Many programs take place in the family home, though others are held in outpatient clinics, children’s centers, or schools. The vast majority of EI programs involve work with parents or pregnant women. In response to the growing visibility and significance of EI research, policy, and practice, the Early Intervention Foundation was established in 2013, a core task of which is to evaluate various EI programs in terms of their effectiveness, and to make recommendations about “what works” to various commissioners, practitioners, and policy makers. For this reason, advocates of EI claim that intervention during the early years is both efficacious and cost-effective. These scientific findings are used by policymakers to advance the case for intervention in the 0–3 years period, since research identifies this as a critical “window” of development in which social stressors are especially impactful. Increasingly, these policy documents began to draw on findings in neurodevelopmental science and epigenetics that demonstrate the impact of a range of social stressors, such as structural inequality, neglect, and trauma, on the developing brain and on gene expression (Heim and Binder 2012 Johnson et al. The ensuing years of the Labour and subsequent coalition governments saw a steady proliferation of EI research and policy, some of which we analyze here. The publication supporting this declaration, “Opportunity for All: Tackling Poverty and Social Exclusion,” defined poverty not solely in financial terms, advancing a broader definition encompassing well-being and flourishing in the way that is now characteristic of EI policy guidance. Sure Start Centres were first introduced in 1998, and in 1999 the UK government announced its target to eliminate child poverty by 2020.
It was not until the Labour government of 1997 that these programs were organized into EI in the form that we recognize today.
Dramatic social and cultural developments in the 1960s and 1970s created new challenges for those seeking to improve child welfare: changes such as the emergence of nontraditional family forms, and increasing numbers of women going to work (Bate 2017).ĭuring this time, interventions designed to increase child welfare were a “dysfunctional patchwork of provision” (Bate 2017, 9). Training of specialist health visitors for young children began in the 19th century, and maternity benefit was introduced in 1911 these services fell under the Ministry of Health in the 1920s, before being subsumed within the National Health Service (NHS) after its creation in 1948. The broad policy goal of improving lives of disadvantaged children through parent support has a long history in the United Kingdom. With this in mind, we conclude with some remarks about the role that philosophical analysis can play in EI policy development. Furthermore, we argue that unless we closely interrogate the underlying values and assumptions in ostensibly “obvious” policy initiatives, we run the danger of subverting the plurality of values and political outlooks held by the society in which policies are to be implemented. While policy documents cannot be required to achieve the most rigorous standards of argumentation, we claim that lack of coherence will hinder effective translation from proposal into practice. Drawing on relevant debate within the bioethics literature, we examine the values underlying policy proposals, highlight where ethical principles conflict, and explore what it would mean to put the proposed policies into practice. In this article we analyze a corpus of EI policy guidance to investigate explicit and implicit ethical arguments about responsibility. EI policy design, therefore, invokes ethical questions about the balance of responsibilities between the state, society, and individuals in addressing inequalities and safeguarding child well-being. As well as maximizing aggregate population health, EI is concerned with the just distribution of “life chances,” so that all children are given fair opportunity to realize their potential and lead a good life. EI aims to identify individuals or families at risk of poor health outcomes, and take preventative measures at an early stage, when intervention is more likely to be successful and cost-effective. Early intervention (EI) is receiving growing policy attention from UK governments, think tanks, and charities.