Relationships are the foundations for change
Working with the child, working with the parent, and working with the parent and child together are the three keys to a new direction, says Alan Sinclair
William Clark is Tesco’s Paisley catering manager in the staff canteen. At age 33 he is excited that his partner, a nursery worker, is pregnant. His keen sense of humour is now put to good use doing stand-up comedy; he recently won first prize in the largest “gong” competition in Scotland.
But a different William Clark existed two decades ago. This was the boy who had lost his loving, cuddling dad after a blazing row; whose mother was emotionally damaged and unequipped to look after him. He was excluded from primary school after attacking another pupil, had his stomach pumped to rid it of alcohol at age 13, and at 15 he was using cocaine.
By 26 he was married and had a child but it was “mental from the go”, according to William, who remembers that he was “totally impulsive”. A second child followed, along with a spell in jail for possessing 7,500 Valium tablets and four police assaults. Rehab, Narcotic Anonymous and a Parenting Matters Dads' group literally saved William’s life.
“I first went on the Parenting Matters course to get a tick from the social work. My kids were on the protection register”, he says. “ I soon found other men talking about their feelings and I wanted to break the cycle and give my kids a more balanced life, where they could make better decisions. I did not want them to be as emotionally immature as me. It is no wonder that my wife left me”.
Today, a five-year-old William Clark would be defined as ”vulnerable”. One Scottish child in every four is vulnerable when they reach primary school, defined as being poor in social competence, emotional maturity, language and cognitive ability or physical health and wellbeing.
In the next five years, the forecast is that 250,000 babies will be born in Scotland – the equivalent of the combined populations of Aberdeen and Hamilton. Unless we change direction we will have added the equivalent of a Hamilton full of vulnerable children. To do this with our eyes open is not good enough.
We are quick to assign conditions to children. But vulnerable children are the direct consequences of an adult condition. This adult syndrome has two sets of symptoms, first, being locked into doing what we have done before, even when we know that it does not work. Secondly, there is a lack of will, skills and dedication to stick with a new sense of purpose and direction. Half in jest and half seriously, I call this the Implementation Deficit Syndrome.
The Victorians, when confronted by endemic cholera and dysentery created an infrastructure to provide clean water and a sewerage system. Babies across the population, or at least the vulnerable like William and his parents, need an investment. This time in engagement and support to help people get ready to have a child and look after themselves and the baby. Improved parenting is a practical and achievable goal. So the first bottom line is the reduction in pain and harm, the space for joy in parenthood and the opportunity for the child to flourish.
Individual and collective economic gain is the second bottom line and is less understood. By examining different datasets that trace people from the start of life to adulthood, James Heckman, an economics Nobel Laureate, has drawn the conclusion that early investment in parents and children produces an annual rate of return of between seven and 10 per cent. The returns come from the reduction in costs of crime, better physical and mental health, more people in work paying taxes, and fewer people on welfare.
Half of Scottish public revenues are now levied in Scotland. If Scotland’s economic base and human capital does not grow or worse deteriorates, the pressure on the public spend will get worse. Given the factors Scotland faces, this is a crisis moment which demands a change in direction.
It is sound advice to know where you are now before taking a compass bearing and heading in a new direction. Holland is top of the UNICEF league table on child wellbeing. Parenting in Scotland and the UK is not a complete basket case; we are halfway up this global table. On returning from a visit to Holland, I asked a Dutch woman living in Scotland for her opinion: “In Holland we love children. In Scotland you tolerate children.”
I am optimistic. All parents of young children are hungry for help. At the core it is about what parents do and do not do. I no longer talk about “early years”; it is too woolly and leaves out mothers and fathers. The Scottish Government has started to shift in the right direction. Health Visitors have been saved from merging into generic Community Nurses and their numbers and pay grade increased. There is a strong need to go further and give the nurses the time to build a personal relationship.
A Baby Box has been introduced as a gift to each new baby and their parents. It is a welcome symbol and the box of goods is much appreciated, especially by financially hard-pressed parents. It is common for mothers to feel isolated during pregnancy and once they have a baby. At the moment the postman delivers the box; in future the box could be presented as part of group sessions preparing for birth and looking after a baby. Relationships are more important than more “stuff”.
By doubling day care for vulnerable two-year-olds and all three- and four-year-olds, the Scottish Government has committed to spend close to £1 billion a year. Quality day care (quality does matter) has a number of benefits: the most at-risk children benefit the greatest from the security and stimulation of day care and it can lift low-income households out of poverty by making it easier for one or both parents to go to work without having the financial gains eaten by childcare costs. Across the board it helps parents cope and children to become socialised.
Day care is the answer to the question: how do we help parents with young children get to work and make sure that it is worth the trouble? But is this the right question? A more significant framing is: how can we best help all parents during the first 1000 days, from before conception to two years, to become better at the most demanding role they will ever face and the one with the longest lasting consequences?
William talks about how impulsive he was in his years of chaos and how he “never once got offered help on being a parent”. Day care might be necessary but it is not sufficient for neglectful, vulnerable, traumatised or chaotic parents. Vulnerable parents are often isolated or scared of day care centres. Scottish children who “dog” school will most likely have dogged nursery.
Like Baby Boxes, day care needs reframing. Human engagement and reaching out to vulnerable parents, building trust and empathy, tea and scones, making food together and chapping doors, walking next to parents — all of these are essential.
Multiple studies have shown that the most effective interventions have three elements: working with the child, working with the parent and working with the parent and child together. Relationships are at the core of the new direction. That is a challenge for parents and for government.
Alan Sinclair is author of Right from the Start: Investing in Parents and Babies