A home-visiting programme that supports parents to provide a nurturing and stimulating home learning environment for their children could complement existing early years services in England. In a new feasibility study funded by the Nuffield Foundation and the ESRC Impact Acceleration Account, we conclude that it would be possible to implement and evaluate a new programme targeted at very young children in disadvantaged families. We also provide a blueprint for what the programme and evaluation could look like. This observation provides a short summary.
The earliest years of life can shape a child’s life chances. Recent evidence suggests that inequalities – in child development and in health – are already obvious by age 2 or 3. While the government has increased spending on the early years, most of these resources are targeted at funded childcare for 3- and 4-year-olds, which is only somewhat successful in closing these gaps.
To help prevent inequalities from opening up in the first place, policymakers need to focus on even younger children. But low take-up rates among existing programmes that serve younger children, like Sure Start Children’s Centres, suggest that outreach to engage the most disadvantaged families in group sessions can be hard.
Previous research by IFS and others suggests that visiting parents at home to support them in providing a nurturing and stimulating home learning environment can have long-lasting impacts on children’s development. The benefits can include better attainment in school and later education, better health, higher earnings, and less crime. These programmes can also benefit the public purse: higher earnings and better education can lead to higher tax revenues and lower spending on programmes such as welfare, remedial education or incarceration. In some cases, these financial benefits have outweighed the programme costs.
But the international evidence base is clear that these programmes need to engage parents in order to have any impact on their children. And there are big limitations in the UK evidence base that leave open questions about the effectiveness, scalability and long-run value for money of these kinds of interventions.
In our feasibility study – conducted by researchers from IFS, UCL and NIESR alongside the People and Communities team at Peterborough City Council and with advisory support from the Stefanou Foundation –, we assess whether a home-visiting programme to support parents, based on the Reach Up and Learn curriculum that has been successfully delivered in countries like Jamaica and Colombia, could be adapted to and evaluated in England. We find a strong case – and local support – for a full trial of the programme to determine whether it can benefit very young children’s development.
Scalability, sustainability, and cost-effectiveness
In our feasibility study, we focus on Peterborough. The city is an ideal case study for this project; it shares many of the risk factors, like poverty, common to other disadvantaged areas in England. Its children perform relatively poorly on early child development tests. And Peterborough City Council is committed to developing and evaluating an intervention to support parenting in the earliest years of life.
But one of our priorities throughout this feasibility work has been to ensure that the programme is designed in a way that is scalable and sustainable. It is important that the evidence any future trial contributes is based on a realistic model that can – if effective – be adopted at scale and in different local authorities. This is why we have integrated the programme with national services and big, well established early years providers.
It is also important that the programme is designed with cost-effectiveness in mind. A full-scale trial is the ideal vehicle to evaluate this; by collecting data on outcomes like development, behavioural problems, and health, we will be able to evaluate the short-term benefits as well as link them to longer-run outcomes and their impact on public spending.
Local support and promising feedback
The Reach Up curriculum supports parents through a programme of frequent, regular home visits. By building up parents’ knowledge of child development and confidence in playing and interacting with the child, the programme supports stronger parent–child interactions and a more stimulating home environment, which in turn promote children’s intellectual and social development.
Parents in focus groups and our pilot study were enthusiastic about such a programme and strongly motivated to take part in it. Practitioners felt that the programme offers something different from existing services and would help them to support vulnerable families more effectively.
In keeping with this enthusiasm, parents in the pilot program made a significant effort to participate in the visits. Many of the parents were dealing with challenges like housing instability and safeguarding concerns, but nevertheless only one of the 20 pilot families dropped out by choice.
Parents and home visitors told us that their commitment to the programme was because they felt that it was effective. Many parents in the pilot sessions reported improvements in their child’s focus and behaviour over just a few weeks. Practitioners reported significant changes in parents’ behaviour over the course of the short pilot, and (particularly encouragingly) early years workers who were not aware of the pilot picked up on improvements in parent–child interactions among pilot families.
Our feasibility study sets out the conclusions of a careful process to analyse the local context in Peterborough and how a new programme could best complement existing strengths, address parents’ needs, and support the home learning environment and child development.
But without an evaluation, the crucial question – whether the programme is actually effective at improving children’s life chances – remains unanswered. The next step, therefore, is to carry out a randomised controlled trial to evaluate the programme’s effectiveness and to support analysis of its cost-effectiveness.
Such an evaluation would add to the international evidence base about the potential of home-visiting interventions to strengthen the home learning environment and provide policymakers with robust evidence on a promising intervention that can reduce developmental gaps between children born into disadvantaged backgrounds and their more affluent peers in England.