14/12/2013 by RFB
The popular choice
There has always been a societal need for childcare during the early years. Traditionally it has been provided by parents, extended family, nannies, and child-minders, based in the home or a family-like setting. However, in recent years, not only has the number of young children in non-parental care increased rapidly (in 1981 76% of 1 year olds were being cared for by a parent, in 2010 it was only 24%) but there has also been a shift in provision. Group-settings such as nurseries have become the non-family childcare of choice; the 25 largest providers in the UK offer a total of 77,219 places. They have become the social norm, and are perceived as a safe and professional option for childcare. However, group childcare settings face a critical obstacle in their ability to meet the needs of babies and children, a factor that brings their suitability as institutions for the young into question: attachment theory.
What is ‘attachment theory’?
Attachment theory was pioneered by psychologists following the Second World War, most notably in the UK through the work of John Bowlby. He was interested in how important the bond between a child and their primary caregiver (usually but not necessarily the mother) was, during the early years, in determining the long-term psychological well being of children into adulthood. Through attachment theory we can understand how developing and sustaining secure attachment from birth has life long implications for how people relate to others, their ability to show empathetic behaviour, and their own mental health and well-being.
“A secure attachment is likely to develop when an adult is sensitive and attuned to the baby’s communications, and when the adult provides consistent and predicable care which meets the needs of the baby quickly and reliably.
An insecure attachment is likely to develop when the adult is insensitive and not well attuned to the baby’s communications, and when the care is inconsistent and unpredictable and does not satisfy the baby’s needs quickly or reliably.”
– Sir Richard Bowbly, ‘Attachment, what it is, why it is important and what we can do about it to help young children acquire a secure attachment.’, European Parliament 2008.
For a secure attachment to exist, there must be a genuine mutual affection between the child and their caregiver, the caregiver must be consistently responsive, and the caregiver themself must be a consistent individual – this relationships is formed between two individuals not between the child and the setting. The pivotal period identified for secure attachment to be established and maintained is during the early years, from birth to age three to five (depending on the needs of the individual child).
Does attachment theory really matter?
The government thinks so – it has influenced NHS policies on hospital visiting regulations (particularly regarding neonatal and paediatric care), and social work practice. It has also informed the Early Years Foundations Stage guidelines which must be adhered to by all registered childcare providers, notably in the specification that childcare settings must have a ‘key person’ system in place. The intention of the ‘key person’ role is that the they form a secure secondary attachment (complimenting the primary one held between parent and child) with the young people in their care. This both preserves the quality of a child’s primary attachment, and serves to protect and meet the the child’s needs whilst in the setting.
Good practice is for people in key person roles to receive additional training in attachment theory with practical strategies that enable them to apply this understanding to their role. It is recommended that children self-select their key person based on whom they naturally warm to in order to increase the likelihood of a genuine bond developing. The key person must facilitate the child in feeling secure (within themself and the setting), and cared for whilst away from their primary care-giver (i.e. parent). For the role to be effective the relationship must be mutually affectionate and consistent.
“The KP [key person] is someone who has significance and meaning from the point of view of the child. It is the person who manages most of that child’s day to day care and who keeps the child in mind. It is the person with whom the child has a special relationship” – Peter Elfer, Principal Lecturer and Convenor, MA Early Childhood Studies – University of Roehampton, ‘Implementing the Key Person Approach’.
Even with the best of intentions, it can be extremely difficult for group childcare providers to establish and maintain secure secondary attachments in their settings. This is due to a number of factors including the following:
- The number of children in an key person’s care, the environment, and the practical demands on the nursery workers can make it extremely difficult to deliver consistent and tuned-in empathetic responses to the children in the setting.
- Many settings do not have a thorough enough grasp of the importance of attachment theory, or a deep enough understanding of what appropriate delivery would look like in practice. This means that the ‘key person’ role can be misinterpreted or not applied effectively, therefore undermining the possibility for secure attachments to be formed.
- Developing genuine bonds between children and non-related adults takes time and understanding, and adequate opportunity for this prior to and during their start at the setting is rarely provided. There is also the ongoing issue of staff absences and staff turnover, and the age related movement of children through the setting which can all have negative implications with attachments being compromised or broken.
Nurseries are businesses.
How have nurseries become seen as such a desirable option for childcare if it is so difficult for them to ensure quality secondary attachments and truly meet the needs of babies and young children? It is important to remember that the majority of group childcare settings are private businesses. Their priority is profitability, and marketing their provision to appeal to parents.
“The children’s nursery sector has grown more than the economy over the past year and its overall value is now £4.6bn, according to Laing and Buisson’s annual market report, which highlighted that nursery groups are a driving force for growth in the sector.” – ‘Nursery Chains: League Tables – the Big Picture’, Catherine Gaunt, 6th November 2013, www.nurseryworld.co.uk
We cannot necessarily depend on nursery settings to share a full and unbiased account of their service. They are not impartial, they are businesses seeking to meet and profit from consumer demand. However, in accordance with the UN Convention on the Rights of the Child, anyone working with children has a duty to understand their needs and work in their best interests, and group childcare providers are neglecting to do this if they do not implement a robust system that reflects an understanding and respect for attachment theory.
“Article 3 (Best interests of the child): The best interests of children must be the primary concern in making decisions that may affect them. All adults should do what is best for children. When adults make decisions, they should think about how their decisions will affect children.” – UNICEF Convention on the Rights of the Child
Is it possible for group childcare to ensure secure attachment?
There are proven examples where secure attachments have been achieved and maintained in a group childcare setting. Pioneering a successful approach was Emmi Pikler, a Hungarian paediatrician who developed a model for the care of babies and young children. Pikler’s model prioritises the children’s physical and mental wellbeing, by creating an optimal environment for their development and ensuring the establishment of mutually respectful and affectionate relationships with their caregivers. Her work was so successful in doing this that it enabled institutionalised orphans to experience an upbringing that could be compared in quality and future outcomes to that of an average family life. In order to achieve this, there were key principles that gave the foundation to the provision that she offered:
- The caregiver must acknowledge the child (from birth) as a free and equal human being, and as an equal partner in the relationship.
- The caregiver does things with the child, not to the child.
- Care giving moments such as nappy changes, dressing, feeding and sleeping are entered into respectfully, and are seen as opportunities for bonding not as tasks.
- Children and babies have freedom of movement so that their development can unfold in due course.
- Children and babies are cared for in groups of eight, by four adults. The children stay with each other and the same four caregivers the entire time they are at the residential nursery (which caters for 0 to 3 years old).
- Children and babies are properly supported in forming a secure attachment to their secondary caregiver.
In the Pikler model the ‘settling-in’ process is granted a minimum time scale of two weeks for each child, but is facilitated for as long as is necessary for them to establish a secure secondary attachment to their caregiver in the setting, before they remain there without their parent. It allows for a gradual and authentic development of trust between the primary caregiver (parent), secondary caregiver, and the child.
“Over this period a very very close relationship is being built between the Mother and the caregiver. In the emotional safety of this growing relationship the child “gets to learn the habits of the daycare with the Mother’s help, [and] the child’s trust can be earned, which is indispensible for him to have a good time with us.” – Dr Gabriella Püspöki (Emmi Pikler Institute), key note address at the New Zealand Childcare Association – Te Tari Puna Ora Conference, Auckland, 12th July 2009.
Adopting a Pikler approach can side-step the potential negative impact of insecure attachments that was identified by John Bowlby, enabling young children to establish healthy attachment in a childcare setting.
“Day care can be made much better all over the world if we learned from the experiment of Lóczy[the Institute led by Pikler]. At most day-care centers, children are cared for randomly, picked up by one person and fed by another. Children are cared for as objects. What the child needs is relationships with the least possible number of stable adults.” – words of Magda Gerber from ‘Respect is Key To Development’ by Joy Horowitz.
Advice for navigating childcare:
1) When considering a group childcare setting for your child make it a priority to ask them about their understanding of attachment theory and how this is reflected in their approaches to childcare provision. Areas for particular consideration are the settling in process, allocation of the key person and establishment of the relationship with the child, drop off and pick up, and caring moments such as nappy changes, feeding and sleeping. Ask if the staff have a thorough understanding of attachment theory. Be aware that nurseries are in the majority private businesses seeking to appeal to parents. Hold in the forefront of your mind that above all else the most important thing for a child’s development and well being in the early years is the responsive and empathetic care from a consistent individual with whom they share an authentic bond. This should be your guide to assess the setting.
2) Seek childcare arrangements that offer a better opportunity to form a secure secondary attachment, where the child receives consistent care from an individual in a home-type setting, such as a child-minder, family member, nanny or nanny share. These providers should also demonstrate an understanding of and appreciation for attachment theory, formally or informally.
3) Parents as primary care givers for children aged one and older has become the minority choice, however parental care gives the best opportunity for children to form long lasting, strong and healthy attachments and it should not be underestimated for its potential benefits. Parental care in the early years is the most preferable option in regards to the long-term well-being of children.
For more information:
The Origins of Attachment Theory, by Inge Bretherton, Developmental Psychology (1992):
Attachment, what it is, why it is important and what we can do about it to help young children acquire a secure attachment, by Sir Richard Bowlby, Alliance For Childhood European Network Group.
Early Years Foundation Stage (EYFS) 2012:
Implementing the Key Person Approach – Peter Elfer, Principal Lecturer and Convenor, MA Early Childhood Studies – University of Roehampton
The Pikler Collection – central resource on Pikler’s work.
Getting to Know You – Dr Gabriella Püspöki’s key note address at the New Zealand Childcare Association – Te Tari Puna Ora Conference, Auckland, 12th July 2009, transcribed by Pennie Brownlee
Interview with Emmi Pikler: ‘Respect is key to baby development’.