Katelyn Hepworth, Research and Evaluation Officer, Bernard van Leer Foundation
John Bowlby, the father of attachment theory, once said: ‘If a community values its children, it must cherish their parents.’ There is growing evidence that responsive parenting can have lifetime effects on all aspects of children’s development including their health, nutrition, learning and protection. Much of this edition of Early Childhood Matters is devoted to the potential of parenting programmes to reduce the incidence and impact of violence in young children’s lives. Exposure to violence at an early age can be extremely detrimental to a child’s development.
Responsive parenting refers to the ability of parents to meet the needs of their children mentally, emotionally and physically through the critical few years after birth, when brain development is at its peak (Engle et al., 2011). As Bowlby theorised, and as science now shows, an infant’s secure attachment to at least one responsive and emotionally stable adult lays the foundations for social and emotional skills later in life (Richter, 2004), and can protect against a range of other risk factors (Carpenter and Stacks, 2009).
However, many parents either are not aware of the need for responsiveness, or their capacity to parent responsively is compromised by poverty, lack of access to services or other socio-economic and environmental factors (Richter, 2004). The articles in this edition explore the approaches and evidence for the effectiveness of a range of programmes that have been developed to educate and support parents in becoming more responsive to their children.
Results show that the Better Parenting Programme in Jordan and the Informed Families – Healthy Generations project in Turkey both positively influenced parental behaviour and practices. Their methods, respectively, are providing parents with essential information about best parenting practices and development, and providing services including father programmes, mother programmes, child playgroups and parenting seminars, through a public centre that provides other social services.
The Israel Center for the Treatment of Psychotrauma developed the Parent’s Place programme in response to a study that concluded that the reaction of children to traumatic events was in direct relation to their mothers’ ability to regulate emotions during the same events. Through play and therapy sessions, the programme aims to mitigate the effects of political violence.
Two contributors from Brazil, YouthBuild and Terra dos Homens, demonstrate the impact of adding parenting to a broader programme agenda. The YouthBuild model originates from the USA and gives adolescents and young adults from favelas – poor urban areas often characterised by violence – the opportunity to develop skills in construction and more general life skills. Many of the participants are parents of young children.
As showcased by the human stories of two mothers who participated in their Local Roots programme, Terra dos Homens provides a range of services that holistically address the challenges faced by parents in the favelas.
Sometimes programmes to support families may have an unanticipated effect on reducing violence by improving parenting. An example is the Allin Wiñanapaq programme in Peru, which set out to improve young children’s health by improving their living conditions; an evaluation also found an impact on the prevalence of violence and child maltreatment, as it seems that better living space made parents less stressed and improved the responsiveness of their parenting.
Often, programmes that say they target parents in practice target only mothers, who typically spend more time with children and are easier to reach. An article by the Fatherhood Institute explains the importance and challenges of also reaching out to fathers, who have a significant role in reducing the risk of exposure to violence or child maltreatment.
One common problem faced by parenting programmes – whether focused on child maltreatment or not – is how to manage the transition to scale. Dave Willis, director of the US Home Visiting and Early Childhood Systems, outlines the challenges and explains the need for research and evaluation to better understand which components are most effective in which contexts.
In targeting different contexts, the original programme design might need to be modified to align with the contexts of new participants. The Madres a Madres programme is an example of one which needed to be adapted for a distinct population: Latino immigrants in the USA. The modifications may need to go beyond linguistic translation, and also take into consideration cultural differences.
Similarly, Susan Jack and Harriet MacMillan discuss the ability to replicate the US model of the Nurse–Family Partnership programme in Canada, in the face of institutional limitations. The process highlights the need to pilot programmes before taking them to scale: although the USA and Canada are very similar, the success of the programme in the USA did not guarantee that it would be equally effective for its northern neighbour. The Nurse–Family Partnership has also been piloted and evaluated in the Netherlands, where it is in the process of being taken to scale; Klaas Kooijman discusses the story so far.
One of the major obstacles in adapting programmes to diverse country settings has been that the majority of the evidence has been generated in the United States. Parenting for Lifelong Health in South Africa is an important initiative to evaluate the ability to replicate programmes coming from high-income countries in low- and middle-income countries, looking at areas such as cultural differences and cost. The objective of the work is to create a toolkit of effective parenting programmes that have been piloted in a multiple low- and middle-income countries.
The Children and Violence Evaluation Challenge Fund is also adding to the evidence base about what works in low- and middle-income countries. The fund connects NGOs with research institutions to better understand the impact of violence prevention programmes, and will disseminate the results of the evaluations to inform policies and practices in the field.
One way to tackle the issue of cost – always important, but especially so in the current global context of fiscal austerity – is to piggyback on existing services, as with the aforementioned programmes in Turkey and Brazil. The Mobile Alliance for Maternal Action is another group that has capitalised on existing networks and infrastructure, in this case telecommunications. The organisation has created text messages that provide pregnant and new mothers with important information on health and nutrition, eliminating some of the issues of access in rural areas.
With effective scale-up of successful programmes, the hope is that parenting programmes will influence national policy. Jamaica is one of the few countries to develop a public policy specifically for parents. In this article, Maureen Samms-Vaughan and Rebecca Tortello discuss the evolution of Jamaican public policy supporting parents and providing parenting programmes, including the importance of evidence to inform decision makers about what types of policies are needed. She presents the current policy and examines specific challenges for implementation.
The selection of authors and programmes included in this issue provides a panorama of responsive parenting; where programmes are currently, how they need to expand and the challenges regarding expansion, and the ultimate goal of implementing government policies that support parents.
Carpenter, G.L. and Stacks, A.M. (2009). Developmental effects of exposure to intimate partner violence in early childhood: a review of the literature. Child and Youth Services Review 31: 831–9.
Engle, P.L., Fernald, L.C., Alderman, H., Behrman, J., O’Gara, C., Yousafazi, A. et al. and the Global Child Development Steering Group. (2011). Child Development 2: Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries. Lancet 378: 1339–53.
Richter, L. (2004). The Importance of Caregiver-child Interactions for the Survival and Healthy Development of Young Children. A review. Geneva: World Health Organization.