A universal systems approach to education, care and health services for all children and families does not mean a ‘one size fits all’ model. There will be shared principles, goals and desired outcomes from adopting a universal approach, but communities and services need to be able to respond to their unique contexts and particular child and family circumstances. Universal high quality early childhood services are ‘ready’ for all children and their families (Brennan et al., 2003; Centre for Community Child Health, 2008c; McLoughlin & Stonehouse, 2006; Centre for Community Child Health, 2003a).
Key features of such a system have been identified as: • High quality expected and provided in every service
• A connected, integrated or joined up system of all the services that children and families might need to access for their education, care and health needs • A tiered system of universal, secondary and tertiary services able to meet the
additional needs of individual children and families
• Services that are accessible and affordable for every child and family • The service and not the child or family make adaptations as part of an
inclusive philosophy, program and environment
• Every child and family experience a strong sense of being drawn into and welcome in the service
• All children’s education, care and wellbeing needs met in the mainstream services, with additional secondary or tertiary services when deemed necessary, provided within the mainstream service where possible
• More comprehensive service delivery and more timely access to services • Trans-disciplinary approach with different professionals learning from and
with each other with ongoing opportunities for the transfer of knowledge, skills and practices
• Respect and acknowledgement of cultural and linguistic diversity Tiered early intervening strategies
An integrated tiered system - sometimes referred to as a public health model (Bromfield & Holzer, 2008; Jordan & Sketchley, 2009; O’Donnell et al., 2008 Scott, 2006), and called progressive universalism in the UK (Feinstein et al., 2008; Statham & Smith, 2010) - differs in approach from the current system in a number of important ways. It can respond to emerging problems and conditions, rather than waiting until problems become so entrenched and severe that they are finally eligible for service. It focuses on targeting problems as they emerge through the secondary and tertiary layers, rather than people as risk categories, thus avoiding unnecessary stigmatising. It aims to drive expertise down to universal and secondary services, strengthening their capacity to deliver
prevention and early intervention strategies. It would have outreach bases co- located with universal services to facilitate collaboration and consultant support. Specialist services such as ECIS are usually funded on the basis of eligibility criteria and are precluded from providing any support until the criteria are met. This is contrary to the fundamental premise of early intervention – that it is better to provide support as early as possible rather than waiting until the problems are entrenched and more difficult to remediate. To overcome this anomaly, new strategies for addressing emerging problems are being developed. These involve the use of a tiered set of ‘early intervening’ strategies of increasing intensity that are designed to respond strategically to the child’s learning or developmental needs and to prevent the problem worsening. Known as Response to
Intervention, these strategies have been widely adapted in schools in the US (Glover & Vaughn, 2010; Jimerson et al., 2007).
The approach has been adapted for early childhood settings where it is sometimes known as Recognition and Response (Coleman et al., 2006; Coleman et al., 2009; FPG Child Development Institute, 2008) or Multi-Tiered System of Support (McCart et al., 2009). Accounts of how the essential components of this approach — universal screening and progress-monitoring with research-based, tiered interventions — can be applied in preschool settings has been provided by Coleman et al. (2009) and the FPG Child Development Institute (2008). According to Coleman et al., the essential components of the approach are high quality classroom instruction, tiered instruction and
intervention, ongoing student assessment/progress monitoring, and family involvement.
Several hierarchical or tiered service models have been developed:
• A ‘building blocks’ model to promote the inclusion of young children with disabilities in early childhood programs (Sandall & Schwartz, 2002)
• A ‘teaching pyramid’ model to promote social emotional development and prevent the development of challenging behaviour (Fox et al., 2003, 2009; Hemmeter et al., 2006).
• Another ‘pyramid model’ involving recommended practices to help early care and education programs support the social—emotional competence of young children and address challenging behaviour (Hunter & Hemmeter, 2009) • A hierarchical intervention system for promoting positive peer relationships in
young children with disabilities (Brown et al., 2001)
• A three-tier model of intervention for parents of young children with
developmental disabilities to reduce negative parent--child interactions and behaviour problems (McIntyre, & Phaneuf, 2007)
There is an emerging body of empirical evidence that this an effective method for identifying children at risk for learning difficulties and for providing specialised interventions, either to ameliorate or to prevent the occurrence of learning
disabilities (Coleman et al., 2006). Tiered early intervening strategies have been shown to be effective in promoting early literacy development (Gettinger
& Stoiber, 2007) and in supporting social competencies and preventing challenging behaviour (Fox et al., 2003; Hemmeter et al., 2006).
The only report of an attempt to implement this approach in a more systemic fashion comes from McCart et al. (2009). They tested the feasibility of delivering a family-based multi-tiered system of support to families of preschoolers through a family support agency. Parents from an Early Head Start agency were offered training to better prepare them to parent more effectively. Three levels (primary, secondary and tertiary) of training and support were employed to match family need with intervention intensity. The results indicate participants were satisfied with the service delivery and may have experienced reduced levels of stress as a result of their participation. This suggests that systems of support in which
parents progress through a series of increasingly intensive interventions
depending on their need appears a potentially promising framework for delivering services to families.
The challenges of attempting to transform a system with distinct organisational differences, inconsistencies in quality and outcomes, and often kept apart by professional silos and the different status of these professionals, into a connected, universal systems approach, should not be underestimated. For families with children who have a disability or developmental delay, these organisational differences may be even more evident if they are using multiple services for their children’s education, care and health needs.