Aims In Ireland, as elsewhere, the cycle of intergenerational poverty continues in established low-income communities with significant negative consequences for child health and development. Providing tailored programmes of targeted and universal interventions to support early childhood development can mitigate the effects for children and families. However, it is essential that, while maintaining gold-standard evidence-based approaches, programmes are appropriate for the local context. The aim of this child-focused community profile was to develop an in-depth understanding of local childhoods and, thereby, inform the programmatic direction of a multi-disciplinary area-based prevention and early intervention partnership.
Methods In 2015, community-level data on child development were collected using validated assessment instruments and administrative data sources. Pre-school Language Scale (PSL-5) and Strengths and Difficulties (SDQ) questionnaires were administered to school-aged children. The Santa Barbara School Readiness Scale was administered to pre-school children. Schools provided anonymised, standardised literacy scores. Administrative data on developmental health (Ages and Stages Questionnaire) and referral pathways were also compiled. All data were aggregated to community level. Results were compared with expected national and international standards and contextualised within existing community-level, socio-economic data.
Results Child development outcomes across all indicators were sub-optimal when compared with national standards. Findings included: 51% of children in their first year of primary education demonstrating auditory comprehension problems; 45% demonstrating expressive language problems; and 18% scoring high or very high for overall difficult on the SDQ. Identified need was greater than anticipated creating a challenge for existing service delivery models. The partnership, which had a strong focus on quality and interdisciplinary working, began a process of re-orientating services to encompass prevention and early intervention. This included oral language support for parents attending nurseled development clinics; an Infant Mental Health home-visitation programme; increased availability of evidence-based parent and infant groups; mentoring supports for services to embed training and enhance quality; and adaptation of traditional service delivery towards early intervention.
Conclusion Relying on adult-focused population health data can result in an underestimation of the developmental health needs of children in low-income communities. The availability of a child-focused community profile can be a catalyst for innovative approaches to supporting child development.
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