Support from the Start phase 2

Equally Well test sites are due to come to an end in March 2012 – East Lothian has been looking at the lessons from the test site as part of a review of early years services commisssioned by the Support from the Start planning Board. The following represents the current thinking in that review of how the lessons from the test site can be developed in the coming years. The ideas in the following paper will be disccussed and developed further at a conference on the 7th Feburary.


East Lothian Council Champions Early Years

A launch pad for the second phase of Support from the Start

1. The Case for Early Years

We know that getting it right for children and young people, families and carers, from the start, ensures that young children are healthy, happy and ready to succeed in life. To a very large extent, children’s life chances, depend on the quality of experience they have in their first years; the secure and reliable attachments they have with parents and other adults important to them; the relationships they build with other children and within their families and communities; the quality of care they are given by parents and other carers; the richness of the learning opportunities they have; and the support and services which children, parents, families and carers can rely on.

East Lothian Council and its partners in health, the voluntary, third and private sectors have done much in recent years in this area. A key development has been the Support from the Start test site which has been running in some areas of the county. Learning from the outcome of the test site will be used to launch an engagement and partnership approach across the county, for the benefit of all East Lothian’s children.

The main aim is to ensure that East Lothian’s children all get the best possible start in life.

To achieve this we will:

· Promote awareness of the importance of early years for everyone in the county

· Engage with parents, young people and partners to take local action to improve the lives of young children and families

· Raise the profile of East Lothian as a national and international example of a place where people work together to give all young children the best possible start in life

· Create an approach free from jargon and unnecessary red tape which is firmly rooted in our communities

· Do things which fit in well with other council and partner priorities and ways of working

· Be open to and share information about imaginative sources of funding, help and learning about what works

· Work with partners to help local people reach their own solutions


2. Engagement with Local People is Key

We will, with our partners, engage with parents, carers, young people, and other people in the county to find out how they think the quality of life of young children and their families can be improved and work with them over the coming years to take action for improvement. We will engage with them to find ways of working together and supporting each other to ensure all young children:

· Have positive parenting and experience good attachments at an early stage

· Are ready to learn and achieve

· Can access quality child care experiences

· Are healthy & happy

· Are not living in poverty

· Have a good opportunity for play, and

· Are protected from harm

3. Cluster Based Engagement

3.1 To achieve this level of engagement we will establish Support from the Start Link-up groups in each cluster area (East Lothian’s school cluster model). These groups will have close relationships with and be linked to local community planning structures where these exist. Each Link-up group will comprise of, champions from a range of services and organisations from all sectors as well as, parents and carers, and others having an interest in the early years. The Link-up groups should be empowered to engage with any relevant Council or Health department.

3.2 In keeping with the lessons from the evaluation of Support from the Start, Council and Health colleagues on Link-up groups should be regarded as Early Years “Service Champions” who should think and act imaginatively and nimbly to assist local parents and communities to improve the quality of life of young children and their families. Council and Health staff serving in Link-up groups should be given time to devote to this work.

3.3 The link up groups will be supported with administrative time and Public Health Practitioners employed by the NHS will help to establish, facilitate and coordinate the work of each Link-up group. A key role will be to ensure that all parents and carers, especially those who do not have positive experiences of working in groups like these, have a voice.

3.4 In keeping with one of the main messages from “Joining the Dots” there should be a “bias for action” and reporting and scrutiny should be kept to a minimum. The Public Health Practitioners would, however, be expected to ensure that any public monies spent by Link-up groups are properly accounted for. In the establishment phase development funds would remains with the Education and Children’s Services department and be administered by the Public Health Practitioner (s), but this may change to more local arrangement as the groups develop.

3.5 Each cluster based Link-up group will be provided with detailed information on their local area, including population trends and service availability and accessibility. This will be provided by Council and Health information analysis working together. Information would be updated on an annual basis. Updates will include data from the use of the Early Development Instrument (EDI) which will help provide an evidence base for early year’s community development. This data from EDI will be available next year but the establishments of Link-up groups should not wait until this is available. Link up groups should also gather and evaluate information about their own areas.

3.6 Link-up groups will be empowered to discuss how services are currently delivered and to engage with service managers to secure change and innovation to better meet local need where change is required. This is not a “one size fits all” approach. Rather it is an approach which will help tailor services to meet the discrete needs of different communities. There will be challenges made to the current way of doing things in some link-up group areas and service managers and staff will need to be responsive to these challenges.

3.7 To be fully effective, each Link-up group will have access to funding which they can deploy to develop new initiatives in their area, or to adjust or build upon existing provision to achieve the objectives set out in sections one and two above. Link-up groups will be encouraged to secure matching funding from a variety of sources.

4. Governance

Link up groups are accountable directly to the Support from the Start Planning Board and their local community through the locality community planning structures. The chair of each link up group would have a seat at the Support from the Start Planning Board. Each link up group would operate within terms of reference set by the Planning Board but would adopt its own ground rules and procedures. The terms of reference would include ensuring that appropriate representation and reporting is established at ommunity/neighbourhood planning groups where these exist.

Each group would have a “simple rules” process for local champions to access the development fund. During the development phase link up groups will report through the Support from the Start engagement officer to the head of childrens services and the Support from the Start Planning Board. The budget for each group would ibe held by the had of chidlrens services and managed by the public health practitioners who would provide reports to the Support from the Start Planning Board. Arrangements for locally held budgets will be developed in accordance with local need and require approval by the Planning Board.

5. Timescale

5.1 The Public Health Practitioners will seek to establish Link-up groups in each cluster from autumn of 2011. While each group will have their own distinct character and priorities, and while each will develop at a varying pace, learning between each will be important and encouraged.

5.2 A county wide conference will take place in February 2012. This conference will be the formal launch pad for the second phase of Support from the Start, it will bring together the range of parents and partners engaged in each of the Link-up groups, Early Years Champions and elected members. The minister for Children and Early Years, national or international experts in the field will be invited to address the conference.


Ronnie Hill

Head of Children’s Services October 2011


Parenting and health inequality

Attended a 1/2 day conference held by the Growing Up in Scotland team earlier this week. The session was led off by the new early years minister Angela Constance and one phrase in her speech caught my attention in particular.

As parents its what we do, not who we are, that is most important.

By which I think she meant that parents who are facing adversity in the form of poverty or poor health can do as good a job as parents who aren’t facing the same adversity. I think we all know that to be true, or at least we want it to be true.

However, it is also true that many parents do become overwhelmed by the adversity they face in bringing up children. Talking to some head teachers in the last week or so has highlighted this for me. In the run up to the summer holidays many parents and children face the summer holidays not with a sense of joy and opportunity, but with with a sense of foreboding -‘how am I going to cope without the structure that school and nursery provides’. For many children this fear is expressed in terms of their behaviour in school, and for the child protection system I suspect it is reflected in the number of Initial Referral Discussions that take place in the run up to the summer holidays. ( I would guess that the economic climate is making the summer holiday period even harder for some parents this year?)

Services are responding with partnership approaches to supporting families over the summer period. In Midlothian Equally well champions are using their development fund to support a project called ‘Play in the Park’ which has been developed in the Woodburn community over a number of years, and will extend it to the neighbouring community in Mayfield, they are also exploring ways of further supporting transition from nursery to P1.  In East Lothian champions are currently discussing whether to support for  a second year a Summer transition programme supporting parents of children who are moving from nursery to P1 who need some additional support

Talking about parenting skills always makes me a bit twitchy, partly because even if nobody is else is making judgements about me as a parent I cant’ help making judgement about myself. For the same reason I have never felt completely comfortable with parenting courses / programmes which are the focus of many parenting strategies. More fundamentally than doubts about my own performance I also wonder whether parenting programmes over emphasise the individual parent behaviours rather than the wider family and community support that is fundamental to good parenting. It is easier to be consistent with rules, be positive and affirmative and to have a good attachment or connection with your child / children if you feel supported as a parent and can access a network of practical and emotional resources. Angela Constance also spoke about the development of a national parenting strategy for Scotland which was a manifesto commitment for the SNP. I for one hope that it is as strategy for family support as much as a strategy for developing parenting skills.

The GUS team have made a particular study of parenting skills and their relationship with health and a presentation on the findings is linked here There is also an audio file of the presentation from Dr Alison Parkes on the GUS website. The slides are quite complex so the audio file is well worth listening to.


What have we been doing & where have we been?

The link below will take you to a document that attempts to describe what has been happening as a result of the Equally Well test site in East Lothian and the rationale behind that activity. It is a report to the National Programme for Equally Well on the two years in which the test site has been in operation.

The report is not an evaluation of Support from the Start,  it simply seeks to tell the story of what we have been doing and why.

I will, however,  shortly be able to post the outcome of an evaluation of Support from the Start in East Lothian, which was taken forward by a Queen Margaret University. The evaluation was delivered using an innovative approach that develops a local partnership linked to academic support to make sure that evaluation is both relevant and rigorous. Two East Lothian practitioners – John Boyce and Ann Hume – were seconded part time to the university to work with a ‘firefly’ team led by Professor Kirsty Forsyth. They carried out a number of focus groups with parents that had been involved in  champion led developments and initiatives, as well as completing a survey of champions. The output from the evaluation includes a resource for practitioners and planners who might want to use some of the approach and ideas that have been used in the test site. The resource is called healthy, Happy Bairns from a comment made by one  of the parents involved in the focus groups. Watch this space

Test site report to Scottish government National Programme for Equally Well

Baby Brain Map

Morag Nicholson – senior health promotion specialist and service champion recently brought this web resource to my attention.

It is an interesting interactive baby brain map site

Is this the kind of thing that  could be promoted to parents in Scotland?

As a 49 year old who considers himself reasonably computer/ Internet  literate, I am still very aware of a gulf between my generation and  younger generations of  people who are growing up immersed in a web based information culture. 

I belong to that generation who wear wrist watches even though such single use devices are now completely outmoded. The mobile phone is the new generations wrist watch, just as I automatically put my wrist watch on in the morning my sons turn their mobiles on. In fact its their mobiles that wake them up with their alarm functions.

During some engagement work with parents in Midlothian I asked parents of nursery aged children where they would go for advice and help – the Internet was a very common response.

Champions development fund

Service & Community champions are a key part of Support from the Start, they are people with an interest in health, equality and the early years from across a wide range of services.

Champions have access to shared learning (action learning) and a small peer reviewed development fund. Many exciting project have been taken forward by the champions using this fund – but this by no means represents the total of initiatives that champions have taken forward only those for which they have used development funds. A link to a monitoring rport for the fund over the financial year 2010 – 2011 is below –

Summary 2010 2011 (4)

Chief Medical Officer meets East Lothian Children’s Services staff

As part of our agenda of looking at how we can improve outcomes for our most vulnerable children, Children’s Services staff in East Lothian council asked Dr Burns to speak to us about the role of Attachment in Early years and the impact it has on health and outcomes in later life.

 It was very inspiring talk. Many of us in Children’s Services are very aware of how important attachment is. The key messages and learning for us were:

 ·         The physiological consequences of poor attachment in relation to brain development and good physical health in adulthood.

 ·         As service providers we need to be aware of the danger of making people passive recipients of services rather than being actively engaged.

           This increases their sense of hopelessness and being out of control   

 A summary of the talk follows below helpfully provided by Vivien McVie (Policy and Planning Officer) Children’s Services. Dr Burns presentation is linked at the bottom of the post

 Hopelessness and Life expectancy:

Studies have compared life expectancy in Liverpool, Manchester and Glasgow: there is 60 % excess morbidity in Glasgow – predominantly in four areas: drug-related, alcohol-related, suicide, violence

Susan Everson did a study of men in 1997 which found a connection between increased risks of dying from heart disease (x4) and hopelessness. The reason for this was that the group of men who felt hopeless had laid down more fat in the carotid artery than the others. Thickening of the carotid artery causes blockages in the artery and leads to stroke and death.  For a brief summary of the study see:

What causes the fat to be deposited in the artery?

Hopelessness is stressful. Stress produces cortisol – used for fight or flight reactions. Cortisol causes abdominal fat to be mobilised for use as energy (for use in fight or flight) so when it breaks away, it can end up lining your arteries if it does not get used up ( running).

Hopelessness may not be acutely stressful but causes ongoing stress – people have been observed to have consistently higher levels of cortisol over the long-term.   Only a slight rise can produce damage over the long-term.

 A study on re resilience

 A study of Jews surviving concentration camps (Aaron Antonovsky) found that while 70 % had the expected poor consequences for health and mental wellbeing, there were 30% who had survived the experience very well. Before their experience in the camps started, these resilient 30% had already developed a sense of coherence in their view of the world, which they had experienced as structured, predictable and explicable, and also had the inner resources to deal with what came next.   They felt they could meet things head on and try to purposefully deal with what happened each day – i.e. a sense of self-efficacy, even in such circumstances:

“a  feeling that … these demands are seen as challenges, worthy of investment and engagement.”

 Causes / Consequences of stress:

 People need to experience the world as understandable, manageable and meaningful, or they will experience chronic stress. Tests in Canada showed that the longer a child remained in residential care (“orphanages”) the higher their levels of cortisol were at the end of each day. Tests of adults have shown a link between lack of control in their working lives and higher cortisol levels.

Dr Burns observed in his own working life as a surgeon that people who are manual workers do not heal as fast from wounds, i.e. not the usual 10 days but 12 days to recover from abdominal surgery.  This is because these people are not as much in control of their working environment as their bosses and so experience more stress. Another consequence of the resultant higher levels of cortisol is an inflammatory response, slowing down healing and this inflammatory response also leads to heart attack and stroke.

The inflammatory response from stress is compounded if you smoke, and are overweight – if you have all three it is x8 worse.

Inflammation in the arteries causes clots to happen, arteries get ruptured  – heart attack follows.

 Attachment : Causes/ consequences of stress in children:

 Inconsistency in parenting is the most stressful for children (more than consistently abusive/neglectful parenting).

Brains of children who have disordered attachment are affected in three parts with a fourth under discovery:

1)     The part of the brain that deals with judgment and decision-making is affected

2)    Short-term/working memory is affected

3)    Aggression, fear and anxiety are all heightened

When fight or flight dominates, there is no room left for learning or any other type of executive functioning.

Domestic abuse can be experienced in utero and it blocks development of certain parts of the baby’s brain because the baby is stressed and is producing higher levels of cortisol – this affects the genes and so they can pass these defective genes on to their own child. 

 Further consequences – self-control is inhibited so this affects likelihood of committing crime, getting involved in drug-abuse, earning a steady income. Reaction times are slightly dulled so road traffic accidents are more likely.

 Supplied byVivien McVie  April 2011

Dr Burns presentation

Harry Burns Presentation 8 March 2011

‘Music and Me’

 ‘Music and Me’, a resource for Nursery staff, is the product of a process that began almost eighteen months ago in Preston Lodge High School. There, as part of a wider conference about ‘Learning, Emotions and Well Being’, Dave Trouton, a talented musician and composer, led a workshop presentation about using music to help develop emotional literacy in a teenage group. At about this time, too, the scoping of an ‘outcome pathway’ for readiness to learn in young children was being developed as part of the planning for ‘Support from the Start’. This process recognised that there was scope for further development of the role of music and rhythm to support language development in the early years. Sheila Laing, HT of Campie Primary School, and Education Department service champion for ‘Support from the Start’, then developed a proposal to pilot work in this area in a nursery setting and, if possible, develop a resource that could be used by all nursery staff, irrespective of their own perceived musical ability.

Many months later, a successful pilot of ‘Music and Me’ has been completed in the nursery classes of Wallyford and Whitecraig Primary Schools, and a second stage pilot in Campie and St. Martin’s nursery classes will start soon. Two key outcomes for ‘Support from the Start’ – improving readiness to learn (aspects such as active listening, concentration, turn taking), and improving emotional well being (for example developing self expression and emotional literacy) are addressed in the resource, as well as skills such as carrying out instructions, turn-taking and co-operation and collaboration. CPD in how to use the resource will be offered to nursery staff in all East Lothian primary schools early next session, alongside a roll-out to all primary schools. The resource has tried to address, among other things, real concerns on the part of the nursery children. Anxietyabout using the dinner hall, queuing, making choices, etc., when they moved up to P1 has been addressed through pupil involvement in a ‘Sound Story’ within the resource, and ‘Grandad Turnip’s Story’ helps children to discuss not only why it’s ok to feel sad sometimes, but also the importance of telling someone about it.


Discussion and active listening play a big part in the lessons. Feedback from the initial pilot has been very positive, not just from staff. ‘Is the music man coming back in?’ asked one pre-school pupil, just a few weeks ago.

Final word must go to Pat Holden, Principal Teacher of Primary Music Specialists, who, while delighted to have been involved in the production of this very practical resource that can be accessed by all nursery staff without requiring any specific musical skills, adds that he sincerely hopes ‘that this is aresource that will be well used and not just sit on a table in the music corner!’

Written by Mary Howie

The following link has a short vdeo of a Music & Me seesion with a voiceover commentary by at Pat Holden

Joining the Dots …

 Joining the Dots – A better start for Scotland’s children


?Susan Deacon’s report to the Scottish Government is now available online at :-

??Just finished reading the report.

In reflecting on how I might introduce the report, and my reaction to it,  for this post; I decided that I could draw on the learning of the amazing authors in P2P at Sanderson’s Wynd.  The children (who have published an e-book on Amazon) have been finding interesting words, including ‘wow’ words, as part of their literacy work.  Here are my wow words for Susan’s report:-





but definitely not  pallid

Sanderson’s Wynd and Whitecraig Primary have pride of place on the front cover of the report with their great outdoor activity and learning photo’s


Steven Wray


Dadswork the East Lothian charity dedicated to supporting the needs of  Dads as parents has been involved in the development of a national organisation of ‘Fathers’ organisations

Organisations and individual can sign up at this link

The role of Dads  has been receiving a higher profile lately.

I am part way through reading Carol Craig’s book ‘The tears that made the Clyde’,  which makes a powerful case for how Scottish male culture impacts on health and social outcomes in Scotland. She argues that this macho male culture  developed partly as a result of men abandoning family life because of desperately poor housing and overcrowding during the industrialisation of Scotland. She goes on to argue that many of the social ills which have proved so resistant to change in Scotland are fed and nurtured by that culture.

 Similar arguments abut male culture and the need to change it are made by supporters of the white ribbon campaign in relation to Domestic Violence –  that it is a problem all men need to own if it is going to change.

At a presentation I attended this morning on ‘attachment theory & practise’ by an Educational Psychologist and researcher –  Penny Rackett,  the importance of dads in supporting children to have secure attachments in early life was stressed. She reported on studies which showed that Dads who felt that their contribution to rearing children had been valued were also the dads that were most attuned to the communication of their babies / children. So involving Dads is important.

Although most children still live in a home with two adults, it seems from statistics that increasing numbers of  Scottish women are raising children without the involvement of a ‘live in father’.  It also seems that lone parenting is a more prevalent experience for Scottish women than other European women. Why is that happening and what does it say about Scottish men and their attitudes to family life? Are men not coping with the kind of  stress involved in raising children and choosing to escape from it. Do men feel that they don’t have any real role in raising children now that their traditional role of breadwinner has faded? What is the role of a father in Scottish culture?

Big questions – and ones that  need to be part of a national discussion and debate. Perhaps what Dadswork have helped to start will be the start of a discussion between fathers of what it means to be a father in 21st century Scotland and how that role can be supported and valued.

Changing culture is very difficult – and I am sure can only start when lots of people ask the similiar question and talk to each other about the implications of those questions.

I am a father – its a role for which I had no preperation  beyond my own experience of parenting. Prior to becoming a parent I don’t think I ever discuseed what a dad is meant to do with anybody. For our first child I did attend the ante natal classes that were on offer, but like many men felt like a spare part. It may well have changed now but twenty years ago it was all about the mechanics of birth – lots of heavy breathing and discussion of pain control options.

I don’t recall my father ever talking to me about what it meant to be a dad. However, I have no doubt that his parenting style has heavily influenced me (for good and bad) because I occasionally catch myself saying things that make me think, ‘God I sound like my old man’.  In writing this I have asked myself the question – Do I know how to talk to my own sons about what it means to be a father? The answer is probably no,  at least not in any coherent way.  Having asked the question I am going to think about it – because I have a sense that Dads are important and that men ought to value  and celebrate the role of father.  In fact I am going to do more than think about it I am going to talk about it, with my wife! Well,  perhaps I will try talking to some of my male friends who are fathers. They may well think I have lost the plot but it will make a change from fishing and shooting. And who knows if enough Dads in Scotland talk to each other about what it means to be a Dad and how you can be good enough at it, maybe the next generation of Dads will have a better steer than the last.

Steven Wray

‘Are We Securely Attached’

Early Years Conference ‘Are We Securely Attached’

March 17th  2011 Queen Margaret University, Edinburgh

 The Early Years and Childcare Team are once again organising an Early Years Conference which aims to raise awareness of the critical importance of Early Years development in improving children’s life chances

 Speakers at the conference are:

Robin Balbernie is currently Consultant Child and Adolescent Psychotherapist in Gloucestershire CAMHS. He works with the Children’s Centres in Cheltenham, Gloucester and the Forest of Dean as lead of the Secure Start team, providing an infant mental health service. He has a special interest in early interventions, originally arising from his work with adopted children, and is on the Committee of the Association of Infant Mental Health (UK) and is also a member of the Young Minds’ Policy and Strategy Advisory Group.”

 Suzanne Zeedyk is currently Senior Lecturer in Developmental Psychology at Dundee University. Suzanne’s work focuses on parent-infant relationships. She works closely with organisations such as the Scottish Violence Reduction Unit, HomeStart, Kids Taskforce and a number of city councils. Her key aim is to increase awareness of the extent to which, when making decisions about the care we give to children. We are also making decisions about the kind of society we wish to build.

 The day will be facilitated by Susan Deacon who was MSP for Edinburgh East and Musselburgh from 1999 to 2007 and Scotland’s first cabinet minister for Health and Community Care.  She holds a range of advisor and non executive roles with organisations in the private, public and third sectors.  She has been a consistent advocate for the importance of children’s early years.

 Who should attend?  Anyone working with young children and their families, or who has responsibility for strategic planning for Early Years services

 The Programme and Booking Form are available from Pauline Evans 01620 827141 or  from this link below –