A report on CANparent Trial for submission at “Nazarbayev Intellectual Schools August Conference for teachers”
Table of Contents
“Being a parent is one of the most important jobs you can do” (Sarah Teather, 2012)
The mission of this paper is to develop parenting competencies and the education sector as a whole in order to provide a better future for Kazakhstani society including socio-economic and political modernisation.
Childcare is an integral part of national policy in Kazakhstan. The speech by N.Nazarbayev, the President of the Republic of Kazakhstan, “Strategy Kazakhstan 2050: a new political course of the established state” (2018), presents new principles of social policy and highlights the major priority of the country’s development and implementation of child protection policies.
A series of commitments have been made by the government to provide social and legal guarantees of a good quality life of the children of Kazakhstan. However, there is a lack of integrated strategic child policy in Kazakhstan (UNICEF, 2015).
In the UK, Government legislature for example, Every Child Matters (2003) and Children Act (2004) were initiated just after the death of Victoria Climbié, an eight year old, who was murdered by her guardians.
This case was the driving force why the government reviewed and reformed children’s care policies. The well-being of children is inextricably linked with the creation of the necessary conditions for their upbringing, education and development.
It should be noted, that the early and pre-school education area in Kazakhstan is not prioritised compared to primary and secondary education. One of the indicators is the lack of vacant places in pre-school educational settings. In order to provide 100% of children with a pre-school education in Kazakhstan a number of programs have been implemented.
The main aim of such projects is to create an optimum environment for the pre-schooling of children aged 3-6. The Kazakh authorities are still a long way off from the 100% target. The defining factor for lack of places in this age group is the demographic situation in the country and an increase in the birth rate (Ministry of Education and Science of the Republic of Kazakhstan, 2014).
The World Population Review (2018), shows that those under the age of 18 in Kazakhstan is exactly 5, 865, 122 (as of March 25, 2018), which is slightly over 30% of the total population.
Recently, serious attention is paid to the maintenance of the system of preschool education. The 1046 consultative centres were opened at standard kindergartens to provide counselling to parents, as well as involving them in the process of upbringing and educating children. However, there is a huge quantity of children, who are inadequately home schooled and in the need of social support (Ministry of Education and Science of the Republic of Kazakhstan, 2013).
“The initiative is important as parenting and the home learning environment are strongly associated with children’s current development and later outcomes, both positive and negative” (Cullen, M.A et al., 2013, p.9).
According to the UNICEF (2015), the number of vulnerable children is 550,000. The problem is that local government cannot offer a sufficient number of places for the growing population. Due to this, parenting education is a crucial factor at the early years’ stage that can enable every young person to obtain necessary social and emotional skills and knowledge for their successful future (UNICEF, 2015).
Shonkoff and Phillips (2000) claim that the parent involvement in early intervention is essential and vital, which increase chances of every baby and adolescent to have a well-balanced adulthood.
Interest in studying early intervention in different societies has become popular in science. As the government policy approach, early intervention started to evolve in 1990s in the UK (Bate, 2017). The UK Government have moved forward on early intervention: it promotes and funds evidence-based programmes, and implements them by a set of policies for adolescents (Allen, 2011).
The term of early intervention is widely explained in many resources. One of the definitions is, “Early intervention is about taking action as soon as possible to tackle problems for children and families before they become more difficult to reverse” (Early intervention foundation, 2018).
Moreover, it also about providing all children a strong and equal basis for their successful development (Allen, 2011). The “Early Intervention: Smart Investment, Massive Savings” report by Graham Allen (2011) presents the cost-effectiveness as a core idea of early intervention. Allen argues that, if the government invests money on early intervention now, the result would be massive savings on fighting crime and poverty in the future, as well as other societal problems which are a result of growing up with poor social and emotional competencies in childhood (Allen, 2011).
In the last three decades, the implementation of early intervention programmes in collaboration with families was one of the significant achievements (Mahoney et al., 1999, pp.131). “Parent education as a key component of early intervention has been greatly deemphasized during the past 15 years” (Mahoney et al., 1999, p.131), although, “the bond between the child and their parents is the most critical influence on child’s life” (Department for Children, School and Families, 2003, p.45).
Croake and Glover (1977) identify parent education as the process of learning by mothers and fathers who want to be efficient in childrearing, to create favourable relationship with a child and behave as a positive role model. Other academics consider, “The term parent education typically refers to systematic activities implemented by professionals to assist parents in accomplishing specific goals or outcomes with their children” (Mahoney et al., 1999, pp.131).
There are a variety of endemic problems in most families, which develop into society problems, therefore raising calls for developing the parenting education market (The Gale Group Incorporated, 2003).
In 2010, the Department for Education (DfE) conducted the survey and found that 30% of parents took an interest in attending local classes and discussing parenting problems with other parents (Peters et al., 2010). This phenomenon can be observed in earlier study of Patterson et al. (2002), who informs that 57.8% of parents are interested in attending parenting classes in the future.
Therefore, initiating the CANparent project was dictated by the need in society. The CANparent trial is a unique policy-led study, which tests the hypothesis whether universal parenting programmes can be de-stigmatised by parent’s attendance to one of the classes and whether this educational market will stimulate the supply.
The key idea of this experiment is universality, which means educating parents of all children by various high quality parenting classes without taking into consideration only specific needs (special educational needs) or children who are at risk.
The main objective of the CANparent project was to improve parenting in the UK, to stimulate creative development of the new market with different parenting programmes and modes of delivery (Cullen, M.A. et al, 2013).
The mixed success of the CANparent trial will be discussed in this paper. This report is the first attempt at analysing and proposing an alternative parenting intervention model for the Kazakhstani audience.
Although, the term of early intervention in its original understanding (Early Intervention Foundation, 2018) is not a new concept for Kazakhstan, but was neglected by the local authorities. Initially, it should be well- established and evaluated with all existing evidence-base in order to accomplish a cultural shift to the early intervention.
This chapter presents a theoretical underpinning that will shed light on some significant aspects of this paper.
The ecological systems theory by Bronfenbrenner (1979) is one of the fundamental research in educational psychology. It explains how environment influence human development, and highlights the value of multiple environments in child’s life.
From a family, to a school, a society to the culture. This model reflects a theoretical grounding of the CANparent intervention. In this framework, culture is a context of the child’s development.
Different environments presented by five layers, which are known as a microsystem (daily home or community environment), mesosystem (interaction between home and school or peers and family), exosystem (extended family members or parents’ colleagues), macrosystem (culture, society) and chronosystem (changes in family structure or address, society changes, changes in parent’s career).
Each level of the system is clearly defined. These systems are the components of human psychological development.
Daro et al. (2005) emphasized that there are not enough empirical studies into family support field, most of them limited by using only participant, provider and programme elements , some of them examine the causes why parents fail to attend parenting classes.
The first thesis, which explains the parent involvement in voluntary programs, is McCurdy and Daro’s Conceptual Model of Parent Involvement (2001). According to the CANparent trial evaluation: First Interim Report (Cullen et al., 2013), the hypothesis of the trial is at the heart of the McCurdy and Daro’s doctrine (McCurdy and Daro, 2001 cited in Cullen et al., 2013, p.24).
Consequently, researchers used this integrated concept of parent involvement as a framework in the CANparent experiment. The trial exactly repeats the schematic view of the theory, which is provided in Figure 1.
Based on this scheme, parent’s enrolment depends on various interdependent factors shown below. The theory shows how factors including intent to enrol, retention, individual factors and programme factors contributes on the successful enrolment to the classes (McCurdy and Daro, 2001).
Figure 1, McCurdy and Daro’s Conceptual Model of Parent Involvement (McCurdy and Daro, 2001 cited in Cullen et al., 2013, p.24) https://www.gov.uk/government/publications/canparent-trial-evaluation-first-interim-report
In terms of Phase 2, the picture shows (McCurdy and Daro, 2001 cited in Cullen et al., 2013, p.24) that intention to enrol for the programmes will depend on the individual’s attitudes including cost-benefit perceptions, readiness to change, subjective norms and experience with programmes, which are possible reasons why the trial at the second phase had failed.
Moreover, it can be clearly seen, that provider factors, particularly the service delivery style was changed on the second phase by withdrawal of education vouchers so that negatively impacted the implementation (McCurdy and Daro, 2001).
The socio-economic context of trial areas apply on this McCurdy and Daro’s doctrine (2001) by neighbourhood factors including social capital and social disorganisation which impact the possibility to enrol (Cullen et al., 2013). To be more specific, the social fragmentation aspects were not significant in four given districts.
However, there were some instabilities in different social levels of local communities, which predicts the low take-up of classes regarding to McCurdy and Daro’s study. For example, in Middlesbrough there are areas with lower levels of social cohesion and the likelihood of attending classes is lower than average.
In the case of employment rates, some parts of Middlesbrough have a higher employment rate compared to others that predicts the lower take-up of parenting programmes. The childcare and parenting support availability in these districts predict the increased possibility of parents’ take-up of classes (Cullen et al., 2013).
In the next study, Deborah Daro et al. (2005) claims that the variables expanded by using data how and when community features impact on the mother’s/father’s access to the parenting programmes. The authors suggest that if parents are ready to changes, used to seeking help and had previous service experience they are likely to enrol.
Also, the intent to enrol predicts an initial enrolment to the programme. For its part, a range of variables such as subjective and objective experiences, provider, programme and community features can predict the retention and enrolment to the programme (Daro et al., 2005).
The literature related to the CANparent trial is not extensive, mostly articles written by academics who led the trial.
During two years (Phase 1) of trial all data was collected and reported to DfE that gave opportunity to supplement and develop the CANparent model during the implementation (Lindsay and Totsika, 2017).
In total, five academic reports were written by the team of scientists from the University of Warwick over the period from 2012 to 2015. The trial was led by the head of Centre for Educational Development, Appraisal and Research (CEDAR) Geoff Lindsay (Jones, 2016), who was the author of main evidence –based reports.
The Department of Education published report findings of Phase 1 and Phase 2 reports were published by CEDAR (2015). The development of the trial can be clearly observed through each report as they continue to complement each other from the early findings to the conclusion (CEDAR, 2015).
Few CEDAR reports were the main resource of this report. In addition, three papers examined strengths and weaknesses of the universal intervention. One study by Lindsay and Totsika (2017) analysed the efficacy of the 18 programmes of the CANparent. Other papers were more specific and focused on the delivery of the intervention (Cullen, S. et al., 2017) and barriers to parent engagement in the trial (Cullen, S. et al., 2015).
In this chapter, two phases of the CANparent experiment will be described with highlighting the features of each phases and its outcomes.
The CANparent trial evaluation or “Tory government’s free parenting classes” (Furedi, 2013) was the UK Government’s initiative in promoting and enhancing a market of parenting education (Cullen et al., 2013), which followed the UK general election in 2010 when new authorities took the power.
The new government was willing to make parenting approach universal, which means all parents of children in their early years from zero to 5 years (later it increased to 6 years) could get high quality parenting education (Lindsay and Totsika, 2017).
One of the focuses of research is testing the mix of programmes and modes of delivery and to analyse what is more appropriate and efficient to increase demand for parenting classes (DfE, 2012).
In the UK, there are 25 reliable early intervention programmes, which are available for the public (Allen, 2011). All of the programmes were designing to strengthen fathers and mothers parenting skills; however, primarily they were focused on vulnerable socially disadvantaged families.
Furthemore, in 2011, the UK Government made a commitment to support families by starting the CANparent trial in 2012 (Reed and Walker, 2014).
The purpose of leading the trial was developing parenting classes in the UK by involving in classes as many parents as possible and evaluating whether parenting classes market can survive without governmental financial support.
The success of this intervention would ensure the better future outcomes as improving current society by surrounding children with appropriate comfortable environment represented by parents (Lindsay et al, 2016).
The goal of the universal intervention is to help parents with raising their children, encourage them to enhance parenting by attending educational programmes, as they would do when attending antenatal sessions, overall, giving them the necessary skills and knowledge to have a positive effect on their offspring (DfE, 2012).
These early preventive measures would save future expenditure on later interventional methods, which are generally more expensive (Allen, 2011).
The CANparent trial was conducted in order to assess effectiveness of parenting classes and stimulating this commercial market in three different places in England: Camden in London, Middlesbrough and High Peak in Derbyshire.
The Department for Education opted for these areas based on their socio-economic criteria: level of deprivation (medium and high) and ethnicity of the local population.
The fourth area – Bristol, was added to the trial without any financial support from the national authorities.
In addition, there are multiple significant criteria such as multi-national and young population, also partly because of the strong economy (Cullen et al., 2013).
The aim of this additional step is to compare whether alternative funding models able to exist in a new developing market (Lindsay et al, 2014). Table 1 represents the demographic details of each area.
Table 1, The CANparent trial areas – demographic profiles (Cullen et al., 2013, p.111). https://www.gov.uk/government/publications/canparent-trial-evaluation-first-interim-report
The government initiative was supported by social organisations: Family Lives (Parenting UK) and Ecorus.
In order to promote high-quality parenting classes and draw more participants there was a need to involve an increased number of accredited suppliers (Lindsay et al, 2016).
ourteen providers met the quality standards to supply parenting programmes at Phase 1 (2012-2014) and six participated at Phase 2 of the trial (2014-2015). In total, outside of the trial areas, there were 33 CANparent quality mark holders, who are from small organisations to national offices became the part of the CANparent Network.
uring the trial, providers and distributors association had financial support from Department for Education in order to deliver a family support service (Lindsay and Totsika, 2017).
The trial included two phases: Phase 1 included a period from 2012 to 2014 and Phase 2 was implemented from 2014 to 2015.
At Phase 1, the method of delivery parenting programmes was well- organised compared with the second part of trial. What helped providers to attract the numbers of parents were the £100 free vouchers used for the provision of classes in the three areas (Lindsay et al, 2016). Boots, and various health and children centres offered parents interested in the classes the free vouchers (Cullen et al., 2013). Vouchers were also available online through the CANparent website. This voucher system increased the chances for success at Phase 1 (Lindsay et al, 2016).
The purpose of the second phase was to develop the project and evaluate if the parenting classes market can be successful in the future without governmental funding. The Phase 2 had substantial differences; first, the vouchers were removed the result having negative affect on the uptake of the project, as applicants to the classes decreased sharply from 2956 at Phase 1 to 164 at the Phase 2.
This fall in attendees was also due to the decrease in the number of contractors, from fourteen at baseline Phase 1, to six at the close of the Phase 2. It was clear, towards the end of the Phase 1 that delivery of the classes required a substantial investment. The Department of Health (DH) thus agreed to provide financial support at the next phase (Lindsay et al, 2016).
Forty parenting programmes were accredited as a quality standard and reliable for the parenting sector (Lindsay et al, 2016), which means all programmes based on scientifically proved evidence of effectiveness.
Each programme should include long-term and short-term aims with potential parents’ outcomes, delivery details and course content (Lindsay et al., 2014). Parents could attend classes not only by working in groups or one –to –one, but also online, sessions were available on the website and/or by self-study (using disks or books).
Alternatively, participants could use mixed methods of learning (Lindsay and Totsika, 2017). Table 2 shows the different modes of delivery.
Table 2, The CANparent programmes in three voucher areas (Lindsay and Totsika., 2017, p.4). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5651580/ Lindsay et al. (2014) report that the length of the programme variated from 1-2 sessions (N = 69) to 6-10 sessions (N = 141) in February 2014.
This chapter summaries recent evidence on CANparent trial evaluation effectiveness in promoting the parenting education market and in the prevention of “bad parenting”, with various implications for future research.
The paper presents an evaluation of the efficacy of the CANparent trial during Phase 1 and Phase 2 in enhancing parenting skills, participant’s satisfaction of the programme and developing the commercial market in the three areas around the England.
This study includes findings from the CANparent trial evaluation in given period from 2012 to 2015.
Overall, 3120 parents of children aged 0-6 enrolled to the offered programmes, six hundred and seventy five of them completed surveys before and after participating in classes.
Parents reported that attending to the programme had a positive impact on their life, particularly they were more satisfied with their parenting role and improved mental well-being (Lindsay and Totsika, 2017).
Parents were positive about attending parenting classes, however, only if classes were at no cost to them, i.e. Government funded or other organisations (Jones, 2016).
In order to evaluate the effectiveness of the study outcomes, comparative data was collected and analysed by Lindsay and Totsika (2017). The comparison group was randomly selected from 1535 parents living in 16 local areas in England outside the trial.
Four criteria were chosen to examine the parenting outcomes:
- A Being a Parent scale (BAP)
- The Parenting Daily Hassles scale (PDH)
- The Warwick-Edinburgh Mental Well-being scale (WEMBS)
- How was your class? questionnaire.
Two criteria were used by academics (Lindsay and Totsika, 2017) as it was efficient from previous studies on targeted parenting programmes. The measure of parenting stress was considered appropriate as parents of children aged 0- 6 at the risk of stress, and fourth criteria assessed attitudes of parents towards classes.
The Parenting Daily Hassles scale (PDH) examines 20 problematic situations that can be challenging for parents.
Crnic and Greenberg (1990) created this measure for parents who have difficulties in childrearing. Two groups showed a good level of internal consistency. The CANparent group had 88 for both intensity and frequency, and a comparison group Cronbach’s alpha is 92 and 87, for intensity and frequency respectively (Lindsay and Totsika, 2017).
Lindsay and Totsika (2017) research findings clearly show that there is no a decrease in levels of parenting stress (PDH frequency and PDH intensity). The standardised betas is 0.34 for frequency and 0.83 for intensity. Moreover, there is a minimal effect size, for frequency d=0.07 and for intensity d=0.17.
The Warwick-Edinburgh Mental Well-being scale (WEMWBS) was developed for monitoring mental well-being of people and for use in academic studies. It comprises positive thoughts and feelings in 14 statements with a 5-point scale response.
The internal consistency of the study is very good (91) with national mean of 51 alpha (Lindsay and Totsika, 2017). The comparison between CANparent WEMWBS scores after attending the programme (Mean=51.0, SD: 8.28) and national norms (Mean=50.7) showed overall a near-zero mean difference (d=0.03, 95%). The standard deviation was lower than a national norm before the course and reached the standard after the programme. To sum up, the CANparent trial was efficient in boosting mental well-being of mothers and fathers (Lindsay and Totsika, 2017).
Parenting satisfaction was assessed by both qualitative (questionnaire) and quantitative (BAP scale) methods. At the end of the course parents (N=234) completed the How was your class? questionnaire, which includes eight statements about the course. They marked answers on 5-point Likert scale from agreement to disagreement. Results shown in the Table 3.
Table 3, Satisfaction ratings from parents with post-course data (%), (Lindsay et al., 2014, p.91) https://www.gov.uk/government/publications/canparent-trial-evaluation-final-report
The table shows that the percentages of those that agree and strongly agree is high: parents express their satisfaction with a course (94%), they would recommend the course to other parents (94%), the class met their expectations (92%) and they have learnt new parenting skills (91%).
The results (Table 4) from January 2014 (Phase 2) shows that satisfaction level is still high: 82% respondents are satisfied with the class and same percentage of respondents would recommend the programme for other parents (Lindsay et al., 2014).
Table 4, Satisfaction Survey: Overall results (rounded %), ( Lindsay et al., 2014, p.94) https://www.gov.uk/government/publications/canparent-trial-evaluation-final-report
According to the final report of the trial (Lindsay et al., 2016), attitudes of participants towards the parenting programmes are mainly positive; mothers and fathers are enthusiastic about the outcomes they gained from attending the classes. In general, it was a promising picture, “overall satisfaction with the classes is high at 85%; slightly more (86%) would recommend CANparent to other parents” (Cullen et al, 2014, p.32).
A Being a Parent scale (BAP) was adapted by Johnston and Mash (1989) from Parenting Sense of Competence Scale (Gibaud-Wallston & Wandersman, 1978). Seventeen items examine Parenting Satisfaction, Parenting Efficacy as a parent and an interest in being a parent.
Parenting satisfaction includes frustration, anxiety and parental motivation, parenting efficacy implies problem-solving skills, competency and parents’ capability to raise children (Johnston and Mash, 1989). Mothers and fathers respond to the range of statements about parenting in line with a 6 –point Likert scale, from strongly agree (6) to strongly disagree (1). All scales are combined together to represent an overall figure.
The study demonstrates a good internal consistency in both a CANparent group and in the comparison sample. 80 points for parents’ satisfaction and 79 for parents’ efficacy in the first mentioned group. Same satisfaction score in the comparison group (80) and 74 alpha coefficients for efficacy.
However, results derived from questionnaire were more positive while the BAP parent satisfaction measure did not have a significant impact (d=0.01 95% CI:-0.20, 0.19). With regard to the Lindsay and Totsika (2017), the effectiveness of the study has shown by weighted effect size of parenting efficacy (d=0.89), parenting interest (d=0.45) and overall parenting rate (d=0.61).
Some limitations and effectiveness of the universal parenting programmes were analysed in this chapter.
Lindsay and Totsika (2017) reported that parents participated at the CANparent intervention had higher levels of parenting stress and were unsatisfied with their role as a parent compared to the national norms.
Furthermore, the rate of parenting stress maintained unchanged even after the course. Findings indicate that a sense of parenting efficacy had significant improvements with a large effect size compared with a comparison group. There were some positive changes in parenting interest subscale; however, mothers and fathers who attended short courses indicated losing an interest in being a parent after finishing the programme (d= -0.37).
It can be seen that the effect size of short, medium or long duration programmes are similar. Alongside, the length of the programme did not affect the level of the stress, but it found that long courses enhance parent’s efficacy and mental well-being. (Lindsay and Totsika, 2017).
Some features of the research presents the effectiveness of the CANparent intervention including improved parent’s efficacy as a parent and their mental well-being. However, in contrast, the leaders of the CANparent trial state that universal interventions have no substantial gains and it is unknown whether such interventions improve parenting.
Also, it was mentioned that future research should conduct follow-up evaluation along with measuring parenting practices (Lindsay and Totsika, 2017). “In the absence of data on actual parenting practices and child behaviour problems, we cannot yet determine whether universal interventions have measurable benefits for overall levels of behaviour problems in the population” (Lindsay and Totsika, 2017, p.10).
The study of Gardner and Woolgar (2018) also had mixed results, it reports that parenting courses improved confidence of participants and led to decrease in levels of parents’ negativity, nevertheless, did not improve positive parenting skills. In another study, there is no evidence of effectiveness “parents-practitioners” interventions (Cummings et al., 2012). Although, the effectiveness of parenting programmes in enhancing parenting skills is scientifically proven fact, along with positive changes in a child’s behaviour and family atmosphere (Scott. et al., 2014; Stewart-Brown and Schrader-McMillan, 2011; Furlong. et al., 2012; Dretze. et al., 2009; Nowak and Heinrichs, 2008).
One of the major limitations is that the trial is a policy- led project.
There is a bias at some points, that the DfE conducted surveys (2012), which were reported a real need for parenting classes (30% wanted to attend local parents’ groups and 70% indicated that parenting is a challenge).
After that the DfE initiated the trial evaluation that engaged a small sample N=3120 parents in total, during three years of the implementation with surprisingly minimal number at Phase 2 (N=164). Lindsay and Totsika (2017) also noted that the project was a “function of the deliberate aims” of the DfE.
Furthermore, Furedi argues, “When confronted with the question 'do you think parenting classes are a good idea' most adults will feel under the pressure to create the right impression and answer in the affirmative” (2013). Second, small but significant factor is the name of the intervention.
Findings of many studies suggest that the brand’s name is an important factor effecting on the intent to purchase (Cobb-Walgren et al., 1995; Bristow et al., 1999; Maheswaran, D. et al., 1992; Bendixen, M. et al., 2004).
Moreover, there were some negative attitudes towards the name of intervention inside the trial process: “One provider expressed strong negative views about the brand name, believing that it suggested that, without classes, parents ‘CAN’Tparent” (Cullen, M.A. et al, 2013, p.42).
Finally as the sample sizes were limited in some programmes the outcomes are not open to further scrutiny and rigorous research (Lindsay and Totsika, 2017).
- I recommend that the Kazakhstani public should be made aware of significant advantages of Early Education and in particular universal parenting programmes
- The Government of Kazakhstan should raise an issue about the importance of parent education, as the results of the study have a positive impact on the outcomes of the parenting
- The Government of Kazakhstan should create an Early Intervention Policy to the country’s Child Development Policy, due to success seen in the UK
- Particular recommendations on parenting should be published and promoted through multichannel marketing for public, especially for parents and carers
- Future (longitudinal) research into universal parenting programmes should be held by using measures of parenting practices and child behaviour
- The title of the intervention should be changed as was mentioned previously
- The effectiveness of using voucher system should be scientifically proved
- Implementation of all early intervention programmes in Kazakhstan should be based on strong research evidence with positive impact on child’s development.
- Children centres and all organisations who work with children should use evidence-based approaches in order to meet the needs of children.
- Trainings based on Early Intervention approaches and training on child development (social, emotional) should be a mandatory condition of work for practitioners and leaders of children centres.
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