Blocks 4Growth is a therapeutic programme initiated by The Learning Initiative (TLI) in 2016 in partnership with the Western Cape Department of Social Development. It targets underperforming children aged 4 to 5 years old and intervenes to promote holistic child development to better prepare them for the formal schooling environment.
The children identified to be ‘at-risk’ of developmental delays receive therapy throughout the year in fun, interactive group sessions. A therapist and facilitator conduct 45-minute sessions with small groups of up to 9 children twice a week, at their ECD centre. Activities focus on gross and fine motor development, vocabulary building, emergent literacy and numeracy, executive functioning, sensory-motor development and social and emotional development.
Therapy groups are complemented by coaching practitioners to facilitate these skills and provide advice and support on helping individual children. Parents are encouraged to be actively involved in the development of their child including homework tasks sent after each group session, workshops and provision of ideas for stimulating their child at home. Currently, Blocks4Growth has 15 teams, each consisting of an Occupational Therapist or Speech and Language Therapist and a facilitator who speaks the local languages. They work in areas across greater Cape Town and through Knysna Education Trust (KET) in the Southern Cape.
Blocks4Growth has been using ELOM since 2016 when they were piloting the intervention and used ELOM to identify target children for the programme and to examine outcomes. ELOM was selected after looking widely for a suitable test that was normed for South Africa, covers the range of developmental domains and could be administered by trained non-professionals, which is an important consideration for scaling. Between 2016 and 2020, TLI and KET have assessed over 5000 children using the ELOM tools.
Initially, screening for group allocation purposes was done on the full ELOM 4 & 5 Years Direct Assessment but this was time-consuming (with hundreds of children) and in 2018 the ELOM 4 & 5 Years Targeting Tool, with 5 items only, was developed for this purpose. This is used with other assessments (e.g. Early Literacy Protocol, Numeracy and Basic Concept Screener, Draw a Person, an observation checklist, vision and hearing screenings) and guides the development of Individual Support Plans (ISP), progress reports, parent and teacher feedback. The therapists also use their clinical knowledge and skill and consult teachers to see if a child would benefit from inclusion in a group. Children who require additional support are referred to appropriate service providers.
Based on the 2016 concept development pilot which included a pre and post ELOM assessment, the intervention was adapted and finalised. In 2017 the programme children showed significant improvements. Since then, the ELOM 4 & 5 Assessment has been used each year on a sample of children to determine programme outcomes, as a requirement of the Western Cape Department of Social Development (DSD).
Because Blocks4Growth has been tracking groups of children every year they have been able to document differences in 2020 when COVID -19 lockdown changed programme delivery. During lockdown educational packs of activities were distributed to the children and daily WhatsApp messages were sent. Parents were invited to upload photos and therapists responded to these and any questions about children in their groups. When sessions resumed in October 2020 the teams targeted areas where children were less proficient as there was no time to follow the whole programme. While it is clear that progress was made despite the difficult circumstances the impact of limited sessions and lockdown was clear.
At the end of 2020, 428 children were enrolled in the programme. The Learning Initiative (Cape Town) and Knysna Education Trust ELOM assessment reports showed that only 45% of the Learning Initiative 60 to 69 month age group were now achieving the standard compared with 55% in 2019. Of the Knysna group, 22% achieved the standard, substantially lower than the 55% of the previous year.
TLI also commented that in early 2021 approximately 70% of children were identified to be at risk or on the periphery of this, compared to the approximate 57% in 2020 at baseline. They attribute this to the effects of COVID-19 and the associated lockdown.
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