Growth and development

The early years are critical to the development and future health and outcomes for all children. Scotland’s key policy documents outline the importance of an early years focus and early intervention. Giving children a strong foundation in the early years enhances the key components of growth and development: communication, physical skills and coordination, learning skills, emotional attachment and resilience, and thus enables them to perform better at school, develop good social skills and grow into healthy adults.

Growth and development and inequalities from 0-3 years

The early years lay the foundations for positive physical, emotional, social and educational wellbeing throughout life.

Health and social inequalities experienced by families can affect the growth and development of children and lead to further inequalities.

There is good evidence on interventions that improve outcomes in a number of important areas.

Quick links:

What are health inequalities?

The WHO defines health inequalities as "differences in health status or in the distribution of health determinants between different population groups."

For a fuller discussion, please see Inequalities in the early years.

Policy context

Activity in this area is consistent with commitments and priorities detailed in the Early Years Framework and the National Parenting Strategy, Equally Well, Achieving our Potential, a range of NHS Scotland's Quality Indicators and is relevant to Scotland's national practice model for child-centred services - Getting it Right for Every Child (all external links).

What affects growth and development in 0-3s?

In order to grow and develop and reach their potential, children require all of their needs to be met. These needs include physical needs for nutrition, sleep, warmth, personal care and a safe, healthy environment.

Just as important are their emotional and psychological needs for comfort and attention, positive and consistent interactions with parents, stimulating play and, later, guidance and support as they begin to explore their world.

The UN Convention on the Rights of the Child asserts that:

"the child, for the full and harmonious development of his or her personality, should grow up in a family environment, in an atmosphere of happiness, love and understanding."

How do inequalities impact on growth and development?

Factors related to family experience of inequality can impact on parents' ability to meet the needs of their children and in turn are associated with an increased risk of children experiencing difficulties in social, emotional and cognitive development.

They include:

  • Socioeconomic status - socioeconomic disadvantage.
  • Income - unemployment/workless household.
  • Housing - living in social housing, a deprived area or experiencing housing difficulties.
  • Parental relationship - lone parent, unemployed lone parent, co-habiting, living with a stepfather and disagreement between parents over parenting.
  • Parenting high level of parental conflict.
  • Ethnicity - Indian, Pakistani/Bangladeshi or Black-African origin.
  • Maternal factors - depression, stress, psychopathology, alcohol consumption during pregnancy, smoking during pregnancy, living away from home prior to 17 years old.

(p32 Evidence Summary: Interventions to support parents, their infants and children in the early years (pregnancy to 5 years) (external link)).

The above factors are derived from population-level studies and are not validated for use at individual level. However, it is appropriate that those working with children take them into account when considering whether children may be at risk of delayed growth and development.

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Health-related factors affecting growth and development in 0-3s

For detailed discussions on key factors, advice for parents and those working with children, and evidence-based interventions that can help, please see the following:

Deprivation, parenting and social and emotional wellbeing

While most families living in deprivation do manage to provide caring, nurturing and stable environments for their children, there are strong links between deprivation and parental substance misuse, mental illness, neglect and domestic violence.

Growing up in such circumstances can lead to emotional and behavioural problems that can affect children's development and opportunities (NICE public health guidance 40 - Social and emotional wellbeing: early years p.18 (external link)).

For a fuller discussion of the issues, advice for parents and those working with children, and information on evidence-based interventions that can help, please see Parenting and Health Inequalities from 0-3 years.

Speech, language and communication development

The communication abilities of babies begin to develop before birth and progress rapidly in the first few months of life.

Although low socioeconomic status is associated with lower scores in assessments of cognitive development, these effects can be moderated by being read to daily at 10 months and engaging in a range of activities and events by 22 months (Growing Up in Scotland (GUS): The Impact of Children’s Early Activities on Cognitive Development (external link)).

For a fuller discussion of the impact of inequalities and key messages for parents and those working with children, please see Speech, language and communication development.

Looked-after children

The fact that looked after children may have come from abusive or neglectful situations and the experience of growing up in the care system - particularly the effect of multiple placements - mean that looked after children generally suffer poorer outcomes in terms of education and health.

This is recognised in The Education (Additional Support for Learning) (Scotland) Acts 2004 & 2009, whereby looked after children are automatically considered as having additional support needs (unless assessment proves otherwise).

There is good evidence to suggest that placement with professional foster carers and lower age at first placement improve outcomes.

For a full survey of research into effective interventions, please see Health Scotland's Evidence summary: Looked after children (external link).

Identifying those at risk

Because those at risk can be difficult to identify, it's important to link with other professionals who may know more about the family and their circumstances, e.g. Speech and Language Therapists, carers, GPs, social workers, health visitors, nursery school and other childcare staff, and voluntary sector agencies.

A range of risk factors should be considered - see the list above in How do inequalities impact on growth and development in 0-3s?

For a fuller discussion of inequalities, see Inequalities in the early years.

A Pathway of Care for Vulnerable Families (0-3) (external link) sets out key contact points and interactions for those working with vulnerable families.

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Providing information and support to parents

The 2012 Health Scotland paper Exploration of the information support needs of parents (external link), was the result of in-depth work with 132 parents from across Scotland.

It found that parents preferred 'personal, empathetic support from individuals in dealing with their specific needs for information and support on child health and parenting'.

Three overarching themes emerged:

  1. Parent information/support is undermined when parents feel marginalised
  2. ‘Trust’ shapes how information is sought, received and used
  3. Parents respond most positively to personalised information and support.

Among its recommendations, the report emphasises the need for:

  • continuing professional development for staff to enable them to present more personalised information and support
  • alternative formats, products and services that more fully take account of the needs, views and preferences of young mothers, fathers and parents with literacy issues
  • increased opportunities for face-to-face peer support and virtual social networks.

 

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Articles in this topic

Policy

Evidence

  • External Resource

    Health benefits to children from contacts with nature [180KB]

    Articles summarising literature related to outdoor and nature contact and children’s health and well-being.

    • When was this published? 11/9/2010
  • External Resource

    The connected baby

    This DVD, developed by Dr. Suzanne Zeedyk, observes and analyses the interaction between baby and parent, sibling or grandmother in a familiar domestic situation, in order to highlight the extraordinary abilities of the young baby to communicate and enter into conversation with a partner.

    • When was this published? 7/17/2012

Professional support materials

  • External Resource

    Alcohol and pregnancy

    The Foetal Alcohol Spectrum Disorders (FASD) Trust works to raise awareness of the effects of alcohol on developing children.

    • When was this published? 8/18/2010
  • External Resource

    Child Growth Foundation

    This site contains information of benefit to parents with a child who has a diagnosed or suspected growth problem, to people who have a growth problem and their families, and to people and medical professionals with an interest.

    • When was this published? 8/17/2010
  • External Resource

    Curriculum for Excellence: Active Learning [674KB]

    Active learning is learning which engages and challenges children’s thinking using real-life and imaginary situations.

    • When was this published? 9/26/2010
  • External Resource

    Development of interaction checklist: 0-12 months

    Development of interaction checklist: 0-12 months

  • External Resource

    Early years information pathway (revised 2013) [313KB]

    This document lists the publications and documents that clients may need, from application forms for benefits, to advice on pregnancy and young children.

    • When was this published? 5/29/2013
  • External Resource

    Education Scotland: Early years matters

    An electronic magazine, Early Years Matters contains information about developments education for young children.

    • When was this published? 5/22/2013
  • External Resource

    Education Scotland: outdoor learning

    Helping children towards active lifestyles and active learning.

    • When was this published? 9/17/2010
  • External Resource

    Fetal Alcohol Harm eLearning Resource

    This new elearning resource from NHS Education Scotland provides comprehensive and up to date information for professionals on the prevention, identification and management of fetal alcohol harm in a lively and interactive format.

    • When was this published? 8/7/2013
  • External Resource

    First words

    Brief guidance to use with parents to support speech and language development

  • External Resource

    Guidelines for referral to speech and language therapy (Word Document)

    Guidelines given by NHS Lothian (Microsoft Word Document)

  • External Resource

    Mindstretchers

    Based in Perthshire, Mindstretchers is an outdoor kindergarten.

    • When was this published? 9/26/2010
  • External Resource

    Play Scotland

    Play Scotland works to promote the importance of play for all children and young people, and campaigns to create increased play opportunities in the community.

    • When was this published? 9/17/2010
  • External Resource

    Play, Talk, Read website

    Information, tips and resources for introducing Play, Talk and Read to babies and young children.

    • When was this published? 5/6/2013
  • External Resource

    Royal College of Paediatrics and Child Health launches new school-age growth charts

    The RCPCH has launched new growth charts for children aged 2-18 years. The charts are designed to be more simple, accurate and relevant than previous versions. They combine data from the WHO growth standards up to age 4 and the UK 1990 growth reference from 4-18

    • When was this published? 7/17/2012
  • External Resource

    Royal National Institute of Blind People (RNIB) Scotland

    Royal National Institute of Blind People (RNIB) is the UK's leading charity offering information, support and advice to almost two million people with sight loss.

    • When was this published? 8/17/2010
  • External Resource

    Scottish Book Trust

    Bookbug reading starter packs available from the Scottish Book Trust for all children in Scotland.

    • When was this published? 9/26/2010
  • External Resource

    Strategic directions for improving the health and development of children and adolescents [584KB]

    This document summarises priority areas for WHO action towards improving the health and development of children and adolescents based on global evidence.

    • When was this published? 8/17/2010
  • External Resource

    Talk to your baby website

    Encouraging parents and carers to talk more to children from birth to three

    • When was this published? 3/17/2011
  • External Resource

    The social baby

    This DVD is available through NSPCC publications. It looks at the ways in which babies communicate, and will help parents to understand the social aspect of a baby's life. It also offers ideas to help parents manage crying, and shows how to establish routines around feeding and sleeping.

    • When was this published? 3/15/2011
  • External Resource

    Youth Sport Trust – start to play

    Youth Sport Trust is an independent charity which aims to build a brighter future for young people through PE and sport. The start to play programme provides a number of fun resources to encourage play and physical activity opportunities for young children, their parents, guardians and carers.

    • When was this published? 5/7/2013

Information for the public

  • External Resource

    AFASIC unlocking speech and language

    The Association For All Speech Impared Children (AFASIC) is a charity that works with young people who have difficulties with speech, language and communication.

    • When was this published? 8/17/2010
  • External Resource

    Alcohol and pregnancy

    The Foetal Alcohol Spectrum Disorders (FASD) Trust works to raise awareness of the effects of alcohol on developing children.

    • When was this published? 8/18/2010
  • External Resource

    Asthma UK Scotland

    Asthma UK is the charity dedicated to improving the health and well-being of the 5.4 million people in the UK whose lives are affected by asthma.

    • When was this published? 8/17/2010
  • External Resource

    Before words [266KB]

    A cartoon-based resource with the key messages for parents to support speech and language development before words. 0-12 months. Developed by Gretel McEwan, Lynn Jones & Foundrymedia

    • When was this published? 11/23/2010
  • External Resource

    BLISS

    This charity provides special care for premature and sick babies.

    • When was this published? 8/17/2010
  • External Resource

    Capability Scotland

    Capability works with disabled people of all ages and their families and carers throughout Scotland. It also campaigns for the rights of disabled people (external site).

    • When was this published? 8/17/2010
  • External Resource

    Child Growth Foundation

    This site contains information of benefit to parents with a child who has a diagnosed or suspected growth problem, to people who have a growth problem and their families, and to people and medical professionals with an interest.

    • When was this published? 8/17/2010
  • External Resource

    Contact a Family

    This UK-wide charity provides advice, information and support to the parents of disabled children.

    • When was this published? 8/17/2010
  • External Resource

    Craighalbert Centre

    The Scottish Centre for Children with Motor Imparements is a special school that caters for children with cerebral palsy and other neurological conditions. Based in Cumbernauld, it provides day care and outreach services to children across Scotland.

    • When was this published? 8/17/2010
  • External Resource

    Cystic Fibrosis (CF) Trust

    The CF trust offers information, advice and financial support to people with Cystic Fibrosis and their families.

    • When was this published? 8/17/2010
  • External Resource

    ENABLE

    ENABLE Scotland is a charity that campaigns for the rights of people with learning disabilities, as well as offering help and support to them and their families.

    • When was this published? 8/17/2010
  • External Resource

    ERIC - national charity dedicated to childhood continence problems

    ERIC is the only national charity dedicated to providing information, resources and support to children, young people & families dealing with childhood daytime wetting, bedwetting, constipation, soiling and potty training.

    • When was this published? 1/19/2011
  • External Resource

    Family Fund

    This charity helps families with severely disabled children on low incomes. It offers grants for a wide range of things, including household appliances, computers and holidays.

    • When was this published? 8/17/2010
  • External Resource

    Genetic Alliance UK

    Genetic Alliance UK seeks to improve the lives of people affected by genetic conditions by ensuring that high quality services and information are available to all who need them.

    • When was this published? 8/17/2010
  • External Resource

    Hyperactive Children’s Support Group

    This charity offers help to children that suffer from ADHD and hyperactivity, and their parents.

    • When was this published? 8/17/2010
  • External Resource

    Jennifer Trust for Spinal Muscular Atrophy (SMA)

    This charity supports people with Spinal Muscular Atrophy (SMA), and funds research into acauses and treatments.

    • When was this published? 8/17/2010
  • External Resource

    MPS Society (Society for Mucopolysaccharide Diseases)

    The MPS Society (Society for Mucopolysaccharide Diseases) is a voluntary support group which represents children and adults suffering from Mucopolysaccharide and related Lysosomal Storage Diseases including Fabry Disease, their families, carers and professionals.

    • When was this published? 8/17/2010
  • External Resource

    National Autistic Society Scotland

    This is the largest UK charity dedicated to sufferers of autism and aspergers syndrome, and their families.

    • When was this published? 8/17/2010
  • External Resource

    National deaf children’s society scotland

    This charity campaigns for education, health and family support services for deaf children.

    • When was this published? 8/17/2010
  • External Resource

    Play, Talk, Read website

    Information, tips and resources for introducing Play, Talk and Read to babies and young children.

    • When was this published? 5/6/2013
  • External Resource

    Ready Steady Baby!

    A website for the public providing information and advice through pregnancy and the baby's first days.

    • When was this published? 8/18/2010
  • External Resource

    Ready Steady Toddler!

    A website for the public with information, tips and advice for bringing up toddlers.

    • When was this published? 9/30/2010
  • External Resource

    Royal National Institute of Blind People (RNIB) Scotland

    Royal National Institute of Blind People (RNIB) is the UK's leading charity offering information, support and advice to almost two million people with sight loss.

    • When was this published? 8/17/2010
  • External Resource

    SANDS- Stillbirth and Neonatal death charity

    Sands supports anyone who has been affected by the death of a baby before, during or shortly after birth.

    • When was this published? 10/14/2013
  • External Resource

    Scottish Association for Children with Heart Disorders

    A charity that supports children and young adults with congenital heart disorders, and the families.

    • When was this published? 8/17/2010
  • External Resource

    Scottish Autism

    The Society has been supporting families in Scotland affected by autism for over 40 years.

    • When was this published? 8/17/2010
  • External Resource

    Scottish Book Trust

    Bookbug reading starter packs available from the Scottish Book Trust for all children in Scotland.

    • When was this published? 9/26/2010
  • External Resource

    Scottish Spina Bifida Association

    A Scottish charity for spina bifida, hydrocephalus and related conditions.

    • When was this published? 8/17/2010
  • External Resource

    Sleep Scotland

    Sleep Scotland supports families of children and young children with severe sleep problems.

    • When was this published? 5/7/2013
  • External Resource

    The Butterfly Trust

    The Butterfly Trust supports people with Cystic Fibrosis in Scotland.

    • When was this published? 8/17/2010
  • External Resource

    You and your baby

    A book for new parents with learning disabilities. This book is available free of charge to Early Years professionals in Scotland as an alternative to Ready Steady Baby! To order contact nhs.HealthScotland-EarlyYears@nhs.net.

    • When was this published? 2/15/2011
  • External Resource

    You and your little child

    Book for parents with learning disabilities with children aged 1 - 5 years. This book is available free of charge to Early Years professionals in Scotland from NHS Health Scotland as an alternative to Ready Steady Toddler! To order contact nhs.HealthScotland-EarlyYears@nhs.net.

    • When was this published? 2/15/2011