Prevention and early intervention strategies
Includes referrals, when a prevention and early intervention response is appropriate, and key programs in NSW
About prevention and early intervention strategies
The abuse and neglect of children and young people can have detrimental and far-reaching consequences. Increasingly organisations are expanding their focus to intervene as soon as possible with families, to help prevent problems from occurring or escalating.
The importance of prevention and early intervention programs is based on well-established evidence that the first years of a child’s life, and at the commencement of changes or stages of development, are crucial in setting the foundation for life-long health and learning outcomes.
Early provision and coordination of services
Early provision and coordination of services for children, young people and their families can assist with giving children and young people a good start in life and can reduce or avoid the need for other services in the longer term, such as mental health treatment, and/or the need for protective action or involvement with the child protection or justice systems.
Prevention and early intervention is the process of identifying and responding early to reduce risks or ameliorate the effect of less-than-optimal social and physical environments.
Prevention services are designed to promote the safety, welfare and wellbeing of children, young people and their families and prevent the development or emergence of problems and issues. They may be targeted to specific community groups who have a history or greater chance of developing certain problems or issues due to the existence of known risk factors or vulnerabilities.
Broadly, the term ‘early intervention’ refers to activities, programs and initiatives designed to alter the behaviour or development of individuals who show signs of an identified problem, or who exhibit risk factors or vulnerabilities for an identified problem, by providing the resources and skills necessary to combat the identified risks.
Early intervention includes intervening early in life or at an identified transition phase in a person’s development to ensure that they are supported in their most formative years. Alternatively, it refers to intervening as soon as a problem is apparent.
One of the goals of early intervention is to prevent the escalation of serious issues that may require a more intensive response involving the statutory child protection or justice systems.
Prevention programs and early intervention programs together operate across the full continuum of service supports. They include programs that assist and promote the necessary conditions for a child or young person’s healthy development.
Prevention and early intervention services can be classified into two main groups:
- Universal/primary interventions: offered to all families and generally preventive in nature.
- Selected/secondary interventions: target at risk families, based on single or multiple risk factors, such as poverty or parental mental illness.
While services across the spectrum vary considerably in character and intensity, the following are some common principles which link all prevention and early intervention services.
Voluntary participation is usually voluntary. This promotes family empowerment, including participation in making decisions about their lives while they are involved in a program.
Strengths-based - a strengths-based approach involves recognising, fostering and building on a person’s skills, capacities and competencies. This approach recognises that each person already has skills and expertise in relation to their lives, and their families. A strengths-based approach aims to enhance motivation, participation and realisation of identified goals and positive outcomes.
Child centred - a child-centred approach means that the focus of intervention is on the child or young person and on realising positive outcomes for that child or young person.
Family focused - while services are child-centred they are also family-focused. Outcomes for children and young people can be achieved by enhancing family wellbeing and supporting parents to develop the necessary skills and understanding to enable them to appropriately nurture and parent their children.
Flexible -there should be a certain level of flexibility in all prevention and early intervention services to allow them to be responsive to the particular needs of each family.
Collaborative entry into prevention and early intervention services should be coordinated and there should be communication and cooperation between services so that families can access the different services and supports they require. This promotes efficiency and consistency of service provision and reduces complexity for families.
Referring to prevention and early intervention services
After determining the appropriateness of a prevention and early intervention referral for a particular family, there are a number of avenues for guidance and assistance with how to engage with appropriate services available in the local area.
As identified, most prevention and early intervention services have specific eligibility criteria. They can also have particular referral pathways.
In these instances the family may have to be assessed to determine eligibility. Avenues for finding out more about suitable services, together with the eligibility criteria and referral pathways include the following:
- Existing referral networks Your organisation may already be actively involved with the local service network and have effective links with a range of local services. If you are not already aware of this, talk to colleagues and/or your supervisor who can be a good source of information regarding local services that are regularly used by your organisation.
- Child Wellbeing Units The Departments of Communities and Justice, Education and Communities, NSW Health, and NSW Police each operate Child Wellbeing Units (CWU) who may be contacted by their staff around the State about referral options and pathways for prevention and early intervention matters or to discuss and record child wellbeing and child protection concerns.
- The NSW Human Services Network (HSNet) is whole-of-government initiative established to support government and non-government organisations in the human services sector to deliver services in a coordinated and effective way. HSNet provides a central location for sharing information and is a key tool for finding appropriate prevention and early intervention services and programs.
HSNet augments local referral networks and enables members to easily locate health, housing, family, legal and community service information locally and across NSW, exchange information and make referrals securely. Membership of HSNet is free and open to all working in the human services sector.
Specific training in how to use HSNet, including searching for services, sending and receiving eReferrals is available. More information about these services is available from HSNet.
- Family Referral Services (FRS) are intended to link vulnerable children, young people and their families who are in need of assistance with the most appropriate, available local support services.
FRS have been established at three pilot sites in Dubbo, Newcastle and Mt Druitt with two more (Tamworth and Wollongong) being established in mid 2011. Two service models are being piloted: a telephone-only service and an augmented service, which includes telephone and face to face intervention.
When is a prevention and early intervention response appropriate?
There is no general; one-size fits all answer. Ultimately, whether a prevention and early intervention response is appropriate can only be determined on a case-by-case basis, depending upon individual circumstances and whether, in light of the identified need(s), a particular program or service is the best way of achieving positive outcomes.
Many prevention and early intervention programs or services have an eligibility criteria, which are a set of characteristics or requirements which must be satisfied before someone will be considered suitable for the program. It should be noted that meeting the eligibility criteria does not guarantee receipt of a service. There are other factors, such as program capacity, which affect access.
The NSW online mandatory reporter guide (MRG) has been developed to promote consistent child wellbeing and child protection reporting. The MRG provides a common platform for decision making to determine whether or not concerns meet the threshold of risk of significant harm and further consideration by the Child Protection Helpline about whether statutory intervention is required.
Where a matter does not appear to meet the statutory threshold, the MRG will provide guidance about possible actions. This could include:
- Consult with a professional – for assistance with determining what actions, if any, might need to be taken you may liaise with your supervisor or a colleague. Alternatively, you may liaise with another organisation to seek additional information under exchange of information provisions.
- Refer to a Child Wellbeing Unit (CWU) – CWUs operate within the Departments of Communities and Justice ( Ageing, Disability and Home Care and Housing), Education and Communities, NSW Health and NSW Police.
- Referrals – when there is no suspected risk of significant harm, but the family may benefit from services and appears open to service involvement.
- Document and continue relationship – where you only need to document the information and continue your professional relationship, where appropriate.
The MRG supports but does not replace workers’ professional judgement. Not all cases will involve suspected risk of significant harm and there may be no need to use the MRG where it is clear that a prevention or early intervention program or service is required. In these cases it may be appropriate to refer the family directly to a service.
However, workers should always be mindful of potential cumulative harm and that there may be past instances of concern, or other current issues, that may inform decisions about what supports a family requires or the nature of risk to the child or young person.
The Children and Young Persons (Care and Protection) Act 1998 (the Act) has a number of provisions that allow children, young people, as well as parents and any other persons, in some restricted circumstances, to ask for assistance before a problem becomes more serious.
Requests for assistance
In 2008 the Special Commission of Inquiry into Child Protection Services in NSW reviewed the request for assistance provisions in the Act and noted that the scope of such assistance should be expanded and could play a role in providing a ‘soft entry point’ for families needing help rather than statutory intervention.
Under Sections 20 and 21 of the Ac, a child, young person, their parent or a non-government organisation in receipt of government funding can seek assistance from Community Services. The matters on which a child or young person can seek assistance are not limited by the Act. A parent can request assistance in order to obtain services that will enable the child or young person to remain in, or return to, the care of his or her family.
Key prevention and early intervention programs in NSW
A wide range of prevention and early intervention initiatives are available in NSW, delivered by non-government organisations and by NSW Government and Commonwealth Government agencies.
These diverse services are designed to help children, young people and families across the spectrum of needs, from universal programs for families who need minimal basic support or guidance right through to intensive, integrated, multi-component programs for families with complex issues.
This section offers a summary of the some of the key programs and services and provides links for further information. Before considering these options it is important to keep in mind that referral to a prevention or early intervention program or service does not automatically guarantee the family a place.
For example, NSW Government early intervention programs, such as Brighter Futures, have specific eligibility criteria targeting families that are most suitable for involvement in the program.
|The Aboriginal Child, Youth and Family Strategy||Early Childhood Health Services|
|Aboriginal Child and Family Centres||Families NSW|
|Aboriginal Maternal and Infant Health Strategy|
|Building Strong Foundations for Aboriginal Children, Families and Communities|
|Child and Family Health services||Maternity services|
|Children’s services||Home visiting|
|Community Builders||Parenting programs|
|Communities for Children||Playgroups|
|Communities for Children Plus||Police and Community Youth Clubs|
|Brighter Futures||Early childhood intervention programs|
|Community Builders||The REACh program|
|Early Intervention and Placement Prevention||Sustained Health Home Visiting|
|Karitane and Tresillian Family Care services||Getting It Together|
|Child and family services|
Aboriginal Child, Youth and Family Strategy
The Aboriginal Child, Youth and Family Strategy (ACYFS) is a prevention and early intervention strategy that aims to provide Aboriginal children and young people with the best start in life. The ACYFS has a particular focus on supporting Aboriginal families expecting a baby or with children aged up to 5 years and includes parenting programs, transition to school programs, family support and community capacity building.
The ACYFS works in close partnership with Families NSW and the NSW Aboriginal Maternal and Infant Health Strategy.
Under the Indigenous Early Childhood National Partnership Agreement, 9 integrated Aboriginal Child and Family Centres will be established across NSW in Blacktown (two Centres), Campbelltown, Ballina, Gunnedah, Nowra, Toronto, Lightning Ridge and Brewarrina.
The overall aim is to deliver more coordinated and integrated services that cover all aspects of a child or young person’s health and wellbeing. Tailoring services to each community’s needs, and bringing them all under one banner, will provide a whole suite of services that are readily accessible to families to improve child care and early learning outcomes.
Once established, Centres will provide early learning and care, parent and family support services as well as health services. Local communities have been involved at every stage of the Centres’ development and Local Reference Groups have been set up to guide the establishment and operation of the centres.
The Aboriginal Maternal and Infant Health Strategy (AMIHS) is a NSW Health initiative that aims to improve the health of Aboriginal women during pregnancy and reduce mortality rates for Aboriginal babies. AMIHS provides culturally appropriate, community based health services for Aboriginal women and is provided by a midwife and an Aboriginal health worker or Aboriginal education officer.
These services include antenatal and postnatal care, education about the effects of smoking, drugs and alcohol during pregnancy and the benefits of breastfeeding, home visits and transport to appointments.
Building Strong Foundations for Aboriginal Children, Families and Communities aims to provide culturally specific early childhood health services to assist parents to provide a good start to life and to assist in children being socially, emotionally and physically prepared to engage in education and life in the following areas: Taree; Tamworth; Newcastle; Gosford, (including Bateau Bay, Long Jetty and The Entrance); Penrith, Cranebrook; Menai and Nowra.
It has strong links to AMIHS, the New Directions for Mothers and Babies program and mainstream maternity, child and family health services. It aims to assist parents to provide a good start to life and to assist in children being socially, emotionally and physically prepared to engage in education and life
Quality children’s services
Quality children’s services help children get a good start to life. The types of children’s services available in NSW include long day care, preschool, occasional care, vacation care, toy libraries, supported playgroups, family day care, home-based care, mobile children’s services and outside school hours care.
Positive early childhood experiences provided by children’s services can prevent problems in families by:
- providing children with a nurturing environment and programs that assist their development
- helping ensure ‘school readiness’
- detecting early, and providing support for, children with behavioural and learning problems
- giving families a break and helping to relieve stress
- giving parents the opportunity to participate in the workforce, to have a break from care duties or to join in social activities
- providing communities, particularly small rural townships, with a focal point for the sharing of information on child and family issues and as a referral point to health, family support and other community services.
A comprehensive listing of children’s services in NSW is available HS Net
Community Builders is a community capacity building funding program that contributes to building stronger communities by funding projects and services that focus on outcomes, alleviate disadvantage, adopt a strengths-based approach and develop community capacity. Community Builders has four service activity categories: community capacity building, community skills development, community sector development and community hubs.
Communities for Children
Communities for Children (C4C) is part of part of the Commonwealth’s Family Support Program which provides prevention and early intervention programs for families with children up to 12 years, who are at risk of disadvantage and who remain disconnected from childhood services.
Of the sites funded nationally, eleven are located in NSW (Blacktown; Campbelltown; Dubbo, Wellington, Narromine; Fairfield; Lismore; Miller; Murwillumbah; Raymond Terrace; Shellharbour; Taree and Wyong).A key local non-government organisation (facilitating partner) in each site acts as broker in engaging smaller local organisations to deliver a range of activities in their communities via a C4C Committee, which is representative of the community.
The facilitating partner oversees the development and implementation of strategies and activities and manages the funding allocation for the site. Much of the funding is allocated to other local service providers to deliver the activities. Examples of activities being implemented under C4C are:
- home visiting
- early learning and literacy programs
- early development of social and communication skills
- parenting and family support programs
- child nutrition
- community events to celebrate the importance of children, families and the early years.
Communities for Children Plus expands the C4C model, but has a stronger focus on building links with statutory child protection services, as well as with services primarily targeted to adults. It aims to tackle known parental risk factors including mental health, family violence, housing and substance abuse.
Six sites nationally have been announced, including Kempsey and Campbelltown in NSW.
Early Childhood Health Services
Early Childhood Health Services are provided to children in the 0-5 year age group and their families. They provide advice and information on a range of parenting and child health matters, assessment of growth and developmental progress of children, dealing with behaviour and developmental issues and early identification of child abuse and post natal depression.
Early Childhood Health Centres are staffed by registered nurses with specialised qualifications and experience in child and family health nursing. Services are offered on a one to one basis either by drop-in, appointment, in group situations, home visiting or telephone.
In addition, Early Childhood Health services are supported by a range of other child and family health professionals such as allied health, women’s health and counselling services. Parenting and other intervention groups are also provided within these services. These services also refer families to other services as appropriate e.g. dental, mental health and General Practitioners.
Families NSW is the NSW Government’s whole-of-government prevention and early intervention strategy for families expecting a baby or with children aged 0 to 8 years. The strategy is implemented through service models that are focused on supporting parents to be confident, connected to their community and its services and equipped to support their children’s development. These service models include:
- Universal Health Home Visiting (UHHV) includes the offer and provision of at least one contact in the family’s home within two weeks of birth by a child and family health nurse. The aim of UHHV is to engage all families with newborns and to provide support to parents with young children.
- Family Worker Services involve skilled professionals working with a range of groups (such as teenage parents, fathers and Aboriginal parents) within local communities to provide support and assistance to parents in developing social networks, life and parenting skills.
- Schools as Community Centres are located in primary schools and provide a range of early childhood initiatives, including supported playgroups, parenting skills courses, breakfast clubs and transition-to-school projects.
- Supported Playgroups are facilitated by qualified workers and provide an informal way for parents to learn from each other, the facilitator and invited professionals about child development and play.
- Volunteer Home Visiting Services involve volunteers visiting parents of newborn babies and toddlers in their home to provide practical advice and support. Volunteers also assist parents in linking up with services and supports within their local community.
- Triple P (Positive Parenting Program) assists all families with children aged 3-8 years to have the opportunity to access parenting information and support, so they have increased skills and confidence and feel better equipped to raise their children. Parents across the state can access Triple P through information seminars, small groups and a self directed program.
The program is provided to parents through a variety of practitioners in local areas, with many courses advertised on the Families NSW website.
Home visiting is often cited as a successful evidence-based intervention. However, home visiting is not a single, uniform intervention, but a strategy for delivering a multiplicity of services. It is often a highly valued and accepted strategy for the provision of parenting information and family support.
It can be used as a means of delivering services to vulnerable, first time mothers in need of support, or offered in conjunction with other services which target the child more directly (such as attending an early childhood education program).
Parenting programs is an umbrella term often used to describe programs that are focused short-term interventions aimed at helping parents improve their parenting skills, their relationship with their child, and preventing or treating a range of problems including behavioural and emotional adjustment.
This can include parent education, parent training, parent support and family skills training. Programs can be offered on a group or individual basis. Parenting programs aim to help parents in the following ways:
- develop knowledge and strategies to build positive behaviours in children and promote positive family relationships
- develop knowledge about appropriate ways to manage misbehaviour
- develop a sense of self worth as a parent.
Play groups provide an opportunity for parents, carers, babies and children (up to school age) to meet on a regular basis in a structured, but informal environment. Playgroups provide an opportunity:
- for children to have fun, make new friends and develop new skills through informal play
- for parents to meet other parents and carers, make friends and share ideas and experiences
- for parents to spend quality time with their children, encouraging, helping or simply playing with them.
Police and Community Youth Clubs are designed to get young people active in life, work with young people to develop their skills, character and leadership and prevent and reduce crime by and against young people.
Brighter Futures is a voluntary program delivered in partnership by Community Services and non-government organisations. The program provides vulnerable families who are expecting a child or have children aged under 9 years with the necessary services and resources to help prevent an escalation of emerging child protection issues.
The program delivers case management and range of tailored services including home visiting, quality child care and parenting programs.
The Early Intervention & Placement Prevention (EIPP) program includes services along a continuum of family and community needs from child, family and youth support to higher intensity and longer term targeted support. The aim of this integrated system is to reduce the likelihood of entering the statutory child protection system, or for those already in the system, from progressing into out-of-home care.
Services or programs under the EIPP service continuum include former Community Services Grants Program services, Brighter Futures, Intensive Family Support and Intensive Family Preservation Services.
Early childhood intervention programs provide support to young children who have developmental delays or disabilities in order to promote the child’s development and inclusion in family and community life. Early childhood intervention programs can include therapy, education, health services, inclusion support in early childhood services, family support and the provision of information and support for transition into school.
The REACh program is intended to improve the capacity of families and caregivers to respond appropriately to children's needs for care, development and safety through timely access to community resources that can support them in their parenting role. It aims to improve access to support services and encourage at risk and vulnerable families to engage with their community through collaborative approaches.
REACh has an emphasis on ensuring the best possible start and promoting successful transitions for children in vulnerable families. The program is about child-centred, family focused and community connected responses. In NSW there are number of funded services, including home visiting, parenting programs, outreach, referral and advocacy.
The Sustaining NSW Families (Sustained Health Home Visiting Program) is presently provided in 3 sites in NSW (Wyong; Kurri Kurri, Cessnock, Maitland and Fairfield, Liverpool) and provides intensive structured health home visiting based around a positive parenting program which commences in pregnancy and continues until the child’s second birthday.
A further two sites will commence from 2011 at Arncliffe and in the Richmond Valley, Kyogle, Lismore local government areas. Services will be provided by the same child and family health nurse and the family will be supported by a social worker and have access to other appropriate early childhood, family and specialist services as required.
Getting It Together provides intensive case management and brokerage for young people, with a focus on helping them gain access to support services such as health, education, training, housing, treatment and counselling.
Services are currently operating in Broken Hill, Cabramatta, Campbelltown, Central Coast, Crows Nest, Darlinghurst, Dubbo, Kings Cross, Lismore, Mt Druitt, Nowra, Penrith, Toomelah-Boggabilla, Waterloo and Wollongong.
- Australian Institute of Family Studies. 2006. Child abuse prevention: what works? The effectiveness of home visiting programs for preventing child maltreatment.
- Australian Institute of Family Studies. 2006. The effectiveness of parent education and home visiting child maltreatment prevention programs.
- Department of Families, Housing, Community Services and Indigenous Affairs., Australian Institute of Family Studies., &Australian Bureau of Statistics. Growing Up in Australia: The Longitudinal Study of Australian Children.
- Families NSW/NSW Health. 2009. Supporting Families Early Package.
- NSW Department of Community Services. 2009. Research to Practice Note: What Makes Parenting Programs Effective? An Overview of Recent Research.
- NSW Department of Community Services. 2008. Research to Practice Note: Prevention and Early Intervention Update – Trends in Recent Research.
- NSW Department of Community Services. 2008. Research Report: Prevention and Early Intervention Update – Trends in Recent Research. Literature Review.
- NSW Department of Community Services. 2007. Research Report: Early Intervention Strategies for Children and Young People 8 to 14 Years. Literature Review.
- NSW Department of Community Services. 2008. Seminar Notes: Early Years Program Evaluations: The UK Evidence Base.
- NSW Department of Community Services. 2006. Research to Practice Note: Parental Alcohol Misuse and the Impact on Children.
- NSW Department of Community Services. 2005. Prevention and Early Intervention Literature Review.
- NSW Department of Community Services. 2005. Research to Practice Note: Effective Components of Home Visiting Programs.
- NSW Department of Community Services. 2005. Research to Practice Note: Parenting Programs: What Makes Them Effective?
- Social Policy Research Centre. 2010. The Evaluation of Brighter Futures, NSW Community Services’ Early Intervention Program Final Report.