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Child Development Parent Education Program

Details: Last Updated on 19 January 2023

The MECSH program includes delivery of the Learning to Communicate child development parent education program, which is one of MECSH's attachment programs to help support families with the different ways to be responsive to their children as they grow from a newborn to a toddler. The use of a formal child development program supports the structure of the MECSH program and is critical for supporting mothers to be future oriented and aspirational.

Learning to Communicate is based on the Interactional Model of Communication developed by Dr. Teresa Anderson. Learning to Communicate parent materials are given to families when they enrol in MECSH, with structured sessions commencing after the baby is born.

The objectives of Learning to Communicate are to provide parents with:

information on the normal development of communication
information on ways that they can encourage their baby’s development
information on the types of toys and play materials that are appropriate at each stage of their baby’s development
the opportunity to practise and discuss the above.

Learning to Communicate aims to help parents understand how their baby learns to communicate and how parents can encourage that development through natural daily activities. The Learning to Communicate content is grouped into two month age bands and each the content of each age band is organised into four areas covering:

Typical development - See what I can do!
Helping baby to learn;
Things that make learning fun; and
Baby's progress.

MECSH Research Publications

Details: Last Updated on 08 August 2023

Click here for the latest MECSH Publications list

MECSH Best Fit Checklist

Details: Last Updated on 19 January 2023

Fit for Purpose

Through the MECSH co-design process, the program is adaptable to fit with local systems and match local needs. MECSH is integrated within the local service system as a sustained home visiting program predominantly for families needing ongoing support but also serving some families who require a more comprehensive response. Since the program builds practitioner skills and system capacity there are spillover effects to the broader community. Clients are identified, assessed for eligibility, recruited, and retained through the routine care provided by the local maternal, child, and family health services system.

Service System Requirements

The MECSH program requires that the maternal and child health services in the area served by the MECSH program have the following five system requirements:

A system for identifying pregnant women**
- Identify before 20 weeks gestation (preferably)
- Hospital booking-in system enables early book-in
- Work with community and health care providers (eg GPs)
A system for assessing psychosocial risks of each family expecting an infant
- Psychosocial risk questions
- Edinburgh Depression Scale
A process for reviewing families’ psychosocial risks to identify those families who would benefit from participation in the MECSH program
- Facility to “flag” files of potential eligible families
- Case discussion meetings to review families psychosocial risks
- System generate a list of families to be offered the Program
A process for contacting eligible families who would benefit from participation in the MECSH program in order to offer them the program
- Initial contact to be made by Program Nurse
A process for monitoring the identification of eligible families and uptake of the Program by families
- Ongoing monitoring of requirements 1 to 3
- Ongoing monitoring of requirement 4

The MECSH® program is a registered trademark of Western Sydney University and was originally developed at UNSW Sydney.

Child and family service providers implementing MECSH in their communities are provided with support through the license and a three-year implementation support package. Granting of a license signifies a commitment by the licensed child and family service to delivery of a quality intervention and service systems to meet the needs of vulnerable families in their community.

If you are considering implementing the MECSH program, please contact TReSI for more information.

** Families are ideally enrolled prenatally, but the program allows for families to start within 6-8 weeks after the baby is discharged home from the birthing admission, including for babies who spend additional time in hospital after birth due to health needs.

MECSH Research Publications (2)

Details: Last Updated on 25 August 2016

Kemp L. Adaptation and fidelity: A recipe analogy for achieving both in population scale implementation. Prevention Science 2016;17(4):429-38. DOI: 10.1007/s11121-016-0642-7.
Zapart S, Knight J, Kemp L. ‘It was easier because I had help’: Mothers’ reflections on the long-term impact of sustained nurse home visiting. Maternal and Child Health Journal 2016;20(1):196-204. DOI: 10.1007/s10995-015-1819-6.
Kemp L, Harris E, McMahon C, Matthey S, Vimpani G, Anderson T, Schmied V, Aslam H. Benefits of psychosocial intervention and continuity of care by child and family health nurses in the pre- and postnatal period: Process evaluation. Journal of Advanced Nursing 2013;69(8):1850-61.
Kemp L, Harris E. The challenges of establishing and researching a sustained nurse home visiting programme within the universal child and family health service system Journal of Research in Nursing 2012;17(2):127-38.
Kemp L, Harris E, McMahon C, Matthey S, Vimpani G, Anderson T, Schmied V, Aslam H, Zapart S. Child and family outcomes of a long-term nurse home visitation program: a randomised controlled trial. Archives of Disease in Childhood 2011;96(6):533-40.
Kervin B, Kemp L, Jackson Pulver L. Types and timing of breastfeeding support and its impact on mothers’ behaviour. Journal of Paediatrics and Child Health 2010;46(3):85-91.
Kardamanidis K, Kemp L, Schmied V. Uncovering psychosocial needs: perspectives of Australian child and family health nurses in a sustained home visiting trial. Contemporary Nurse 2009;33(1):50-8.
Aslam H, Kemp L, Harris E, Gilbert E. Socio-cultural perceptions of SIDS among migrant Indian mothers. Journal of Paediatrics and Child Health 2009;45(11):670-5.
Kemp L, Harris E, McMahon C, Matthey S, Vimpani G, Anderson T, Schmied V. Miller Early Childhood Sustained Home-visiting (MECSH) trial: design, method and sample description. BMC Public Health 2008;8:424.
Kemp L, Eisbacher L, McIntyre L, O’Sullivan K, Taylor J, Clark T, Harris E. Working in partnership in the antenatal period: what do child and family health nurses do? Contemporary Nurse 2006;23(2):312-20.
Kemp L, Anderson T, Travaglia J, Harris E. Sustained nurse home visiting in early childhood: exploring Australian nursing competencies. Public Health Nursing 2005;22(3):254-9.

MECSH Trial Outcomes

Details: Last Updated on 19 January 2023

The Evidence

The original MECSH trial demonstrated the intervention was effective in improving child, maternal outcomes and the developmental quality of the home environment. The program evidence has been subjected to independent scrutiny and received approval as a quality evidence-based program by the USA Department of Health and Human Services Home Visiting Evidence of Effectiveness (HomVEE) review (eligible for MIECHV funding).

Results of an Australian multi-site randomised controlled trial build on the growing body of evidence that the earlier a community invests in its children, the higher the return on investment for the child, their family and the whole community. The right@home (MECSH-based program) evaluation at child age 2 years shows proven benefits for parenting and the home environment, including helping mothers to get their child to bed at a regular time, ensuring the child is safe at home, providing warmer parenting, and ensuring the home is a place where their child learns.

Original Trial

The MECSH Randomised Controlled Trial (mothers were recruited between 2003-2005) demonstrated that children, mothers and their families who received the program achieved the following impacts and outcomes:

New mothers

tended to be more likely to experience a normal, unassisted vaginal birth;
felt significantly more enabled and confident to care for themselves and their baby;
had significantly better self rated health;
could name two or more measures to reduce cot death risk.

Children

were breastfed for longer;
had improved cognitive development, particularly for children of mothers who were recorded as having psychosocial distress antenatally;
were more engaged with their mother.

Mothers of infants and toddlers

tended to have a better experience of being a mother, particularly for mothers who were recorded as having psychosocial distress antenatally and mothers who were born overseas;
provided a home environment that was supportive of their child’s development through improved verbal and emotional responsiveness, providing a more organised environment, providing developmentally appropriate play materials and greater parental involvement.

Drawing by a child of the MECSH Trial aged 4 years