Can the whole child thrive in a fragmented world? Children increasingly inhabit complex social environments. Global social changes challenge traditional family structures and roles. In many parts of the world, including Canada, an array of service types has developed over the years to support young children and their families across the preschool period. However, these services are usually fragmented in ways that reduce their effectiveness in supporting family life, healthy child development, and the transition to school. Furthermore, access to these services is often limited for families from minority language groups, with lower incomes, etc. While the first years of schooling tend to be universally available and publicly funded, other early childhood services are often a patchwork of user-pay, targeted-to-risk, public and private provision. This applies to the different forms of child care provision as well as to a range of other services, ranging from nursery schools to prekindergarten, parenting programs, recreational, library and other community programs.

Navigating the service patchwork can be a daunting task for parents and not all parents are equally positioned to pay for or make connections to services. As a result, inequitable access to preschool services, such as quality child care, can actually widen gaps between the haves and have-nots. Providing targeted public services is not a complete solution since targeting will miss some children in high risk groups (Barnett, 2010) and vulnerable children who happen to be in lower risk groups (Willms, 2002). Even when children are enrolled, navigating service boundaries is also a daily problem for children who shuffle between programs such as half-day child care and half-day school kindergarten programs.

Improving service coherence, quality and accessibility for improved outcomes requires new approaches in Canada and elsewhere (Mahon, 2009). Two policy directions that have drawn increasing attention in early childhood are universal programs and service integration (e.g., OECD, 2006). Providing a universally available system of preschool education and other services may help to solve a number of problems (Barnett, 2010; Patel & Corter, in press). For example, universal programs may reduce stigma associated with targeted programs; they increase the pressure to raise program quality by drawing in middle class users and more political support; and they reach all children who may benefit, not just those who happen to be targeted (Barnett, 2010). Similarly, integrated early childhood programs reduce service disconnections, with potential benefits for program quality and equitable access; they may also help child and family outcomes and quality of life, by providing more coherent programming for children while supporting parents in their parenting and needs to work or study (Pelletier & Corter, 2006).

A fundamental form of service integration is the blending of child care and education (Kaga, Bennett, & Moss, 2010), which is a long-standing policy in some Nordic countries, but not yet a reality in other parts of the world including most of Canada and the US (Huston, 2008; Mahon, 2009). In addition to child care and early education, other service types such as parenting and health programs and parent-child drop in centres may be brought into the integration mix to provide both better service and more cohesion in the lives of children and families.

Integrated approaches to early childhood services in Canada have taken a variety of forms. Demonstration projects, such as Toronto First Duty, have examined the implementation and effects of integrating a wide range of services types at the community level and making them universally available to all children through community centres or school hubs. On a broader scale, several provinces are currently moving to universal systems combining child care and early education (Beach, 2010; Mahon, 2009). As the prime example, integrating early care and learning to support young children and parents has developed in Quebec through its family policy developed over the last decade and the establishment of Centres de Petite Enfance (CPEs). CPEs serve children up to five years of age in non-profit centre-based and family child care programs with widespread, but not universal uptake. Benefits and limitations of the system have been addressed in a number of research reports (e.g., Japel, in press).

Whatever form it takes, service integration is not a goal in itself; it is a means to various ends. Across service integration initiatives in Canada, integration has multiple social aims: overall child development, school readiness, prevention of later problems and promotion of healthy life-long development. The aims may also include healthier parenting and work-family balance. In some cases, such as the Aboriginal Head Start program, community development is a collateral aim of supporting child development and parenting (Ball, 2005, in press), as is the promotion of equity and social justice through effective and culturally competent programming and outreach to the underserved.

Despite widespread and long-standing policy interest on early childhood service integration, the research has not kept pace in Canada (Cleveland et al., 2006; Peters, Howell-Moneta, & Petrunka, in press) or elsewhere (e.g., Siraj-Blatchford & Siraj-Blatchford, 2009). In Canada the research on the implementation and outcomes of the Quebec system has not focused on the integration of services beyond the CPEs. However, there is promising evidence from process evaluations of Aboriginal Head Start emphasizing the importance of integrated community approaches bringing together services and community members; nevertheless, evidence on outcomes for children is still needed (Ball, in press). Both process evaluation and long-term outcomes for a 25-year study of community-level service integration are now appearing for the Ontario Better, Beginnings, Better Futures demonstration project (Peters et al., 2010).

The Toronto First Duty Project

This report on the Toronto First Duty (TFD) project presents findings on an extensively researched demonstration project designed to test a universal, integrated model for early childhood services. The intensive research design included both process and outcome evaluation through mixed methods, case study, and quasi-experimental methodologies (Corter et al., 2007). The aim of the project was to generate evidence that would be mobilized in different ways to improve practice and policy. Over the course of the project, formative findings were fed back to project sites to allow leaders and practitioners to work on improving programming and delivery as part of a research and development (R&D) approach. At the same time, process findings, showing how an existing fragmented system could be integrated to improve program quality and outreach to the underserved were shared with levels of government from municipal to provincial, along with other stakeholder groups in education and social services. As outcome findings began to emerge for children and parents, they were also shared with policy and practice stakeholders. Although research evidence can transcend political boundaries, demonstrating that a project that works locally can be important politically, as well as scientifically in taking into account contextual factors that moderate program success.

Toronto First Duty began in 2001 as a demonstration project testing an ambitious model of service integration across early childhood programs of child care, kindergarten and family support in school-based hubs. Other services such as public health were also part of the service array. The goal was to develop a universally accessible service model that promotes the healthy development of children from conception through primary school, while at the same time facilitating parents’ work or study and offering support to their parenting roles. Phase 1 of TFD, with implementation of the model in five community sites, concluded in 2005 (Corter et al., 2007). Phase 2, covering the period 2006 to 2008 (Corter et al., 2009), focused on knowledge mobilization, policy change, and further development of the TFD model in one of the original five sites, Bruce WoodGreen Early Learning Centre. Phase 3 of TFD extends to in press with focused research on integrated staff teams and learning environments in full-day early learning programs, and additional studies on integration of community services for children under four. The following description of findings is organized around the evidence that processes working through two pathways—program improvement and parent support and outreach— led to positive outcomes for child development.

Program Improvement

In the TFD model, integrated early learning environments were to be constructed at each community site by teams of different professionals working together-family support and child care professionals along with kindergarten teachers. The Phase 1 research began with mixed methods case studies to describe the implementation process in terms of variations and adaptations of the model across the five communities, as well as common struggles and eventual successes across the sites (Corter et al., 2007). Struggles included issues related to professional turf when different professional groups began to work together, missing nuts and bolts of space and funding, staffing and leadership turnover, and working without “system support” for integration across sectors that are not integrated at higher levels of government. Nevertheless, the findings also showed successes. Strong leadership and time to meet allowed staff teams to come together over time to improve program quality and delivery.

In terms of the process of moving from separate to integrated service delivery, comparisons across the implementation period showed that progress was made in each of the sites on five dimensions of service integration (staff team, programming, access points, local governance and parent involvement), as indexed by an Indicators of Change measure developed in the project (Pelletier & Corter, 2006; Corter et al., 2007) as well as on program quality improvement as assessed by the ECERS-R (Harms, Clifford & Cryer, 1998). Case study analysis over TFD Phases 1 and 2 revealed a strong positive association between staff teamwork and program quality (Corter et al., 2009).

Parent Support and Outreach

Parent involvement was a core element of Toronto First Duty design for service integration. Various lines of evidence show gains for parents from the TFD experiment that go beyond client satisfaction. For example, converging evidence from interviews and surveys with parents, site management, and staff members documented improvements in parental input into the design and access to services over the course of project implementation (Patel, Corter, & Pelletier, 2008).

Another line of evidence examined potential effects of the TFD experience on parent involvement in learning and school. There is a body of evidence indicating that parents’ participation in their child’s education—reading to the child, talking to the child about school, and meeting with staff to assess student progress—is related to school success (Corter & Pelletier, 2005). The preschool period and parent participation in preschool services may build capacity for parents’ later involvement with school and other community services. To assess whether TFD affected parent involvement, we surveyed a sample of parents of kindergarten-aged children in TFD sites and demographically matched comparison sites (Patel & Corter, 2006). The quasi-experimental comparison of TFD parents with parents at schools with kindergarten only, or kindergarten and a single family support service, showed that TFD parents were more likely to feel empowered to talk to their child’s kindergarten teacher and to help their child learn at home. This capacity building worked for parents who were new to Canada as well as for those born in Canada.

Beyond the direct experience and involvement in early childhood programs and school, does service integration improve everyday family life and children’s experiences? To answer this question we employed a quasi-experimental design to compare the daily experiences of parents and children accessing integrated TFD services versus families using traditional, separate kindergarten and child care services in demographically matched communities (Arimura & Corter, 2010). Parents provided information about daily routines, daily parenting hassles, social support networks, and views about early childhood services via interviews and surveys.

Children also reported their views about their daily routines through interviews. Findings indicated that service integration is associated with lower levels of daily parenting hassles in navigating between child care and school, greater satisfaction with some forms of support, and greater levels of continuity in children’s days. It is especially notable that parents in TFD sites named both kindergarten teachers and early childhood educators as part of their social support network. In comparison sites, only early childhood educators were named. Children in TFD sites spoke about their experiences in a seamless way. In contrast, several children from the non-integrated sites noted differences between their experiences at school and at the child care centre (e.g., “We have to learn a lot in kindergarten but we mostly play at daycare”).

Although TFD improved family life and connections to school, was community outreach and participation in the programs equitable? In Toronto there are clear gaps in preschool service use for many minority groups (O’Reilly & Yau, 2009), but the integrated hubs in TFD appeared to eliminate these gaps. Intake and tracking data on who enrolled at TFD sites and their service usage showed that the uptake of services reached out across the demographic diversity of TFD neighborhoods. The profile of TFD users matched neighborhood demographics in terms of maternal education and immigration status. For example, since TFD sites tended to be situated in “higher-risk” neighborhoods with lower SES levels and more immigrant families, more than half of TFD users spoke English as an additional language. Nevertheless in one site where the school straddled a demographic divide between an affluent, established neighborhood and a low-income neighborhood with more immigrant families, the universal TFD programs drew equally from both sides of the divide, attesting to the popularity of the universal approach. Importantly, the findings of program benefits for parents and children held equally across demographic groups defined by language status and maternal education (Patel, 2009).

Child Outcomes

Given increased program quality and coherence, greater parent involvement and reduced stresses on families, better outcomes for children should result. In fact, evidence for short-term positive effects of the TFD model were found on children’s social-emotional development on the Early Development Instrument, a widely used teacher assessment tool used to assess school readiness at the end of kindergarten (Corter, Patel, Pelletier, & Bertrand, 2008). These associations were seen in both pre-post comparisons within TFD sites and in quasi-experimental comparisons with demographically-matched communities. A case study of one site showed how an integrated staff team used EDI school-level profiles, along with formative feedback on program quality, to target and improve programming. Over the course of implementation, the integrated program environment quality ratings and EDI scores improved in relevant areas assessing quality of interaction and social-emotional development.

In addition to the community control comparisons of potential child development outcomes from TFD, we also employed dose-response analyses within the group of families using TFD to assess potential program effects. After applying various demograhic controls, we found that more intense use (number of hours of TFD services) also predicted children’s cognitive and language development (Patel, 2009). The links between TFD experience and more positive child outcomes held across maternal education levels and language status and program use was generally independent of demographic factors.

In addition to participating in standardized assessments and ratings, children were interviewed about their experiences in the Toronto First Duty project (Corter et al., 2007) on the principle that children’s voices should be among those heard in early childhood program evaluations (Lansdown, 2005). Children were asked to tell about their day at the site from the time they got there until they went home and were asked what kinds of things they did at the site. Specific probes included asking what they liked and didn’t like and what they were good at and not so good at. An important point is that “play” was the most common answer to the question “what do you like best?” Academic-related activities, crafts, etc., had far less appeal. Interestingly, play also led the list of things that children “don’t like.” Play can go badly when other children “don’t let you play” or “don’t play nice.” These findings are a reminder that children’s motivations and experiences need to be taken into account in programming and monitoring.

Implications for Policy and Conclusions

TFD was designed with the explicit aim of influencing practice and policy at the local agency, municipal, and provincial government levels. Part of the influence strategy was funding a broad-scale evaluation with a focus on the process of implementation, as well as on the outcomes of the new service model. Giving politicians concrete evidence that implementation of the new approach was feasible in local contexts, starting with services that already exist, may have been as important in moving policy as evidence on positive outcomes. But there was also evidence of positive outcomes for children’s development at the end of kindergarten and for parents’ involvement in learning at home and at school, as well as improved quality of family life for families who didn’t have to navigate between separated programs of child care and school kindergarten in the same day. A replication of some of these findings in another Ontario region (Pelletier, in press) has added weight to the evidence. Replication of results is an important science principle but this project also reflects the appetite for locally based research results that can be brought to local practitioners and administrators in a formative evaluation approach that improves local programs and practice. In addition to the local evidence to motivate Ontario politicians there was evidence from integrated early childhood interventions in other provinces or countries such as Quebec CPEs, the US School of the 21st Century (Zigler & Finn-Stevenson, 2007), and UK Sure Start (Melhuish, Belsky, & Barnes, 2010). The TFD project has contributed to both local policy development in several school boards and municipalities and to provincial policy in Ontario (Pelletier, in press). The knowledge mobilization strategy has been supported by the Atkinson Charitable Foundation, a TFD partner, and with the support of the Margaret and Wallace McCain Foundation (WWMFF, 2009) is being extended to other provinces in the Atlantic region of Canada. In Ontario, the TFD research was an important contributor to a visionary report by the Early Learning Advisor to the Premier (Pascal, 2009). The report provided a blueprint for a universal and integrated system to support child development and learning from birth to age 12. Based on the blueprint Ontario government has now moved to the phased implementation of a universal approach to providing integrated care and education in full-day early learning kindergarten programs for 4- and 5-year-olds. The government is also working on plans to extend the early childhood platform to younger children through the development of Child and Family Centres that will combine care, learning and family support in schools and other community sites.

While the TFD model is not being scaled up in “cookie cutter” fashion, there are important evidence-based design features that are being reflected in government policy. For example, a primary design feature of the TFD model is that programs are delivered by integrated teams of professionals, respectfully sharing the fundamental work of program design, delivery and monitoring. In the TFD research, joint professional development and time to meet were found to be important to the success of staff team integration. In the full day educare program being implemented by the province, licensed early childhood educators and kindergarten teachers are teamed to deliver programs to 26 students per class and have a mandated “duty to cooperate” in doing so. Professional development for the newly formed staff teams is an important part of the early implementation strategy but whether the teams have time to meet on an ongoing basis remains to be seen. Another design feature of Toronto First Duty is a play based curriculum, which was endorsed by the TFD child interviews and which was also associated with positive child outcomes. A new provincial Full-Day Early Learning-Kindergarten Program (Draft version) (Ontario Ministry of Education, 2010) has appeared that draws from the same play-based approach.

Other design features of TFD have not yet been adopted in the steps taken by the provincial government. For example, program quality was regularly assessed in TFD sites as an important indicator guiding improvement by staff teams and their leaders. In the provincial full day Early Learning Kindergarten program for 4- and 5-year-olds, there is no corresponding measurement of program quality. And a crucial difference is that service integration included multiple services in TFD but is limited to child care and kindergarten in the provincial program for 4- and 5-year-olds. Since some of the success of TFD in outreach and enhancing parent involvement may have reflected a wider menu of service in the school for children under 4, it also remains to be seen whether the new provincial program will increase capacity for parent involvement in learning and school across demographically diverse communities as TFD did.

Perhaps the most crucial design feature of TFD was the fact that the universal school-based service hub provided a tangible platform for service integration and delivery. The provincial integration of child care and kindergarten provides the same sort of platform for 4- and 5-year olds and the planning for Child and Family Centres anticipates extending the integrated service platform down in age. The centre or hub-based approach to service integration in TFD was not tested directly against other forms of integration, such as community networks or service navigation, but there is growing evidence for the importance of a platform or centre for effective service integration from a variety of other early childhood initiatives (e.g., Ball, in press; Melhuish et al., 2010; Peters et al., in press).

A number of provinces beyond Ontario are now working on universal programs integrating care and education (Beach, 2010). The initiatives hold out the promise of developing early childhood systems that provide the platform for further elaboration and improvement. Experience from the Toronto First Duty project suggests that ongoing research and development will be an important part of ensuring the success of system change.