The aggregation of marginal gains in relation to ecological intervention and support for children with additional needs.

What do the heating of Formula 1 racing car tyres, one-piece skin suits in cycling and approaches to supporting children with additional needs all have in common? The answer is that they can be all be related to the concept of the aggregation of marginal gains. This means that improvement in a particular activity is not the result of some magical one-off solution delivered by an expert in set sessions, but is the accumulation of many factors naturally occurring in daily life all contributing a small percentage gain to the overall picture. The concept of the aggregation of marginal gains has been a major contributor to the success of the British Cycling Team over the last two Olympic games with the Director of Cycling, Dave Brailsford breaking down the whole cycling activity into small component parts and achieving a small percentage gain in each one. In this paper the concept is taken and applied to children with additional needs, with specific reference to children with movement difficulties and incorporating this into an intervention approach known as Ecological Intervention (Sugden and Henderson, 2007). In this approach, instead of an ‘expert’ delivering a programme say once a week to children with difficulties, different individuals are assigned different roles within the child’s activities of daily living. This involves slightly modifying the context of the child’s life in a number of areas, each one small, but the totality of these marginal gains leads to an overall improvement in the child’s functioning and is a cost effective approach, a recognition of the complexity of the lives of individuals and empowerment of stakeholders.