‘a quiet, calm and safe space...Here children can focus, concentrate, absorb information, reflect, create and acquire new skills’
Introduction to the series
In this serialised essay I want to explore positive and favourable environments for providing early child and family support when babies and young children have conditions that potentially reduce their capacity for development and learning.
In the first parts I will contrast the busy and often neurotic atmosphere of the hospital with the quiet and calm space that we generally assume is required for learning in babies and young children. I will then explore the implications for early child and family support much of which is traditionally hospital-based. Finally I will argue that society’s mind-set and approach to these children and their families should be less medical and more educational.
Positive environments for early child and family support. Part 2: Favourable environments for education and learning
In the first part of this serialised essay I suggested hospital and clinics are not favourable environments to promote education/learning in babies and young children who have conditions that affect their development and learning in the long term. I characterised these medical environments as busy, neurotic and morbid and set them in contrast to places where, typically, babies and children can be relaxed, inquisitive, respected, secure and ready for learning. In this analysis, early child and family support (‘early childhood intervention’ to use a harsher term) cannot be effective for these children and families in hospital and clinical settings. So what are the characteristics of a favourable environment?
The Chambers Dictionary tells us that to educate is ‘to bring up and instruct; to provide school instruction for; to teach; to train.’ and to learn is ‘to be informed; to get to know; to gain knowledge, skill or ability in.’
Education and learning go hand in hand. Learning, the acquisition of new understanding and skills, is a life-long process starting at birth and, before that, in utero. Learning can come about naturally or be the result of some sort of education. In early child and family support we often pair the terms ‘development’ and ‘learning’. Development too can happen naturally or be the outcome of some sort of informal or formal programmes. In my experience learning and development are an essential mystery with some unfathomable combination of naturalness, intervention and other factors. A favourable space or environment is a major factor.
Some early education and learning is on the parent’s lap. We can observe the cocoon of private space that fosters bonds of attachment with physical contact, gazing, rocking and vocalizing ̶ all unhurried, gentle, calm and reassuring. This enclosed favourable environment can be created by baby and parent even in busy places. When parent and child for whatever reason do not have these quality times for learning about each other, development and learning are curtailed with long-term consequences for the child, the family and, perhaps, society. (I will suggest that a neurotic parent might find it harder to create these quality times and that this can be the result in part of a neurotic hospital environment.)
As the baby grows, family life provides a mix of learning experiences ̶ some with high activity, noise and excitement focused on doing and others that are more deliberately educational at a slower pace. These first educational times can be characterised by having a quiet, calm and safe space with an interested adult or older sibling in responsive relationship.
I will use the school classroom to typify a favourable learning environment for older children and will set this within a more or less ordered and civilised society where there is a level of mutual respect between teachers and children, together with a generalised respect for education and learning.
Ideally the classroom is a space just for teacher and pupils. Here children can focus, concentrate, absorb information, reflect, create and acquire new skills. Staying with the ideal, teacher and pupils relate to each other with calmness, attentiveness and respect. School management and teachers will try to preserve this space by reducing as much as possible all ‘noise’ coming in from the outside and discouraging or prohibiting visitors into the classroom during lesson time.
I have described the hospital environment as neurotic with contributory factors that include competition and intrigue amongst staff members in highly pressurised working conditions. I would not pretend that schools and colleges are free of all of this or that staff members are not subject to pressures from within the school and from authorities outside the school, but competent teachers know how to leave all of those concerns outside the classroom in order to preserve an environment conducive to learning. Competent school managers and external inspection regimes will strive to maintain this essential standard of the calm classroom.
An alternative to the classroom is the tutorial space for an individual pupil or student or for a small group. This can be in a school, college or private home. As with the teacher in the classroom, the tutor will try to organise a quiet space free from interruption where tutor and learners can focus on the subject matter. This will be a safe space for respectful and attentive dialogue.
Inevitably, various negative mental states are present in all these educational/learning environments in both children and adults. These can include fear, anxiety, self-doubt and conflict. These mental states in children are monitored, managed and reduced as much as possible in an effective education environment while in hospitals they probably are not.
So how does my contrast between busy, neurotic and morbid environments and those conducive to education and learning relate to work with babies and infants who have atypical or delayed development?
Effective early child and family support has the three essential pillars of health, family support and education. Health interventions, in my thinking, are best reserved for necessary responses to threats to life and illness with a focus on diagnosis, treatment and cure. Family support will almost certainly be required from the time a disabling condition is suspected or confirmed and aims to preserve the wellbeing of the whole family. Elements within this are empowerment of parents and strengthening the family for future challenges.
Much of the work in early child and family support is focused on education, learning and development in the baby or infant and this is best considered as external support for the process of growing up. This support encompasses posture, movement, communication, dexterity, cognition, self-esteem, etc. and can last through babyhood and infancy up to school entry. Much of it is the province of paediatric therapists and in many countries will require frequent regular visits to a hospital, clinic or therapy centre. These are health environments in which medical thinking dominates.
In my analysis, these environments are potentially neurotic and morbid with multiple stressors including mental disturbance, anxiety and fear. Babies and infants will surely respond to this environment as they perceive it themselves and will also pick up on whatever negative feelings their parents have about being in the medical environment.
We have to consider that for some babies and young children, hospital and clinic visits evoke the same negative feelings as many of us have in the dentist’s chair.
Parents carry the responsibility to bring up their child. This means that people who come along to help the child’s development and learning must support the parental role rather than taking over. The work then is to help parents acquire new understanding and skills so they can be the educators of their new child. This help is sensitively and respectfully offered as soon as parents ask for it – not before.
Parents and other carers who are being helped to acquire the new understanding and skills that they need to bring up their babies and infants will need a space conducive to this education/learning, just as children do. Parents whose blood pressure mounts on entering a hospital or clinic, those afraid of people in white coats, those being reminded of the trauma of their child’s health emergencies at birth or since will not have the calm mind and self-assurance necessary for learning. Much of the detail they need to quickly absorb about helping their child’s movement, communication, comprehension, etc. will be missed or soon forgotten and the session will be largely a waste of everyone’ time.
I am sure I am guilty of some generalisations and stereotyping in this analysis, but in spite of that I hope I have established a valid contrast between health service environments and education environments and built the basis of an argument that early child and family support is not well-placed in hospitals and clinics. At least, I hope I have also offered some sort of rough framework for managers, practitioners and parents to use as a tool in considering the suitability of the environment they provide, work in or visit for early child and family support.
In the third part of this serialised essay I will suggest how parents and practitioners can respond in the short-term to this issue about appropriate environments. In the fourth part I will argue that atypical or delayed development in babies and young children is an education issue and not a health issue.
Your comments are welcome.
Peter Limbrick, August 2020