Background

Early intervention encompasses a broad range of policies, approaches and programmes aimed at identifying and supporting people at risk of developing poor outcomes. Early intervention approaches can be implemented for any person or family who are considered to be vulnerable or at high risk of disadvantage. However, early intervention is often targeted at very young children and their parents/carers within early childhood.

It is widely acknowledged that early childhood is a critical period of learning and development for young children. Early life experiences within the first few years of a child’s life can have a significant effect upon their future outcomes. For children who do not have positive early childhood experiences and do not have their needs effectively met, there is an increased risk of developing problems in later life, including poor physical and mental health, and low academic attainment, which can lead to crime and anti-social behaviour.

The main priority of early intervention is to identify and provide support to children and their parents/carers as soon as possible to prevent problems developing and continuing into adulthood. Therefore, early intervention is based upon the notion of prevention, rather than reactive intervention. Once problems have been established in early childhood and children are not supported to overcome them, as adults it becomes much more challenging and costly to provide intervention. It is additionally acknowledged that early intervention approaches and programmes are much more effective and have better outcomes with children, than with adults. Within early childhood, early intervention is most effective when implemented within the first three years of a child’s life. This creates a very narrow opportunity for children to be identified as needing support and the subsequent plan of action to be implemented.

Children with SEND

Early intervention policies and programmes can be targeted at specific groups of people who are considered to be at potential risk of being vulnerable. Children with SEND are identified as being a vulnerable group who are at risk of developing poor outcomes in later life, compared to their peers without SEND. In particular, it has been acknowledged that children with SEND are at greater risk of experiencing social, education and health inequalities from a very young age.

Therefore, it is important for early intervention to commence as early as possible  for children with SEND, to have the most impact upon their learning and development. In their early years, children with SEND often require intervention and targeted support aimed at improving key developmental skills.  Key developmental skills relate to areas of a child’s personal, social and emotional development, as well as their communication, language and physical skills. These key developmental skills provide a strong foundation for other areas of learning. A lack of early support for key developmental skills increases the risk of children with SEND experiencing poor mental health, further social inequalities and a bigger gap in their academic attainment.

It is important for early intervention to start within the first three years and continue throughout their childhood, if required. However, often children with SEND are not accessing early intervention until they reach compulsory school age (often around the age of 5 years old), or later into their school life. By this time, the optimum window to start early intervention has been missed. While it is still appropriate and beneficial to a child to still commence early intervention at this late stage, the overall impact may be less successful and will require significantly more input over a longer period of time.

Gap between policy and practice

There is an overwhelming acknowledgement of the benefits of early intervention on the outcomes of children with SEND being recognised and embedded within policies and legislation. However, despite this commitment, in practice early intervention is not available or accessible for the majority of families across England. The availability of SEND services and programmes are inconsistent, with a ‘postcode lottery’ often attached to them of who is able to access them. Further barriers preventing the implementation of early intervention also include:

• Parental knowledge and signposting - parents/carers may not realise that their child may have a SEND need or know who to go to for advice and support if they are concerned.
• Lack of services - with varying services available, or not available as often the case is across localities, stricter criteria and reduced capacity due to government funding cuts, children are not receiving the specialist support they need.
• Waiting lists - again, due to a reduction of services due to government funding cuts across education, health and care services and a recruitment crisis hitting these sectors, waiting lists to see professionals have significantly increased. From the point of identification to referral and being seen by specialist services, children can be sat on waiting lists for months, even years in some cases, for assessment and intervention.

These barriers preventing the implementation of early intervention have been exacerbated by the Covid-19 pandemic. Waiting lists are even longer and services further reduced resulting in many children with SEND being left without support and widening the gap in their learning and development. For children who  have already been identified as having a SEND need, this is extremely frustrating, as the need is there, but the next step in terms of accessing support is not.

The vital role of early years practitioners

Early intervention is best served when there is a multi-agency approach. Inequalities children with SEND encounter often do not happen in isolation, and require targeted support across health, care services and educational provision. Therefore, in nurseries and school settings, practitioners and teachers have a responsibility to support children with SEND. This statutory requirement is outlined within the SEND Code of Practice (DfE, 2014 :79):

“Providers must have arrangements in place to support children with SEN or disabilities. These arrangements should include a clear approach to identifying and responding to SEN. The benefits of early intervention are widely recognised- identifying need at the earliest point, and then making effective provision, improves long-term outcomes for children.”

Furthermore, for the youngest children who attend a nursery setting, they may have an underlying SEND need that has yet to be identified. This is when the role of a key person in the processes of observing and tracking a child’s development becomes integral. Through high quality planning, tracking and reviewing a child’s development, practitioners can more effectively identify a potential developmental delay and be a key enabler of implementing early support. Once a need has been identified, practitioners can begin a form of early intervention within the setting. This will often come in the form of a ‘graduated approach’ of ‘assess, plan, do, review’ cycle:

• Assess - practitioners will identify a need from their observations.
• Plan - following the initial assessment, practitioners will agree on a plan of action with the child and their parents/carers.
• Do - the plan will be implemented to ensure the agreed intervention, adjustments and support are actioned over a specific timeframe.
• Review - the impact of the plan will be reviewed to establish if the plan needs to be continued within the setting or a referral for further support is required.

During each stage of the ‘graduated approach’, it is important to keep clear and accurate records as they can serve as supporting evidence when making referrals to specialist services. With stricter criteria and reduced capacity, support will often be directed to those most in need. Therefore, practitioners need to present a strong case as to why the child they are referring requires their support.

With the current challenges and barriers to accessing specialist support and intervention from other services, often the work practitioners do with young children within their setting will be the only support they receive. Due to a lack of access and support from other specialist services in some localities, without early years practitioners working together with young children and their parents/carers, many of them will ‘slip through the net’. Although this puts further pressure on practitioners, it is vital that they continue to put as much targeted support in place as practically possible. Although, this form of early intervention may not be enough, it can still make a significant difference to a child’s learning and development, while they wait for specialist support from other agencies.