care and wellbeing needs of all children and families and the additional needs for children with disabilities or developmental delay and their families if they are to achieve positive developmental outcomes and genuine inclusion in their
communities. Much has been written in Australia and internationally confirming the importance of these matters by researchers and in numerous reports, directions’ papers, policy briefs and other documents prepared for or by governments, agencies and service providers (Bach, 2002; Gascoigne, 2006; Guralnick, 2005; Premier’s Children’s Advisory Committee, 2004; McLoughlin & Stonehouse, 2006; Centre for Community Child Health, 2003a; Shonkoff & Meisels, 2000).
Connecting evidence-based best practice in early childhood education, care and health services with evidence-based best practice in early childhood intervention remains an elusive goal and ongoing challenge in Australia and Victoria. While there are examples of this type of connecting, a systems-wide universal
approach has not yet been achieved despite the rhetoric and compelling
evidence arguing for the overall benefits for individuals and communities and as a right for all children and their families (McLoughlin & Stonehouse, 2006; Noah’s Ark, 2006).
In Victoria, there are many parents of children who have additional needs who would like them to gain access to early childhood services such as child care or preschool, but they find structural and process barriers to this access. It is unethical and economically inefficient to have these children and families
excluded from services, or gaining limited, conditional access, or gaining access only in the year prior to the child’s school entry. Ensuring that all children and families can gain access to high quality children’s services is an important issue which challenges countries globally. In countries such as the United Kingdom, the solution to these ethical, economic and empirical issues is believed to be found in a commitment to an approach focused on the child and family, and where every child and family can access the full range of high quality services from birth to school age and beyond (Every Child Matters,
www.everychildmatters.gov.uk).
In Victoria, this continuum of access options for children birth to eight years could include the Maternal and Child Health Nurse service, playgroups, supported plagroups, childcare, family day care, preschool, primary school and out-of- school hours care. While the majority of children’s education, care and health needs can be met within high quality mainstream services, those children with additional needs should be able to access additional services or interventions within the mainstream services (via secondary and tertiary tiers or levels of
through home-based interventions with the support of consultants or key workers.
Early childhood services and early childhood intervention services in Victoria could be deemed to be at a crossroad - a time when significant reforms are being planned or undertaken at national and state levels which will have an impact on future and current service provision and practices. The question is whether these reforms will result in the transformations that are needed to ensure meaningful participation for children with developmental delays within a universal systems approach? The recommendations outlined in the final part of this review identify how the reforms could support such a transformation.
Central to the philosophy underpinning the benefits of a universal systems approach is the recognition that the particular histories, cultures and practices associated with different sectors and service types (including the staff who work in these sectors or services) can act as barriers to reforms or transformations in early childhood education, care and health provision. Focusing on the needs of every child and family shifts the balance of the discussion from being focused entirely on the particulars of each sector (eg. public and private) and service (eg. childcare and preschool; mainstream and specialist) to a more holistic and universal understanding of what needs to be provided for all children and families, wherever the context or whatever the choices a family makes. The features of evidence-based best practice discussed earlier are elements that need to be provided within the context of all children’s services (Gascoigne, 2006; 2008; McLoughlin & Stonehouse, 2006).
A universal approach to services for all young children and their families has been identified as an effective way to ensure genuine participation, amelioration of disadvantage and improved developmental, learning and health outcomes for all children (Allen Consulting Group, 2009; Centre for Community Child Health, 2006; Gascoigne, 2006; Moore, 2001, 2009c; O’Donnell et al., 2008; Perez- Johnson & Maynard, 2007; Siraj-Blatchford et al., 2008). A universal systems approach will help to ensure:
• continuity of investment in all children and families • commitment to all children and families
• whole of children’s services sector reform
• the breaking down of service, professional or practitioner and research ‘silos’ • equity in service provision and access to services
• better response to families who have increasingly complex needs
• earlier identification and recognition of children and families’ additional needs and prevention, treatment or intervention strategies developed in response • most interventions are offered in a less stigmatising environment
• trans-disciplinary staff teams are available to support all children and families • reduction of social isolation experienced by some families and children