When Chiara Nielsen* had her third child, she was just twenty-one years old and had lost her two eldest children to social services due to her struggles with severe mental illness. In a last attempt to keep she and her son together, the British courts sent Nielsen to the Early Parenting Unit at the Anna Freud Centre, in London. She knew it was her last chance to create a stable home for her baby.
“I had such intense anxiety for the first two weeks, I would be hiding in the toilet,” Nielsen said, who has severe trepidation in trusting or meeting new people.
Nicola Labuschagne, who runs the Early Parenting Unit, is accustomed to hearing similar fears. The idea for the centre’s treatment plan came after mental health staff in court assessments would witness children from 8 to 12 years with severe behavioral problems, often caused by poor parenting.
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“We knew we needed to catch children under five years-old and assist with that age group. It’s such an important age to work with the parent to benefit the child; afterwards it becomes very difficult to fix,” says Labuschangne.
Anna Freud joins a growing number of early childhood intervention programs focusing on giving parents the skills, education and support they need in rearing children under five years old. In 2016, science journal The Lancet named providing support to parents as one of its four recommendations to improve early childhood development globally.
Such programs can either involve training parents in the home or having families come into a community center. Staff and trainers give specific advice while using simple language and demonstrating the activity they are discussing.
For example, a trainer might say to the parent, “We need to give the baby a bath now,” then go through bath-time step by step. They may need to show how to check the temperature of the bath, lower the baby inside the water, and keep the child calm during the experience.
At the Anna Freud Center participants come twice a week to engage in therapy sessions and learn skills on how to care for their children.
Therapists work on the parent-child relationship, child development, and the parent’s mental health, all within a structured environment.
Techniques include singing songs, and teaching the parent how to play with their children, maintain eye contact, cook and eat a meal with their child.
Therapists video record sessions between parents and their child and then review them so they can go over possible improvements.
Since 2011, the Early Parenting Unit has had 20 families successfully complete the treatment, almost 50% of their caseload, which costs £49,750 for one family.
Labuschangne points out that only high-risk, complex cases are enrolled in the program, mostly court-mandated, and it costs over £100,000 to put a child into foster care rather than keep them within the family.
There are 8-9 families enrolled in the program at a time, 60% get through the assessment phase and 30% of their children are removed from the family. She says the staff creates a safer community as they know when a child has the chance to be safe or to remove them from the home. Nielsen is just four months away from completing the program and has thus far met all the benchmarks set by the court to keep her son.
“It’s so much easier for him and I to communicate now,” Nielsen says.
Anna Freud’s results signal that it is possible to improve interactions between parents and young children in fraught households. If adults, who tend to be isolated and don’t have access to resources that other new parents normally get, are supported, the outcomes for children can improve.
This parent-first approach can succeed amongst various types of needs and demographics. Across the United States and Europe, an array of programs use a catchment style open-door approach to engage with parents at various socio-economic levels.
One size fits all
Preparing for Life, an early invention program in northern Dublin, works with a wider array of parents than the Early Parenting Unit. The project assists parents of kids from birth to five years to ensure their children are school ready.
Participants can stop by the centre’s main office whenever they need and therapists go to their home once a month, says Sue Cullen, Preparing for Life’s program manager. Children are considered school ready if they meet the required standard in five areas of development: language, solid approaches to learning, cognitive development, social and emotional well-being, and physical well-being.
Their main asset, Cullen says, is to provide easy to digest tip-sheets to the parents, covering everything from what to expect when mothers-to-be are pregnant to becoming a dad for the first time. These tips are clear and easy to absorb for any level of education and boils down the onslaught of incoming information into digestible bites. “It really helps them manage and understand their expectations on parenting,” says Cullen.
It also provides simple items for the parents to use in their home, such as a play mat and developmental toys. The parents work with their assigned mentor on how to properly use them.
The mentors show the parents how to set a routine such as bed and bath time, storybooks, and to talk to them about their day. In a randomized controlled-study conducted with over 200 families from Preparing for Life, researchers were able to measure positive outcomes in all five objectives for the children after completing the program.
“Without the parents, we can’t get to the child,” says Cullen. “For children years 0-5 are so vital, it is when all the learning takes place. We need to teach parents to shine the light.” — Cara Tabachnik
(Picture credit: Pixabay)
*Chiara Nielsen is a pseudonym we have used to protect the mother’s identity