When a child establishes a pattern of behaviour problems very early in their life, it seems that these problems will often have negative implications for all of their childhood and school life.
Over the years there has been a deepening awareness of how poverty, disadvantage and dysfunctional family background impact negatively on child development and ultimately damage life outcomes. In recognition of this, there has been a move towards more intervention, through family support and outreach services, and an increased emphasis on working in partnership with parents.
But a new report commissioned by philanthropic organisation the Sutton Trust calls into question just how effective these strategies are. The report's research, which was based on a Strengths and Difficulties Questionnnaire (SDQ), highlights how inequalities in behaviour linked to income have, in fact, widened over the past two decades.
For example, the report found that disadvantaged girls born in the early 1990s were twice as likely as their better-off peers to have behavioural problems at age seven. But this figure increased to three-and-a-half times more likely for girls born within the last ten years.
For boys there is less evidence of a widening gap in clinical levels of problems than in the average levels of symptoms, with low-income sixto seven-year-old boys nearly twice as likely to record high levels of symptoms in both the earlier and later cohorts.
The report underlines that socio-economic background is becoming a more crucial determinant. Those children who demonstrated more modest symptoms at an early age, and who were from more advantaged backgrounds, went on to improve significantly as they got older. But those without this advantage were unable to bridge the gap.
ACTIVE LEARNING IS KEY
There is, however, a danger of over-simplifying the picture, says Michael Pettaval, head of the Randolph Beresford Early Years Centre in west London.
'SDQs are not always the best way of analysing behaviour, and some of the questions that we have received in the past from clinical psychologists have not always been developmentally appropriate.'
He adds, 'SDQs can be a twodimensional way of assessing something complex, and when it comes to child behaviour there are a lot of societal factors at play which are not legitimised by government. We know that therapeutic interventions can take years to come to fruition and they are not measurable in a straightforward way. Evidence points to the fact that it is parenting, not poverty, which is most influential, and cycles of poor parenting become self-perpetuating.'
A body of research supports the idea that stressed, unhappy parents who may be verbally and physically aggressive towards their children pre-dispose them to low self-esteem, dysfunctional behaviour and social isolation. These types of parents are least likely to be responsive to their children's needs and least likely to engage with local services.
Regions where workless households have been the norm for more than two generations and where incidences of family breakdown are high represent a vicious circle of negative factors for the very young - factors which the Sutton Trust report reflects.
While the Government has flagged up its intention to return Sure Start to its original mandate of focusing on disadvantaged families, those professionals working on the frontline know just how big the challenge is.
Sally Goddard-Blythe, director of the Institute for Neuro-Physiological Psychology in Chester, emphasises that more training is needed to help practitioners understand the extent to which behaviour is the product of a child's physical, emotional, social and cognitive abilities within the context of their environment.
'Children from disadvantaged families are at greater risk of being reared in an environment with less opportunity for physical interaction with the environment, social engagement and exposure to rich language,' she says.
The Government's plans to increase the number of health visitors could make a difference, although Ms Goddard-Blythe thinks there also has to be additional training of professionals in understanding specific areas, such as why physical development and opportunity in the early years is important to support later learning.
She says, 'The impression I get is that even Sure Start professionals do not always understand the underlying mechanisms involved. While social factors are very important, frequently they are only part of the story, and physical factors also need to be addressed if long-term improvements are to be made.'
Consultant child psychotherapist Robin Balbernie agrees that properly trained and remunerated health visitors could begin to make a difference.
He says, 'There is a myth that babies and toddlers and their families only need a comparatively low level of skills (as reflected in low levels of salaries in the sector), when of course the difficulties and consequences can be so complex, and important, that the most highly trained staff are called for.'
On the subject of parenting classes, he says, 'I have little faith in them for the really vulnerable families, which I suspect will be pushed as a quick solution, and I also think the idea that you can change someone by instruction is naive.'
The Centre for Social Justice, which helps to inform the Government's social policies, points out that despite current policy's far-reaching positive implications, a 'golden thread' is missing: a recognition in the underpinning framework of the importance of relationships in every young child's development.
Robin Balbernie feels that this emphasis on relationships is entirely appropriate. 'It is not just about the importance of relationships from the very beginning, but also the importance of helping services be relationship-based organisations. It is not easy these days, with all the pressures of form-filling and procedures dreamed up largely to give managers something to monitor.'
Michael Pettaval testifies to the fact that children who are below average at entry level to his centre are able to make outstanding progress. His approach is to address the impoverishment of experience.
'If a child has never been taken to a farm or given any of these special experiences, he won't be able to write or use them as part of learning,' he says. 'It is these experiences that enable children to engage creatively with learning and apply it in a practical way. At our centre we give children that quality of experience and enable them to bridge the gap.'
A CROSS-COHORT COMPARISON OF CHILD BEHAVIOUR PROBLEMS - PRELIMINARY FINDINGS
In the wake of its report, the Sutton Trust is working in partnership with venture philanthropic organisation the Impetus Trust to provide a package of funding and support of up to £350,000 to various organisations that work with children from birth to five years.
Its projects will embrace the evidence that behaviour trends are not irreversible and that with the right interventions, there is hope for every child.
- - The report compared the prevalence of child behaviour problems in two cohorts of children (aged from three to seven) born in the early 1990s and the early 2000s.
- - Data was gathered using the Strengths and Difficulties Questionnaire (SDQ) with parents. The originators of the SDQ defined fixed scores that can be used to classify scores as normal, borderline or abnormal; the latter two categories may signal problems that require clinical intervention.
- - A common finding from both cohorts is that behaviour problems are much more common among disadvantaged children prior to the start of schooling, and these differences change little between the ages of three and seven.
- - In both cohorts, behaviour symptoms are strongly apparent by the age of three, before children start school, with the gap changing little by the age of seven.
- - There is evidence of some improvements in behaviour in the later cohorts, with the strongest improvements for more advantaged children with moderate levels of symptoms. This trend has led to a widening socioeconomic gap over the period for most children, because the prevalence of clinicallevel behaviour problems that are related to deprivation has changed less over time.
Research carried out by the University of Bristol for the Sutton Trust. Visit www.suttontrust.com.