1. Themed Breakout: Understanding the Emergent Learning around the 27-30 month child health check John O’Dowd johnodowd@nhs.net Early Years Collaborative Learning Session Two Day 2

2. Stretch Aim 2 To ensure that 85% of all children within each Community Planning Partnership have reached all of the expected developmental milestones at the time of the child’s 27-30 month child health review, by end-2016.

3. Stretch Aim 3 To ensure that 90% of all children within each Community Planning Partnership have reached all of the expected developmental milestones at the time the child starts primary school, by end-2017.

4. Ready to Learn pilot Started in August 2011 Covers NE and NW Glasgow, East Dunbartonshire and Renfrewshire Approximately 600 children per month Builds on previous work done in West Glasgow around a 12 and a 30 month universal contact

5. Evaluation & Research NHSGGC: –John O’Dowd –Michelle Affleck –Lucy Thompson Glasgow University: –Phil Wilson –Fiona Sim Newcastle University: –James Law

7. Ready to Learn pilot Focus on developmental readiness of universal nursery provision Create progressive universalism Built on local needs assessment around the prevalence of communication needs and known links between behavioural problems and risk of future conduct problems/disorder Pathways to early intervention Second element still underway: –validation of tools

8. Ready to Learn - tools Strengths and Difficulties Questionnaire (SDQ) –5 domains: emotional symptoms, conduct, hyperactivity, peer relationships, and prosocial domains Sure Start Language Measure (SSLM-R) –50 common words –Below 20 suggests significant delay –Below 50 provides stimulus to promote language (but no normative need)

9. Findings- reach

10. 80% uptake across all quintiles in first month Dropped off with time and competing demands Rally with feedback through managers Positive reaction from staff and parents Learning from exceptions

11. Findings- communication Communication category by SSLMR Percentage of completed checks 50 words28% 21-49 words62% 20 words or less10%

12. Findings- behaviour BehaviourPercentage of completed checks No needs (normal range) 73.4% Possible needs (Borderline range) 12.7% Probable needs (Abnormal range) 13.9%

13. Findings- behaviour and communication SDQ No needs SDQ Poss needs SDQ Prob needs Total SSLMR 5023%2.7%2%28% SSLMR 21-49 43.4%8.2%10.4%62% SSLMR ≤ 20 6.7%1.7%1.4%10% Total73.4%12.7%13.9%100%

14. Pathways to intervention RTL contact Behaviour +/or communication needs Behaviour Needs Promote communicationIntervene in communication Triple P Parenting Intervention Behaviour and comm needs Communication Needs Only Multiagency planning group and intervention Request assistance Needs Resolv ed Needs Unresolv ed Needs Resolved Needs Unresolv ed Needs Resolved Needs Unresolv ed Reformulate or escalate Needs Resolved Needs Unresolv ed

15. Emergent learning Reach: –capacity –engagement : positive framing using developmental readiness Learning from errors: epistemology of practice Working together – interdisciplinary before interagency! Capacity –cumulative intervention –concerns about reduced time for targeted work Capability and developmental assessment Capability, capacity and new interventions Individualised solutions versus organisational pathways

16. Acknowledgements Parents and children in the 4 pilot areas Staff in the pilot areas Early Years Collaborators One Glasgow Research collaborators Healthy Children Programme Board and operational team