On-line version ISSN 2076-3433
Print version ISSN 0256-0100
S. Afr. j. educ. vol.33 n.4 Pretoria Jan. 2013
Catherine PittI; Rosemary LugerI; Ann BullenI; Diana PhillipsI; Martha GeigerII
The purpose of this paper is to present a preliminary, qualitative review of a therapeutic programme for preschool children and their parents in severely under-resourced contexts to aid the development of the underlying skills required to be ready for formal school. A team of two pairs, each comprising an occupational therapist and a community worker, responded to teachers' requests to assist struggling children in their classes. This led to the development of a programme focusing on Grade R classes, by firstly helping teachers to develop their capability and confidence in assessing and assisting children to develop the abilities underlying vital school-readiness skills during whole-class, therapeutic group sessions. Secondly, parent group sessions were added to empower parents to understand and support their children's development needs at home and so to complement the work done by teachers in the classroom. This second aspect, of working with the parents, developed owing to observations of the children's irregular school attendance, scant parent-school contact, and teachers' reports indicating that parents were not aware of, nor equipped to deal with, the challenges faced by their children. Implications for practice, for planning and for further research are discussed.
Keywords: early childhood development; group assessment; group interventions; occupational therapy; parent groups; school readiness; teachers' assessment skills; teacher support
While working to facilitate the inclusion of children with recognised disabilities in schools, teachers have repeatedly asked us about the many other children in their classes who have difficulties. This led us to develop a group programme focusing on preschool or Grade R classes, to address the broader needs of all children in such a class and to support the development of the underlying skills required for school readiness. Most importantly, this included the development of an innovative parent support and empowerment programme to enable parents to understand and experience first-hand some of the challenges faced by their children and help them in the development of school readiness skills. The work described is part of the early childhood development and therapy programme of The Chaeli Campaign,1 a non-profit organisation (NPO) working in diverse communities in southern Africa and actively involved in including children with disabilities in all aspects of life, including schooling. A strong focus of The Chaeli Campaign is the participatory approach of collaborating with families and communities in exploring and implementing effective solutions to suit their specific context.
The policy context
In South Africa, the first democratically elected government of 1994 has recognised the need for broad-based early childhood development (ECD) services that are accessible to all. Policy development reflects this transformation and can be traced from the comprehensive situation analysis recorded in the national audit of ECD provisioning (Department of Education, 2001; Williams, Samuels, Mouton, Ratele, Shabalala, Shefer & Strebel, 2001). The National Integrated Plan for ECD services followed, recognising ECD services as a multi-sectoral responsibility with co-ordinated efforts from the Departments of Education, Health and Social Development (National Government of South Africa & UNICEF, 2005). This was followed by the implementation guidelines for ECD services (Department of Social Development, 2006).
Positive outcomes include more preschools (and crèches) registering with the Department of Social Development and thus obtaining extra resources and training opportunities for the teachers and managers. A more recent audit commissioned by the Provincial Government of the Western Cape province has confirmed what had been informally yet widely evident for some time: access to ECD has grown significantly, but quality remains a major challenge (Biersteker, Dawes, Hendricks & Tredoux, 2010). The Department of Basic Education's (2011) Strategic Plan for 2011-2014, formally acknowledges that there has been considerable success in expanding access to Grade R, but that the more challenging objective of improving the quality of Grade R and ECD generally will extend beyond 2014 (Department of Education, 2011). In the meantime, NPOs are valuable assets in providing key support to ECD services (Kurian, 2012).
The environmental context
Our interdisciplinary team of therapists works in various informal 'townships' around Cape Town where there are some formal structures and services, but also many families living in self-built shacks. Some parents are employed, but at minimum income levels owing to the generally low levels of education and prevailing shortage of opportunity. High unemployment rates and persistent cycles of poverty mean that where one member of a family may qualify for a state grant (be it a pension, disability, child, or care dependency grant) a whole family often survives on such a single government grant. The preschools in these areas range from well-resourced (through state and private funding) to very poorly resourced unregistered schools where teachers rely on school fees alone to fund the facility. The first language in our areas of work is generally Xhosa.
While attention is being paid to the quality and formalisation of ECD and Grade R services, the children in the severely under-resourced areas where we work are at risk of underachieving at school owing to a number of well-documented and interrelated contextual factors, including:
- Physical, neurodevelopmental and cognitive under-stimulation (Biersteker et al., 2010; Draper, Achmat, Forbes & Lambert, 2012; Rossi & Stuart, 2007; Sherry & Draper, 2013).
- Human and other resource limitations (Biersteker et al., 2010; Williams et al., 2001).
- Infrastructure lacks, including limited classroom space and equipment (Biersteker et al., 2010; Moloi & Chetty, 2011).
- Poverty-related lack of space, security and opportunities in the homes to play (Kruger, 2011; Moses, 2006).
- High rates of developmental delays, with malnutrition (Department of Education, 2001) and Foetal Alcohol Syndrome (Rendall-Mkosi, London, Adnams, Moroj ele, McLoughlin & Goldstone, 2008) among the contributing and/or compounding factors.
- Parents are often physically absent due to work commitments, while others are emotionally absent due to poverty-related substance abuses and associated mental health problems (Mampane & Bouwer, 2011; Sheridan, Knoche, Edwards, Bovaird & Kupzyk, 2010).
Given these factors, which are all related to the family and community contexts rather than being limited to the child in isolation, an ecological systems approach with its focus beyond the individual child was applied here (Garbarino & Ganzel, 2000). In this approach, causative and contributory elements in the environment are considered and addressed, because the problems manifested in the individual child are recognised as being symptoms of the broader context. An ecological systems approach emphasises the need to consider the child in the context of, and in interaction with, her family and community environment (Garbarino & Ganzel, 2000). The parents, as the key parts of the immediate 'ecosystem' of the child are critical in the well-being and the healthy development of the child, and the child's functioning and progress at school. Furthermore, an asset-based approach esteems parents who are involved as a particularly valuable 'asset' in considering the functioning of children at school (Ebersöhn & Eloff, 2006; Eloff & De Wet, 2009). The critical stake of parents in all of these issues cannot be over-emphasised and their key role in providing appropriate and sustainable support is well-documented (Ebersöhn & Eloff, 2006; Lemmer, 2012; Mitchell, Skouteris, McCabe, Ricciardelli, Milgrom, Baur, Fuller-Tyszkiewicz & Dwyer, 2012).
However, the observation, that many parents have little education with a majority barely having completed elementary or primary school, prompted further queries. We learnt that even fewer parents had had any preschool or ECD experience during their own childhoods. Confirming earlier evidence (Baker, Camero, Rimm-Kaufman & Grissmer, 2012; Moses, 2006; Lifter, Foster-Sanda, Arzamarski, Briesch & McClure, 2011), it became clear that the parents had limited insight into the importance of the prerequisite areas of development needed as a foundation for basic literacy and numeracy. We observed that parents largely lacked knowledge about and ownership of their right to be involved in the decisions shaping their children's education; despite having high hopes for all their futures through the education of their children.
In line with both international and local findings (Baker et al., 2012; Eloff & De Wet, 2009; Hurley & Horn, 2010; Lee & Thompson, 2007; Motala, 2009; Moses, 2006; Rossi & Stuart, 2007; Sheridan et al., 2010), our stimulation programme was expanded to include parent-training workshops. The purpose of these was to grant parents insight and first-hand experience in the developmental skills required of their children to be ready for school. The goal was to support parents to become partners in their children's education so that, equipped with the right tools and information, they could provide support and backing for the work of the teachers in facilitating the skills needed for their children to proceed to Grade 1 and further.
Methods - what we did
This is a preliminary, qualitative review of part of a therapeutic school readiness programme, implemented in 20 schools in the less-resourced areas around Cape Town, over four years. This review falls into the realm of reflective practice (Ng, 2012; Schön, 1995), rather than a formally planned research study. Schön's writings (1995) are considered seminal in the bridging of formal, academic research and learning in/ from experience, or 'action science' (Reynolds, 2011, Schwandt, 2001). The review described here included action, critical reflection and further planning with reference to evidence from literature published in related fields and thus exemplifies a step towards the much-needed 'evidence-informed reflective practice' (Ng, 2012:129).
Ethical considerations in this no-risk review included the careful adherence to the general principles of justice, beneficence and non-maleficence (Health Professions Council of South Africa [HPCSA], 2008; Horn, 2011). This meant that those who participated in the training were simultaneously the primary beneficiaries of the training and were also not exposed to any dangers and/or maleficent factors. Furthermore, all participation was entirely voluntary, and any identifying information was removed and responses were anonimised in accordance with the principles of anonymity and confidentiality (HPCSA, 2008; Horn, 2011).
Two occupational therapists (the first and second authors), each working with a community worker,2 responded to teachers' requests to assist struggling children in their classes. Iterative or self-generating cycles comprising action, critical reflection and adjustment to planning (Chambers, 2010; Denzin & Lincoln, 2000; Reynolds, 2011), with subsequently adjusted implementation of the school readiness programme over four years, have facilitated some preliminary conclusions and tentative recommendations. The format and content of (a) the therapeutic support for groups of preschool/Grade R children and (b) the corresponding programme for the parents, evolved as follows.
The group programme for teachers and their learners in the classroom
Over the course of four years, we went into approximately 20 schools or preschools and offered our support. We also attended forum meetings and networked with the Department of Education role-players at a district level, most of whom were enthusiastic. Schools were subsequently supported at their own request.
Upon confirmed arrangements with the appropriate authorities, we went into each school and held three to four one-hour sessions with each class of pre-schoolers and their teachers. We started each session with gross motor activities and then went into rhymes, songs, perceptual and fine motor activities, our rationale being that this was a normal developmental sequence as the ability to control all movement follows the ability to move and then to learn control. The focus of the programme, spread over four weeks, was on initially identifying what the children could do and build on that for school readiness. The sessions were conducted by an occupational therapist and a community worker who interpreted the session into the children's home language, Xhosa. The team then did some problem-solving with the teachers and gave suggestions on how they could work on the areas challenging to the children in their specific group, so that areas of underperformance could be improved.
Each of the fundamental competencies we were looking for, and aimed to develop if absent, is essential to the basic concepts needed for literacy and numeracy (Sherry & Draper, 2013). The beginning emphasis on visual and motor competencies here was guided by recent literature which highlights the fundamental importance of motor development (including gross motor, fine motor, and visual motor development) as an underlying foundation for other areas of development, (Draper et al., 2012; Mitchell et al., 2012; Park, Jeong & Bornman, 2011; Sherry & Draper, 2013). Limited opportunities for activities that support the development of these competencies have been described among the challenges encountered in low socio-economic contexts, such as those in which we have been working (Draper et al., 2012; Sherry & Draper, 2013).
These fundamental competencies allow the child to concentrate and give attention to the work presented by the teacher, and so it is imperative for these skills to be acquired before a child goes to school.
After the weekly general sessions with whole classes in some of the schools, the children who showed difficulty were further engaged in a small group for extra group work alongside their teacher. These lasted for about a term/quarter. Again, during each of these sessions, we explained and/or demonstrated the activities that a teacher could try, to facilitate the development of skills that were weak.
However, we realized through these processes that there was a problem, as many of these children did not attend school regularly. Teachers were also frustrated by the lack of participation and commitment by parents. The gap between the development of the children in the under-resourced preschools and communities and those in suburban schools in the middle and higher socio-economic areas was evident, where the latter usually go home after school to a stimulating environment where they often have the opportunity to reinforce their fine motor skills through having access to crayons or different crafts at home. We wanted to narrow this gap for these children. And so we began the parent programme. This programme was to invite and excite parents to be involved as partners in the education of their children and to highlight the value that their contribution makes to their children's future.
The parent workshops
We first put together a standard box of resources that parents would need to assist their children with getting prepared for Grade 1. The boxes each contained a pair of scissors, pencils, a box of pencil crayons, a box of wax crayons, a drawing book, a colouring-in book, assorted coloured paper, an eraser, a sharpener, a ruler, a glue stick, tubs of play dough, items to thread, a bean bag, and an inflatable ball: all items which are taken for granted in many homes, but which, in reality, are simply considered luxuries in the homes of the children we work with. But we did not want to just give the box to the parents; we wanted to teach them how to use this box of resources; to empower them and make them eager about their role in preparing their children for school. We wanted to make parents feel excited and give them hope for their children's futures. We put together a short series of training workshops to demonstrate the developmental milestones of their children and what was needed to be developmentally ready for school. The three workshop sessions lasted two hours each and were presented in the parents' home language, Xhosa, with the help of the community worker. We kept a register, drew up a contract with parents at the start of the first workshop, and distributed attendance certificates and a resource box they could keep, to those who attended all six hours.
The workshop content for the parents focused on the same expected age-related skills addressed in the preschool programme with the teachers and their groups of learners. The workshop approach allowed the parents to experience the skills their children needed to develop, such as following instructions to cut out, paste, and colour a figure. At the outset we framed the sessions as a group learning experience and regularly used pairs and small group tasks to allow parents to affirm and develop their own knowledge and confidence in order to help their children learn through everyday interactions. We also wanted to form a relationship of trust with the parents so that they could ask questions about their concerns and feel comfortable coming back to us for individual sessions or referring friends who had children with problems. Though this may not be a tangible, measurable variable, we strongly felt it was the key to parental involvement.
The following fundamental skills were addressed through the activity ideas we covered :
- Eye control (ocular motor control): the eyes need to follow and focus on an obj ect near (such as on the table) and far (such as on the blackboard) and move between the two.
- Hand-eye co-ordination: the hand must be able to follow what the eye is guiding it to do such as direction, copying, knowing how things are in relation to each other.
- Visual discrimination and matching skills: the ability to see things as the same or different based on their properties.
- Motor planning: the ability to plan a movement or copy an action are necessary so that children can learn new skills.
- Foot-eye co-ordination: the ability of the foot to follow what the eye is showing it to do; such as in controlling a soccer ball or balancing on a balance beam.
- Dexterity: the ability to manipulate things in the hand, e.g. a pencil, for drawing, moving the eraser around in the hand, picking up small stones or buttons.
- Stereognosis: knowing what is in the hand without looking, such as feeling that the pencil is in the hand correctly and knowing whether the hand is holding an eraser or the sharpener.
- Sitting posture: the ability to sit well on the mat or on a chair for an entire activity without slouching or -wriggling. The child should be strong enough and have sufficient endurance to control its posture and allow the hand/arm independence to perform functional movements. The child's first years of learning movement are very important; the child rolling, crawling, starting to stand, climbing, hanging, standing on one foot, bouncing a ball, playing fun games, etc., all contribute to the development of the control and endurance mentioned. The lack of opportunity to practise these, on the other hand, has been shown to have a direct impact on the school readiness and subsequent learning of children in the under-resourced communities in which we work (Biersteker et al., 2010).
- Listening skills and communication: children need to be able to sit and listen to a story and then answer questions about it; to tell what they had for supper the previous evening; what they did on the weekend, and to follow a three-stage instruction (based on auditory processing abilities vital to the process of learning to read and spell).
- Spatial skills: the understanding of space around them and the prepositions that go with space (on, under, behind, in front of, next to, etc.).
- Body image: the ability to understand their own body and how things relate to their body, including the concepts of right and left. This is fundamental to all the skills mentioned above.
As therapists, we encouraged development of these skills in the children through fun activities and often parents were sceptical about the activities we chose, as their relationship to literacy and numeracy was not always immediately clear. However, we chose the activities specifically to develop the targeted skills, listed above.
An example of a craft activity which we used to demonstrate these skills was to construct paper-plate faces using waste materials such as bottle tops. In the respective group sessions, each participant received a paper plate, a piece of Prestick, a box with bottle tops, etc. and and was encouraged to follow step-by-step instructions and a demonstration to construct a face. The instructions went something like this:
"We are going to make faces" (while the prototype was held up). "We will find the objects we need in the box and using the prestick we will make the faces. So, slip your hand into the box without peeking, and find two eyes, (same size).. .a nose and a mouth... Now, pull off a small piece of prestick, roll it in your fingers into a small ball and press the eyes, nose, mouth etc. into their places".
The skills used to complete these tasks include stereognosis (identification of objects by touch, without looking), fine motor control and dexterity (pulling the prestick and making the balls), and visual discrimination (looking at the therapist's example and copying it exactly), sitting posture, eye-hand co-ordination, and motor planning.
We shared with the parents that the targeted skills developed in a sequence, so once it was observed that a child had difficulties, we went back to what the child could do and worked on the skills that followed in the developmental sequence. This type of (seemingly playful) exercise can be used by parents (and teachers) to help determine what a child can do. So, with a child struggling to hold her pencil properly and draw herself, we should reflect back to how the child understands her body, can she recognize her body parts? Can she touch and name body parts? Can she sing a song (e.g. "Heads and shoulders, knees and toes...") and match singing the name of the body part to pointing to it? Can she do other fine motor activities? (e.g. draw a house, tear and paste small bits of paper 'mosaic', cut with scissors?) Does she slouch on the chair and wriggle around? Perhaps she is not comfortable sitting at the desk and has weak postural muscles? By asking these questions, it is easier to understand the barriers a child is facing.
Results: what we found
The focus of this review was the parent groups, while a separate impact analysis is underway and will reflect detailed quantitative and qualitative results and impacts from the group sessions with teachers and their classes of Grade R learners. Preliminary observations do however indicate positive results in terms of learners' gross and fine motor abilities and specific skills such as completing a 'Draw-a-man' task.
In the parent groups, many parents were initially amazed by how much their children were expected to know or do for Grade 1. They understood the developmental milestones and could comment on the discrepancies between what they saw in their children and what was expected of them at school. The overall response of parents was very positive and one group asked if they could form a support group to help their children as they went up through the grades. Parents also seemed to feel included and respected by participating. Additional outcomes of the workshops are best left in the words of the parents themselves who were requested to give written or verbal feedback in English, or their home language of Xhosa, at the end of the final workshop:
- We liked what we learnt because we now know what our children need to know.
- We know what the school expects of us and the child.
- It opened my eyes to know what I must start doing now to help my child achieve his dreams.
- I realised that it is not only the teachers who must teach the child, but that the parent needs to participate as well.
- I have ideas how to help educate my child and help them with their school work. I know how to see when my child has a problem and how to fix it.
- We learnt through playing and practical group work how to do activities with our children to get them ready for school.
The turn-out was sometimes poor, especially in the first sessions, when the therapist and community worker were not yet well known in the community, but this has improved over time and teachers and learners have become our promoters in some schools. It was usually challenging to get the parents to participate freely in the first session and some expressed embarrassment at having to perform tasks expected of their children, but this generally improved as trust developed and they became more familiar with an adult-education type of workshop. This was also taken into consideration by changing the sequence of activities to include very non-threating activities early on. The expectation and knowledge of parents was varied within the groups and care had to be taken to provide enough information for some and not to make things too complicated for others. Some parents were wary of us, while others were so enthusiastic, coming with questions and more ideas. We tried where possible to meet the parents at the school so that our inputs were recognised as being in collaboration with the school and teachers, and a relationship developed between the school and the parent.
The language barrier remains a challenge for predominantly English- or Afrikaans-speaking therapists and Xhosa-speaking parents, but we are working towards the Xhosa-speaking community worker in each team running the programme with the therapist in a support role. The current 'stop-start' use of interpretation is not ideal, especially as the aim is to create a support group type setting for parents to explore their hopes and dreams for their children whilst also learning practical skills on how to help their children achieve these goals.
Another challenge was that the activities were sometimes too 'suburban' (relevant to middle and upper socio-economic contexts and experience) as the therapists relied on what they were used to. However, the parents themselves often came up with good suggestions that would be relevant in the township context and adjustments were made to the material as we went along. An example would be the use of arts and crafts to build finger and wrist strength. Indigenous games such as 'morabaraba' and 'diketo', which have got lost in the urbanisation process, and their value in achieving the same goals, is an area needing further exploration (Ramugondo & Barry, 2011; Western Cape Government, 2013), and parents/grandparents are the most valuable and knowledgeable partners in optimising this resource (Barry, 2012; Ramugondo & Barry, 2011). This is also something that needs to be taken into account in the formal school curriculum, as parents are often unfamiliar with the more western ideas.
Another difficulty parents faced was encouraging their children to stay indoors after school/preschool to do any of the tasks we had suggested to them. Many parents were not at home in the afternoons and those who were found it difficult to call their child from playing with their friends, etc.
Lastly the lack of clear educational outcomes was a barrier for some parents. For example, they could not see how reading to their children would help their child to read, but rather felt that the child should be encouraged to read or copy letters. This necessitated some additional explanations and demonstrations of developmental listening skills and auditory-visual integration.
This preliminary review supports previous research that parents need to be acknowledged and empowered as partners in the education of their children from the start and not only after an occurrence of emotional or behavioural problems, such as underachieving, low self-esteem, and school drop-out. We believe that parents would be better equipped to support their children through the 12 years of formal education if they could start early and understand the vital developmental milestones that their children need to achieve before they go to school. They would also be empowered to engage with teachers over barriers to learning and to be involved in finding solutions.
We recognise the limitations of this preliminary qualitative review, but venture to state some implications in the confidence that development (to scale) of such a programme, and the transferability and generalizability of including parents, would have relevant application elsewhere. Practical conclusions and recommendations based on the lessons learnt here include:
- Further development and a formal, large-scale impact assessment of the school readiness and parent group programme, with before-and-after measures across some of the communities in which we work (we have piloted an assessment tool and have started collecting data).
- Collaborative exploration with parents of some of the indigenous games and activities often lost in the process of urbanisation, but instrumental in the development of the underlying perceptual, cognitive, gross and fine motor abilities of preschool children.
- Mentoring and systematic support to develop current and future community workers to present such a school and parent group programme independently.
Furthermore, ECD programmes need to encourage and strengthen a developmental approach to teaching the curriculum, with the necessary support for the development of the skills underlying the learning of literacy and numeracy (e.g. gross, fine and perceptual skills). In line with the recognition that ECD services are a multi-sectorial responsibility, as documented in the National Integrated Plan for ECD (National Government of South Africa & UNICEF, 2005), parent training and community development programmes are needed to bridge the gap between what the parents understand as education and what the Department of Education expects from their children. Further research on homework content and strategies would also be helpful to assist parents develop healthy routines to promote regular homework from the earliest stages.
As a closing point: NPOs working in the ECD sector (of whom The Chaeli Campaign is only one example) are strong links to communities and many have established long-standing and trusting relationships, collaborating with community stake-holders over time. As such they are valuable assets and need to be recognised and supported for the country to fully benefit from their potential as key service delivery partners in the ECD sector (Kurian, 2012).
The work was made possible by funding from the Western Cape Provincial Department of Social Development and The Chaeli Campaign. We thank Olwethu Nqevu and Bukiwe Mkhuba, the two community workers on the programme, for their invaluable language and cultural expertise and their patience and friendship during the learning process.
2 'Community worker' is a general term used here to describe members of the team who have significant experience and skills, but not necessarily formal qualifications.
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