Rangiteaorere tribe have lived and protected the site as place of healing and revitalisation. The Sodom and Gomorrah Pool can reach temperatures in excess of 100 degrees Celsius and water can erupt from the pool up to two metres in height.

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