Positive Relationships: Progress Checks - Single file

Given that many practitioners are still struggling to get to grips with the new and upcoming reforms to the two-year-old development reviews, it's understandable that parents are likewise scratching their heads over what it really means to them and their families.

Depending on where they live, parents will have had wildly different experiences of development reviews at age two. Some will have heard talk of a 'universal' health review that they don't recall having ever received. Others may have heard that another review will soon be added on at their nursery, seemingly doubling up on a number of checks already in place.

Whatever experience parents have previously had with development reviews, we all know that parental engagement can make or break the success of children's learning and development. That's why it's so crucial that parents understand the value and benefit to their child of the new integrated health and early years review that will come into effect in 2015. It's also why practitioners must remain sympathetic and be ready to manage any questions and confusion that may arise in the meantime.

WHAT HAPPENS NOW?

As part of Government's Healthy Child Programme, when a child reaches age two they are required to attend a health review. However not everyone will get a full face-to-face review at this time and in areas where health visitors are hard pressed to accommodate local need, a phone call may be used to discuss the health and development of your child.

A key component of strengthening the health review and making it a truly 'universal' experience will be the Department of Health's drive to recruit 4,200 health visitors by April 2015. Until this target is met, the review at age two will remain patchy with varying levels of parental engagement from one region to another. The latest Department of Health quarterly report (September-December 2012) admits that numbers are currently below trajectory but assures us that they are heading in the right direction.

The Department is planning to train more than 6,000 new health visitors before 2015 and three times as many health visitors began training in 2011/12 compared to those in 2010/2011. Additionally, in some early implementer site areas, the coverage of the two-year review is as high as 85 per cent.

In addition to the health review between age two and two and a half, from September 2012 in the new Early Years Foundation Stage there is now a requirement for parents to be provided with a written summary at age two of their children's progress in the EYFS prime areas of learning.

Currently these two opportunities for review of a child's progress at age two to two and a half are not integrated in a coherent way and that is what will change with the advent of the integrated review in 2015.

THE FUTURE OF TWO-YEAR-OLD REVIEWS

From 2015 early years settings and health professionals will be required to work together to produce a single comprehensive report, removing duplication between and building on the strengths of the current early years progress check and the health review at age two.

Experts in early years development, health, and officials from the Department of Health and the Department for Education have been working together since autumn 2011, under the banner of the Integrated Review Development Group, to fully consider the challenges and opportunities involved in integrating early years health and educational support.

From a health perspective, the review may draw heavily on the Ages and Stages Questionnaire (ASQ-3), an assessment tool which helps parents to provide information about their child's development across five areas:

• communication

• gross motor

• fine motor

• problem solving, and

• social - personal.

The integrated review will also cover the three prime areas of learning and development of the EYFS:

• Personal, Social and Emotional Development

• Physical Development, and

• Communication and Language.

It will also consider the wider context in which the child is living, looking at the parenting, home learning environment, family circumstances, social/community circumstances.

WHY INTEGRATE?

The main ambition in integrating the equally important areas of health and early education is to achieve a simple, parent-friendly system which provides the best opportunity for professionals to engage the parent in their child's developmental needs. True, the period of time leading up to the integrated review, where separate checks will take place, may feel anything but simple, leaving parents confused about why different reviews are taking place in different settings.

Where frustrations are voiced by parents, practitioners need to explain in detail the process and urge them to keep faith with the long-term ambition of the reviews and the direction that is being taken. We truly believe that we are headed towards a better system which puts due importance on the integration of health and early years, the needs of the child and the parent at the heart of the system -and not before time. Long has been the cry from the early years workforce to have greater involvement of health professionals to support children's learning and development.

Under the new system, it is hoped that parents will be spared the hassle of toing and froing between their child's setting to the health base for information on their child's development, and repeating themselves from one professional to another. As well as making life easier for parents, the integrated review will also provide a more holistic view of their child's development, making it easier for parents to understand the wider context and reinforce support in the home. Importantly it will improve integration between the health and early years sector.

COLLABORATIVE WORKING AS SECOND NATURE

Many children's centres have been working in partnership with health agencies for years with excellent results. Offering health-led services such as weigh-ins, health visitor appointments and follow-ups within children's centres has led to many parents receiving a variety of support and advice that they would not have accessed or known about had the children's centres and health agencies kept their distance.

From September 2015, as the integrated health and early years review at age two is introduced, working in partnership with health will become second nature to early years professionals. For many, forming new health partnerships will require a whole new way of both thinking and working. For those who already have a strong culture of sharing information and working in partnership with health professionals, the shift will be less challenging.

Hackney Council has been selected as one of a number of areas to pilot models of the integrated review throughout 2013. Already, the integrated review is gaining popularity with some parents who have embraced the integrated process and the opportunity to discuss their child's achievements. The programme sees private, voluntary and independent settings as well as children's centres being designated a link health visitor who forms the main point of contact for early years staff.

Where a child attends an early years setting, or in some cases just a drop-in session, the reviews are initiated by early years staff and take place at the setting. Where a child isn't registered to a particular group or childcare setting, the review is more likely to happen within a health setting. Importantly, if possible, parents are given a chance to state their preference for where their review takes place and the information is shared among the health visitor, early years professional and the parent.

Initiating reform is rarely a quick and straightforward process but if the sector stands behind the reforms and puts parents at the heart of the process, the benefit to children and families will pay dividends.

PRACTICAL STEPS TO EASING THE TRANSITION TOWARDS WORKING WITH HEALTH PROFESSIONALS

• Are you confident about the Progress Checks that your setting is offering two-year-olds? If not, speak to colleagues or management and ask for clarification on what is involved and expected of you.

• Is working with health professionals part of the development plan for your setting? If not, ask a manager or room leader about how they intend to create future health partnerships and what you can do to help

• Share a copy of the non-statutory EYFS guidance document Development Matters with a health colleague.

• Ask health colleagues to explain the 'Ages and Stages Questionnaire 3'.

• Find out whether there is any training or additional knowledge you can access to help you work successfully with health professionals.

• Make sure you are prepared and confident in explaining the forthcoming changes to parents? Your attitude towards the changes will have a major impact on theirs so be positive and promote the benefits to them and their child.

• Make sure that you share information with health professionals wherever it is appropriate or possible to do so. If you start early, there will be less of a culture change to manage when 2015 arrives.