Intersectoral Collaboration

Proposed trial of the "Common Language" Program in Australia

A professional development program that aims to promote effective service integration and evidence-based practice is currently being developed under the leadership of Dr Rebekah Grace.

In 2012 Dr Rebekah Grace was supported by a Creswick Foundation Fellowship to spend two months at the Dartington Social Research Unit. The purpose of this visit was to learn about the "Common Language" program and assess the feasibility of trialling this program in Australia.

CHETRE is currently in discussion with local services in South Western Sydney to develop a trial of the "Common Language" program, and funding to support the trial is being sought.

Background

The importance of service integration

A growing body of research supports an integrated model of service delivery as the optimal method to improve outcomes for children and families, particularly those experiencing social disadvantage.

The importance of the early years as critical in laying the foundations for healthy child development and positive life outcomes is supported by a very strong research base (Shonkoff & Phillips, 2000). Increasingly, this body of research looks beyond physical and neurological development in isolation to explore the relationships between child outcomes and social/environmental variables. This understanding has led to considerable investment in a range of early intervention programs and early childhood education. It has also driven the development of parenting programs based on the premise that improvement in parenting efficacy will enhance the development, resilience and life chances of children (Moore, 2008).

The large body of evidence to support the interconnectedness of child growth and development, parenting, socio-environmental and educational variables has prompted the review of service delivery models. To provide health, family support, child intervention and education services within distinct 'silos' is to separate out what we know to be interconnected. It follows from this that the most effective intervention services leading to positive outcomes and change will be those that bring together a range of professionals and programs to address the complex needs of children and parents in a holistic and integrated manner (Godfrey, 2006).

Service integration is defined as the formation of a unified and comprehensive range of services in a geographical area where the intent is to enhance the effectiveness of the delivery of services (King & Meyer, 2006). An integrated model of service delivery has the potential to reduce service fragmentation for families, reduce social isolation and increase service engagement, fill service gaps and ensure a smooth continuum of services for families. The Special Commission of Inquiry into Child Protection Services in NSW conducted by Supreme Court Judge James Wood (2008) along with the National Framework for Protecting Australia's Children (2009) emphasized as a key component the importance of integrating services and developing a unified approach between government and non-government agencies to improve outcomes for families and children.

Despite support at the social policy level, there remain some significant barriers to achieving service integration that must be addressed. For example, integration can be challenging for professionals who have not been prepared to work in this way. In their scoping review, Lord et al. (2008) identified the training and ongoing professional development of staff as the first feature of effective integrated practice. It is critical to provide opportunities to understand and break down the competing discourses of professional groups and develop shared theories and explanatory frameworks that guide practice (Atwool, 2003). The ultimate goal is to develop a 'community of practice' in which there is shared vision and an openness to learning from each other and reflecting upon practice without requiring professionals to relinquish a sense of professional identity (Wenger, 1998).

Researchers from the Dartington Social Research Unit have argued that if we are to improve children's services, and consequently outcomes for children, the two most important challenges to be addressed are:

  1.  the complications of interagency working and multi-disciplinary responses to children's needs; and
  2.  ensuring that the evidence-base both guides and is informed by practice.

Common Language

The Common Language program has been developed by leading researchers at the Dartington Social Research Unit in the UK, including respected implementation scientist Dr Michael Little. This program is designed to promote cooperation, integrated ways of working and practical connections between all services and service sectors involved in supporting the wellbeing of children within the community (e.g. health, education, social welfare and housing). The Common Language program also promotes the increased utilisation of research evidence to guide service decisions, encouraging 'research-mindedness' within practitioners.

The Common Language program is a professional development program designed to be conducted with a mixed group of professionals, representing as many of the professional groups involved in the care and protection of children within the community as possible, such as: GPs, nurses, teachers, social workers, etc.

The Common Language training comprises core ideas and methods to compliment the specialist knowledge and skills required in each profession. A child development perspective underpins four core program concepts explored in 14 modules over 14 days:

  • Need: understanding the risks and protective factors in children's lives and the ways in which these factors interact in causal chains to effect child health and development;
  • Threshold: developing a common approach across agencies to determine the seriousness of the child's needs;
  • Service: designing services that know what works for whom, when and why, and specifying how proposed patterns of services might be expected to alter the developmental trajectories of children; and
  • Outcomes: assessing whether or not risk has been reduced and protection increased, and learning to put outcomes rather than outputs consistently at the fore.

Internationally this program is one of very few professional development programs designed to address the challenges of integrated service delivery, and one of only two that have undergone rigorous evaluation. In the current policy climate it is timely and potentially of great value to trial the Common Language Program in Australia.

References

Atwool, N. (2003). If it's such a good idea, how come it doesn't work? The theory and practice of integrated service delivery. Childrenz Issues, 7(2), 31-35.

Council of Australia Governments (2009). Protecting children is everyone's business: National framework for protecting Australia's children 2090-2020. Canberra, ACT: Commonwealth of Australia.

Godfrey, C. (2006). Responses to early childhood educational intervention with disadvantaged families: An exploratory study. Doctor of Psychology (Clinical Psychology), Victoria University. Retrieved Friday, 21 May, 2010, from http://wallaby.vu.edu.au/adt-VVUT/uploads/approved/adt-VVUT20070509.155333/public/01front.pdf

King, G., & Meyer, K. (2006). Service integration and co-ordination: a framework of approaches for the delivery of co-ordinated care to children with disabilities and their families. Child: Care, Health, and Development, 32(4), 477-492.

Lord, P., Springate, I., Atkinson, M., Haines, B., Morris, M., O'Donnell, L., Benefield, P., Harper, A. & Sharp, C. (2008). Scoping Review: Improving developmental outcomes for children through effective practice in integrating early years services. Centre for Excellence and Outcomes in Children and Young People's Services (UK).

Moore, T. G. (2008). Rethinking universal and targeted services. CCCH Working Paper 2. Parkville (August 2008). Parkville, VIC: Centre for Community Child Health.

Shonkoff, J., & Phillips, D. (2000). From Neurons to Neighbourhoods: The Science of Early Childhood Development. Washington DC: National Academy Press.

Wenger, E. (1998). Communities of Practice. Cambridge: Cambridge University Press

Wood, J. (2008). Special Commission of Inquiry into Child Protection Services in NSW.