What About the Children? Conference Report March 2022

Critical Connections

One of the themes that has dominated thinking within What About the Children? since the charity was founded in 1993 is the importance of attachment and connection – particularly with a few close, loving caregivers – in the lives and the future development of our youngest children. This was taken as the topic for the first of two half-day conferences in 2022.

Like all WATCh? events since the first coronavirus lockdown, this conference took place online, using Zoom. It was held on 10 March, a few weeks after Russia’s catastrophic invasion of Ukraine. Lydia Keyte, the chair of trustees, made reference to this in her introduction, when she described 2022 as an acutely anxious and difficult time for children and their parents with the ongoing pandemic, a cost-of-living crisis, and now war. But whatever the environment, the most important needs of young children are unchanged: for security and warm, loving care. The two speakers, Paul Ramchandani and Mary-Anne Hodd made these points in very different ways; both talks were fascinating, and both were followed by lively discussions.

The Critical Connection between Children and their Carers

Paul Ramchandani holds what must be a near unique position in UK academia: he is a professor of play. Strictly speaking, he is the LEGO Professor of Play in Education, Development and Learning (PEDAL), based at the PEDAL Research Centre in the Faculty of Education, Cambridge University. He also works clinically as a consultant child and adolescent psychiatrist for the NHS. His research focuses on the role of play throughout children’s lives, starting in babyhood.

Paul introduced his talk by, again, reflecting on the tragedy in Ukraine and on the ‘perhaps hundreds of thousands of families’ where there has been a disruption in parent-child relationships. (Now, in mid-April, the UN estimates that almost five million of Ukraine’s 7.5 million children have fled their homes.) He would be focusing on aspects of the relationships between children and their carers that are as crucial in ‘normal’ times as they are in ones as extreme as this: the importance of the early years, the role of fathers and how children learn and develop through play.

He used the Nobel-winning US economist James Joseph Heckman ‘s eponymous ‘Heckman curve’ to explain that the earlier governments invest in children’s care and education – in babyhood, if not before birth – the greater the economic returns from that investment society will see. There is truth in this way beyond the economic sphere, and it can be demonstrated using the trajectories of two hypothetical children: one with a happy, secure childhood and the other experiencing many adversities. The difference in outcomes between these two children will diverge as they grow up; interventions can improve the prospects of the less fortunate, but the earlier they are started, the less difference they will have to make up. There is truly something unique about the ‘first 1,000 days’.

And the UK is not in a good place as a country. Between 2000 and 2017, approximately 10% of children and adolescents in the UK had recognisable mental health difficulties; this seems bad enough, but that number has jumped to about 18% in the last five years. We have what it takes to improve this situation – knowledge of early infant and child development and of interventions that have been proven to make a difference – but we are not putting it into practice.

Much of WATCh?’s work focuses on the mother-child relationship and the importance of attachment and sensitivity. All such relationships, however, take place in the context of a family and a wider community. In these other, less intense relationships, engagement and stimulation are just as important as attachment, if not more so. The father’s role is critical. Paul’s own research has shown that there is a correlation between the amount that fathers engage with their babies and those babies’ cognitive development. And one of the most important ways in which fathers engage with babies and young children is to play with them.

The UN Convention on the Rights of the Child defines some key characteristics of play as fun, uncertainty, challenge, flexibility and non-productivity; the right to relax and play, without having to achieve anything, is a critical right for a child. It follows from this that all children need to be able to explore their environment in a free, unstructured way, but throughout the 20th and early 21st centuries this has become harder and harder for children in the UK to do. Paul illustrated this by considering four generations in a hypothetical family. Ed, aged eight today, is only allowed to walk to the end of his street alone. At the same age, his mother could walk half a mile to the local swimming pool; his grandfather, a mile to the woods, and his great-grandfather, eight in 1919, six miles to go fishing. Parents are naturally anxious, and they can have good reason to be, but this diminishing of children’s horizons is very limiting. And the pandemic has narrowed their horizons further, robbing them of opportunities to interact with their peers and to make friends.

It is true that children will always play, and that they will adapt their play to fit the circumstances they find themselves in. Parents can do a great deal to support their children’s play, particularly when those children are very young, but they do not always know the best ways of doing so. Paul and colleagues in the PEDAL centre designed a study called ‘Healthy Start, Happy Start’ to test a way of using video in feedback. They recruited families with young children, in half of which health visitors recorded the parents playing with their children and then discussed the videos with them, providing positive feedback. After two years, children in the families who had the video intervention were significantly less likely to suffer from behavioural problems than those in the other, control families. In concluding his talk, Paul said that this is only one example of an intervention that can help parents build their relationships with their children through play. We already have many such tools in our toolbox, but we need to keep using them: a one-off intervention, however well thought out, will be less effective than consistent family support throughout infancy and childhood.

When we Connect: Through the Child’s Eyes

Mary-Anne Hodd is a qualified psychologist, teacher, consultant and trainer, and other prestigious lectures under her belt. She is also a care leaver: she had a very troubled early childhood and spent nine years in foster care. Her mission is to demonstrate her ‘lived experience’ of the care system, to show those on the ‘other side’ what it is like from the child’s point of view and how troubled children can be helped to rebuild their lives. Mary-anne does this by combining her care, Psychology (Bsc) and teaching experience (PGCE). She started with an exercised that she had used , showing a picture of a child and asking, simply, ‘what does that child need?’. All children’s needs are similar: love, safety and education but also a social life and a culture. All these need to be considered when taking a child into care.

Mary-Anne then took delegates through the story of her early life, which was sad, shocking but ultimately hopeful. Her parents had both grown up in poverty, they experienced alcohol and drug addiction and met in a soup kitchen. She remembers experiencing neglect in early childhood, but also, crucially, loving relationships. Children need to feel safe and to learn that they have a place in the world. In her own early childhood, the love was there – particularly from her father, who she was very close to – but many other things were not. Professionals have identified ten types of Adverse Childhood Experience (or ACEs), including abuse and neglect, and many studies have shown that the more ACEs you have, the more vulnerable you are likely to be in adulthood. People who experienced four or more ACEs when growing up have been shown to be more likely to die prematurely and, in particular, to be fourteen times as likely to attempt suicide than those with untroubled childhoods. Mary-Ann remembered taking the ‘ACE test’ herself as a young adult and coming up with a score of seven: she was shocked, and began asking ‘how am I OK?’

This drove her to study, and to come to understand, her own response to the trauma that blighted her childhood. She quoted several definitions of trauma from different researchers: Gabor Mate, who talks about trauma as ‘a disconnection from oneself’, and Patrick Tomlinson who describes it as emotional shocks that we lack the resources to manage for ourselves. We need to see beyond the (often very bad) behaviour of a traumatised child or adolescent in the care system and ask how we can create an environment in which they feel safe. We are all grown-up versions of the children we once were, and if we are unable to process the trauma we experienced then we are likely to pass it on to our own children.

She described her early life with her parents as one where the home was full of alcohol and drugs and where she often didn’t know when she would eat next. However, she still felt loved, and that element of love and connection enabled her to heal. In contrast, her foster carers were often authoritarian and saw play as ‘a reward, not a right’. For a long time, she didn’t feel as if she could trust people and she would slip into a mode of doing exactly what she was told for fear of being moved on. When she started to analyse these experiences, she moved from thinking about ACEs to what she called PACEs – protective and compensatory experiences – and how she learned that if harm is relational, then healing must be relational too. She identified some of her own PACEs, which are also near universal: having a best friend, being part of a community, volunteering, hobbies and being part of a social group. She feels lucky to have had such a good relationship with her dad, who she remembers calling her his ‘little sidekick’ and saying that they were fighting their demons together. These memories will have helped her recover from trauma.

A study by the NSPCC suggests that nearly one in 5 people in the UK experienced some kind of abuse or neglect in childhood, that 47% of the population experienced at least one ACE and 9% at least four. There are therefore a huge number of people in this country who will be to some extent vulnerable and may need extra support. We are all connected through joy and through pain, and we need to build on these connections: not least with those with the most traumatic experiences to share. We change when we feel compassion for and connection with each other, and it really does take a village to raise a child. And she ended with her favourite quote from Archbishop Desmond Tutu: “The fundamental law of human beings is interdependence; a person is a person through other persons”.

The second What About the Children? national conference in 2022 will take place in the morning of Monday, 17 October, also held online using Zoom. Its title will be Our families, our future: an investment and it should be an equally fascinating and worthwhile way to spend a morning. Tickets will be available soon.