1. Working together better for two year olds: Tracy Smith Team leader; teaching and learning Islington Council EYFS Team The integrated health and education review at aged 2 Images courtesy of ‘A good place to be two’: Community Playthings 2013

2. What is the Integrated Review? Joint Health and Education review for children aged 24- 30 months Recommendation of Tickell review (2011) of the Early Years Foundation Stage Brings together:  Health review part of ‘Healthy Child Programme’  Statutory EYFS Progress Check for children attending an early years setting To be implemented nationally by 2015

3. Islington context Borough of stark contrasts Islington Fairness Commission (2011) First 21 Months initiative Established integrated working 1000+ 2-year-olds in provision (50% of cohort) Education progress checks

4. Our vision for the Islington Integrated Review To provide the best possible support for parents and children To share professional knowledge, learning and support between services To use the review as a key opportunity for early identification and intervention To have a truly integrated review

5. Evidence- based tool e.g. ASQ-3 Physical Development and Self Care Personal, Social and Emotional Development Communication and Language Physical Health Learning And Cognitive Development Attachment relationships Parenting style Couple Relation- ships Home Learning Environment Family Health (physical and mental) Family Education/ qualifications Family Employment/ Economic status Adverse Family Circumst- ances Neighbourhood Deprivation and local resources Community Support The Community The Child in the Family The Family The Child The Child In Context

6. Work so far Partnership working at strategic and operational levels Named HV for each early years setting Ongoing communication with frontline practitioners Developed documentation and supporting guidance Trained health and education practitioners together Adopted a phased approach to roll-out: 1.Children’s centres 2.Private, voluntary, independent & school settings 3.Childminders 4.Children not in EY provision Gathered evaluations - ongoing

7. Engaging parents

8. Ages & Stages Questionnaire – ASQ The government intends to introduce a public health measure at aged 2 Pilot LAs have been asked to trial the Ages and Stages Questionnaire (ASQ) Areas measured include: Communication Gross Motor Fine Motor Problem – solving Personal Social Hearing/vision/medical

9. Successes High no. of people trained across both education and health since summer 13 Development of skills and knowledge across both sectors Making and developing links – particularly between the PVI and health sector and between PVI and CCs Well-received by frontline practitioners and by parents Increased support for early home learning

10. It’s not often you get a chance to sit down and talk in depth about your own child. They pointed out things that my son has been doing that I didn’t know were important. I felt included; they asked what I thought and how he is at home. With my daughter who’s now 5 I had a regular review. The integrated review for my son felt like it gave a more complete picture. For me it really worked – it felt safe and thorough and just all-round a positive experience. Successes: what parents say

11. What practitioners say I had worries about the child’s speech and the health practitioner agreed. Sometimes there’s a bit of a grey area and you wonder ‘am I being a bit too hard, is the best fit too low?’ - so it was good to have that back up from another professional.

12. It was so useful to work with a non health professional and get their contribution about the child. What health practitioners say

13. Challenges Design phase Establishing a robust system Practical challenges – time, space Culture change Data sharing and data recording Quality assurance

14. Next steps…….. Embed systems, processes and ways of working Consider roll-out to children not attending EY provision Evaluate timeliness and impact of interventions on children Joint conference

15. Being two……. By the time I am two I have a story to tell you about lots of things. The highlights of my story give you insights about the understanding I have and the things I can do now. I am two! Working effectively with two year olds and their families Kay Mathieson 2013