Thursday June 3, 2021

And quietly in the background – something stirs

So much has been drowned out by the roar of the pandemic.  Understandably so, the loss, the suffering and the economic consequences of covid 19 are so overwhelming and may well be felt for years to come. 

But, as we begin to think about life post-pandemic, I am beginning to feel that there is something stirring that could genuinely have a positive impact over the next few generations. 

I am talking about a possible revolution in the way that we, as a country, support parents so that all children have the best start in life.  And, if we get that right, then we stand a real chance of reducing levels of violence and improving overall health and wellbeing outcomes.

A quick recap

The scientific evidence for the link between early life traumatic experiences (such as abuse, neglect and witnessing domestic violence) and emotional and physical ill-health is well established.  The work of Dr Vincent Felitti (who carried out a study of over 17,000 people in the USA in the late 1990s) was one of the first major studies to identify the relation between multiple traumatic adversities in childhood and physical and emotional problems throughout a lifetime.  This work, since replicated many times, including in the UK, shockingly showed that someone who had experienced four or more potentially traumatic experiences (Felitti called these Adverse Childhood Experiences, or ACEs) was, for example:

• Two times more likely to get heart disease
• Ten times more likely to ever inject drugs
• Nine times more likely to go to prison
• Twelve times more likely to commit suicide

So far so bad.  But we now also understand the mechanism by which these adverse experiences impact directly on the developing brain and how this can then lead to these consequences.  In simple terms, our brains develop to operate in the most efficient way that they can responding to the environment that we are in.  If the environment is rich in ongoing (toxic) stress – then, in response to constantly raised stress hormones, we develop brains that can efficiently deal with this.  We learn to be hypervigilant, expect bad things to happen and respond accordingly without always prioritising or feeling that we have choices.

But, conversely, if we experience less toxic stress, we develop brains that learn to respond to stressful situations as they happen and do not expect every situation to be stressful, we learn how to self-regulate, prioritise and to make better choices.  In short, we develop a set of skills known as executive function that act as a sort of air-traffic control for our thoughts.  This makes us more resilient and better able to cope with future trauma.

There are several particularly sensitive periods of brain development, with our brains continuing to develop into our mid-to-late twenties.  The period when we are most sensitive to our environment is conception to age two.  What happens to us then creates a neurological foundation that we carry with us as we develop into adults and beyond. 

 

So, is something really 'stirring'?

So, back to my optimistic assertions about something stirring that could genuinely have a positive impact for generations to come.   Over the last thirty years or so, a growing number of experts and early years practitioners have talked about how we should focus more attention in developing a framework that supports the first three years of a child’s life.  Just follow the science – reduce toxic stress in the first three years of life and you will reduce incidences of violence and crime whilst improving physical and emotional health.

There have been policy flare-ups when politicians have come on board – Sure Start, the work of Graham Allen MP on early intervention that was commissioned by the Coalition Government and the current Trouble Families Programme all come to mind.  Reports have come out demonstrating that investing in this focused early intervention is also more cost effective, such as WAVE Trust’s ‘The economics of early year’s investment (2013)’, produced for the Department for Education, which stated:

“there is general expert consensus that it is somewhere between economically worthwhile and imperative to invest more heavily, as a proportion of both local and national spend, in the very earliest months and years of life.”

But, somehow, these seemingly obvious and powerful arguments for a fundamental overhaul of the way that we support these precious early years never quite seem to deliver the sort of fundamental policy shift needed.  But that may be about to change.

The Government review by Andrea Leadsom MP, ‘The best start for life: a vision for the 1,001 critical days’, was published in March of this year.  In her introduction, Leadsom says:

 

“Two is too late! We spend billions on challenges in society from lack of school readiness to bullying to poor mental health to addictions and criminality; and further billions on conditions such as obesity, diabetes, and congenital heart disease. Yet, the building blocks for lifelong emotional and physical health are laid down in the period from conception to the age of two and we don’t give this critical period the focus it deserves. Prevention isn’t only kinder, but it’s also much cheaper than cure – what happens to an infant in the 1,001 critical days is all about prevention, and a strong, supportive policy framework in this area can truly change our society for the better, while saving billions for taxpayers.”

She goes on to describe six action areas that she and her team will now focus on.  These include developing seamless support for families, establishing national and local leadership specifically focused on the first three years, the requirement to have ‘start of life’ offers for every family and empowering the workforce.  It is cross-departmental, local and national, and hugely ambitious.  In short, it is not just a single programme, it is (or could be) the beginning of a new national focus on delivering the best possible start to every child in this country. 

If this goes well, then it really could be a once in a generation opportunity to tackle many of the issues caused by intergenerational trauma.  Levels of violence could be reduced, well-being improved, levels of chronic disease reduced, educational standards raised and economic opportunities could open to more.  It really is that significant.

 

Haven’t we been here before?

But haven’t we been here before, only to be let down?  Possibly, but there are some differences this time.

Firstly, there is now a large cross-party consensus that we need to invest in our early years.  The WAVE Trust 70/30 campaign that aims to reduce levels of abuse, neglect and other forms of childhood adversity by 70% by 2030 is supported by hundreds of politicians across the UK.  This is not a fringe issue.

Secondly, the Leadsom report is describing a systemic change, recognising that delivering change in this critical area is a team game.  This is not a single intervention – it is the development of a whole system focused on the first three years of a child’s life.

Thirdly, Andrea Leadsom has form in this area – she has been committed to this for over twenty years.  As she says in the report:

“I chaired the Oxford Parent Infant Project from the late 1990s and founded the national charity PIP UK in 2012; in Parliament I established the APPG for Conception to the Age of two and the 1001 Critical Days Manifesto, which is now supported by over 160 charities and professional bodies. I also chaired the Inter-ministerial Group on the Early Years from 2018-19, working across seven Whitehall departments to build the beginnings of a vision for how to give every baby the best start in life.”

And fourthly, for now at least, she seems to be supported across Government to deliver. The report is very much an initial overview of what needs to happen – Leadsom and her team are now working on what happens next.

At long last a breakthrough?

So, call me overly optimistic, but I do feel a little hopeful that, at long last, we may be about to make a breakthrough.  Supporting the first three years of a child’s life should be as important in policy terms as (say) the defence of the realm.  Currently, despite warm words, it is often an afterthought and the first thing to be cut when times are hard. 

And that, of course, will be the test – even if Leadsom can persuade the Government to run with her plans, will the Government also commit to the long-term associated funding that this will require?

Time will tell but, for now, I would urge all those interested and passionate about the early years to do all that they can to build support locally and nationally for the full implementation of the Leadsom recommendations.

It has been stirring quietly in the background for too long – it is time for early years services to be front and central.  And let optimism reign.

Peter Watt is Strategic Projects Director at WAVE.

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