If a child does not receive a good start in life their health and wellbeing can be negatively affected. A baby’s early experiences are influential in determining their future emotional, intellectual and physical development. From early infancy, children naturally reach out to create bonds, and they develop best when caring adults respond in warm, stimulating and consistent ways. This secure attachment with those close to them leads to the development of empathy, trust and well-being; however, parental skills and confidence can be affected by a range of risk factors which can also affect the child’s social and emotional and behavioural outcomes.
Training in the promotion of attachment and the measures used to assess attachment would be beneficial for all professionals in the early years sector.
Health visiting teams are trained to promote attachment but as yet do not have a commissioned perinatal mental health service that meets national best practice into which they can refer women who are anxious and depressed. About 50% of women who are assessed as needing emotional support and physical help and who are referred to Improving Access to Psychological Therapies (IAPT) ante or postnatally, do not attend these services unless supported by the voluntary sector. This is a gap that is echoed across Berkshire. There is a gap too in perinatal mental health training for early years staff and volunteers who work with families. This requires multi agency action and has been set as an outcome within the voluntary sector strategy.
Speech and language delay is a major contributor to poor school readiness and collaborative working is recommended to identify commonalities between the ASQ-3 and EYFS communication and language criteria.
Promotion of on line checking of child development is essential. Parents concerned about their child’s communication can go to the local Berkshire Healthcare Foundation Trust integrated therapies website and self assess their child’s progress using the early years toolkit. This can be found at http://www.berkshirehealthcare.nhs.uk/page_sa.asp?fldKey=305.
A focus on avoiding child maltreatment (whether by neglect, physical or emotional abuse) and wider safeguarding is essential. Referrals to the early help team are supported by programmes that aim to reduce the risk of a child being taken into care. The early help process offers self help programmes to parents coping with the impact of domestic abuse, alcohol or drug misuse or low levels of parental mental health that do not meet the criteria for referral to adult mental health services.
Strategies for reducing barriers to uptake of the 2-2.5 year review include offering improved drop-in and bookable sessions for working parents through commercial settings and evening and weekend access. This is now a quality indicator in the health visiting service contract.
The purpose of the 6 High Impact Area early years documents is to articulate the contribution of health visitors to the 0-5 agenda and describe areas where health visitors have a significant impact on health and wellbeing and improving outcomes for children, families and communities:
Improved data sharing would benefit how progress is tracked in early years and thus enable timely and developmentally appropriate interventions to be implemented.
Parents can be assured that the health visiting services have been trained in motivational interviewing; a technique used to support lifestyle/behaviour change and an optimum way to assess child development.
