This topic provides an overview of the benefits of integrated and coordinated early childhood development services in order to meet the needs of families and young children in a coherent way, and presents some models that have proven effective.Synthesis PDF Complete topic PDF
How important is it?
Parents fill multiple roles in the life of their children, including the role of care giver, teacher, nurse, nutritionist, and moral guide. Yet, parents are not always able to coordinate all these roles or to provide all the resources to meet their children’s needs. As a result, most parents seek help from a variety of services (e.g., health, education, child care, social or other family support services). However, developmental outcomes vary depending on the extent to which these services are integrated together to form a cohesive system that can be easily accessed by families. Specifically, fragmentation of services often results in overall lack of coherence for children and families. When children are seen by multiple service providers, it is not rare that parents received mixed and conflicting advices limiting the effectiveness of these services. On the other hand, integrated services are more suitable to meet the needs of children by offering them and their families a variety of support services. Considering that children’s academic success is dependent not only on their cognitive development, but also on their physical, social, and emotional well-being, programs that coordinate responses across all these components produce the best results. Similarly, policies that integrate child care and education, produce more coherent experiences for children and better quality programs.
What do we know?
During the past decade, many programs offering integrated early childhood services have been implemented worldwide. Most of them were created in order to: 1) improve children’s health and overall development; 2) provide support to families; 3) decrease gaps in school readiness; and 4) reduce the negative outcomes associated with living in poor neighbourhoods. Early Head Start, Sure Start, Better Beginnings, Better Futures, and Toronto First Duty are examples of both broad scale government programs and demonstration projects that have also been the object of an evaluation in previous scientific studies.
Early Head Start
Early Head Start is an American federal program created in 1995 in order to serve low-income pregnant women and families with infant under the age of three. This program offers high quality child development services through home visits, center-based child care, health care, and case management. It integrates two-generation programming and aims to establish community partnerships to increase the availability of services to families. Benefits resulting from the implementation of this program include improvement in children’s socio-emotional development starting at age two.
Sure Start Local Programs (SSLPs)
Sure Start Local Programs have grouped health, social, and educational services to help poor children under the age of five and their family in England since 1999. Over time the mandate to integrate these services has been strengthened, evolving from a variety of community networks to more coherent children’s centres. Evidence suggests that greater integration leads to more benefit. Several positive developmental outcomes have been found for all sections of the populations living in SSLPs areas, including improvement in child’s health at age five (e.g., less severe injuries and respiratory infections) as well as several aspects of school functioning. Regarding the family, greater life satisfaction and improved parenting were reported by mothers.
Better Beginnings, Better Futures (BBBF)
BBBF is a project that examined the impact of integrated services in eight economically disadvantaged communities in the province of Ontario, Canada. It was designed to reduce emotional and behavioural problems in children (0-8 years old) and to strengthen parents’ abilities to meet the needs of their children. A variety of high-quality services were offered to children and their family, including health, social, educational, and family support services. In terms of impact, the creation of partnerships with community service providers increased the visibility and the funding for programs. It also increased the collaborations among service providers which in turn led to the development of new settings to offer services to children and families. Positive developmental outcomes were found in 4- to 8- years- old children and their families.
Toronto First Duty Project (TFD)
TFD is a project that began in 2001 to test the impact of integrating kindergarten, child care, and parenting support services into a single program on preschool children (0 to 6 years old) and their families in the greater Toronto area. Positive impacts of this project included an increase in parental engagement with school and a diminution of parental stress due to frequent negotiations between kindergarten and child care arrangements. In addition, children’s cognitive and language development improved when these integrated services were used on a frequent basis.
What can be done?
In order for programs to be efficacious (i.e., capable of producing expected results) and part of a cohesive system, some important aspects should be applied and taken into account. First, community members need to develop common goals to guide their partnership activities. Second, given that collaborations across agencies provide the best results, service providers should not work independently but rather try to establish collaborative relationships with other community organizations (e.g., by sharing information). This will help public and professional services to be more consistent. Similarly, providers from different sectors (education, health, nutrition, family support, etc.) must be able to refer children and their parents to services outside their professional purview. Consequently, they also need to coordinate with other service providers when serving the same child and family. Lastly, service providers should keep in mind that making the services available to family is not sufficient. Specifically, services also need to be affordable, accessible, and active in outreach in order for families to be aware of and to benefit from these services. Some families may lack resources or face social/economic circumstances preventing them to benefit from these services. Therefore, the coordination between services and the development of strategies to reduce barriers to access services are two important aspects to privilege before implementing a program. Evaluation of implementation and continuous monitoring of outreach need to be built in. Finally, integration at the community level requires system support in the form of program and policy support from different levels of government.
What do integrated early services do?
Parents are the primary caregivers to their children. They play the role of early teacher, nurse and moral guide.
Sometimes, however poverty or other factors make it difficult for parents to coordinate all these roles to best meet their children’s needs.
Integrated early services include a range of services such as health screening, family supports and early childhood education. These can level the playing field for children at risk, especially those from different socio-economic backgrounds and poor neighbourhoods.
Above all, integrated early services are the perfect example of how by working together towards a common goal, parents and communities can help children thrive and reach their full potential.
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March 2017 - Published by the Canadian Council on Social Determinants of Health (CCSDH), in collaboration with the Centre of Excellence for Early Childhood Development (CEECD)
Birkbeck University of London, United Kingdom