Integrated children’s services: re-thinking research, policy and practice

The integration of human service work for young children and their families is now a global policy trend. Policy initiatives in England, Australia, New Zealand, Portugal, Germany and elsewhere are actively supporting the development of new sites and modalities of inter-professional/trans-professional/multi-professional work in early year’s health, welfare, education and care. Such initiatives give recognition to features of early year’s practice that have always been evident to practitioners: that working with young children is complex, context specific, culturally located, rich with creative possibilities and highly demanding.

These initiatives have also arisen in response to what Rittel and Webber (1973), after C. West Churchman, called ‘wicked problems’. Writing in the context of urban planning, they argued:

A great many barriers keep us from perfecting such a … system: theory is inadequate for decent forecasting; our intelligence is insufficient to our tasks; plurality of objectives held by pluralities of politics makes it impossible to pursue unitary aims; and so on. The difficulties attached to rationality are tenacious, and we have so far been unable to get untangled from their web. This is partly because the classical paradigm of science and engineering – the paradigm that has underlain modern professionalism – is not applicable to the problems of open societal systems. One reason the publics have been attacking the social professions, we believe, is that the cognitive and occupational styles of the professions – mimicking the cognitive style of science and the occupational style of engineering – have just not worked on a wide array of social problems. The lay customers are complaining because planners and other professionals have not succeeded in solving the problems they claimed they could solve. (160)

For many governments, their persistent failure to solve the health and education challenges that they claimed they could solve, and which still confront large portions of their population, constitutes one such wicked problem.

This special issue highlights recent research into integrated children’s services internationally, reporting on some of the ways in which practitioners, researchers and policy-makers are attempting to engage with this problem. It illuminates a range of understandings, discourses, policy approaches, opportunities for participation and stakeholders’ perspectives in the attempt to address the present and future achievement and well-being of our youngest citizens. The papers in this issue also focus on the pragmatic aspects of issues, models, processes and research directions, and contextualise these within current policy frameworks and initiatives in Australia, England, Germany and Turkey. These papers not only portray local contexts but also the range of methodologies being employed by researchers in the attempt to understand and advance this work, including – in this issue – a thematic review, social practice analysis, cultural-historical activity theory, bricolage and survey research. Finally, the range of practice settings across these six papers is also wide, ranging from children’s centres to hospitals to municipal policy environments.

The papers in this issue fall into two broad groups. The first group of three papers speaks primarily of issues of research and governance. The paper by Sandie Wong and Jennifer Sumsion is an ideal starting point for those interested in the nature and consequences of integrated early years services (IEYS). Wong reports on the findings of a thematic review of research literature, employing five search strategies: multiple database searching, citation and footnote tracking, consultation, hand searching and browsing. This resulted in a corpus of 197 journal articles, chapters and reports from a range of disciplines (e.g. education, special education, health, child protection and social policy), including empirical research, commentaries and policy discussions. Four themes are discussed: broad support for IEYS, critiques of claims about IEYS, a focus on inter-professional practice and the challenge of evaluating. It is clear from this review that there are strong conceptual arguments for the provision of integrated services for young children and families, which fit with current policy initiatives based on social inclusion and social capital discourses. However, Wong also sounds a warning note: without a substantial evidence base, the efficacy of IEYS may be hard to defend if there is a shift in policy direction.

The implementation of integrated services to provide early support for young children and their families is the subject of Sybille Stöbe-Blossey’s paper. In the Federal State of North Rhine-Westphalia (Germany), childcare centres have evolved into family centres due to the positive effects of integrated services on child development and the prevention of child neglect and maltreatment. This shift has naturally had implications for governance structures at different levels (state, across institutions and at the individual centre management level). Stöbe-Blossey reports on the way in which having transparent standards has enabled the family centres to grow, whilst controlling their development and their ability to link central standards and decentralised services, which has seen more families served by these centres. It is interesting to note that despite limited resources and the lack of time to build cooperation across partner organisations, the implementation of family centres already has a high acceptance rate after only a short time, with local youth offices considering them an important element of their policy.

The views of policy-makers, academics and practitioners about their endorsement of and perceived feasibility of a model for integrated early childhood education and care services in the Turkish context are described in the paper by Demet Gören Niron. Despite improved access to services and a plethora of evidence showing the benefits of early childhood education and care, participation remains low in Turkey. Gören Niron argues that Turkey’s current ‘split’ system of education and care is having an adverse effect on participation, and that the focus of policy and practice should turn to the integration of services. In this way, a sense of holistic development could be fostered for children and their families, with the aim of quality and equity for all children.

The second group of three papers in this issue focuses more specifically on the experiences of practitioners in early year’s settings. The results of a survey of 52 early year’s educators, recruited from a range of settings with differing histories and arrangements for working with other agencies in England, are reported in the paper by Jane Payler and Jan Georgeson. Findings are presented relating to the experience of inter-professional working, woven together with case studies that provide examples of practice. Variability in the work undertaken with other professions, and in the practitioners’ reported levels of confidence and competence, are identified as being due, in part, to the type of setting in which the work takes place. Payler and Georgeson propose a conceptual framework for interpreting early year’s inter-professional practice that takes into account specific contexts, with special attention paid to the conditions that appear to promote boundary-crossing competence. These findings suggest the need for adequate training, tailored to individual contexts, and argue for securing spaces for practitioners to gain experience of inter-professional working through mentored opportunities.

The paper by Jennifer Cartmel, Kym Macfarlane and Andrea Nolan reports on an Australian initiative, Developing and Sustaining Pedagogical Leadership in Early Childhood Education and Care Professionals, where academics and professionals shared knowledge, experience and research about working in a trans-disciplinary way in multi-agency organisations. The aim was to develop an understanding of the strategies and skills required by early childhood professionals and practitioners to strengthen their pedagogical leadership when working in these organisations. The conceptual framework underpinning the design, analysis and evaluation of the project was that of ‘bricolage’, which enabled the researchers, professionals, practitioners and other organisational members to reflect on principles of multiplicity, complexity, relationality and criticality. A model of professional development was constructed from the analysis of the data and subsequently used to develop an open source learning website.

Finally, Joce Nuttall’s paper offers a different context in which to reflect on inter-professional work. Her paper reports from the first phase of a study of the work of hospital play specialists, in which she tested the utility of Edwards’ (2010) concept of ‘relational agency’. In observing and interviewing hospital play specialists in two London hospitals, Nuttall attempts to identify key concepts that might assist in understanding inter-professional work and in the preparation of early year’s practitioners for this distinctive form of practice. Crucially, the play specialists in the reported study were able not only to clearly articulate their own core expertise but also to identify the motives underlying the work of a range of other professionals. The paper concludes with discussion of the study’s implications for further research and of its potential to inform the preparation of a range of professionals who engage in inter-professional work.

The diversity of settings and methodologies reflected in this collection, and prior research and practice efforts in health, welfare and education to understand inter-professional work, have given rise to a range of terms being used to describe the labour processes inherent in these settings. These include ‘integrated’, ‘inter-professional’, ‘multi-agency’ ‘multi-professional’ and ‘cross-disciplinary’. For readers who are primarily interested in studies of work, please feel free to treat these terms interchangeably. At the same time, we need to remember that how we name the world also constructs that world – whilst also constructing us as subjects, professionals and actors for children, their families, and our professions. A serious study of the semiotics of naming this important form of work would be most welcome in a future issue of Early Years.

We hope this special issue will inform and provoke professionals and policy-makers about how to imagine and implement integrated children’s services. As researchers in this field ourselves, we also welcome debate amongst international researchers about the usefulness of various theories and methodologies in researching integrated service settings. Ultimately, we hope these papers will stimulate lively and constructive debates about the relationship between policy, research and practice in engaging with the ‘wicked problem’ of ensuring the best possible health, education, welfare and care services for young children and their families.

Andrea Nolan and Joce Nuttall
Guest Editors