Mr. Noel Kelly:

I do not propose to rehearse our background because Ms McClorey has done a good job in setting the scene for the prevention and early intervention programme, the methodologies we have used and the principles we are following. I will instead speak briefly about our programme and the prevention and early intervention network.

Our programme is based in the Dublin 17 area. Typically it is attached to Darndale but it covers a wider area including Priorswood, Bonnybrook and Kilmore West. We decided in 2004 that we needed to do something about the number of children in our area who were not school ready when they started primary level. We commissioned a study using the early development instrument and found that more than 50% of the children demonstrated deficiencies in critical areas relating to school readiness. We engaged in a planning process which was similar to that described by Ms McClorey with all of the health, education and community partners to identify what we could do in our community to address this deficiency and help children. We collectively decided to develop a discrete programme focused on supporting families and parents.

Our hypothesis is that if parents are adequately supported during pregnancy and the early years of a child’s life, this will lead to improved outcomes for children, their families, schools and wider society. Waiting until children arrive in school before intervening leads to a range of negative outcomes for children and their families which begin to manifest themselves as soon as the child starts school. Many of these negative outcomes continue to be a drain on resources throughout the child’s life and impact on his or her ability to fully engage. We wanted to test the efficacy of investing in and supporting parents during pregnancy and preschool years. We are carrying out a random control trial over that period of time. Random control trials are governed by a range of restrictions and rules and we can only release outcomes when we have full sets of data. As we currently have outcomes for six, 12 and 18 months, I can share this information with the committee.

The areas on which we are predominantly focused with parents are child development and parenting. We are using a rigorous process including Triple P, which is an international evidence-based parenting programme. In the area of child development we are using all the information that the HSE has made available but we are packaging it differently to make it accessible to families. The programme is based on working with families in their own homes. The vast majority of families, or approximately 80%, agree to work in their own homes but if that is not their preferred option we will work with them in community settings. We are also supporting all of the early year settings in our area to improve their quality. We have participated in the Síolta quality framework and we are delighted that six of our services have been accredited by the Department of Children and Youth Affairs. Our intervention with families is holistic and takes place on a wide variety of levels. It includes physical health, social and emotional development, approaches to learning, language and literacy and cognition and general knowledge. We are trying to support parents and their children across these areas. The Geary institute in UCD is working with us on our research and a number of international people are also involved. Members may be familiar with Richard Tremblay, an associate professor in UCD, who is leading this part of the research.

We are finding significant results after six, 12 and 18 months in a number of important areas. We are starting to find significant results in cognitive development of children in both growth and fine motor skills. We are also seeing a number of positive developments in parenting. One of the parenting outcomes is that parents are less hostile towards their children. There is a detrimental effect on children's growth if parents have a hostile relationship with them. Reducing hostility improves the parent-child relationship. We are also seeing improvements in home environments so that children are being brought up in more stimulating and safer environments. There are significant improvements in interactions between parents and children, in social support for parents and in the health of the children.

In the current climate we are very conscious that obesity and child health represent a major issue. Diet needs considerable attention in communities such as ours because, unfortunately, many of the children would not have a very rounded diet and we are working effectively with parents on that.

From a medical point of view, we have also had some very significant birth outcome impacts where the number of women who had caesarean sections at birth was significantly below the national average and the number of women who had induced labour was also significantly lower. The medical community has got quite excited about this because it has failed to impact on those areas. The work we did with parents during pregnancy seems to be the factor that has made a big impact there.

We will continue to work with these families. The first of the children started school in September and the rest of the children in the study will start in 2013, 2014 and 2015. Unfortunately, our final results will not be available until the last child arrives in school, but we are incrementally releasing the results. At the moment we have our six, 12 and 18 months' reports which are available on our website - I flagged that on the document I submitted to the committee.

Nationally, 25 organisations are involved in prevention and early intervention work. Over the past two years we have formed a network, the Prevention and Early Intervention Network, which has become a very vibrant and active network which has gained considerable traction. We have had considerable communication with the Department of Children and Youth Affairs, with politicians and policy makers. We are delighted with the interest in this area at the moment, as Ms McClory said. It is a very rich environment for child policy at the moment and we want to contribute our piece. We all collectively believe that investment in early intervention and prevention will, in the long term, produce better outcomes for children, families and for the country as a whole. I have some cards on the Prevention and Early Intervention Network and if members are interested, details of the work and research we are doing are available on our website.