Abstract
In playing with the concept of ‘credibility’, this article presents a critical examination of the discourse of evidence and the programming of upbringing in early intervention policy and practice. The truth claims of the evidence discourse in policy are explored through a single complex case study of an early intervention city in Northern Ireland. The framework for the study discussed uses Bourdieu's thinking tools of habitus, capital and field alongside Foucauldian discourse analysis to explore the ways in which early intervention policy and practice impact on children, parents and communities. A key question is to consider how evidence is constructed within the discourse and how this can be considered as a Foucauldian regime of truth. Building from the emerging body of critique around scientism and parenting, the study extends this through a sociopolitical lens to the Northern Ireland context. Despite a strong tradition in Northern Ireland of community-based activism and political transition from direct rule to devolution, early intervention policy and programming have tended towards direct read across from Britain and the USA. The study documents that community-based practice struggles within the policy field for recognition, yet ‘home grown’ carries significant social capital within and across communities. The dominant policy discourse of the (in)credible ‘fiscal prize’, transformation through evidence-based interventions contrasts with the backdrop of worsening child poverty in communities. Contrary to the truth claims, this suggests the reproduction rather than transformation of social disadvantage.
Introduction
The rules of the game of science as described by Bourdieu (2004: 59) are like a sporting field, conducted within a ‘space of possibles’. Enquiry presents a range of choices as to question and method, which, to extend the analogy, reflect different positioning and importance in the field. Moss (2017) reveals the current field of early childhood as subject to a dominant positivist policy discourse driven by a narrative of return on investment. With respect to early intervention in particular, this dominant discourse draws selectively on knowledge capital from neuroscience and different forms of ‘evidence’ to prescribe regulatory parenting programmes for a range of social problems. The cost of early intervention as opposed to later remediation, the predicted high economic return to society is referred to in the policy discourse as the ‘fiscal prize’ (Allen, 2011; Chowdry and Fitzsimons, 2016; Fitzsimons and Teager, 2018). The confluence of the discourses of evidence and neuroscience and the construction of the child as social investment in the Allen (2011) report on early intervention has shaped UK policy over the subsequent decade. In this report, neuroscience is employed to diagnose a range of social maladies, and an elite of 19 ‘evidence-based’ parenting programmes, selected by a panel of UK- and US-based advisors, is prescribed as the solution. In this way, research from neuroscience and evidence have been appropriated to support a neo-liberal discourse of child and parent. In reconceptualising parenting as a skill set detached from social context, Allen deploys the phrase from the research of the Effective Provision of Pre-School Education project (Melhuish et al., 2006; Sylva et al., 2004), since reified in countless policy documents that ‘what parents do is more important than who parents are’ (Melhuish et al., 2006: ii).
Brief contextual review of the literature: influence and critique of the landmark studies
The regime of truth in relation to the social and economic return on investment, the ‘fiscal prize’ of early intervention has been shaped by a number of experimental trials and longitudinal studies. The most prominent of these are the historical trio of the Perry Preschool study (Berrueta-Clement, 1984; Schweinhart et al., 1993), the Abecedarian experiment (Ramey and Campbell, 1991) and the Chicago Parent Program (Reynolds, 2002). These longitudinal studies were fundamental in shaping policy thinking around both evidence and cost–benefit analysis of early intervention. They formed the basis of the much quoted ‘Heckman Equation’ (Heckman, 2004; Rolnick and Grunewald, 2003) – the claim of a gain to society of US$8 for every dollar invested in early intervention. This formula has been widely used in research, practice and advocacy for investment in young children in the USA and internationally (Karoly, 2016; Nutbrown, 2018; Popli, 2013). The claims of the cost–benefit equation have since been revisited and contested (Campbell-Barr, 2012; Hanushek and Lindseth, 2009; Whitehurst, 2017). Perhaps the most important caveat comes from Heckman et al.'s (2010: 11) own reappraisal, which concluded: ‘In general, the estimated rates of return are above the historical return to equity of about 5.8% but well below previous estimates reported in the literature’.
Cost–benefit extrapolated from landmark studies was the subject of a critical review which highlighted the relevance of sociopolitical context (Penn and Lloyd, 2007). Participants across the landmark studies were from impoverished urban African American communities with high rates of incarceration, leading the reviewers to conclude that ‘cost–benefit findings could not be generalized beyond the original contexts in which the studies were carried out’ (Penn and Lloyd, 2007: 15). Vandenbroeck et al. (2012) extended the contextual critique, highlighting that in contemporary studies of early intervention, programmes were also often drawn from contexts characterised by deep social inequality and ill-performing welfare states.
The necessity of critical challenge to the ‘what works’ and cost–benefit claims of early intervention effectiveness studies is illustrated in an example from Gardner et al.'s (2015) systematic review of the effectiveness of early intervention programmes. The finding of the review was that while interventions transported to ‘western’ countries showed comparable effects to trials in the origin countries, the effects were actually stronger when interventions were transported to culturally dissimilar non-western countries. The explanatory narrative suggested is that ‘parents in more traditional cultures might be more responsive and respectful to perceived experts and therefore engage more willingly, and learn more, from the intervention’ (Gardner et al., 2015: 759). The failure to problematise epistemic or cultural dominance in this type of explanatory narrative says much about the urgency of critical challenge to the ‘what works’ and cost–benefit claims of effectiveness studies.
Aims and objectives of the study
The aims of the research case study that is the focus of this article were therefore to examine the policy discourse on early intervention using critical discourse analysis; to critically explore early intervention approaches in practice in a case-study context; and to add to the theoretical understanding of policy-to-practice implementation.
Theoretical framework and methodology
The theoretical framework for the study employed the ‘thinking tools’ of habitus, capital and field as identified by Bourdieu (1990, 2004) to explore the ways in which early intervention discourses might impact young children, parents and communities, as well as in the broader political context .
An initial challenge of utilising a Bourdieusian theoretical framework is that there is no explicit methodological guidance offered. Bourdieu took an open-ended approach to conducting research, guided by his philosophical orientation and using the thinking tools that he had devised, but his work was not method-prescriptive. Bourdieu does, however, alert us to the danger of unanchored theorising, suggesting that ‘discourse on scientific practice is quite disastrous when it takes the place of scientific practice … one cannot think well except in and through theoretically constructed empirical cases’ (Bourdieu and Wacquant, 1992: 59). The challenge was therefore to identify a case-study context to explore how early intervention policy was enacted in practice.
While not specific about methodology, Bourdieu does provide an explicit account of what it means to analyse a field (Bourdieu and Wacquant, 1992: 104–107). The approach is outlined in terms of three stages: first, to analyse the position of the field vis-à-vis the field of power; second, to map the structure of relations between the positions of agents who compete for forms of authority, of which the field is the site; and third, to analyse the habitus of the agents. The challenges were both theoretical and practical: first, identifying a context that was feasible as a single researcher but allowed for this broader field analysis and, second, identifying a methodological approach that would facilitate this in practical application. In this respect, Merriam's (1998, 2009) critically informed but pragmatic approach to case studies was a useful guide.
Chouliaraki and Fairclough (1999) criticise Bourdieu for underestimating the role of discourse in the struggle within and between fields, and offer critical discourse analysis as a supplement to Bourdieu's theory. They also suggest that using a Bourdieusian conceptual framework can anchor discourse in the logic of practice by combining discursive and non-discursive elements. This is useful in considering policy-to-practice translation in the context of competing discourses within or between fields, as between science, politics and economics in the case of early childhood intervention. In this way, critical discourse analysis was a useful compliment to the theoretical framework and thinking tools of Bourdieu.
Critical discourse analysis attempts to identify the power dynamics within discourse, examining how this is mediated, for example, through a policy text or in practice. Following from the work of Foucault (1977, 1980a, 1980b) in particular, the methodology is useful in exploring how relations of power and dominance within societies and cultures are embedded in and reproduced through both language and practice. Critical discourse analysis was utilised in the study to examine key early intervention policy documents as data, considering the broader sociopolitical culture in which they were created, as well as the impact on practice. A critical, extended approach to case study (Burawoy, 1991) enabled the researcher to connect everyday practices in local communities to globalised discourses.
The limits or boundaries of the case are a defining factor in case-study methodology (Merriam, 2009; Stake, 1995) and have practical and theoretical implications. The aim of this research was to identify a case study within an area larger than a locality where a range of programmes was being implemented. The opportunity to focus on a recently self-identified early intervention city at a particular policy moment facilitated the exploration of institutional, political and community dimensions (Burawoy, 1991). Consistent with a critical approach (Lather, 2015), the system was considered holistically rather than as separate levels of analysis, with a focus on complex rather than linear relationships. The concept of a case as holistic, multidimensional and changing is also recognised by Merriam (1998). However, consistent with the pragmatic approach Merriam (1998, 2009) advocates, this was underpinned by systematic data collection, utilising interviews and focus groups with key informants at different levels of the system. This structure, running alongside analysis of the policy discourse, was employed to manage the process of inquiry.
Outline of case study
The Northern Ireland context was a particularly interesting position from which to examine the outworkings of discourses in early childhood intervention from both a policy and practice perspective. The field was constructed from implementation in a self-identified early intervention city, Ballymore. 1 This was considered in relation to the broader field of power, the structure of relations and analysis of the habitus of the agents. The different, interconnected levels of enquiry – policy, city, neighbourhood and programme – could thus be explored in a single complex case study. The key informants were those who managed interventions – neighbourhood, programme and Sure Start managers (n = 10); those who delivered interventions, family support workers and health visitors (n = 16); and parents and carers who participated in programmes (n = 86). Regional managers and commissioners in health and social care (n = 2) and early intervention partnership members (n = 4) were also interviewed to establish the connection from policy to practice locally. In this way, purposeful sampling allowed for systematic data collection at each level of the system (Bryman, 2008; Merriam, 1998). The interviews were semi-structured (Patton, 1990), with broad areas agreed in advance, while allowing for emergent narratives (Denzin, 2017). Parents and carers (n = 86) engaged in larger numbers through focus groups, with rich data emerging from the opportunity to build on narratives as well as challenge, argue and debate (Dörnyei, 2007). In relation to the researcher as interviewer, an awareness of positioning, reflexivity, and the potential for both epistemic dominance and the uncritical reproduction of claims or assumptions were also important in this process of critical enquiry (Denzin, 2017; Merriam, 1998).
Critical analysis of UK policy on early intervention
Although the roots of early intervention can be traced to initiatives in the USA from the 1960s, it has emerged in the UK in the last decade as a dominant policy discourse and field of practice in the context of austerity policy under the Coalition and subsequent Conservative governments (Edwards et al., 2015; Gillies et al., 2017). The definition of early intervention most drawn on is in the 2010 practice guide produced by the Centre for Excellence and Outcomes in Children and Young People's Services (2011: 3): ‘Intervening early and as soon as possible to tackle problems emerging for children, young people and their families or with a population most at risk of developing problems’.
The ways in which issues, populations come to be framed as problematic, the way problems are constructed and presented in government policy and practice is important in what Foucault (2007) terms the ‘genealogy of problematisation’ (141). The political timing of this framing is also important, inviting a series of questionings as to ‘why a problem, and why such a kind of problem, why a certain way of problematizing appears at a given point in time’ (141).
Using Foucault's (1977, 1980a, 1980b) concept of the dispositif, it is possible to critically examine the ways that early intervention discourse produces, regulates and governs practice, and constructs children and parents as objects of policy intervention. Foucault identified three aspects to the concept of the dispositif: first, that it comprises a heterogenous assembly of, for example, discourses, institutions, scientific statements, and moral and philanthropic proposals; second, that the nature of the connection between these aspects is important, such as the connection between programmes and practice; and third, that it functions at a given historical moment in response to an urgent need. Recession, austerity and the wider global regime of neo-liberalism are therefore important aspects of the emergent context for early intervention.
The early intervention dispositif therefore mobilises government and research institutions, draws on a knowledge base from science and economics, proposes a moral and therapeutic solution, and, finally, consolidates its philanthropic proposals in establishing an early intervention foundation (Allen, 2011). The focus on efficacy in the discourse has driven and resourced a body of research studies – the ‘what works’ of early childhood intervention, with applications to nursing, social work, child protection and education.
Critical analysis of Northern Ireland policy on early intervention
In order to further apply this analysis, a summary of the context of policymaking in Northern Ireland is required. During the period of political violence known as the Troubles, Northern Ireland was governed by direct rule from Westminster (Mitchell and Wilford, 1999; Ruane and Todd, 1999). Following the Good Friday Agreement in 1998, the British government devolved powers, leading to the establishment of the Northern Ireland Assembly on a consociational governance model – an elite-led coalition government with parallel institutions to protect distinct identities (Lijphart, 1975; McGarry and O’Leary, 2004). Assembly elections are based on a system of proportional representation with the allocation of ministerial posts determined using the D’Hondt formula in accordance with party strength. Policy and legislative decisions have to be supported by an overall majority and, on issues of significance, must also secure a minimum of 40% support from the Unionist and Nationalist blocs (Arthur, 2001; Wilson, 2010). Positioning in the field of power therefore interacts with ‘ethnic habitus’ (Connolly et al., 2009; Grosswirth Kachtan, 2019) in particular ways and, in the context of such significant political change, exploration of transformation as a dominant policy discourse is important.
While implemented as a means to achieve democratic decision-making in divided societies, critics argue that consociationalism can actually entrench cultural divisions (Horowitz, 2001; Ryan, 1995), and failure to achieve consensus carries the risk of policy or indeed wider institutional paralysis. Arguably, the very mechanism that achieved political transformation from violent ethnic conflict has had the opposite effect in policymaking since. Social policymaking in key areas such as childcare, education and health under the devolved Assembly has been characterised by deep fractures on communal lines, decontextualised policy import and impasse (Birrell and Heenan, 2013). The Assembly has been stalled by frequent suspensions and, at the time of writing, has recently reopened after an extended three-year period of suspension into a complex environment shaped by a global pandemic and at a critical interface of its relationship with the rest of the UK, the island of Ireland and Europe (Moriarty and McClements, 2020).
A number of the overarching policies use the term ‘transformation’, and the most notable iteration in relation to this discussion is the Early Intervention Transformation Programme (Department of Health, 2014). This programme, jointly funded by the government and US-based philanthropy, operated from March 2014 to March 2020 with a budget of £30 million over a six-year period (Department of Health, 2020). Its aim was to improve outcomes for children and young people through embedding early intervention knowledge and approaches across universal health and education services. In the political discourse, the construction of the social investment model – the ‘fiscal prize’ of early intervention (Allen, 2011; Chowdry and Fitzsimons, 2016; Fitzsimons and Teager, 2018) – is premised on sustained shared working and shared investment in children, families and communities across ministries and departments. However, as outlined above, the particular ‘rules of the political game’ in Northern Ireland have resulted in policy stagnation rather than transformation. Key interdepartmental strategies such as the Child Poverty Strategy (Northern Ireland Executive 2016) and the Children and Young People's Strategy 2 have languished in political inaction (Northern Ireland Commissioner for Children and Young People, 2020). Importantly, in relation to economic capital, fiscal and macroeconomic levers influencing policy areas such as child and family poverty are still operated from Westminster.
The Ministries and Departments implementing the Early Intervention Transformation Programme (2014–2019), such as Education, Health, Social Services and Justice, reflect a differentiated political discourse, draw from different ‘regimes of truth’ (Foucault, 1977) and types of evidence. Foucault's (1977) original usage of the term was concerned with the ways in which ‘scientific’ discourses became entangled with the power to punish, and thus the application of the evidence discourse across different policy fields merits closer examination. Evidence discourse in health and social care policy, unsurprisingly, draws from the medical model, focusing on ‘evidence-based interventions implemented through evidence-based programmes’ (Public Health Agency, 2015: 9). Education policy discourse has a focus on social inequalities and draws from the evidence base of the Effective Provision of Pre-School Education study, advocating that parents ‘get involved because education works’ (Department of Education, 2013: 29). The Department of Justice’s (2012) strategy, Reducing offending: Towards a safer society, highlights that evidence links criminal behaviour back to early life experiences. This is a mainstay of the ‘fiscal prize’ truth claim – that intervening early will be both efficient (saving money over the longer term) and effective (saving children from entering the criminal justice system). While drawing from different regimes of truth, the discourses coalesce in placing the responsibility for transformative change with parents in disadvantaged communities, rather than with government.
Northern Ireland has twice the proportion of children living in poverty than is the case in Britain (Horgan, 2011), and those areas and neighbourhoods that experienced a high impact of conflict map closely to those of high child poverty (Fay et al., 1999; Horgan, 2011; McAlister et al., 2009). This context of high child poverty, as well as differences in local and national governance, meant that the Sure Start programme was sustained in Northern Ireland when public spending cuts under the Coalition and Conservative governments dismantled the programme in Britain (Duddy, 2019; Lewis, 2011; Sawyerr and Bagley, 2017). Of the 38 Sure Start partnerships in Northern Ireland, 26% are governed by Health and Social Care Trusts and 74% by community and voluntary sector led bodies. 2 Another feature of social capital was that during the years of direct rule from Westminster, a vibrant and vocal community sector flourished, which was further bolstered by European Union Peace funding in the wake of the Good Friday Agreement. This is described by Morison (2001: 298) as an ‘alternative site of politics and an unofficial opposition’.
Key findings from the early intervention city case study
In addition to complexity and challenges, there were important opportunities for insight in the context. Early intervention was emerging as a significant policy driver at the time of initiation of the study in 2015–2016. A particular city in Northern Ireland, Ballymore, the location for the study, was formulating an articulated focus at the local level on early intervention. 3 Ballymore has the highest levels of child poverty at local authority level in Northern Ireland. The population of children under three is 6472, of whom 3644 (56%) attend one of the four Sure Start programmes in the city. The neighbourhoods in which these programmes are located are, for the purposes of the study, named North River, South River, East River and West River. Alongside critical discourse analysis of policy at the regional level, fieldwork took place in Ballymore at local partnership, neighbourhood and programme levels. By interviewing multiple informants, the study incorporated different layers of meaning and experience in the interactions between agency and structure at different levels. The translation of the discourse of evidence from policy to practice could thus be explored.
Fidelity and cultural context
The most striking observation from the initial mapping of early intervention programmes in the case-study area of Ballymore was that a very small percentage (less than 3.5% or 9 out of 253) was drawn from the menu of 19 randomised controlled trials (RCT)-tested programmes listed in the Allen (2011) report . This gave an initial indication that what was happening in the community might be at variance with the dominant discourse. Subsequent interviews with commissioners, managers, practitioners and parents helped to illuminate both endorsements of the discourse and sites of resistance.
The commissioning perspective on programme implementation from the Public Health Agency emphasised a strong adherence to fidelity as essential in upholding the ‘what works’ claims of evidence-based parenting programmes: The evidence says this programme works, provided that you do A, B, C, D, E, and you do it this way and this way and this way. As long as you do that, the evidence holds, the ‘it works’ holds, because you are replicating it the way it was done. But if someone is to take that training and cherry-pick the nice bits they like and leave out other bits, calling it ‘******’, and then say, ‘The evidence base says it works’, then the evidence base doesn’t say that works. (Public Health Agency commissioner)
From the perspective of the Public Health Agency, the evidence discourse was not only useful from a commissioning perspective, but also served a purpose in justifying ‘decommissioning’ programmes that were considered ineffective: What it [establishing an evidence base] has allowed us to do is to take the programmes that there is a very good chance are going to make a difference and to stop doing the others – instead of having 99 different programmes all sort of vaguely going in the same direction. (Public Health Agency commissioner)
The perspective of the Public Health Agency commissioners differed considerably from the perspective of community managers, where the importance of relationships, structures and social context was emphasised by managers on the ground: You cannot deliver an evidence-based programme without the structures around it. I know that you need the relationship; you need access to people outside the two hours in the week. You need to have more. You need, preferably, to know the person before they start the programme; they need to have some trust in you. There needs to be so much more than just the programme. (Sure Start manager, North River)
At the community level, the managers emphasised relationship-building, professional expertise (particularly within Sure Start) and resistance to the ‘menu of programmes’ approach: The whole notion of importing programmes and bringing them in for us is important – ‘If only we would do that and stick to it and stick rigidly within the programme plan … then things will be different’. Well, actually, ‘no’, you need to have a relationship with people. The same is true of the programme for two-year-olds. Actually, you need to build a relationship first. (Sure Start manager, South River)
Imported programmes also raised the issue of cultural context being related to the concept of fidelity, and the managers raised the necessity of adapting externally developed programmes to the local experience: We also deliver Incredible Years but I would say, in relation to fidelity, it is more loosely connected. Some of the vignettes they use are quite dated and very American. It's not culturally equivalent to our experience here, so that is an issue. (Sure Start manager, North River)
The issue of cultural context was not only raised by the practitioners but also noted by parents, who had developed their own shorthand for Americanised terms – the ‘coffee pot moment’ – to describe practices that were culturally unfamiliar. This was frequently used as a jovial alert within a programme when they came across terminology or practice that jarred culturally. The parents in one of the focus groups talked about how, within manualised parenting programmes, the family sitting round to talk about ‘issues’ was something artificial that they did not feel suited their home or cultural context: Tina made a wee comment last week that we are not the ‘all-American family’ you see on TV. We call it a ‘coffee pot moment’. They are made to look all perfect and you think it's the road you have to go in … It's not realistic. (Carrie , parent, North River)
Perspectives on evidence: professionals who listen
Overall, amongst the practitioners and facilitators, there was a much stronger emphasis on the importance of professional wisdom and listening to parents over adherence to a manualised approach. An interesting perspective raised by the practitioners was whether the ‘what works’ perspective was about validating the programme first and the needs of the parent or client second: That [the evidence base] is coming from a different perspective; let’s prove this works; scientific – the programme is the most important thing there. Where we are coming from is client-centred. We are responding to, reflecting, anticipating need; we are bringing people with us … and yes, if the programme works, fabulous, but we have to make sure it works for those people as human beings. (Jodie, facilitator, North River)
From the perspective of the parents, there was little interest in the issue of the ‘evidence base’, indicating that this was not the capital on which they based their decision to participate. The most important quality from a parent perspective was the professional knowledge, flexibility and communication skills of the facilitator – in itself an implicit critique of the notion of fidelity: Flexibility is the most important thing. They [facilitators] have to be flexible to be able to adapt all the content to each individual child. Everything we could work around the individual child. There was always something that they could pull out of you that was actually going on at that time. So, you were going home with answers rather than feeling ‘What the hell am I going to do?’ (Orla, parent, North River)
The facilitators’ support in relation to interfacing with other less accessible professionals – for example, doctors and teachers – was also important to the parents. What seemed to be happening here was that the facilitators – who were often qualified midwives or health visitors – through sharing knowledge capital, enabled parents to be more powerfully positioned in their communication in the field: Letting you know you can talk to a health-care professional, like a person, not just like a number. It's your child and you know everything about your child, so that's why I felt I don’t have to go by what the doctor said. I could say, ‘I want this done for my child now’. That's what I ended up doing, and my son is now getting sorted. (Karen, parent, North River)
Another important observation from the case study was that while much of the research on the effectiveness of parenting programmes focuses on the effect size of a single programme (Currie, 2000; Martin, 2010; Reynolds et al., 2001; Schweinhart et al., 1993), the parents in the case-study area often participated in a number of programmes, with the same group remaining more or less intact: We have been together since we were pregnant. We did the pregnancy classes, did the baby classes, we are now doing the toddler classes and then some of us will be back to do the pregnancy classes again [laughs]. (Aideen, parent, South River) It's kind of a run-on from previous programmes – not a run-on but an add-on. And we have done others together, so we are comfortable with the people we are doing it with as well. (Jamilla, parent, North River)
It is clear from the case study that, in the real-world situation, programmes are in an ‘open system’, and multiple programmes, approaches and influences are impacting communities in organic ways. Participation in multiple programmes as a group also points to the creation of social capital within the group – what Bourdieu (1986: 248) describes as ‘the aggregate of the actual or potential resources linked to the possession of a durable network of relationships of mutual acquaintance and recognition’.
While this was clearly a supportive experience for the parents taking part, this pattern of small cohorts of parents participating in multiple programmes raises the question of the larger body of parents and children in the community who do not participate. A number of neighbourhood and Sure Start managers referred to the barriers that formal programmes can present for families: The experience of families, and particularly for families who are at the hard end of the economy and the hard end sometimes of communities, people with learning disabilities or with their own health issues, people living in domestic abuse situations, addictions, I think they would see very little connection with what we are doing … and who are we to offer the 10-week solution to their problem? (Sure Start manager, South River)
Another neighbourhood manager commented that attention should be focused on those in the community who were not participating: It's about who is not attending rather than who is attending … I don’t offer no programme; it's building the trust and relationship first. The most vulnerable have multiple issues – debt, marital problems, domestic violence – that need to be worked through first. This is time- and resource-intensive … No one gives you resources to build trust. You are dictated by outcomes, quick wins, results. You can’t put a timescale on a family. (Neighbourhood manager, North River)
Struggle, if not transformation, was evident at all levels of the system in neighbourhoods. The neighbourhood manager in North River explained this as some families being in ‘fight mode’ in dealing with statutory agencies: We have clients that totally love their kids but they have been through the care system themselves and they are so protective. They are in fight mode; they are just fighting to survive, but that is not what is appropriate when you are dealing with agencies. We have to sometimes go on in there with them as advocates, as they are constantly in fight mode. (Neighbourhood manager, North River)
Struggles to acquire capital for home-grown programmes
The struggle with statutory bodies does not, however, end there. The same manager then spoke of their own struggles in communication with statutory bodies in an attempt to develop an early years communication campaign, ‘Little Talkers’.
4
The ironies of the situation are all too apparent, as the community organisation was prohibited by the Health Trust from using the words ‘speech’ or ‘language’ in relation to the programme: We were basically told by the Trust that we should have nothing to do with speech, language or communication – we were not the professionals. It should be left to the Trust. As a community organisation, we had employed former Trust staff, qualified speech and language therapists who were working privately on the ‘Little Talkers’ campaign. We were told by the Trust not to use the words ‘speech’ or ‘language’ in any of our communication. (Neighbourhood manager, North River)
Here, the statutory body not only has control of the knowledge capital in relation to the evidence base of programmes and the power of commissioning; it also controls this by controlling the discourse itself, restricting the use of the words ‘speech’ and ‘language’ to evidence-based programmes run by professionals in the field and prohibiting their use in home-grown programmes. Effectively, the struggle at the community level is in trying to change the political, economic and institutional regime of the production of truth (Foucault, 1977).
Transformation or reproduction?
Taking a Bourdieusian overview of the case study, tracing the discourse through from policy to practice, what must be considered is whether the outworking of the discourse of evidence in early intervention is reproducing or transforming inequalities. Transformation is one of the most powerful concepts that characterise the early intervention policy discourse. In the broader context of Northern Ireland politically, the discourse of transformation can be supported with reference to a Peace Process and Peace Agreement that many would have found unthinkable 20 years previously. Underneath this political transformation is another reality, where the life chances of children are massively constrained by poverty, where parents and local communities are in perpetual struggle, and where governance is stalled or too fragile to articulate a credible strategy to address these issues in the here and now.
Discourses of reproduction and transformation are recurrent at different levels in the case-study context. Underneath this powerful political discourse at the macro level of political transformation post-conflict, a number of the overarching policies use the term ‘transformation’, and the most notable iteration in relation to this discussion is the Early Intervention Transformation Programme (Department of Health, 2014). The programme’s board commissioned the Early Intervention Foundation to quantify the fiscal cost of late intervention in Northern Ireland (Fitzsimons and Teager, 2018). This was tabulated by the economists as a total of £536 million per year on late intervention, equating to £1166 per child. The largest contributors to these figures included child protection and safeguarding, domestic violence and economic inactivity (Fitzsimons and Teager, 2018).
The Early Intervention Foundation’s report concludes that there are fiscal as well as moral benefits in early intervention, but includes the following caveat: It should be noted that these figures do not present an estimate of the total amount that can be feasibly saved: that is, cutting the incidence of some of these negative social outcomes by a certain fraction will not lead to a direct reduction in costs by the same amount. However, the overall fiscal prize is clearly large. (Fitzsimons and Teager, 2018: 21)
The impact of the Early Intervention Transformation Programme has recently been published as a government infographic, which restates the cost of late intervention but is considerably more measured in its claims (Department of Health, 2020). It acknowledges that impact is rarely realised quickly and can be challenging to measure; that there was no baseline position established; and that projects were unable to measure long-term outcomes for practical, ethical and financial reasons. Similarly, an interim evaluation of the Early Intervention Support Service resourced through the Early Intervention Transformation Programme in 2018 concluded that ‘this current evaluation does not provide any formal evidence of the effectiveness of the intervention’ (Winter et al., 2018: 75). The picture of service provision in this evaluation echoes many of the challenges that were also evident in the Ballymore case study: Targets and caseload numbers were reported by all to be unattainable and unsustainable if the service was rolled out further. Complex cases were a regular issue, i.e. families were referred with extremely complex needs, or emerging problems with multiple family members. (Winter et al., 2018: vii)
Conclusion
The expectations of public sector change following the Peace Agreement in Northern Ireland were enormous, with claims made that structural reform (e.g. reorganising health, education and local government) would be ‘transformative’ and lead inexorably to better-quality public services. Instead, reforms became part of a wider political struggle, some of which remain unresolved and have tested the effective working of the power-sharing Northern Ireland Executive (Knox, 2016). At the city level in Ballymore, the context is ‘transformation through regeneration’, with early intervention as a key theme and catalyst programme whereby the aspiration is that the city will become ‘the best place to be born and grow up in’. 5 This continues at the neighbourhood level, where enactment of a neighbourhood renewal policy (Department for Social Development, 2003) aspires to ‘transform our area into a safe place which people will choose to live in, invest in and visit; where all will feel welcome in an inclusive community at peace with itself and others’ (Neighbourhood Renewal Action Plan, 2011: 2) 7 . This aspirational discourse is set against a backdrop in which the reproduction rather than transformation of social disadvantage is reflected in the empirical data.
Many parents are bravely trying to change intergenerational patterns; some parents are getting the benefits of services designed for the more marginalised; some are constantly in ‘fight mode’ with the system; and many are grappling with issues that are too oppressive to engage at all. From a Bourdieusian perspective, habitus change, at whatever level this is happening, is much more complex than changing habits. Contrary to the dominant discourse of early intervention, ‘who’ parents are and what their economic resources are has a massive impact on what they can do with and for their children. In order for change to be transformative, it needs to be at both the individual and social levels – government needs to face up to its responsibilities beyond advising parents to face up to theirs. A specific structural issue in tackling underlying determinants is that limited devolved power in economic matters impedes the ability to address poverty, which is one of the main influencing factors for children's outcomes. Northern Ireland spends less per capita on children than any other area of the UK (Black et al., 2020). A credible level of investment is what is needed, not the reiteration of incredible fiscal promise.
While, at this point in time and within this context, early intervention has not transformed social inequalities, it has clearly brought positive benefits – although not on the scale that the discourse promises. It could be argued that the mismatch between reality and aspiration, reproduction and transformation, is actually set in the discourse itself. Bourdieu (2005) reminds us that economics, while expressed in facts and figures, is a social construction, which cannot explain what happens in reality. The expectation of transformative change has been constructed on overstated claims. The ‘fiscal prize’, the cost–benefit claim and the Heckman Equation, while sold as hard evidence, do not exist anywhere other than in an economist's construction. They have, however, been embedded in the public imagination as part of a transformative discourse, capturing the possibility of what early intervention can offer. Perhaps the future for early childhood intervention is in a more realistic and grounded approach, which is more modest in its claims, continuing the essential work of supporting children, families and communities but recognising that this is long term and needs to be supported by structural change with clear strategies for addressing poverty and inequality at the level of governance.
Footnotes
Funding
The author received no financial support for the research, authorship and/or publication of this article.
