A literature review on the importance of early interventions in enhancing children’s physical and mental well-being

Tagged: Medicines & Healthcare

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Introduction

In recent years, children have been dealing with various challenges that were uncommon in previous generations, and their harmful effects on physical and mental health are yet to be measured. The stressors include climate change, war, terrorism, displacement and the COVID-19 pandemic. A growing body of evidence emphasises that hazards which can be biological(like infectious disease and malnutrition) and psychosocial(like poverty and violence), lead to poor outcomes(Nelson, 2020). In addition, it has been estimated that about 250 million children worldwide aged under the age of 5 years(43% of the global population) are at risk of not achieving their developmental milestones due to physical and psychosocial factors. Interventions have been given much importance, especially in the first three years, when the developing brain is vulnerable to events and the environment (Jeong, 2021). Early intervention is regarded as critical in moulding children’s health, social, educational, and cognitive outcomes, and this is reflected in all current policies, advice, and research that promotes a shift towards child-centred services and care provision (Body, 2020).

While early intervention to improve health and nutrition can facilitate healthy development, research from recent studies reveal that parental interventions incorporating elements that improve early childhood learning or strengthen the parent-child relationship are highly effective in improving early cognitive, language, motor, and socioemotional development. Parenting interventions are social and behavioural programmes that are designed to increase the knowledge, attitudes, practises, and abilities of caregivers to promote optimum early childhood development (ECD). Parenting treatments can include a variety of interventions that address different risks, behaviours, or elements of parent-child relationships. These many parenting techniques have consistently demonstrated advantages throughout a wide age group of children, particularly during their formative years. (Jeong, 2021). The review focuses on the available literature on early interventions for children, their effect on overall development and the measures taken by the UK government to improve the physical and mental well-being of children.

Intervention in Earlier life stages

‘The First Thousand Days’ is a period from when a woman conceives until the child turns two years old. It was first discussed in 2010 at an international conference on global child undernutrition. It is a period when parents are more susceptible to advise and the child to adversities; therefore, intervening at this stage is essential. Healthy nutrition and development would subsequently impact the child’s overall health. This concept has gained much importance in developed countries to inform policy measures (Darling, 2020).

Developed countries worldwide have emphasised the importance of early childhood intervention. While education has been at the forefront by enrolling children in Early Childhood Education and Care(ECEC), research suggests that ECEC is beneficial for cognitive, social and emotional development (Melhuish, 2019). The UK government has always made consistent efforts that are aimed at improving outcomes for children. A study by Barnett(2008) revealed that early intervention services in children were associated with improvements in behavioural problems, like a lower tendency to exhibit aggression, increased attentivity and more engagement during play.

The cost of early intervention

Adverse events encountered in childhood may lead to complications in later stages, which can be physical and mental, and adversely affect the quality of life (Nelson, 2020). Engle (2011) recognises that early intervention service is the most cost-effective strategy to guarantee positive outcomes and make the child realise their full potential. However, it is stated that service providers may not prioritise services, resulting in gains that would not be realised for years. Many programmes are under-resourced, and governments focus on different sectors, like education and health, than the holistic development of children (Clark, 2020).

Measures taken by the UK government

Clark(2020) suggests that a multisectoral approach must be used for the holistic well-being of children to improve the overall outcome.

‘The First Thousand Days’ was discussed in the UK in 2011, and various initiatives have been implemented in the UK. At the heart of the initiatives is HENRY, which encompasses training healthcare practitioners and community healthcare workers, forming an early intervention team, and they work with parents to create a more favourable environment in their homes. This program has been implemented in Leeds and Wales.

Scotland has focused on early intervention for over a decade, with an explicit government policy commitment in 2008 and innovative quality improvement measures to support better early child outcomes—their Children and Young People Improvement Collaborative website use case studies to demonstrate the success of this method.

‘A Better Start’ is a 10-year, £215 million National Lottery-funded programme run by the National Children’s Bureau. It began in 2015 with five collaboration regions spread across the UK. It focuses on improving outcomes for young children by investing in early childhood, co-designing services with families and stakeholders, and sharing learning and solutions across the network and beyond(Darling, 2020).

Conclusion

Interventions in the earlier stages of life have been gaining much importance, particularly in recent years. Early intervention services are regarded as critical in moulding children’s health, social, educational, and cognitive outcomes, and this is reflected in all current policies, advice, and research that promotes a shift towards child-centred services and care provision (Body, 2020).

Research continues to place importance on improving the early childhood experience to improve the overall development of children, where parenting interventions are critical. In addition, early intervention is also more cost-effective, leading to better outcomes. However, the initiatives are under-resourced and focus on separate sectors than holistic development (Clark, 2020).

Measures taken by the UK government include HENRY, wherein community and healthcare workers work with parents to create healthier environments for their children, and it has been implemented in Leeds, Wales and Scotland. ‘A Better Start’ focuses on improving outcomes for young children by investing in early childhood, co-designing services with families and stakeholders, and sharing learning and solutions across the network and beyond(Darling, 2020). However, these initiatives need to be evaluated, calling for additional research in this area. Nevertheless, the UK government continues to take measures to ensure holistic well-being for children through early intervention.

References

1. Nelson, C. A., Bhutta, Z. A., Harris, N. B., Danese, A., & Samara, M. (2020). Adversity in childhood is linked to mental and physical health throughout life. bmj, 371.
2. Jeong J, Franchett EE, Ramos de Oliveira CV, Rehmani K, Yousafzai AK (2021) Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. PLoS Med 18(5): e1003602. https://doi.org/10.1371/journal.pmed.1003602
3. Body, A. (2020). “Part II: On the frontline of early intervention”. In Children’s Charities in Crisis. Bristol, UK: Policy Press. Retrieved Jun 16, 2023, from https://bristoluniversitypressdigital.com/view/book/9781447
4. Darling, J. C., Bamidis, P. D., Burberry, J., & Rudolf, M. C. J. (2020). The First Thousand Days: early, integrated and evidence-based approaches to improving child health: coming to a population near you? Archives of Disease in Childhood, archdischild–2019–316929. doi:10.1136/archdischild-2019-316929 
5. Melhuish Edward, Gardiner Julian (2019), Structural Factors and Policy Change as Related to the Quality of Early Childhood Education and Care for 3–4 Year Olds in the UK, Frontiers in Education, https://doi.org/10.3389/feduc.2019.00035
6. Barnett, W. S. (2008). Preschool Education and its Lasting Effects: Research and Policy Implications. New Brunswick, NJ: National Institute for Early Education Research, Rutgers University.
7. Engle PL, Fernald LC, Alderman H, Behrman J, O’Gara C, Yousafzai A, de Mello MC, Hidrobo M, Ulkuer N, Ertem I, Iltus S; Global Child Development Steering Group. Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries. Lancet. 2011 Oct 8;378(9799):1339-53. doi: 10.1016/S0140-6736(11)60889-1. Epub 2011 Sep 22. PMID: 21944378.
8. Clark, H. et al. (2020) ‘A future for the world’s children? A WHO–UNICEF–lancet commission’, The Lancet, 395(10224), pp. 605–658. doi:10.1016/s0140-6736(19)32540-1.