AAPCH
The Australian Association of Parenting and Child Health (AAPCH) is an international organisation of key agencies in Australia and New Zealand providing early parenting education, guidance and support for professionals working with families and young children. AAPCH is committed to optimising the physical, social and emotional health, safety and wellbeing of children.
AIM
This position paper provides guidance on the importance of recognising and prioritising the emotional, social and physical needs of the baby and young child, when
delivering care in early parenting programs. Working in partnership with parent/s is a key philosophy of planning and delivering services. However, there are times when the parent/s goals and expectations are contrary to the emotional and developmental needs of the child. AAPCH strongly believes the child remains at the centre of all clinical interventions through increasing parental knowledge and understanding of child development to optimise positive child-parent relationships.
This paper uses the term child to include the baby and young child. The word parent is used whilst recognizing that it may also mean a caregiver who is not a parent. This paper aligns with the AAPCH Position Statement Responsive Parenting (AAPCH, 2018).
DEFINITION/S
Early Parenting Centres provide services to families with babies and young children from all cultures and backgrounds. Early Parenting Programmes: services are provided as educational and therapeutic group and individual programs that are both community and residential based and provided by a range of trained multidisciplinary health professional and other personnel. These programmes may be delivered as primary, secondary or tertiary services utilising a range of modalities.
Representing the baby and young child informs the practice and delivery of all programs. The child remains at the centre of all program goals, strategies and interventions. Child safety and responsive parenting are core concepts of all early parenting programs and interventions. Practitioners assess child physical, social and emotional development and recognize the importance of responsive child-parent interactions. They represent the child by reflecting with the parent, the child’s
feelings, needs and unique personality. Parent/s are supported to address their physical, social and emotional parenting challenges, enabling them to enhance their
availability to their child. Family Sensitive practice is a core component of the working relationship with families. This strength based, respectful model enables the parents to develop their own parenting skills and problem solving abilities (Center on the Developing Child at Harvard University, 2016; Day, 2013).
Whilst working with families in early parenting programs the practitioners may be faced with the following issues:
• Parents who may be unable to set realistic goals due to misunderstanding what is appropriate for their child’s age and development
• Parents implementing strategies which are rigid and are unresponsive to their child’s cues
• Parenting challenges which may impact their ability to prioritise the child’s needs
• Parents needing support to recognize their child’s cues and ability to respond to their child’s emotional needs.
• Routines which need an improved focus on responsive interactions to their child’s needs.
• Parents needing support to understand the importance of playful parent interactions
These issues may not meet the criteria for mandatory reporting, related to child abuse and neglect. However, parents who demonstrate inconsistent responses to their child’s emotional and physical cues are at risk of negatively impacting their child’s emotional development and the parent child secure attachment.
KEY PRINCIPLES FOR RESPONSIVE PARENTING
The Australasian Association of Parent and Child Health adopts the following principles to guide practitioners in representing the child’s perspective
Principle 1: Rights of the Child and being Child Aware:
Babies and toddlers are at a vulnerable stage of their life due to their physical and emotional immaturity and their total dependence on their caregivers to provide a nurturing and protective relationship and ensure a safe environment. The World Association for Infant Mental Health Position Paper on the Rights of the Infant (2016) states the following:
“An all-too-common view is that the baby is ‘too small to really understand or to remember’ and thus the baby’s perspective is often not appreciated by health professionals and even by parents. Infants have unique nonverbal ways of expressing themselves and their capacities to feel, to form close and secure relationships, and to explore the environment and learn – all of which require appropriate nurturing since they are fundamental for building a lifetime of mental and physical health”.
Many parents are struggling with their own issues and stressors. Whilst they may provide a caring and supportive environment, parental issues can adversely impact their children. Parenting stress can manifest as sadness, frustration, anger, aggression and anxiety and may inhibit their ability to respond consistently to their child’s emotional developmental needs. This may lead to abuse and/or neglect. Providing support and parenting education is critical to helping parents cope with their challenges and stressors (Lerner, 2017; Zero to Three, 2015).
Practitioners must ensure that babies and children are at the center of all decision making and care planning. Knowledge is shared to promote child safety and a nurturing family environment that encourages child emotional, physical and social development. A community approach is vital to support the parents to build their
parenting capacity and develop and enhance their parenting skills, knowledge, confidence and resilience. Many parents are socially isolated and lack practical help.
Practitioners support families to link into professional and social networks (Australian Institute Family Services, 2010; Centre for the Study of Social Policy, 2019).
The Child Aware Approach is an example of a framework which guides the development of parenting programs which are responsive to families, child centered
and include a community approach. Every child has the right to be safe, protected from neglect and abuse, and have an emotionally secure and nurturing relationship with parents. Research indicates there are more positive outcomes for families when a strength based approach is central to practice and families are empowered by being included in decision making (AIFS, 2010; Holzer, et al., 2006; WAIMH, 2016).
Principle 2: Representing the Child
The first three years are a critical time in a child’s brain development and their early experiences can enhance or diminish this process. Parents who are unaware or
unresponsive to their child’s emotional needs may have a negative impact on their child’s brain development; their child’s ability to form secure attachments; and their development of sense of self. Children who do not have their emotional cues met experience higher levels of stress hormones which negatively impact brain
architecture (Center on the Developing Child at Harvard University, 2016; Perry, 2005; Schonkoff, 2007).
Arietta Slade (2002) whilst discussing parent’s reflective capacity states “Clinicians success in helping parents attend to the baby’s cues, to follow the baby’s lead, and to respond in a contingent fashion depends on helping mother’s [Parent’s] develop the capacity to make sense of the child’s mental state. Without an emotional
understanding of the child, parenting skills are of little use”. Practitioners help parents to connect to their child by representing the child’s inner world by asking questions about what the child may be feeling and what is happening for them emotionally.
The practitioner represents the child’s feelings, needs and emotions in parenting discussions, goal setting and development of strategies. Parents are supported,
encouraged, and educated to recognize their child as an individual. Together, practitioner and parents observe the child to make sense of the child’s feelings and
actions. The practitioner may be the voice of the child by asking “wonder” questions and providing a narrative to the child’s actions. The parents’ ability to recognize and respond sensitively and consistently to their child’s cues appear to be the most influential factor in determining attachment (Lerner, 2017; Paul, 2015; Slade, 2000).
Responsive parenting practices which are warm and positive enhance the child’s emotional development and their ability to learn. Having a strong attachment
between the child and their parents is vital for the development of the child’s brain architecture and their ability to learn. Babies and children need a parent who supports their exploration and who are able to recognize their cues, respond sensitively, and provide comfort when they are distressed (AAIMH, 2017; Schonkoff, 2007; Winter, 2010; Zero to Three, 2015).
Principle 3: Family Sensitive Practice
Family Sensitive practice recognizes the importance of focusing on the strengths and resilience of families. Practice is respectful and inclusive of all cultures, religions and genders. Practitioners strive to build a professional partnership with the family to ensure goals and strategies are appropriate to their unique situation and outcomes are child centered and positive. The family partnership model is a framework which provides guidance in ways of developing relationships with families by actively listening to their story. There is acknowledgement of the challenges families face and the parent’s capacity to problem solve. Clear guidelines and boundaries must be negotiated at the beginning of programs. Practitioners develop and enhance their qualities and skills of empathy, genuineness and respect to build trusting relationships with families (Day, 2013; Moore, 2017).
The practitioner is clear when representing the best interests of the child and they develop the skills to facilitate difficult discussions when necessary. This clarity is
respectful and includes curiosity about the parents interpretation of what is happening for their child. Practitioners are solution focused and work with family
strengths. Respectful curiosity and active listening skills enable the practitioner and parents to identify underlying issues and areas in parenting practice they wish to
change. There is a sharing of knowledge and expertise and space to hear the family’s story before moving to problem solving. Goals and strategies are set in partnership and adapted to each family and are developmentally age appropriate and responsive to the child. The best interests of the child are paramount to all decision making, goals and strategies (AAIMH WA, 2015; Center on the Developing Child at Harvard University, 2016; Day, 2013; The Bouverie Centre, 2017; Winter, 2010; Zero to Three, 2015).
Moore (2017) suggests that parent’s belief system guides their parenting behaviour and that both parents and practitioners belief systems are crucial to the success of the program. The parent’s confidence and willingness to adopt change is based on their trust of the practitioner. (Day, 2013; Moore, 2017).
Principle 4-Reflective Practice
Reflective Practice Supervision is crucial to developing practitioner qualities and skills and to ensuring best practice outcomes for the child and their families. This approach encourages practitioners to explore their own feelings and actions and to reflect on the care provided to the child and their family. The reflective practice process can occur as self -reflection, individual or group reflection. Research indicates that creating a regular time and opportunity and having a mentor will enable the practitioner to critically reflect and grow their skills. This is particularly important in providing another lens or way of interpreting actions and thoughts. Reflective practice must be an emotionally safe space for practitioners to raise challenging issues, difficult conversations and explore and enhance their skills. Reflective practice is key to keeping practitioners emotionally nourished and preventing professional burn out (Gilkerson, 2011; Harvey et al., 2014).
Conclusion
In conclusion, the Australasian Association of Parenting & Child Health recognizes that representing the child is an integral core value of all parenting programs. By adopting the key principles the practitioner supports and educates parents in recognizing their child’s emotional, physical and social needs.
Programs and working practices are child aware which keeps the child central to all decision making, goals and strategies. Child safety and rights are represented in a clear and respectful manner. Adopting family sensitive practices has the best outcomes for supporting parents to meet their goals and change unhelpful parenting practices. Reflective practice supervision is an integral component of early parenting programs. It provides the opportunity for practitioners to review and reflect on the care provided to families and ensure their practice is child focused. It recognizes difficult issues that practitioners may face and ensures that they are provided with support and emotional nourishment. Reflective practice provides the parallel process of developing practitioner skills to ensure best practice and outcomes for families. It enables the development of goals and strategies to support the parent to recognize their strengths and implement parenting changes. Parents are supported to enhance and develop a secure attachment with their child.