Early Years Collaborative and the AHP contribution– what have we learned so far in Tayside?
Gillian Boag & Beth Brewster , NHS Tayside
We are both Speech and Language Therapists [SLTs] working in an early year’s capacity in Dundee city. In April 2013 we embraced the opportunity to work as Early Years Collaborative Coordinators for AHP groups across Tayside for six months to raise the awareness of AHPs in Tayside of the Early Years Collaborative (EYC) and to increase their involvement.
What is the Early Years Collaborative?
The EYC is the driving force behind empowering and supporting agencies from health, education, social work and voluntary sector to work in partnership to make Scotland the best place in the world to grow up in. It aims to accelerate the progress services make towards meeting the objectives of the Early Years Framework, that is, shifting our focus to deliver early, preventative intervention in a way that can be sustained, to deliver better outcomes and reduce inequalities for Scotland’s most vulnerable youngsters . There are 4 workstreams within the EYC each with their own stretch aims.
What did we achieve?
We learned there was mixed awareness across each of the AHP groups. We also found that there was a willingness from therapists to invest in the EYC to carve out and develop an early and preventative role within services. However a particular challenge was repeatedly raised
How could the time needed to build relationships and to test new ways of working be found?
We hope we have been able to inspire and motivate staff to identify
What they can do differently working with other agencies to promote early health promotion messages and deliver early intervention.
We feel that during our six months we were able to raise the profile of the EYC and what its aspirations mean for AHP services across Tayside.
We also collated information on tests of change being carried out by AHP colleagues across Tayside and shared this information with managers and staff in each of the localities and below are some examples of these
Colleagues in Perth city occupational therapy worked collaboratively with nursery staff to provide a programme called ‘Jungle Journey’ with the aim of increasing the number of nurseries in the area including fine and gross motor groups as part of the nursery day. The therapists initially ran the groups alongside staff and then provided advice and information for the staff to continue running the groups alone. Activities included those to improve hand-eye co-ordination, pencil control and finger isolation along with ideas for improving ball skills and check lists for dressing skills.
In Dundee the physiotherapy team have been involved in a project called ‘Tummy Time’. The team had found they had increasing numbers of children referred with low muscle tone and it was felt this was due to lack of time spent by babies from six months of age playing on the floor. The first cycle involved one child and her parents being encouraged to use floor play for crawling and high kneeling. Within three months the child was more accepting of floor play, was moving more and pulling to stand and began to walk unaided within six months of starting the project. Tummy Time has now been used successfully with groups of parents and other agencies involved in working with parents of young children have been advised on the importance of promoting exploratory floor play.
Communication & Language
An Angus SLT has been joining a Health Visiting colleague when she has been carrying out the 27-30 month screening assessment. This has highlighted a need to change the question format for parents in order to gain appropriate and sufficient information to make a decision as to whether a referral to the speech and language therapy service is required.
Dundee SLTs have been collaborating with the adult learning team, One Parent Families Scotland, educational psychologists, midwives, health visitors and others to deliver programmes to groups to promote early play and communication skills targeting families in more vulnerable areas of the city.
What we learned
During our six months as early years co-ordinators we learned that there is a lot of enthusiasm across a broad spectrum of agencies to work with others to ensure Scotland is the best place to grow up in. A significant part of our learning was about the variety and number of groups working with families across Tayside.
We also learnt about Improvement Methodology e.g. making small tests of change and scaling this up to work with larger numbers of children and their families. An important lesson was that there is as much to learn from a failed test of change as there is from a successful one.
Planning and evaluating tests of change through PDSA‘s was useful and we are now more confident about using PDSA’s. More recently we have been introduced to run charts as a way of collecting data and recording our work.
The importance of attachment as a human requirement to meet and overcome challenges and difficulties in life is the highest ranking factor we have learned about during our time as early years coordinators. This is now being raised as one the main areas to focus on within workstreams. We are now aware that people who have had more than four traumas in their childhood are likely to have health and social problems in later life although those with strong attachment fare better. We look forward to continuing to work with others to improve this vital process.