Learn to parent: Dublin intervention scheme pays off

Marion Dennis was "terrified" when she learned she was pregnant at the age of 42 with her son Jamie, even though he wasn't her first child. But having given birth to her daughter, Lorna, 16 years earlier, there was a big gap between the two.

So when, at her booking visit to the Rotunda maternity hospital, she was told about a new “Preparing for Life” programme she could sign up for, she decided “there was no harm in trying”.

Living in Coolock, north Dublin, Marion was one of more than 200 expectant mothers in the Dublin 13 and Dublin 5 areas recruited for this early intervention scheme, which runs from pregnancy to when the child starts school.

It is designed to achieve “school readiness”, in an effort to prevent children from lower socio-economic areas being at a disadvantage from day one when they walk into junior infants, compared with their peers from more affluent homes.

As the pilot programme was being rigorously evaluated by UCD’s Geary Institute for Public Policy, half of the families who signed up were randomly assigned to a control group, while the others were given intensive supports for the next five years.

These included fortnightly home visits by a mentor with a series of tip sheets through pregnancy and various stages of their child’s development, covering topics as diverse as food preparation and healthy eating, immunisations, bedtime routines and discipline.

There was also the opportunity to do both a baby massage course and the internationally renowned Triple P parenting programme.

The control group did get something too – €100 worth of developmental materials, three sets of book packs and they were given somebody to contact if they wanted any information on services in the area. They could also attend classes on healthy eating and stress management.

Results

While all the families were recruited between February 2008 and June 2010, it is only now, with the youngest participants in junior infants, that the final results can be announced. The first findings released in May were eye-catchingly impressive and a second wave to be announced tomorrow, June 22nd, is also extremely positive.

Among the families who participated in Preparing for Life (PFL), the IQ of the children was 10 points higher than those in the control group. Just 13 per cent of the intervention group children scored below average for cognitive development at age four, compared with 57 per cent of the control group.

Other positive benefits for the children on the programme included being less likely to be overweight (23 per cent compared with 41 per cent) and fewer had behavioural problems (2 per cent compared with 17 per cent). It even seemed to affect how these babies came into the world – the Caesarean section rate among the mothers on the programme was 15 per cent (the optimum rate as far as the World Health Organisation is concerned) while among the control group it was 25 per cent (the national average).

A further report into the impact of Preparing for Life that is to be launched tomorrow will show the programme had a significant positive impact on school readiness among children. It will show statistically significant improvements in physical health and wellbeing; emotional maturity and in the communications skills of children who received the home-visiting programme.

The outcomes have exceeded the expectations of both the implementation team at Northside Partnership and its evaluation team at the Geary Institute, who have worked together on the scheme for nearly 10 years.

Changing lives

The results are both clinically and statistically significant, says Dr

Orla Doyle

, who led the evaluation. Developed as a holistic programme to target school readiness, “it tried to change the children’s lives in multiple domains and I guess what’s surprising is that it actually did do that. I was reasonably confident it would have some effects. The fact that it affected all areas of school readiness was probably the biggest surprise.”

Internationally, other home-visiting programmes have had effects on children’s cognitive abilities and emotional skills “but the impact of PFL seems to be larger on average compared with the international literature”, says Doyle, who has been invited to speak about it in countries around the world.

“If the programme continues, it could actually help to break that inter-generational cycle that has characterised this community for so long,” she says.

"One of the big challenges for us was waiting for the results [while] we were working away with the families," says programme manager Noel Kelly. It was "a relief" when they came.

"I have been working for families for 30-odd years and this is the first time I have seen this level of change," says Kelly, a former teacher in Darndale. He says that those changes are being generated by parents themselves within the family home and not by an external agency.

There’s “no rocket science” in the parenting advice being given and it would seem like common sense to those who have been brought up that way, he says, but not if you haven’t. It takes courage by parents, he adds, to challenge the norms in this community.

When Marion was assigned her mentor, Val Smith, just two weeks after signing up for the programme, she began to do things very differently for this pregnancy.

“I gave up smoking. I changed my eating habits, cooking everything from fresh. I made sure I had my five [fruit and veg] a day. I drank plenty of water,” she says, sitting in the front room of her mother’s terraced house in a Coolock cul-de-sac.

First time around, she says, “I drank, I smoked and did everything I wasn’t supposed to, although I didn’t drink a lot.”

“And I was on breastmilk,” chimes in the now five-year-old Jamie, lifting his head from a drawing of hot rods and other cars over which a helicopter hovers.

“As soon as Jamie was born, from day one, the routine was set,” his mother continues. “Even to this day he still has his routine. I breastfed – as you know – for about eight weeks,” she says smiling. She didn’t know any family or friends who had breastfed but she is glad she did.

“You can see the benefit of it, Jamie doesn’t carry weight.”

Discipline

A different approach to discipline was another of the tips that she found invaluable for her parenting second time around.

“Go down to him and give him eye contact, like you are speaking to an adult. He is his own little person and if you treat him with the same respect, you’ll obviously get it back.”

She cringes at the memory of how she used to tower over Lorna, shouting at her. “I would be over her and so in her face.”

Marion also learned the importance of following through and teaching Jamie that when she said “no”, she meant “no”. Whereas with her daughter, she was inclined to give in and still does to this day, she says.

However, she has seen the difference staying firm has made with Jamie. “He attempts to throw a tantrum, if that makes sense, then it’s ‘Mam, I’m sorry,’ and it’s over.”

Living with her mother, Marion had to sit down with her and explain that this time “it has to be my way and it has to be my rules when it comes to chastising. Like the dinners, if he doesn’t eat it, don’t give him something else.”

Her partner, Carl, is on board, although Jamie is inclined to push the boundaries a bit more when he’s around, she says.

Marion reads to Jamie and makes games out of learning numbers and letters. “I would never have done that with Lorna, ever. She would ask, ‘How come you are doing that with him and you never did that with me?’”

She has to admit to her daughter that she was just put to bed “for some peace and quiet”. Does Marion feel guilty? “Of course I do.” She looks back and wonders why she used to roar and shout at Lorna when she was Jamie’s age. “They will only mimic what you show them.”

Marion believes the opportunity to participate in Preparing for Life has been a blessing. However, she has had to explain to friends that she is not doing it because she is a bad parent, but rather it is a chance to retrain.

“They thought I was doing it because I was in trouble in some way. They all thought Val was, like, a social worker.”

Everybody can see Jamie is different from other children, she says. “I’m not just saying that because he’s mine. He is a good child. You can bring him anywhere. He’s not aggressive, not running around causing trouble. He plays well with other kids. He doesn’t smack because he has never been smacked.”

Her firm, comfortable relationship with the bubbly but polite Jamie is evident throughout this interview, as he occasionally tries to make his presence felt.

“He is such a good boy, I don’t need to be stressed out all the time,” she says. “I love Lorna to bits but it’s more enjoyable [this time around] because I set boundaries from day one. I think if you stick with them, they actually work.”

For more information, see preparingforlife.ie

swayman@irishtimes.com

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