Dr. Maria O'Dwyer:

I will take the Deputy's first question, on what poverty looks like and the kind of impacts it has, and then I will hand over to Mr. Chance. The pandemic has doubly disadvantaged families that were already disadvantaged before it began. As a result, we are starting to see more tangible and evident forms of poverty in regard to fuel poverty and green poverty, etc. I will bring it back to the basics of physical and mental health and start from there. Children who grow up in families where there is responsive caregiving, where their cues are being met and where there is attunement, attachment and security with the parents from the time they are born enjoy a foundation of learning for later in life and positive mental health to be maintained throughout the course of their lives. In families that experience disadvantage on an ongoing basis, on an occasional basis or on an emergency basis as in the case of Covid-19, responsive caregiving is not doable to the full extent. In such cases, parents cannot engage with children in a way that is for the best, optimal development of the child mentally and physically. Small daily caregiving activities like providing opportunities to play and reading to babies do not happen in such families. We see that increasingly as a result of the pandemic. A couple of years ago, there were atrocious pictures of a child in emergency homeless accommodation whose space to play was between the beds. As a result of direct provision and the pandemic, we are seeing more and more of those confined spaces. This has a significant impact on the development of gross and motor development skills. Many children do not have access to play or access to nutrition. We know that food poverty was heightened during the pandemic. Families have always experienced food poverty, but the closure of early years services in schools heightened food poverty, which had an impact on nutrition.

Engagement with services is something we see with families who are experiencing difficulties. It is not as linear. If you have a problem, you know where to go and there is signposting. If there is a whole other plethora of things going on for that family, the access to those services is not as direct as it should be. Nationally we spend a great deal of time thinking about how to unblock referral pathways and uncomplicate the systems we have. Sometimes we unblock those referral pathways more for the service providers than for the families at the end. We really have to start with where the families are. We can get a bit sniffy - I do not know if that is the right word - when we talk about technology. There is a sense that if somebody does not have an iPad or does not have access to such-and-such, it is a very middle-class concern. I would say that prior to the pandemic, in child development we would have thought that having a screen was not essential. The pandemic taught us that we have a significant digital divide in Ireland between those who can access technology and those who cannot. We saw it in such things as homeschooling. It was not even always about the technology itself, but about having a space or an extra device in the house that a parent could use. Parents and families were struggling, which impacted on learning.

In regard to the health and development of children who are experiencing poverty, their outcomes are always impeded by the circumstances they live in, for example if they are on waiting lists. Currently there is a two-year waiting list for early intervention services. If an issue is flagged, the two-year wait sometimes means that the prevention and early intervention window has been missed and the problem is likely to escalate.

We see that with speech and language attainment. Initiatives such as the early based childhood programmes are doing stellar work in community clinical joint interventions where previously something like a speech language deficit or delay was picked up at the seven- to nine-months check-up, and maybe would not have been spotted again until school. We now know in the early years that such deficits are being picked up earlier through the early years community clinical collaborations, such as ABCs, so now there is a chance of prevention and early intervention.

In regard to life opportunities over the life-course, we know children are exposed to things such as domestic violence at home, in which there was a 25% increase over the pandemic, and to levels of aggression. It is very hard for parents who cannot regulate themselves to support regulating their children. That is a cycle. We saw in the pandemic the expectation that all parents can stay calm and guide children through this when in fact half the adult population was panicking.

In regard to prevention and early intervention, the message there is about getting in early enough and learning from the pandemic. For example, mental health services ironically were one of the last to manage to go online effectively. While the business and education sectors pivoted, mental health services which should have been front of stage were a little later to come online, so the impact of that meant that those with high anxiety who were supporting children who probably had high anxiety did not have access to support as and when needed.

The key message about child poverty and disadvantage is we cannot be offering too little, too late. It has to be when they need it, and in most cases for us, before they need it. I will hand over to Mr. Chance.