Early Child and Family Support: Principles and Prospects. Part 2

For parents and practitioners who are impatient for change

The following extract is the second of three from Chapter 5 of ‘Early Child and Family Support: Principles and Prospects’ written by Peter Limbrick and published by Interconnections in 2022 (ISBN 978-0-9576601-9-9).

 

Chapter 5: Prospects for offering effective integrated early child and family support to all families

Offering effective integrated early child and family support to all families who want it must be the aim in any country if we want to move beyond projects supporting only a limited number of children and families. There is no logical reason for supporting some families in any city, region or country while leaving others who want help to cope on their own. But this selective approach is happening everywhere. This chapter addresses major barriers to progress with suggested ways forward under five headings: 

1. Out-dated institutional attitudes and medical conservatism (In Part 1)
2. General prejudice and discrimination (In Part 1)
3. Families as an oppressed minority group
4. The common failings in top-down reform
5. Local early child and family support task forces to accelerate the pace of change

 

3. Families as an oppressed minority group

It is valid to describe families of these babies and pre-school children as    a severely oppressed minority group. They can suffer prejudice and discrimination, have to struggle to survive with inadequate resources, are financially impoverished, socially isolated and, typically, sleep deprived. Study, work and careers are interrupted or terminated. Family members’ mental health and the new child’s bonds of attachment are put at risk. These harsh conditions impact negatively on everyone in the family.

            In very many, or most, countries there is legislation catering for the educational needs of children of school age. In only a very small minority of countries is there legislation that considers the needs of babies and pre-school children who have significant challenges to their development and learning or that considers the needs of their families. An important consequence of this is that there are no official bodies to appeal to when early support is inadequate or absent. Families in most countries must thrive, struggle or sink without government intervention. The stark choice for parents when support is absent or inadequate is to put up with it or go into battle without any sort of official recognition or help. Is this true where you are?

            When we look for causes of this oppression, we see a group of families in all countries that largely exists outside of public consciousness and whose struggles and triumphs are not reported in press and media, not researched or helped by academics in their local colleges and universities and not recognised by their elected political representatives.  

            For a variety of reasons, the general public might rarely or never come into contact with families whose baby or infant has significant challenges to development and learning. This can be because:

• the child is in hospital for periods of time and then has frequent visits to outpatient departments – all keeping the child away from the normal childhood places
• parents are physically unable or nervous about joining other families in mother and baby groups, playgroups, etc.
• a child’s special buggy and the medical equipment some children have with them make people nervous of approaching and starting friendly conversations
• parents’ tiredness, low self-esteem and stress result in them keeping themselves to themselves

When the medical world attaches the word disability to a new child then the child and family can be subject to the prejudice and discrimination that people who have physical, sensory or mental impairments might suffer at all ages. At worst, this might bring a dismissive response from the average woman and man in the street when they hear about the plight of these families. While oppressed people can and do struggle, more or less effectively, to improve their conditions, parents in this oppressed minority are probably too tired, too busy and too impoverished to fight campaigns. Also, the preschool years pass very quickly, after which parents might then be in a long struggle for effective education! When the general public    and civic bodies are not aware of a minority group in their locality and   are not witness to their joys and struggles, we should not be surprised that public money is not channelled in their direction to fund effective integrated support.

            I am aware, though, these families are not usually described or thought of as an oppressed minority group. A common and more or less dismissive attitude is that fate has given each individual family a very unwelcome challenge that most of us would never expect or cope with. These families are not usually considered collectively as a social group deserving of serious political or academic attention. The merit in talking now about oppression of a minority group is that we can move the discussion towards the rights of children and the rights of families. When those rights are established in a city, region or country they can be evoked to help remove elements of oppression – discrimination, poverty, isolation, lack of support, etc.

 

4. The common failings in top-down reform

It is always tempting to believe that if we influence policies at the top of local and national governments and at the top of public agencies and non-government organisations, then new policies and improved practice will inevitably filter down to the children and families who need early child and family support. There is some logic in this top-down approach because the people at the top can establish policies, have authority over people lower down in the hierarchies and can allocate resources. The people in these very senior positions are undoubtedly powerful, yet there can be three pitfalls in this approach:

• Policy and practice can be perverted and distorted in the filtering down.
• The new work survives for only a short time.
• The new work does not spread out horizontally at the grass-roots to embrace children and families beyond the limited scope of the initial new initiatives or pilot projects.

Being aware of the limitations of the top-down approach can encourage us to consider other approaches and, when we use a top-down approach, show us what safeguards we must build into it.

How policy and practice can be perverted and distorted in the filtering down

It is unlikely that senior people at the top of our vertical organisations can share the same long-term commitment and passion for improved support for these children and families that we find at the grass-roots. This is inevitable. While they might initially give everything to a new initiative to build or reform early child and family support, they will have other pressing challenges on their desk next week or next month. The same will be true for managers lower down in the hierarchies. These middle managers who have the responsibility to pass down the new work will have varying levels of passion, commitment or enthusiasm and will accordingly vary in the amount of time, energy and resources they want to devote to it. The same must be true for the practitioners at the grass-roots who work with children and families. Each will have attitudes about the new policies and practice and views about the benefits or challenges they bring to their present way of working and to their professional standards.

            Emotions have their part to play too. Effective integrated early child and family support relies on teamwork that relies in turn on a high level of honesty, trust and respect between colleagues. The filtering down process can founder here when practitioners do not yet have the required personal skills for genuine teamwork.

            Sadly, perversion, distortion and delay in enacting new policies at the grass-roots can happen even when the new policies come in some sort of legal framework.

Why new work might survive for only a short time

New systems for a city, region or country’s effective integrated early child and family support are likely to be fragile and might eventually succumb to one or more common threats. This can be because: 

• ministers, managers or practitioners lose their initial enthusiasm and commitment
• initial funding comes to an end and no new sources are found (as very often happens to pilot projects)
• the plight of another group of people in need comes to the fore and takes precedence over the children and families we are discussing here

Why the new work might not spread out horizontally

The only valid intent must be to offer effective integrated early child and family support to all who need it in each city, region or country. There is no logic or fairness in restricting the effort to only a limited number of families. By this logic, each new initiative must have two phases:

• Firstly, to establish a new system for a first group of children and families.
• Secondly, to roll successful work out horizontally across the city, region or country.

This second phase presents very different challenges from the first and     is often neglected. The first phase can be seen as the easy part and is counted as a success when a number of families are helped. The official reports and press releases will reflect the achievement with new benefits brought to these families but, at the same time, fail to mention the number of families who have not been helped and might never be. Arithmetically, it might be that of the children and families who need the new work, only 10%, 5%, 1%, 0.1% or 0.01% or fewer have been helped. The second phase is very important indeed but might be neglected because it does not have all the glamour and excitement of the first pioneering project. But in fact, it is only the second phase that justifies the energy, time and money invested in the first.           

           

An example of a failed top-down approach was the work Interconnections did with the UK government. The then Labour government set up an innovative nation-wide Early Support project early in the 2000s and involved Interconnections in a minor way in its planning and promotion. TAC became part of the new government guidance for supporting babies and infants who had multifaceted conditions. In very many localities, TAC became commonplace with the appointment within public services of TAC Co-ordinators, a new role to oversee local TAC development. Very sadly, Early Support came to an end in 2015. First of all the 2008 banking crash meant local authorities were now starved of the cash they needed for new initiatives and the project gradually ran out of steam as the Labour government changed to a Conservative government in 2010. My impression is that the new government under David Cameron as prime minister did nothing to help keep the Early Support project  going despite the Cameron family having an infant son with very significant disabilities.

            This is a personal and very brief account of the rise and fall of UK’s Early Support project. From my perspective its very welcome focus on babies and infants and their families has since been lost. The story shows what can happen when there is over-reliance on government authority and resources. The great advantages can disappear as soon as one government gives way to another in the democratic process. The Early Support project was too short-lived to create lasting cultural change despite all the good work that happened within it.

 

Note: Part 3 of this short series witll cover:

5. Local early child and family support task forces to accelerate the pace of change

 

Peter Limbrick, November 2024.Comments welcome.