Children: Parenting for Success in School

Baroness Verma Excerpts

Thursday 3rd February 2011 Lords Chamber

[Baroness Hollins]

My Lords, it is a real pleasure to be able to welcome the noble Lord, Lord Ahmad of Wimbledon, and to congratulate him on his maiden speech. I want to mention that we share not just Wimbledon in our title but a great love for Wimbledon and Merton, where he is very well known. The noble Lord has already had a stellar career in the financial sector and is an expert in marketing, but we have also heard about his contributions to the voluntary sector. He has also made a huge contribution to local government. I know too that the noble Lord has a lot of international connections and I look forward to getting to know him and seeing something of his youthful energy applied to the work of this House in the future.

I am grateful to my noble friend Lord Northbourne for introducing this debate. The topic is close to my heart as I originally trained as a child psychiatrist. My daughter is also a consultant psychiatrist and psychotherapist working in the field of perinatal mental health and infant development. I am going to focus on the role of specialist mental health services in enabling vulnerable parents to be successful in preparing their children for school.

Graham Allen’s report brings something to our attention that I am particularly pleased about. On page 40 he mentions the impact that unresolved trauma in youth can have on later parenting. He also draws attention to the importance of early intervention in leading to permanent improvements in a child’s health and developmental outcomes, but he stresses that this must happen in the first months and years of life, and even during pregnancy.

Research has increased our understanding of the importance of early experience for later child health and development. The evidence is strong. The emotional and physical environment and relationships during pregnancy and infancy are crucially important in enabling a child to be successful in school and in later life. This applies equally to children with learning disabilities, whose parents must also come to terms with their disability.

The evidence tells us that the first relationships in life are central to healthy development. Professor Schore, from UCLA, says that,

“the child’s first relationship, the one with the mother, acts as a template, as it permanently molds the individual’s capacities to enter all later emotional relationships”.

This profound statement has been understood within the psychoanalytic and psychotherapeutic traditions for decades, but now this has been recognised on a neurobiological level. He explains that the architecture of the growing baby’s brain will reflect the quality of the relationships that it has adapted to. The circuits formed during these early years, when the brain is most plastic, may last a lifetime. A baby needs a mother who can help him by responding sensitively to his distress, so the baby feels understood and can begin to manage his own physical and emotional experiences, both now and in later life. This is the foundation of communication, and when communication is absent the health of this emotional attachment needs attention.

Margot Waddell’s book Inside Lives: Psychoanalysis and the Growth of the Personality gives some excellent examples—which I do not have time to share with your Lordships now—which show well how a parent helps a small child to develop a capacity for learning by helping to manage their emotional experiences. Waddell explains:

“Something happened … which enabled the child to feel understood … Inseparable from this, no doubt, is an experience of being loved and of loving, and the deepening expectation of similar feelings to, and from, others”.

Without a stable early emotional development, children will be less able to form relationships and communicate with others, to learn or to take advantage of their school experiences. The early relationship with mother impacts on peer relationships at nursery and at school, and this can further affect the child’s ability to enjoy school and to be able to share in and learn from group activities.

So what early intervention programmes or treatments can help those who are struggling? An effective intervention recommended in Graham Allen’s report is the family nurse partnership. This programme was developed in the United States over 30 years ago but it has also had impressive results here in the United Kingdom—for example, by improving educational achievement and parenting practices, and by reducing child abuse and crime.

However, some women need more specialised mental health interventions to improve outcomes for their children and will not be able to respond to social or community-level interventions alone. Serious problems can affect women of all ages, cultures and socio-economic groups—for example, parents who themselves have experienced abuse and neglect are more likely to need health-led interventions—and there are other special cases.

Research is clear that mental health problems such as depression, psychosis and anxiety during pregnancy not only carry significant risks for mother and baby but can have long-lasting effects on cognitive, emotional and behavioural development. The complexity of attachment difficulties can be better understood by carrying out psychiatric and psychotherapeutic assessments. Health-led interventions are needed to address these complex and painful situations.

Perinatal and parent-infant psychotherapy can treat distressing experiences such as depression, anxiety and terror by understanding the cause of the difficulties and by focusing on improving the relationship between mother and baby from pregnancy onwards.

Tertiary centres such as the Cassel Hospital are also needed. Sadly, the future of the Cassel is under question. I hope the Minister will recognise the importance of providing specialist mental health services for mothers and their infants rather than waiting for child psychiatry services to intervene at a later stage when problems have already become established.

[Baroness Verma]

I remind noble Lords that this is a timed debate and that they have five minutes.