helen henningham school of psychology
Post on 24-Feb-2016
39 Views
Preview:
DESCRIPTION
TRANSCRIPT
Using Government Services to Improve the Development and Behaviour of Young Jamaican
Children: Interventions for the Home, the
Clinic and the School
Helen HenninghamSchool of Psychology
Why is early childhood important?
Brain development most rapid and vulnerable from conception to 5 years.
Experiences in early childhood can have lasting effects on children’s ability to learn and their behaviour.
Interventions are more cost-effective than at other ages.
Without quality early childhood care children arrive at formal schooling with deficits in cognitive and social skills. This detrimentally affects their school progress.
Millions of children < 5y not fulfilling their potential in development (WHO, 2006; UNICEF 2006)
Stunted Poverty Disadvantaged< -2z scores < $1/day (Poor &/or stunted) HAZ
156m
126m
219m (39% of children <5y)
Stunted +Poverty not stunted
1. Deficit in grades attained (Brazil)
2. Deficit in learning per grade (Phillipines,
Jamaica)
3. Estimate total deficit (1+2)
20 % loss of yearly adult income
Loss of yearly adult income
Conclusion
Loss of children’s potential is an enormous problem affecting >200million
It has economic and social costs both to individual and nations
Interventions for the Home
Importance of stimulationUnstimulating environments and lack of quality
parent-child interaction are major risk factors for poor development
Stimulation: Weekly 1hr home visits by community health aides. Play session with mother and child. Focus on:• Enhancing
maternal-child interactions
• Language• Praise• Showing mother
how to promote development through play
In Jamaica, we have shown benefits of psychosocial intervention to children’s development as well as mothers’ child rearing knowledge and practices
Children enrolled at age 9-24 months received 2 years of intervention
Followed up at age 22 years
Benefits of Stimulation at age 22y: IQ
p=0.003p=0.004
p=0.02
Benefits of Stimulation at age 22y:Education
p=.004 p=.014
p=.005
Reading Maths General Knowledge
Benefits of Stimulation at age 22y: Psychological Functioning
p=.03 p=.05
Benefits of Stimulation at age 22y: Reduced violent behaviour
p=.04p=.06
Interventions for the Clinic
Parenting DVDs Developed
9 modules (3 minutes each) 1. Love2. Comfort3. Talk to baby4. Bath time5. Toys6. Praise7. Books8. Drawing9. Puzzles
Health Centre Intervention• 3 modules were shown at each Child
Health clinic when the subjects: 3 months 6 months 9 months 12 months 18 months
Group discussion & demonstration with mothers
1. Discuss the video with caregivers− What did they see on the video− What can they do with their baby− Practice− Praise caregivers and label what
they are doing2. Song or Game3. Homemade toy− How to make it− How to use it
During Nurse ConsulationNurse asks mother what she saw on the video
and what she thinks she could tryGives mother a message card and reads it
through with herEncourage mother to try these behaviours at
homeIf the mother has not yet seen the video
encourage her to watch it
Supplements to DVD –Message cards, Books and Puzzles
Interventions for the School
Children with social, emotional and behavioural problems
School entry
Primary school
• Poor relationships with teachers
• Peer rejection
• Poor parent-teacher relationships
•Low participation in the classroom
• Continuing behavior problems• Low level of bonding to school• Associate with deviant peers • Low academic achievement
Primary school
Adolescence
Adulthood
Aggressive & disruptive behaviour
Juvenile delinquencyTruant / dropout from school
Substance abuseDepression & suicide ideation
Crime and violenceAntisocial personality disorderLow educational and economic
attainment
Content1. How to create an emotionally supportive
classroom environment Praise, incentives, play, following child’s interests
2. How to be proactive to prevent problems Classroom rules and routines, keeping children
engaged, ‘with-it-ness’
3. Dealing with child misbehaviours Ignore, redirect, consequences
4. Teaching social skills to children Sharing, asking, waiting, trading
Process
Video vignettes of Jamaican classrooms Group discussion Role plays Practical activities Small group work Classroom assignments In-class support: modelling, coaching & praising
Build on Teachers’ Previous Knowledge Brainstorm at the beginning of each new topic:
Advantages, disadvantages, barriers
What are the advantages of attention, encouragement and praise: To children To teacher-parent relationships To teacher-child relationships
What are the barriers to praising children: In general For the more difficult children
Small Group Activities Activities given to small groups:
e.g. Scenarios involving child misbehaviour and group must decide what strategies they would use
Groups role play their solutions for the whole group
Detailed feedback on strategies used by the group: What was good Why was it good
Whole group brainstorms other strategies that may be used
Classroom Rules: Quiet hand up Walking feet Inside voice Eyes on teacher
Friendship Skills: Sharing Waiting Asking Taking turns
Teaching Skills to Children
Explicitly teach children examples and non-examples of the skill
Have a visual aid Let children role play
the skill Practice the skill in different
contexts during the day Promote children’s use of the skill – e.g.
praise children who are using the skill throughout the regular school day
How to Teach a Skill
In-Class Consultations Boost teacher confidence and
motivate them to use the strategies consistently
Help teachers to problem-solve Help tailor strategies to fit the
classrooms Promote continued use
of strategies over time
Classroom Assignments Practice a specific skill taught
in workshop E.g. Labelled praise, ignore minor
misbehaviour
Record on prepared sheet What child was doing What teacher said / did
Observe and record the effect on child/ren What child did or said How child was feeling
Results: benefits to children
Observations
Baseline Final5
10
15Teacher Report
Baseline Final110
120
130
140
150
160
Parent Report
Baseline Final110
120
130
Change in conduct problems in intervened and control classrooms
Intervened Control
p<0.01 p<0.01
p<0.05
Baseline Final2
4
6
8
10
12
Baseline Final60
65
70
75
80
Baseline Final7
8
Change in friendship skills in intervened and control classrooms
Parent Report
Observations Teacher Report
Intervened Control
p<0.001 p<0.001
p<0.05
Results: benefits to teachers
Baseline Final45
85
125
165
205
Baseline Final50
75
100
125
Teacher Positives Teacher Negatives
Change in observations of teachers’ classroom behaviours in intervened and control classrooms
Intervened Control
p<0.001 p<0.001
p < 0.001; Values are median frequency / 90 minutes of observation
Change in observed teacher interactions to high risk children in intervened and control classrooms
Baseline Final5
10
15
20
25
Baseline Final4
6
8
10
Teacher Positives Teacher Negatives
Intervened Control
p<0.001 p<0.001
p < 0.001; Values are median frequency / hour of observation
Percentage of teachers using physical punishment through observation
Baseline Final0
10
20
30
40
50
60
70
Control
p<0.001
%ns
New InitiativesDeveloping and evaluating an integrated
intervention to promote child development from conception to age 5 to be embedded in existing government services in rural Colombia
(with University de los Andes, Bogota & Institute of Fiscal Studies, London)
Developing and evaluating a combined intervention of CBT for depression and early stimulation for depressed mothers and their infants in rural Bangladesh
(with the International Centre for the Diarrhoeal Disease Research, Bangladesh)
New Initiatives in JamaicaSimplify and scale-up teacher training
intervention for Jamaican preschool teachers
Pilot a consultative model of teacher training with Jamaican primary school teachers
Develop training materials and package the Jamaican home-visiting early stimulation curriculum for global dissemination on-line
Thank you for your attention
Diolch yn Fawr Iawn
top related