Upgrading Early Initiatives
Developing and Testing the Detection Model

English Summary

The task of the research project

This project concerns the development, testing and knowledge acquisition of effective early detection methods with a view to upgrading the early initiatives targeting socially vulnerable children between the ages of 0 and 10 early in their lives and before problems escalate. The development work is being carried out in close cooperation between six municipalities: Assens, Haderslev, Kerteminde, Norddjurs, Viborg and Vordingborg and AKF, UdviklingsForum (Development Forum) and the Danish Evaluation Institute.

The researchers’ tasks are, together with the local authorities, to develop a detection model with methods and tools for early detection of children displaying social problems to a larger or smaller extent or indications that problems are beginning to develop, and to support implementation and model testing in the municipalities concerned.

The local authorities’ task is, together with the researchers, to develop a detection model and subsequently implement and test it in their own municipalities.

Description of the detection model

Early detection with subsequent early initiatives involves both discovering any problems at an early stage, and being able to act quickly and skilfully when a child is discovered that has problems or is about to develop problems.

The project’s primary target group is children who require special support, cf. section 52 of Serviceloven (the Danish Social Services Act), but it covers all children between the ages of 0 and 10, with a special focus on children requiring special attention to avoid more intrusive initiatives at a later point in their lives.

The detection model includes methods and tools at three levels: individual level (individual employees), collective level (close working community) and organisational level (the way in which the municipality has chosen to structure how it solves tasks).

During the process with the six municipalities it was important that the model was based on a common set of core values and common principles for early detection that could be adopted by all municipalities and the research institution.

The following values and principles were adopted as the basis for the detection model:

• The child’s behaviour should be seen in the social context in which the child exists.
• The parents should not simply be involved and heard. They must be active collaborators.
• The multi-disciplinary cooperation and professional resources involved must be given high priority.

The children must be seen and understood in the context in which they live and are part: This could be the group of children in the day-care centre, the class at school or the family situation in which they live. In other words, the project is based on system theory and children development model in which the point of view on children is the individual child’s resources and scope for development rather than the child’s problems alone.

Priority is given to parents being active collaborators in the cooperation with the professionals when their child displays problems. In other words, they take part in all meetings concerning their child as far as possible, and they are listened to, including their suggestions for any solutions to the child’s problems, and are provided with a high level of information.

A multi-disciplinary approach is given priority in the professional cooperation, which involves using each other’s competences for developing a common language with a common view of children and understanding of children’s problems. There must be scope for individual professionals to reflect and for common professional reflection within the individual’s own institutional frameworks; however, multi-disciplinary reflection and joint action, i.e. cooperation with other professional groups, are also core elements of the joint detection in situations where other professional groups’ knowledge is required and action across professional groups and institutions is necessary. The working procedures in this cooperation must be rapid and visible, particularly when action is required in relation to a child or a family.

The following tools and methods were developed and selected for efforts to upgrade the early detection initiatives:

• Continuous upgrading of the professional skills of the teaching staff through regular external professional sparring
• A special focus on and special knowledge sharing concerning very small children by establishing a childcare team for infants in each municipality.
• A wellbeing form for regular systematic assessment of all children’s wellbeing and development (see appendix 1).
• A transition form that follows all children during the transition from one institution to another to promote common knowledge sharing, facilitate the children’s transition and ensure that the recipient institution/school is ready to receive the child, particularly when children with special needs are involved.
• A dialogue model for meetings on a child/children.
• An “anchor person” for each child and at every meeting who is responsible for coordinating information and for ensuring that decisions are implemented in real life.
• The prioritisation of implementing Barnets Reform (the Child’s Reform) with a view to strengthening cooperation between the decentralised institutions (day care and schools), healthcare, childminders and the municipalities’ social services concerning the joint assessment and any reports, and ensuring a rapid response to reports filed.

External professional sparring: The continuous upgrading of the professional skills of the professionals involved is an important tool in early detection. Professional skills and readiness to act are to be strengthened so that professionals both see the children and act in relation to the children that need support. To ensure the continuous skills upgrading and further professional development, it has been agreed that continuous external sparring is to be ensured by an “external consultant or the like”. This will give the teaching staff the opportunity to discuss uncertainties and questions concerning individual children/individual groups of children with an “expert” and external sparring partner. This person can see the child with “fresh eyes” and ask questions in an attempt to give the staff at the institution/school new angles from which to view the child and group of children. This external sparring is to be carried out in relation to all institutions (schools and day care) and all professionals who are in contact with children during their everyday work (healthcare, childminders). The continuous sparring is to be carried out by a qualified professional selected by the municipality (e.g. an educator, psychologist, teacher, social worker).

Infant childcare team: Very young children in particular can be overlooked, probably because their problems are not very visible, and the model therefore specifies that at least one specialised infant childcare team comprising professionals with special knowledge on very young children is to be established in each municipality. This team must have both an outreach function, i.e. ensuring municipalities have a high level of knowledge on very young children, and must be available as consultants and advisors when the professionals request help or are unsure about their assessment of very young children.

Specific tools have been developed both for maintaining the continuous focus on children’s wellbeing and development and for knowledge sharing during “transitions”, which will support and develop the professional work. These include a “wellbeing form” and a “transition form”.

Wellbeing form: Some children’s needs for special support and attention are not visible in day-to-day life (quiet children, very well-adapted children). An important part of the detection model is therefore for everyone who is in day-to-day contact with children between the ages of 0 and 10 years to regularly use a wellbeing form, in which the development and wellbeing of all children in the institution/school is assessed to ensure that all children are “seen”, and that any lack of wellbeing or problems are revealed as early as possible. At the same time, the wellbeing form is also the pivotal point for professional dialogue during which children’s signals of any lack of wellbeing are interpreted.

Transition form: Knowledge sharing is also necessary when a child leaves one system to go to another, to ensure the recipient institution is aware that some children may need special attention and possibly special institutional frameworks, as attention is directed both towards the individual child’s needs and towards ensuring the recipient system adapts to receive the children. Knowledge of each other’s systems and cultures is also required. This applies for example to the transition from day care to school, which involves various institutions with different cultures, frameworks and expectations concerning the children. To ensure this knowledge is shared, it has been decided that knowledge sharing should take place via structured transition forms, which are used to disseminate knowledge from one institution to another.

During the transition from one institution to another (including school), all children’s wellbeing and development is assessed to ensure that important information on a child that could be significant in relation to his/her successful integration in the recipient system is passed on so that the child does not experience escalating problems that are discovered far too late by the recipient system.

Dialogue model: To ensure a targeted structured dialogue and a common understanding of the meeting content and purpose, a dialogue model has been developed to rationalise the meeting process and thereby both the multi-disciplinary professional cooperation and cooperation with the parents. The dialogue model is also intended for use during the subsequent meeting evaluation. With the dialogue model, meetings are structured based on the domain of meaning in which one finds oneself. Is it the domain of reflection, sparring, analysis or decisions?

Anchor person function: To ensure that meetings are efficient and decisions are anchored and implemented, while everyone remains fully informed of the process involving a child/a family, it has been decided that an anchor person must be appointed in each process and that the anchor person is to function as a coordinator for information dissemination to safeguard that decisions are realised. A special task for the anchor person is to ensure that the parents are fully informed about all decisions concerning their child.

Fast response to reports filed: Information reported to the social services must be processed rapidly, and the decentralised institutions must receive feedback from the social services on the extent to which action will be taken in response to the information reported. They can then adapt their work with the family and child based on this knowledge. This necessitates a special focus on the opportunities provided by the Child’s Reform in relation to discussing children, also without the parents’ consent, to find out whether the information should be reported to the social services (cf. section 153 of the Danish Social Services Act). Inspired by the SSP cooperation (school, social system and police), professionals involved with the SSD cooperation (social services, school, healthcare and day care) are now permitted to exchange information in their early preventive work (cf. section 49a of the Danish Social Services Act). The changes in the law also help to clarify when reports should be made and that professionals are entitled to feedback on the information they file if they request it.

Experience in implementing the detection model

According to plan, the model was to be fully implemented in the autumn of 2010 but the process has taken somewhat longer than anticipated.

First and foremost, this is due to the thorough dissemination of information on the model and associated forms and tools to all parts and levels of the municipality while written instructions were to be prepared for the forms, etc. This work has been far more comprehensive than anticipated, particularly because new forms had to be developed, e.g. various transition forms that matched the forms already developed by the municipality.

Numerous replacements at managerial level, extensive staff cuts and reorganisation at administration level have also affected implementation of the detection model. Notably, restructuring in schools has hampered the implementation of the methods and tools for use during the transition from day care to school, as well as the use of wellbeing forms for the systematic regular focus on the pupils’ wellbeing in the reception class and up to 4th grade.

During implementation, it has also proved to be vital which role the steering group and working group have played during the development and practical implementation of the model itself.

The detection model is a framework model for early detection in the municipalities. The first tasks the municipalities faced were therefore to fill in the frameworks in relation to the individual points of the model, so that it fitted into the municipalities’ child policies, organisational structures and other initiatives in the area, and not least to find the means within the existing frameworks for the special methods that were new in the municipalities’ child and youth policies. The latter has not been easy in all the municipalities due to comprehensive cutbacks in local spending.

The municipalities have tackled the task of fleshing out the content of the models’ points very differently, which appears to have had a major impact on the further implementation of the model.

In some municipalities, the working group has carried out the work together with the project manager. In others the project manager has been largely in charge of this work. Implementation has been most successful in municipalities where the whole working group has been fully involved in the entire process. Especially in municipalities where the working group has comprised members of the top and middle management levels, the work on and support for the project manager during implementation appears to function best, while the working groups that have comprised members at employee level have not shown the same drive and support in connection with implementation due to the lack of managerial anchoring.

In municipalities where the project manager has been very alone with the work of filling in the content and implementing the model, this has hampered implementation of the model. This applies in particular to cases with inadequate managerial focus, and where the municipality’s working group has not played an active role in developing and implementing the model.

All the municipalities have tried to integrate the model in the existing child policy to ensure the project is anchored. A couple of municipalities attempted to integrate the model in existing projects. This meant that the detection model was not visible for the employees and managers in the municipality, which hampered implementation of the model.

Half of the municipalities held kick-off meetings at which the research institution (AKF) presented the model. These were attended by all the employees and managers in the participating local districts. At these meetings, the employees and managers were given a detailed review of the model and expectations on the part of the municipality for its implementation and their work with the model. These municipalities in particular are well under way with testing the model. The start-up has therefore had major importance.

All the municipal project managers have made a great effort to directly disseminate information to the municipalities’ front-office staff and day-care managers and school principals with varied levels of backing from the heads of the municipalities’ administration and departments. This support has proved to be very important when implementing the model.

Inadequate managerial focus on the project of developing and implementing a detection model appears to have hampered implementation and realisation of the following elements of the detection model that in particular require extra resources or redistribution of existing resources in the municipality: the external professional sparring for childminders, day care staff and school staff as well as the establishment of infant childcare teams.

Experience shows that successful implementation of the model requires that all levels related to the field of children in the municipality, in other words, top management, middle management and employees, participate actively in implementing and prioritising this work.

The wellbeing forms are the element in the model that has been most successfully implemented, with day care, including childminders and in some cases schools, regularly focusing on the individual children with a view to obtaining a common assessment of and dialogue on their wellbeing and development.

However the schools in some municipalities have been difficult to involve in this work. This is partly because schools in particular have been restructured in the municipalities, and partly because the schools felt they already worked with many forms. The principals in some municipalities also explained that the focus on children’s general wellbeing was not within the scope of the work to be carried out in the schools, where teaching is the core concern. However, from the project’s perspective, the schools are particularly important, as all children between the ages of 6 and 10 are in contact with a school.

The municipalities’ social services have not had the same level of perception that they were part of the project, as the perception in some municipalities is that detection and upgrading of the early initiatives should take place in the normal area. Their task concerns mainly filing reports on children with serious problems that cannot be dealt with within the normal area.

This would suggest that some municipalities have paid limited attention to the opportunities and intentions in the Child’s Reform, i.e. the cooperation between the social services, healthcare, schools and day care (the SSD cooperation) and the new opportunities for exchanging information also without the parents’ consent when the parents’ consent cannot be obtained and there is justified concern about a child’s circumstances, and the question of whether to report the matter to the social services is under consideration. The same applies to the opportunity for rapid feedback concerning reports at the request of the person filing the report. It cannot be excluded that this may be in full swing, but the municipalities may not associate it with the detection project (alone).

Experience concerning testing the methods

The report from the municipalities is that both at management and employee level, people are very satisfied with the detection model, which fits in well with the municipalities’ policies and strategies in the area. The childminders in particular are very enthusiastic about their participation in the project and feel it gives them a professional boost and reflects appreciation of their work.

This has strengthened the municipalities’ motivation for realising the project because the background for the municipalities’ participation in the detection project was that they would like to strengthen their existing work.

The core values and principles for the model closely approximate the existing core values and other initiatives, particularly in the municipalities currently implementing the ICS model and LP (learning and education) model, which are both based on the child’s interaction with his/her surroundings and understanding for and analysis of this interaction.

However, some of the municipalities report that disseminating the model’s core values, i.e. the systems theory approach to analysing the child’s problems, has been a special challenge. Educators, teachers, community nurses and particularly childminders are more used to focusing on individual children rather than seeing them in their social context interacting with their surroundings, and to thinking in terms of practical courses of action.

In relation to the individual elements of the detection model, the municipalities have worked in particular on introduction of a systematic approach (viewing the child and any problems he/she may have in a social context), organisation of the multi-disciplinary coop-eration and rationalisation of the meetings by using the dialogue model, upgrading interviews with parents and using wellbeing forms, particularly in day care and at childminders, and to some extent transition forms when the child moves from one institution to another.

Those involved are particularly satisfied with the wellbeing forms, which are to be used to focus on individual children. These are reported to provide a very different systematic approach to assessing individual children. The childminders in particular express satisfaction, while the schools in some municipalities are more reserved, as they already have pupil development plans that focus on the learning aspect in particular.

The transition form with subsequent assessment meeting has also been met with great satisfaction. Now the schools, for example, will be given the same form for all the children regardless of which day-care centre they come from. This is also expected to promote and enhance the professional dialogue between the schools and day-care centres.

As regards rationalising meetings, the municipalities are well under way with eg training meeting moderators and using the dialogue model developed during the project to align ex-pectations before the meetings, structure the course of the meetings and subsequently evaluate and analyse the meetings.

In April 2011, the infant childcare teams and the external sparring for front-office employees were continuing in a few municipalities, though mostly at a planning stage, and had not been fully implemented. In addition, not all municipalities have included social workers in their family administration in the work concerning early detection and thereby in the multi-disciplinary cooperation.

Future challenges

During the coming year, the entire model must be tested and a method found for continuous knowledge acquisition concerning the model’s effectiveness in relation to “discovering” children requiring special attention and possibly support at an early point.

In specific terms, the detection model can result both in a less pronounced need for initiating intrusive support and measures for children in vulnerable circumstances, and in a special focus on the child and family and support for the parents and closest caregivers at an early point before a problem begins to escalate being adequate to ensure the child can cope under normal conditions without special support.

Naturally, this is difficult to measure specifically. However, the project will focus on one measurable goal in particular: Do the professional staff feel better equipped to detect early signals that a child is not thriving, and do they experience that they are better equipped professionally to support a child and family when the child experiences problems?

The means are the continuous skills upgrading of professional staff, closer professional cooperation within their own institutions concerning the children’s social and developmental wellbeing, closer coordinated multi-disciplinary cooperation, including cooperation between institutions during transitions (when a child moves from one institution to another), and closer cooperation with the parents and any social services during the clarification phase when the child is deemed to have problems or is about to develop problems.
However, if all this is to be “measured”, it is vital that the municipalities remain fully focused on the detection model, so that the work that is under way can be further developed and continued.

The challenge for the municipalities will be ensuring that the “drive” is maintained in the professional staff as well as middle and top management, so that the model does not gradually crumble or become forgotten in the day-to-day work, or fade out when new managers and employees are hired.

The research institute will play a vital role in this, partly by continuing to be aware of any new research in the area, and partly through a continuous focus on the individual projects run by municipalities and on the steering group’s initiatives in relation to ensuring that the project progresses. This will be achieved both by continuing to hold meetings with the mu-nicipalities’ project managers, working groups and steering groups, and through regular visits to the municipalities with sparring and advice when required by the municipalities.

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