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Foundations for life: what works to support parent child interaction in the early years: report overview

The first five years of a child’s life are a period of momentous change – a baby grows into a child who can walk, talk and relate to others, both family and friends. Parents and carers help lay the foundations for a child’s life chances and life skills in the ways in which they interact with the child, including the ability to build strong relationships, manage their emotions, communicate and solve problems amongst much else.

Young children thrive in environments that are predictable and responsive to their needs. Children can struggle, however, when environments are neglectful, unpredictable or overwhelming. The quality of a young child’s environment is shaped by his or her parents or carers and the wider context – for example if a parent is isolated, vulnerable or in economic hardship. In these circumstances it is vital that parents have access to additional support that is of high quality and wellmatched to their needs and this is the focus of Foundations For Life: What Works to support parent child interaction in the early years.

As an independent charity and What Works Centre, the Early Intervention Foundation has published a groundbreaking assessment of 75 early intervention programmes aimed at improving child outcomes through positive parent child interactions in the early years. Foundations For Life is the latest review by EIF and the first major use of our own methods for robustly rating the evidence and costs of early intervention programmes.

Early intervention is about identifying and responding to signals of risk for children and families before they become more difficult to reverse, from conception to young adulthood. Identifying and applying early intervention approaches which have strong evidence of impact on child outcomes has great potential to reduce the high fiscal and social cost of late intervention in the UK and realise the benefits of early intervention for families.

The UK market place of programmes which support parent child interaction is vibrant and full of potential. The review has found 17 programmes that are well evidenced, and a further 18 that have preliminary evidence of impact. There are also many other programmes based on sound science at an earlier stage of development that are committed to developing their evidence, and must be supported to do so.

Questions about ‘what works’ are not straightforward. Nothing ‘works’ in all circumstances and evidence changes and evolves. Building evidence of programme
impact has a number of stages and takes time. A vital part of this journey is learning from disappointing evaluation results and adapting in response. The best evidenced programmes have often had disappointing findings and evaluation set backs in the past, and learnt from these to strengthen the programme model. Experimentation can be the source of breakthroughs and greater innovation.

If early intervention is to realise its potential the UK must prioritise evaluation and testing. It must value both the discovery and verification of evidence, and incentivise innovation and smaller scale evaluations.

Local children’s services, maternity, public health and NHS commissioners have a critical role in both growing and applying the UK early intervention evidence base. They need access to the latest evidence to inform spending decisions, but also need to invest in better monitoring and testing of promising and innovative interventions being delivered in the UK. This is particularly important in areas where the evidence base is less well developed, such as attachment and cognitive development programmes.

Careful commissioning and effective implementation are as important to the success of a programme as the evidence that it has worked previously. The suitability of a
programme to a specific context, the quality of programme implementation systems, and the readiness of a local area for change and innovation can all combine to make or break a programme irrespective of success elsewhere.