Ms Eleanor McClorey:

Today, we anticipate we will be celebrating our 1,000th Ballymun baby through the ready, steady, grow service and the parent child psychological support programme.

First, I want to provide some context and rationale around the imperative to implement comprehensive, area-wide, evidence-based approaches to tackling poverty. Social exclusion, poverty and intergenerational deprivation have major impacts on life outcomes. Social determinants at birth, including parents' education, health and housing status, are significantly correlated with children's educational attainment, health including mental health, employment chances and other significant life outcomes. High concentrations of need at area level impose significant burdens on children and families, on services, communities and the State.

A cycle of disadvantage is replicated, in part, because we are not investing in the right types of evidence-based supports to families to build protective factors and skills early enough in life and with sufficient consistency. Disadvantage is heavily concentrated in certain geographical areas and family level disadvantage is compounded by neighbourhood effects. Area-based approaches are critical to addressing this. Structural cause and effect mechanisms of poverty can be impacted on through whole-community integrated service strategies. We know what can work to counteract social determinants at birth. With an integrated service plan, appropriate capacity-building, sufficient motivation and focus, we can measurably improve life outcomes for children living in areas of social disadvantage and risk of poverty.

Youngballymun, along with our colleagues in Tallaght and Darndale, was established as a Prevention and Early Intervention Programme for Children in 2007. Jointly funded by Atlantic Philanthropies and the then office of the Minister for Children, we were tasked with designing and implementing a ten-year strategy to improve outcomes for children and families in Ballymun. To ensure a comprehensive lens was brought to planning the youngballymun initiative, we paid particular attention to the service design phase of the work. Partners from across the education, health and community sectors, as well as local parents and residents, were brought together to strategically map out the needs of the area and appropriate evidence-based responses. Our service design phase involved in-depth needs analysis across different ages and stages of development, the investigation of service strategies that had been proven to work in other contexts and in-depth reflection by local service providers on their roles in delivering measurably improved well-being and learning outcomes for children and families. The design phase resulted in the development of a comprehensive area-based service plan, comprising four interconnected programmes of work - infant mental health, quality early years practice, social and emotional development, literacy and language practice, and youth mental health.

Infant mental health is about activating the resources of parents in fostering healthy infant development through interventions by public health nurses, speech and language therapists and community practitioners. The quality early years practice is about developing capacity of early-years services in Ballymun to implement the Síolta quality framework and the high scope curriculum. The social and emotional development, literacy and language aspect involved interconnected programmes and initiatives to build capacity of parents, children and teachers to foster social and emotional development and language and literacy skills. The youth mental health aspect is about re-engineering, ensuring access to and building the capacity of youth and health services to actively promote and respond to young people's mental health.

There are a number of core features of the youngballymun model. The life cycle response is fundamental. We need to start from pregnancy and birth to build protective factors and set the right foundation. From this solid start, we continue to implement rigorous supports consistently in a child's journey through life in tandem with public services. Evidence-based approaches are at the heart of everything that we do. All the initiatives we implement have a strong basis in evidence and ongoing analysis of child and family outcomes is central. We must all invest in what we know will work.

Changing outcomes for children means building capacity of those they interact with to foster and nurture their growth and development in a conscious and informed way. This means parents, service providers and the wider community. Capacity building is the development of specific skills and competence in order to implement evidence-based practice and to work collaboratively. The practice changes that youngballymun promotes are taking place within existing systems - health services, schools, preschools and community groups. The embedding of practice in mainstream services allows universal reach to a whole community of children and also for the practice to be sustainable.

The youngballymun model is designed to be replicated. The approaches we promote can be scaled up in other communities interested in this way of working and we hope to be in a position in coming years to support that process. However, services are only cost effective when they deliver outcomes for children and families. All of our work has a keen eye to efficiency and effectiveness and we are committed to delivering results and demonstrating returns on investment. A value for money study forecasts return to the State of €4.50 for every €1 invested in youngballymun.

Outcomes to date from practice in Ballymun are encouraging. Successful examples include a 70% uptake of the parent-child psychological support programme which an evidence-based programme for babies up to the age of 18 months delivered in partnership with public health nurses and speech and language therapists. Early indications suggest that the proportion of babies demonstrating secure attachment, which is a strong indicator of a resilient protective factor, is greater than that of typical population samples. We have published the evaluation of our early years three-four-five service and it indicates that measurable improvements have been achieved in the quality of service provision. Children who have participated in a junior and senior infant social and emotional classroom curriculum, the incredible years programme, have shown reduced hyperactivity and conduct and peer problems, and increased pro-social behaviour. In parallel, parents participating in the incredible years parenting programmes exhibit significantly lower levels of stress and depression following the programme. These improvements are largely sustained at the six month follow-up point. Increased time is being spent on literacy in schools and pupils’ literacy scores have improved across the primary school community. The number of children in the lower percentiles has decreased and first class children in Ballymun are now achieving reading scores above national averages.

The programme for Government acknowledges the importance of drawing on a strong evidence base and reconfiguring existing services to fundamentally reform our approach to child poverty. This is reiterated by the 2013 budget commitment to an area-based approach to tackling child poverty. Youngballymun is an active working model of how an area-based strategy to tackle child poverty is delivering real results for children in the real world context of Ballymun. The establishment of the child and family support agency, the new service commissioning strategies across the HSE, the priority given to evidence, the development of family support service pathways nationally and a renewed policy focus on supporting parents offer important opportunities for policy and practice integration locally. We look forward to working with the Department of Children, the child and family support agency, primary care providers and other partners in prevention and early intervention to develop practice and share learning.