Positive Relationships: Key person approach - Pressure points
Tuesday, June 23, 2009
Some difficulties in implementing the key person approach are pinpointed by Julian Grenier as he listens to nursery staff.
With the recent death of Elinor Goldschmied, now is perhaps a good time to focus again on one of her key achievements. In 1993, working with her co-author Sonia Jackson, she outlined a system to provide better care for babies and toddlers in nurseries, which they called the 'key person' approach.
They defined this as 'promoting a special relationship between the child, his family and a particular caregiver' through specific work practices, including the key person undertaking a home visit before the child begins, working closely with the child and parent to settle the child into the nursery, attending to intimate care routines like nappy changing and toileting, and organising a regular small gathering of the key group which they called the 'island of intimacy'.
Like most attempts to advance practice and policy, the key person approach has generated a good deal of controversy. Perhaps the strongest recent critics of the approach are Gunilla Dahlberg, Peter Moss and Alan Pence, who have urged the abandonment of 'ideas of intimacy, closeness and cosiness' in nurseries, and propose instead a 'complex and dense web or network connecting people, environments and activities'.
Some research also appears to indicate that despite increasing emphasis on the key person approach, which is now a legal requirement with the EYFS, babies and toddlers frequently do not get the sort of loving, playful and intimate care that the approach envisages.
For example, Peter Elfer, who is one of the leading exponents of the key person approach, concluded in a recent article co-authored with Katy Dearnley, a consultant child and adolescent psychotherapist, that 'even in nurseries nominally committed to the key person approach, there is a failure of implementation'.
It is also interesting to note that the research into Neighbourhood Nurseries could not identify any approaches that appeared to have anything more than a modest impact on children's social and emotional development. Strangely enough, those Neighbourhood Nurseries that achieved the highest ratings in their personal care routines had the children who were found to be the least co-operative, least sociable, and least confident.
The question of what helps practitioners to develop the key person approach, and what gets in the way, has been researched from a number of angles. But the voice of the nursery practitioners themselves has tended to be somewhat overlooked. So, earlier this year, I decided to bring together a group of six nursery practitioners from five different settings to listen to how they talked about being a key person. With such a small group, I knew I would not be able to claim that my findings could be generalised to other nurseries, but I was hoping to explore and learn about some of the issues.
In general, they talked about being a key person very much as Elinor Goldschmied and Sonia Jackson originally described the approach. They talked in great detail about providing intimate care routines for children, in ways that I often found very moving.
For example, Marcia and Julie (not their real names) talked about a toddler they were working with who settled happily when she arrived, but as the day went on became tired and distressed. As Marcia put it, 'One day I set up a bed with her own pillow from home. I said "sleep here", she said "OK" but didn't. Around 3pm she started to cry. I said "are you tired?" She said "no" but she fell asleep on my lap, though not for long.' Julie added that 'it is hard for her'. They were aware that they could not really 'meet the needs' of the child.
While the EYFS is full of videos and examples of practitioners making everything all right, real practice in nurseries is often about trying to offer 'good enough' care and accepting that sometimes a child's unhappiness can be recognised and responded to, but it cannot necessarily be solved.
I noticed the members of the group rarely talked about play as part of the role of the key person. Their emphasis was almost always on care routines, and managing difficult and upsetting incidents - which they did with great skill.
Since conducting the group discussions, I have wondered whether this way of looking at the key person role might place a great deal of stress on the individual practitioner, making her or him feel largely responsible for the child's emotional well-being in nursery.
Play can be a tremendously powerful medium in which children can work through emotional difficulties, conflicts, anger and disappointment. Yet there was no discussion of how, for example, an observation of a child's difficulties might prompt the staff team to plan or resource play in a particular way, an aspect of the key person role which is considered in Julia Manning-Morton and Maggie Thorp's Key Times for Play.
The group generally talked about the children in their care with great understanding and sympathy. But just occasionally, a rather harsh tone would take over. When I looked closely at my transcript of the discussions, I thought I could identify a pattern: when the tone became a bit harsh, it was almost always when practitioners were talking about events in the nursery that were running out of their control.
When things got difficult in this way, they appeared to respond by becoming a bit distanced and withdrawing from their closeness to the children. For example, a discussion started up about parents who stayed too long when they dropped their children off. One nursery nurse commented, 'Sometimes I feel like there's parents who want their children to cry before they leave the nursery, and then some parents get upset when they see they've got their little baby who runs to their key person and doesn't say goodbye.'
Here, the parent is only talked about as a disruption to the smooth running of the day. Later the nursery nurse said that nursery is 'kind of a big step for the parents, like your child is growing up, you're not the main person in their life any more', which suggests rivalry between the two.
Picking up the pieces
It may seem hyper-critical for me to take the words spoken and analyse them like this. That is not my intention. I was struck by the great professionalism and sensitivity of the members of the group. And it is undoubtedly very difficult when events happen like a parent seeming to linger in the room until a child gets upset. It is nursery nurses who have to pick up the pieces and manage difficult situations like this.
It is inevitable that work in nurseries will sometimes run out of the control of staff, but there did not seem to be opportunities for staff to talk over things like difficulties with parents. It seemed as if staff were often left with distressing and complex problems to solve on their own. They responded by distancing themselves somewhat, by taking on harsh attitudes: in this instance, there is no consideration of the mixed feelings a parent may have about leaving a baby in nursery.
This leads me to suggest that one of the reasons for difficulties in implementing the key person approach is that individual members of staff - the people who must, after all, implement the system - feel that they have a great responsibility for the emotional well-being of each child. But they do not seem to feel, either, that there are other ways to help children's emotional development (for example, play) which do not fall so squarely on them.
At times what the practitioners said suggested that they felt that when events run out of their control there is no-one to listen to them, support them and help to think through problems.
When staff feel under pressure, they may respond by withdrawing some of their care and taking on harsher attitudes. This undermines the whole point of the key person approach in the first place. It may explain, in part, why it is still proving so difficult to implement the key person approach more than a decade after it was first outlined.
On the other hand, the careful, loving descriptions that members of the group gave of the intimate care they offered the children illustrated just how powerful and effective the key person approach can be.
- Julian Grenier is head of Kate Greenaway Nursery School and Children's Centre in Islington, London.
- Report on neighbourhood nurseries is at www.surestart.gov.uk/_doc/P0002388.pdf
- Goldschmied, E and Jackson, S (2005) People Under Three: young children in day care. Routledge
- Elfer, P and Dearnley, K (2007) 'Nurseries and emotional well- being: Evaluating an emotionally containing model of continuing professional development', in Early Years: An International Journal of Research and Development, 27 (3).
- Dahlberg, G, Moss, P and Pence, A (2007) Beyond Quality in Early Childhood Education and Care: Languages of Evaluation. Routledge
- Manning-Morton, J and Thorp, M (2003) Key Times for Play: the first three years. Open University Press