This series of short essays is intended as an introduction to TAC or as a refresher course for everyone around babies and infants who need special support for their development and learning. The article can be translated for use in newsletters, networks and websites in any country
NINTH PRINCIPLE: Support for a new child’s development and learning is much more an education issue than a health issue. Visits to hospital and clinics are kept to a minimum. Paediatric therapy can be redefined and differently organised.
In TAC philosophy, a baby and infant’s first learning in balance, movement, dexterity, communication, cognition, social skills, vision, hearing, confidence, emotions, etc. come under the umbrella of education – which I define as the acquisition of new understanding and skills with or without teaching and instruction.
It is a hangover from the last century that much of this early learning has been thought of as a health concern and made the responsibility of paediatric therapists in hospitals and clinics. These therapists, usually highly trained in an aspect of child development, have an important contribution to make but they are not trained in the science of how babies and infants learn and, in very many cases, are not specifically trained to see the whole child.
The consequence of this historical anomaly is that new children and their parents might have months or years of regular visits to hospitals, centres and clinics for ‘therapy’. This will probably mean:
- A continual drain on family time, energy, spirit and money.
- Disruption of child’s essential daily routines with unnecessary stress and anxiety.
- Reinforcement of the medical idea of a problematic disability to be treated (if not cured).
- Loss of opportunities for inclusion in more natural baby and infant social/educational environments.
In my understanding paediatric therapists have a dual role with babies and infants: firstly, they support the acquisition of new understanding and skills (education); secondly, they offer essential medical interventions to do with drinking, eating, respiration, muscles, joints, etc. Obviously, for the second of these it might be necessary for the child to attend hospitals and clinics.
But education is best supported in the family home and then in nurseries and first schools. Surely it is a principle of inclusion that children should be with their peers as much as possible?
When a new child has a multifaceted condition, the ideal TAC will bring the understanding and skills of parents, teachers and therapists into a collective effort to support development and learning. All of these people have separate competencies that can be brought together to create collective competence in whatever new learning is being focussed on.
This TAC approach brings paediatric therapists out of their hospitals, centres and clinics to work/play with the child where they are – at home or in nursery or school. Following TAC principles, a large part of the role is to help parents acquire new understanding and skills as they bring up their child. When there is TAC agreement to reduce the number of practitioners around the child, some practitioners will act as consultants to the others and, for a period of time, reduce their direct contact.
Following TAC thinking, the term ‘paediatric therapy’, is a misnomer since these practitioners are either supporting education or providing health treatment – neither of which needs to be called ‘therapy’. In the interests of early child and family support and providing clarity for families, it would be good if a less misleading term were agreed.
Earlier this year I posted an article on Interconnections website entitled Five propositions for de-medicalizing early child and family support in a radical redesign The following is extracted from it:
‘These five propositions aim to adjust the balance between health supports and education supports in what has commonly been called early childhood intervention (ECI) for babies and young children with conditions that do or might compromise their development and learning.
- Children’s visits to hospitals and other health centres should be reduced to the absolute minimum.
- In early child and family support we think of each child as a learning child and move our mind-sets away from disability, dysfunction, etc.
- The primary task of specialist early child and family support practitioners is to educate parents and other practitioners.
- We recognise that much of what we call paediatric therapy is actually education.
- All specialist practitioners in early child and family support should be considered as a coherent group in each locality’s workforce. [With a new title for the role.]
‘While recognising the good work that happens in hospitals and health centres around the world, and acknowledging the high levels of practitioners’ caring and competence, I believe placing early child and family support in these institutions has happened by default with no conscious decision making.
‘I also believe that the work is unhelpfully flavoured now with negative medical terms about deficiencies while education terms tend to be about growth. I see a great need and great opportunities now for a radical redesign.’
[I developed this argument for de-medicalising early child and family support in a series of seven essays beginning in autumn 2020. The first one is here: Positive environments for early child and family support. Part 1: Hospitals are often neurotic environments and are therefore to be avoided ]
First TAC Principle here
Second TAC Principle here
Third TAC Principle here
Fourth TAC Principle is here
Fifth TAC Principle here
Sixth TAC Principle here
Seventh TAC Principle here
Eighth TAC Principle here
Ninth TAC Principle here
Tenth TAC Principle here