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FORUM on Corrections Research
An Integrated Model for the Prevention of Emotional and Behavioural Problems
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A potential decrease in future juvenile delinquency is one of the benefits of an integrated model for
primary prevention programs developed in 1989 for the Ministry of Community and Social Services (MCSS)
of Ontario. Primary prevention programs provide social services to children and their families in a community context. They are designed to prevent young children living in economically disadvantaged communities from developing emotional and behavioural problems. To reduce the risk for children living in poor communities, the MCSS decided to support a number of well-evaluated primary prevention research demonstration projects. In 1988, the Ministry drafted terms of reference for the Coordinated Primary Prevention Initiative. The project proceeded with a strong recommendation to develop guidelines for community involvement and research. One of the biggest problems in the field of primary prevention is the great gap between the well researched programs known in academic circles and the grass-roots programs with small budgets supported by the community. With this in mind, the Ministry formed a Technical Advisory Group to evaluate the current state of primary prevention programming for young children in low-income communities. Consisting of 25 prominent researchers and program directors from across Ontario, the group provided a broad cross-section of disciplines and specialization relevant to the field of children's mental health. It included educators, community workers, psychiatrists, psychologists, public health nurses and social workers. The advisory group extensively reviewed literature and programs on primary prevention. Based on the findings, it developed Better Beginnings, Better Futures, an integrated model of primary prevention of emotional and behavioural problems. This report provides program directors, agencies and communities with information on the current status of primary prevention programming. Components of the Model 1. Integrated systems and program components Within a community, services to children and families must blend and unite. Conceptually, the integrated model moves beyond "co-ordination of service" to a full integration of service planning and delivery. Since poverty and early childhood risk factors such as poor nutrition and family stress are closely associated, programs aimed at a number of risk factors should produce better long-term results than programs aimed at just one risk factor. 2. Two types of integration Two types of integrated systems are recommended: a. prenatal through preschool (five years) b. preschool through primary school (five years) The systems providing the prenatal/infant development programs (i.e., public health or MCSS-sponsored infant-stimulation programs) must integrate with the system providing the preschool program, which in turn must integrate with the primary school system (i.e., education). 3. Comprehensive programs The integration of education and community services can be tailored to meet a community's specific needs with the addition of complementary programs. Examples include nutrition and diet-supplement programs, family planning, parent training, child development education, parent support groups, drop-in centres, employment training and parent-child resource centres. 4. Inclusion of important discrete stages of childhood development Together, both integrated systems (prenatal through preschool and preschool through primary school) permit analysis of the growth and development of children in prevention programs from the prenatal period through to age 7. This includes all of the critical transition periods of social development in early childhood from prenatal development, birth, assimilation into family, infancy, entry into child care or preschool (if applicable), entry into junior kindergarten or kindergarten, and entry into grade one. 5. Services for five years of children's lives The five-year program is supported by indications that one-, two- and three-year programs are probably inadequate to produce large enough (or long-term) positive results to justify their cost. For example, one- or two-year programs apparently do not have lasting effects for the children after they leave the program. 6. Quality programming, with community support and careful evaluation Effective programs are ones of quality rather than ones of quantity. The best research demonstration projects will not try to provide every known component. Each program component should be of the highest quality and carefully matched to community needs. The best projects will have several excellent components, with committed cross-professional collaboration, community involvement and detailed attention to evaluation and research. 7. Six years for program implementation and evaluation The first year is one of development including planning, start-up, establishment of integrating mechanisms and testing research measures. Five years of program implementation and evaluation follow. One group of children would be tracked through the entire five years of each integrated system. 8. Long-term follow-up research through the teen years Children in the program as well as a control group of children must have long-term follow-up to determine whether prevention programs in the early childhood years actually prevent emotional and behavioural problems in adolescence and young adulthood. 9. Fielding projects for generalizability Projects should be fielded in different types of economically disadvantaged communities to establish the applicability of the model to different situations. 10. Adhesion to community and research guidelines Reviews of both the research literature and the Ontario programs emphasize the importance of involving the community and conducting good research. Although some underdeveloped communities may need resources and time to develop leadership and infrastructure, primary prevention research demonstration projects must hold both community involvement and research as fundamental. Programs and Community Projects Below are some examples of well-researched and documented infant, preschool and primary school programs and community projects. Infants
Source: Ministry of Community and Social Services, Better Beginnings, Better Futures.- An Integrated Model of Primary Prevention of Emotional and Behavioural Problems. Toronto: Queen's Printer for Ontario, 1989. |
