Early childhood is a critical time for socialization and cognitive development in young children. Development in this period establishes the foundation of children’s success both in school and in life. Supporting early childhood development can help children reach their full potential, as brain development is more rapid during this time. Early intervention can lead to improvements in children’s physical and cognitive growth, their health, and their social development.
In Thailand, early childhood is defined as the period from birth through 6 years of age, and through the Thai Health Promotion Foundation, Thailand has invested significantly in addressing the needs of this population. The Capacity of a Community Treasure (COACT) project was established in 2013 and is led by Associate Professor Dr. Jutamas Chotibang. The Thai Health Promotion Foundation has been a major funder of COACT since its inception and the project has grown from a small project at the Faculty of Nursing to a collaborative effort involving the provincial public health office as well as other faculties at Chiang Mai University including Agriculture, Associated Medical Sciences, Medicine, and the College of Arts, Media, and Technology.
The most recent round of funding included 51 million THB granted to four projects: three to scale up the COACT model within Chiang Mai Province, Northern Thailand, and throughout the country, and a final project to promote family- and community-based initiatives. COACT works to create an integrated system of support for early childhood development at all levels of society, from the village to the provincial level. Through the promotion of a prototype system across Thailand, the project promotes best practices as well as healthy weight and development in early childhood. Currently, the prototype is being used in 43 child care centers in 23 provinces. These child care centers will then serve as resource centers for other child care centers.
Before adopting the COACT model, most early childhood care centers and kindergartens did not have a system or mechanism for improvement. Illness spread easily and developmental delays could remain undetected. The COACT model features five systems to optimize development and health promotion: administrative management, environmental management, curriculum, health promotion, and family and community participation.
COACT created a holistic screening system that assessed achievement of developmental milestones as well as health status. School administrators and educators were taught to recognize the types of infectious conditions prevalent in the school setting such as the common cold, hand, foot, and mouth virus, conjunctivitis, and the flu. They were also given a protocol regarding personal hygiene and room disinfection to reduce the spread of illness.
The Developmental Surveillance and Promotion Manual (DSPM) was used to systematically screen for developmental issues. The DSPM grades children on gross motor, fine motor, receptive language, expressive language, and personal and social skills. Any child below the 70th percentile for their age group was identified as needing assistance in meeting their developmental milestones. Teachers were taught various strategies to help children meet their milestones. Children with more pronounced delays or conditions such as autism or attention deficit disorder were referred to a specialist at the local health promotion hospital.
The impacts of the COACT program have been impressive. Early detection of delays and subsequent in-class teacher interventions meant that students needing assistance were often meeting developmental milestones within one semester of identification. Rates of illness also dropped dramatically in schools using the COACT model, as sick children were quickly identified and sent home, thus limiting contagion. This was a great change from when whole classrooms or even schools had to be closed due to widespread illness.
The success of the COACT program was recently featured at the 2019 Thailand Education Partnership (TEP) Forum held in Bangkok on June 8 and 9. TEP is a consortium of non-profit, private, and government groups with a common interest in improving the Thai education system. These groups are collaborating to create a new social paradigm that involves community participation and a deeper understanding of teaching and learning. The theme of this year’s TEP Forum was “Whole School Transformation.” As a featured speaker, Assoc. Prof. Dr. Jutamas spoke about best practices for early childhood in her talk, “Effectiveness of the benchmarking process to improve the quality of child development centers.” Over 1,000 participants attended the event.
Moving forward, COACT hopes to build on its successes by fostering greater collaboration between schools and their communities to help identify and address issues that impact the health of young children. COACT is also developing relationships within public health to report on their findings from the community and to make policy recommendations that will benefit early childhood development. Next year, the Faculty of Nursing will be the lead organization in a proposal for additional funding to establish a Center for Early Childhood Development. This Center would be established in conjunction with faculty partners at Chiang Mai University and would operate under the umbrella of FON’s Center for Excellence in Nursing Research.