This series of short articles is intended to be relevant to you if you are in some sort of non-family early child and family support capacity for families who have a new baby or infant with impairments that are predicted to impact on health, development and learning.
In the UK, in my memory, some parents whose new baby was found to have very significant problems / difficulties / challenges were given a choice of leaving her or him in hospital. This was the first step for the child to one of the long-stay mental handicap ‘hospitals’ which could house people cradle to grave. I would like to think that such cruel institutional care has come to an end in this country but we still hear of some private hospitals that take very vulnerable people and house them in appalling conditions. At a conference this year in Czech Republic a mother of an infant spoke of being given the option of leaving the child in hospital. We know many countries use institutional care to manage vulnerable people of all ages.
I think in the UK we have done half a job. We have closed the institutions in the expectation that even the most vulnerable babies will stay with their families. Good news indeed! But we have created a problem of families who cannot cope because we are not providing enough support.
The load on a family can be tremendous with real threats to everyone’s mental health. The issues include: long-term exhaustion and stress accepted as the norm; inadequate housing; impoverishment and debts; sleep deprivation in parents and siblings; insurmountable difficulties in continuing work or study; very dark thoughts when parents feel they cannot carry on; battles to get effective services; battles to get a child into a decent school; battles to get adequate support in school. Some families will collapse under the strain.
The main point of this episode is for professionals to be fully aware of what families might be going through and then to act accordingly. Here is an example: As a keyworker I had already had a series of sessions with a baby of just a few months of age. On this particular morning I drove to the home with some ideas of the games I would play to promote hearing, vision or posture – I forget which now. After a short time I could see the mother was not joining in as she usually did so I asked her if she felt I was doing the wrong things. She burst into tears and told me her husband had walked out yesterday evening. Her mind was in turmoil.
Since then, I have always checked in with parents to see what has been happening since we last met, being prepared to change any plans I had made as necessary. I also make each session long enough to give attention to the child and to the parent or parents, letting the focus change naturally. Having this much time is a luxury for any professional but it is essential in early support for children and families. Managers need to know this. In this approach, professionals need to feel strong enough to listen to whatever parents might say and be able to respond appropriately. Are you ready for a mother who wants to discuss her thoughts of suicide? Are you ready to have a father cry on your shoulder?
To summarise, in the UK we keep babies and infants out of institutions but we have not yet learned how to support families effectively so child and family can have a good quality of life. Actually, we have learned but the good practice is in only very small pockets here and there. Across the world, there are no systems providing effective integrated early child and family support to all the families in the locality. None.