Abstract
For a dedicated early interventionist, it was a pleasure to review this impressive volume. It is not often that one reads a textbook through from Foreword to conclusion (in this case, some 700 pages) as if it were a novel, but it was worth doing in this instance. The authors of all 28 chapters are household names in their field, and very few disappointed this reader. Even the chapter on the economics of early childhood intervention proved (unexpectedly in my case) easy to comprehend and, as with many others on the strengths and shortcomings of past and current programme goals, methodology and evaluation, it is essential reading for all those involved in policy-making, programme development and research in the early childhood field. Given the quality and the comprehensive nature of the material, this is definitely not an expensive book. If you are considering setting up, or even participating in, an early intervention project, please read this book first.
The second edition does not replace the first and it is important to have access to both as, although there are new chapters here, many contributors have built upon their offerings in the first edition. Both volumesare ‘designed to integrate the science, policy, and practice of early childhood intervention… to serve as a comprehensive vehicle for communication across the many disciplines and perspectives that contribute to this complex and continually evolving field’. Theory, research, practice and policy are thoroughly discussed. It will be a critical reference text for advanced students and experienced professionals in the fields of early intervention, prevention and health promotion in education, child care, general child health, health policy, social policy and community capacity-building. I do not consider it appropriate for novices; it presupposes a considerable knowledge of the field and the level of critique and discussion is sophisticated.
The book is very much a USA product, notwithstanding useful chapters by Kamerman, on ‘Early childhood intervention policies: an international perspective’, and Rutter, on ‘Resilience reconsidered: conceptual considerations, empirical findings, and policy implications’. Thus the discussion refers mainly to a limited body of American work (e.g. Head Start and Early Head Start), although this has, of course, been very influential. Nevertheless, much of the commentary and discussion is clearly applicable to other contexts, including Australia. For example, Meisels and Shonkoff note (p.23) that three challenges currently face young children and their families: (i) diversity in definition and structure of the family, changing gender roles, and the altered nature of adult work, (ii) the growing gap between rich and poor, and (iii) increasing racial and ethnic diversity in our communities alongside undiminished racism and discrimination. They add that the greatest challenge facing thefield ‘demands that we address the broad social, economic, and political fabric of American society’. Many chapters comment on the complex political environment in which early interventionists must operate, and bemoan the lack of political will to address poverty and the causes thereof as fundamental issues relevant to the health and welfare of the community as a whole. These issues are global, like everything else these days. Incidentally, until I read Kamerman's chapter, I had not given adequate thought to the fact that, whereas in the USA early intervention usually implies defined, targeted programmes, specifically funded and frequently under threat of funding withdrawal, many countries in Europe provide antenatal, infancy and early childhood strategies as aspects of a universal service that is taken for granted. As such the latter are rarely formally evaluated, but are seen as both essential and effective.
Early childhood as defined here begins at birth and extends to age 5 years. Nevertheless, those interested in intervention in early infancy will need to continue to refer to more specific texts in that field. The two chapters on neurobiology (developmental vulnerability and the neurobiological bases of early intervention) were very welcome, but no text as yet gives more than a passing nod in the direction of the critical 9, or less, months of foetal life. Our limited understanding of many of these fundamental aspects presumably underlies the lack of quality research on useful strategies for antenatal intervention, for example to address the effects of smoking, alcohol and other substance use, domestic violence, lack of antenatal care, stress, anxiety, depression and other influences.
Here, as elsewhere, the politically correct word ‘parent’ is often used in describing programmes, but ‘mother’ is still what is usually meant. Fathers are important, but they are often unwilling research and service participants. Insufficient clinical, research and policy attention is paid to paternal education, mental health, parenting effectiveness and investment, resourcefulness, and so on. With the exponential growth in this field, it is to be hoped that the editors have additional, appropriate material for their next edition.
In the decade since the first edition of this important reference text, much has evolved in the field of early childhood intervention, and yet, as many of the contributors noted, we still have a long way to go. Also, despite their clear commitment to early childhood intervention, they sensibly emphasized the modest nature of the positive effects reported in most studies and the warning that we are unlikely to discover, far less be able to implement, a simple, universal intervention to prevent or remedy the problems of children and their families.