Ms Nuala Doherty:

I thank the Chairman and the committee for the invitation to address the committee meeting today. Our job in the Centre for Effective Services is to bring good quality evidence to policymakers in the area of services to children, families and communities. We translate the learning from research into messages that are usable for policymakers and practitioners.

There is a synergy between our work and that of the previous speaker. We will focus in our presentation on new emerging evidence with regard to prevention and early intervention and how this can be applied to an early years policy.

Members will be familiar with the concept of prevention and early intervention to address problems when they arise. There is compelling international evidence, contained in enough reports to fill the room from floor to ceiling, for the importance of reorienting services away from later to earlier intervention in order to achieve better outcomes for children.

This morning, however, I propose to focus on the significant body of Irish research and evidence we have collected in the past decade to support prevention and early intervention. Investment in this area has come primarily from Atlantic Philanthropies, but also from successive governments. Some €127 million has been invested over the past ten years or so in 52 programmes, and the lessons from that are now emerging. Our job was to synthesise those lessons and make them usable for the committee and other interested parties. As members can see, we have structured our findings into seven areas and given 12 recommendations. We will test members' memory later. We are saying that if we want to ensure better outcomes for children and families, intervening in these seven areas will make a difference. Our first three points relate to who we need to focus on, namely, parents, very young children from birth to three years, and the professionals who work with children. The second bundle concerns the areas we need to focus on, which are transitions for children and children's learning. The third category relates to how we need to work.

I will begin with the role of parents, an issue that was also highlighted by the previous speaker. We now know that the relationship between parent and child is the most important factor in terms of child outcomes, more important than issues such as income or family structure. Indeed, one of the key lessons is that if we work in supporting parents, we will achieve better outcomes for children. The research under the prevention and early intervention programme showed significant decreases in stress and depression among parents, significant increases in their confidence in their parenting skills and significant improvements in children's behaviour. The lesson is that with the right support, it is possible to achieve these types of improvement in outcomes. In that context, we are calling, as did the previous speaker, for a national approach to parenting and a national parenting action plan to co-ordinate the range of good work that is being done in supporting parents.

The second issue we highlighted relates to focusing on children from pre-birth to three years of age. We now know that this period is the most significant period in a child's development, when brain development is at its strongest. A safe nurturing environment and secure relationships during this period can deliver very good long-term outcomes. Reference was made to the importance of nutrition. We now have evidence, derived in this country, that breastfeeding is directly linked to a reduced likelihood of obesity at age three, something which has become a major public health concern. Findings from the programmes have shown that support in the form of home visits, for example, led to improvements in nutrition, a lower rate of hospital stays and better uptake of immunisation programmes.

The third issue we have identified, support for health professionals, also links very well with what the previous speaker said. We know that professionals working with children play a hugely important role in their well-being and development. They must, of course, be adequately trained, but that is not enough. We want them not only to have the necessary skills but also the suitability and aptitudes to do the job. The evidence is pointing to the need for a much more active type of training for professionals, with more skills-based learning, coaching and mentoring in addition to formal learning.

The fourth area we highlight relates to the key transitions in a child's development. Children go from home to preschool to primary school to post-primary school and on to the world of further education and work. While most children make those transitions without difficulty, children who are vulnerable can fall through the cracks at these times. The projects show that if we focus on the transitions, such as preparing children to transition from home to school and from primary to secondary level, we can achieve significantly better outcomes for them. School mentoring, for instance, can be of great help in supporting children through what can be the difficult transition from primary to secondary school.

In terms of supporting children's learning, which is the fifth issue we deal with, we know that the social and economic costs of poor school attainment are very high. There are many reasons children do not do well in school. There is a significant emphasis on literacy and numeracy in the programmes and many have achieved significant improvements in that regard. There is also, however, a focus on love of learning. One of the findings was that promoting a love of learning, in addition to focusing on literacy and numeracy, will make a difference. There is a linkage here with supporting parents in order to enable them to help their children at home.

The final two issues we have identified focus on how all this work should be done. It will come as no surprise to members that the programmes showed that parachuting initiatives and projects into communities does not work. Instead, there must be consultation with communities - finding out what they want, understanding what life is like for them and determining how the programmes can best meet their needs. The final point we make, under the same heading of how the work should be done, relates to the issue of inter-agency work, which is again very well matched with the point made by the previous speaker. Inter-agency co-operation is like the glue that makes the whole thing hang together. What we want to see, essentially, is the various bodies and agencies in the areas of education, health and justice working together. The local mechanism for doing that at county level is the children's services committee. That is already Government policy and we are recommending that it be given nationwide coverage this year.

In conclusion, there is substantial empirical evidence that intervening early in children's lives - a prevention and early intervention approach - offers substantial benefits not only in preventing a great deal of suffering for children and their families and the associated negative social consequences but also in so far as it is cost-effective.