Many, many thanks for your most interesting and stimulating presentation last night. I know I speak for everyone present when I say how much I enjoyed your presentation but - more importantly - how constructively provoked I feel after listening to you.
— Jim Anderson, Director of Education, Angus Council
Good antenatal programmes can have a major impact on the expectations and attitudes of parents. This section lists interventions that we have found promising.
Nurse Family Partnership
Nurse Family Partnership is the most thoroughly researched and recommended early intervention in the world and since WAVE worked with its originator, David Olds, between 2004 and 2006 to bring it to the UK, it now runs in this country as the Family Nurse Partnership.
Centering Pregnancy is a model of group antenatal care developed at the Yale Schoolof Public Health that has since been widely replicated. Women are engaged as active participants (e.g. measuring each other’s blood pressure). With little added cost women receive 10 times more contact time. Suggested benefits include reduced preterm births, increased birth weight and increased breastfeeding initiation rate.
It is commonly said that the peak age for violent behaviour is mid-adolescence. Four decades of research by Professor Richard Tremblay demonstrate that a more accurate statement would be that while the visible consequences of violence are greatest in mid-adolescence, the peak age for aggression and violence in children is 2-3, with those children destined to be the most troublesome offenders in teenage years already distinguished at age 3 by levels of aggression 10 times higher than the most peaceable 30% of toddlers. Tremblay’s research is summarised and has an important message for the most effective age of intervention to reduce violence in society.
There is good evidence for the effectiveness of Healthy Families America in preventing child maltreatment. It is a national initiative to help parents get their newborns off to a healthy start. While participation is strictly voluntary, outreach is included in the initiative. Crucially, the home visiting is carried out by trained Family Support Workers rather than health visitors.
The Croydon Total Place initiative has similarities with the above Highland Region approach, including team-working across agencies, single points of contact for difficult families, early identification etc, plus a number of additional ideas such as involvement of the community, proactively engaging parents and an Early Years Academy to train staff. An approach combining the best of both the Highland Region and Croydon models could deliver much improved outcomes for children as well as significant cost savings.