Prevention and early intervention

Our frameworks

There are several key policy frameworks and evidence guides that inform prevention and early intervention work in NSW:

• The NSW Human Services Outcomes Framework (HSOF) is a cross agency framework that specifies seven wellbeing outcomes for the NSW population, and links these outcomes to evidence on how to achieve them. The Department of Communities and Justice (DCJ) has also applied the HSOF to specific early intervention evidence.
• Brighter Beginnings - the first 2000 days of life is a whole-of-government initiative to give children the best start in life. It is a strategic policy framework developed by NSW Health that outlines the importance of the first 2000 days of a child’s life and guides service delivery priorities to ensure that all children have the best possible start in life.
• The Australian Research Alliance for Children and Youth (ARACY) Better systems, better chances report is an extensive 2015 review of the prevention and early intervention evidence designed to highlight the core components of an optimal prevention and early intervention service system.
• The National Framework for Protecting Australia’s Children is a long term approach to deliver a substantial and sustained reduction in levels of child abuse and neglect over time. The Framework identifies 6 evidence informed outcomes intended to achieve this goal.
• The US Centers for Disease Control and Prevention have collated research and resources on the impact of childhood ‘Adverse Life Experiences’ (ACE’s) on life outcomes. The ACE’s model examines opportunities for prevention by identifying specific childhood experiences and their relationship to health, wellbeing, and opportunity.
• Closing the gap is a national agreement designed to achieve equality in health status, life expectancy and life outcomes for Aboriginal and Torres Strait Islander people, and eliminate the gap between Indigenous and non-Indigenous Australians.
• The Australian Institute of Family Studies has published an evidence review and recommendations for the prevention of child sexual abuse. The review highlights the need to address the underlying causes of child sexual abuse with sustainable prevention efforts.
• The Australian Centre for Child Protection has published an evidence review on improving service responses to vulnerable families during pregnancy and infancy.
• In response to the Royal Commission into Institutional Responses to Child Sexual Abuse, the NSW Government is developing a framework for the prevention of and responses to children with problematic and harmful sexual behaviours.

Key messages from the evidence

The policy and evidence frameworks highlight key prevention and early intervention service delivery and practice lessons.

Key messages for service delivery

The evidence has some clear messages about targeting service delivery for outcomes:

• Prevention matters. A strong foundation of universal services and initiatives that address the broader systemic causes of child abuse and neglect are important sites of investment.
• The prenatal period is a critical time for early intervention. Brain development begins during pregnancy, and this can be a period of high motivation for parents.
• Brain development in early childhood is a key window of opportunity for prevention and early intervention that shapes long term trajectories, particularly in the first 2000 days of a child’s life.
• Brain development during adolescence is another window of opportunity due to the transition to peer influence and increased exposure to risky behaviors.
• Parents, play and home environments matter. Quality of relationships with family is a protective factor from social and economic disadvantage.
• There is no one driver or point of intervention that ensures positive outcomes for all children. A complex mix of risk and protective factors is unique for each family, and requires flexible service delivery that can adapt to individual need.
• An effective system must take into account the specific needs of communities and use responsive approaches, particularly when working with Aboriginal communities, children and families.

Key messages for practice

The evidence has also generated some core practice principles:

• Being strengths based matters for prevention and early intervention as much as for work in tertiary services. Work with families, communities and groups to recognise and build upon strengths. A strengths based approach operates on the assumption that all people, even if they are experiencing problems, have some strengths and resources from which they can draw on to make positive change. A strengths-based approach does not ignore problems and always holds the safety of the child or young person as paramount. It focuses on utilising personal strengths to inform strategies to support individuals.
• Being trauma informed matters. Trauma-Informed Practice is a strengths-based framework grounded in an understanding of and responsiveness to the impact of trauma, that emphasises physical, psychological, and emotional safety for everyone, and that creates opportunities for survivors to rebuild a sense of control and empowerment. Don’t assume being trauma informed is less important in a prevention or early intervention context. Understanding the early experiences of adults and children is critical to being effective.
• Work in partnership with families, communities and other agencies. This is important at each stage of the spectrum.
• Culturally safe approaches are critical to safe and respectful engagement, particularly for Aboriginal children, families and communities.

For more information on evidence informed practice approaches see Working with children and families