Parenting

Good parenting and the relationship between parent and child are critical to the development and health of a child  future outcomes throughout childhood and as an adult. More specifically, bonding, attachment and attunement between parent and child from birth have critical implications throughout life for the health and wellbeing of the child and future adult.

The ability to make a relationship with a baby is not innate but is a reflection of the type of relationships the parent has experienced in the past and currently. Where the parent has had difficult childhood relationships and is now lacking good support from a partner, family or friends making a secure relationship with the baby is harder but with support, parents can learn to be nurturing and sensitive to the baby’s needs

Responsibility for encouraging, supporting and nurturing good parents falls both to the early year's workforce and to wider society. The expertise and experience of the community and voluntary sector is crucial to this area of the early year's agenda and working in partnership is essential.

Parenting and Health Inequalities from 0-3 years

The first few months of life are crucial to the development of secure and positive relationships between children and their parents.

The quality of these relationships can be affected by avoidable inequalities and in turn influence a range of health and social outcomes for both parent and child over many years. 

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 general discussion of health inequalities and the early years, 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).

Under the terms of the Disability Discrimination Act, public sector service providers must discharge their Disability Equality Duty to promote equality of opportunity for people with disabilities, including those with communication support needs or communication disabilities.

What do we mean by 'Positive Parenting'?

Parents are the primary caregivers for a child, whether birth parent, adoptive parent, foster carer or corporate carer such as in local authority care.

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."

Under the age of about eighteen months, the main focus of parenting should be on sensitive attunement and recognition of the child’s needs for nurturance and responsiveness. At about eighteen months children begin to be more active in asserting their wishes. While responsiveness and sensitive nurturance remain important, children now need support to manage their behaviour and to start to develop  emotional self-regulation

The National Parenting Strategy (external link) considers positive parenting in the following way:

"‘Loving children doesn't mean always letting them have their own way. It involves providing a positive role model, setting appropriate boundaries and applying them consistently, all of which is integral to a secure, safe and nurturing home environment. This also helps children learn what's acceptable behaviour and what's not, how to get along with people and how to resolve differences in an appropriate way - essential life skills that can all be learned by families doing basic activities such as talking and listening, eating together, doing chores together and critically, playing together.’ (p.12)

The Getting it Right for Every Child (external link) approach introduced by the Scottish Government provides a checklist parents can use to measure the wellbeing of children and which is re-iterated by the National Parenting Strategy:

  • Safe - protected from abuse, neglect or harm
  • Healthy - experiencing the highest standards of physical and mental health, and supported to make healthy safe choices
  • Achieving - receiving support and guidance in their learning, boosting their skills, confidence and self-esteem
  • Nurtured - having a nurturing and stimulating place to live and grow
  • Active - offered opportunities to take part in a wide range of activities, helping them to build a fulfilling and happy future
  • Respected - to be given a voice and involved in the decisions that affect their wellbeing
  • Responsible - taking an active role within their schools and communities
  • Included - receiving help and guidance to overcome social, educational, physicaland economic inequalities; accepted as full members of the communities in which they live and learn.
  • How do inequalities relate to parenting in 0-3s?

    A range of factors related to inequalities can impact on parents' ability to meet the needs of their children.

    These are influenced by the social, economic and political structures of a society and consequent access to resources.

    Though not to be mistaken as direct causes, a useful list of influencing factors can be found on p32, Evidence Summary: Interventions to support parents, their infants and children in the early years (pregnancy to 5 years) (external link)).

    Another aspect of parenting which can be affected by inequalities relates to the impact the quality of the home learning environment can have on speech, language and communication development.

    For a fuller discussion, please see our sections on Speech, Language and Communication Development (SL&CD) and Health Inequalities from 0-3 Years.

    Inequalities and attachment styles

    Infants and children are dependent on their parents or caregivers to take care of their basic needs, to protect them and to keep them safe. When they are tired, unwell or scared, children will seek contact with, or to be close to, the person they think will take care of them. Attachment is the term used to describe the bond from a child towards their parent or primary caregiver.

    The first few months of life are the key stage during which children develop their attachment style - secure, avoidant, ambivalent/resistant or disorganised. There are links between a child’s attachment style and their later social and emotional outcomes.

    For a secure attachment style to develop where the child feels safe, confident and supported to explore and learn about the world, caregivers must respond sensitively, appropriately and consistently to the behaviours very young children use to indicate their basic needs. Attachment behaviour that should not be ignored in very young children includes crying, grasping, smiling and clinging.

    Anything that reduces parents’ awareness of children's needs or their ability to react sensitively and consistently can make the development of secure attachment more difficult. Many of these factors can be associated with health and other inequalities.

    The 2012 Health Scotland briefing paper A Brief Guide to Attachment (external link) summarises available evidence in this area.

    It concludes: "secure attachment is associated with positive outcomes including self esteem, self confidence, resilience and emotional regulation. Disorganised attachment is a strong predictor of later relationship and emotional difficulties"

    and

    "Interventions that focus on improving sensitive responses to the child’s attachment behaviour are the most successful at promoting secure attachment."

    Please also see bonding and attachment in babies and young children.

    Promoting positive parenting for parents of 0-3s

    On a broad level, effective interventions include pre and postnatal home visiting of vulnerable children, by suitably skilled health professionals (e.g. health visitors), high quality childcare and education and enhanced specialist programmes for those identified as experiencing difficulties.

    A review of research evidence by Health Scotland, Evidence summary: Interventions to support parents, their infants and children in the early years (pregnancy to 5 years) (external link) found that the following interventions are associated with improved outcomes (parent-child interaction, secure attachment, infant behaviours, infant physical symptoms, child cognitive and social development):

    • skin-to-skin contact with infant (also known as kangaroo care)
    • information about sensory and perceptual capabilities of the infant
    • use of soft infant carriers
    • infant massage
    • media-based parenting programmes
    • group-based parenting programmes.

    Where specific problems have been identified in older children with behaviour problems, parental drug addiction or where parents have a recognised learning disability, targeted training and professional supports improve outcomes.

    When targeted at 'at risk' groups, well-resourced early childhood development programmes that include centre-based and home visiting supports improve child and longer term health and development outcomes.

    A good example of a targeted approach in current use with young mothers is the Family Nurse Partnership.

    Other examples used widely with parents are 'Triple P' (external link) and for children over three Mellow Parenting (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. Maternity services, Speech and Language Therapists, carers, GPs, social workers, health visitors, nursery school and other childcare staff, and voluntary sector agencies.

    NICE PH40 Social and emotional wellbeing - early years (external link) recommendations suggest that Early Years professionals develop trusting, non-judgemental relationships with families, which focus on the child’s needs.

    Identification of risk factors should include consideration of things which affect the parent’s capacity to provide a loving and nurturing environment e.g. mental health, family circumstances.

    Identification of risk should be part of ongoing developmental assessment and take into account emerging risk factors e.g. withdrawn or unresponsive, delayed speech or poor language skills, behavioural problems or indifferent or harsh behaviour from a parent towards a child.

    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, empathic 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.

    Many of these actions may require additional support and resources for frontline staff from management - please see advice given for service managers and commissioners.

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    Articles in this topic

    Policy

    Evidence

    Professional support materials

    • External Resource

      Alcohol Focus Scotland

      Scotland's national charity for alcohol issues.

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

      Care Coordination Network (CCNUK)

      CCNUK is a networking organisation promoting and supporting care co-ordination or key working for disabled children.

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

      Childrens workforce development council

      The Toolkit is a searchable database of parenting interventions designed to provide information and guidance for commissioners, service managers and programme developers on the quality and effectiveness of parenting programmes/approaches

      • When was this published? 8/24/2010
    • 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

      Early Years Scotland

      Early Years Scotland delivers support and guidance to providers of pre-school education and childcare services operating throughout mainland Scotland and the Islands.

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

      Fatherhood Institute

      This organisation gathers research material for professionals about fatherhood, and gives guidance on supporting new fathers.

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

      HandsOnScotland Website

      HandsOnScotland is an online resource for anybody working with or caring for children and young people. It provides practical information and techniques on how to respond helpfully to children and young people's troubling behaviour and offers advice and activities on how to help them flourish.

      • When was this published? 11/15/2010
    • External Resource

      Making gender equality real for children, young people and their fathers

      This website run by Children in Scotland supports and encourages service providers to involve fathers positively in their children's lives. It is aimed at professionals providing services for children and families.

      • When was this published? 11/8/2010
    • External Resource

      Mellow Parenting, Mellow Babies

      Mellow Parenting is a 14 week, one-day-a-week group designed to support families with relationship problems, along with their infants and young children.

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

      National Parenting Development Project: Summary Report [175KB]

      This project aimed to develop the range and quality of parent support services across Scotland.

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

      NCT (formerly The National Childbirth Trust)

      The main website for the National Childbirth Trust provides advice and resources for parents and healthcare professionals.

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

      Parenting Across Scotland

      A partnership of adult relationship organisations and children's charities working together on issues affecting parents and families in Scotland. They run parent hotlines and have a professional remit coordinating and helping to impact policy.

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

      Peep (Peers Early Education Partnership)

      Peep (Peers Early Education Partnership) is an evidenced based, universal, parenting programme for children and families aged 0-5 years. The programme focuses on building relationships and early communication skills and is also an adult learning programme.

      • When was this published? 7/7/2011
    • 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

      Scottish Childminding Association

      SCMA provides support, training and information to childminders to ensure they are confident they offer the best possible service.

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

      The Incredible Years Programme

      The Incredible Years, is an award-winning parent training, teacher training, and child social skills training approaches have been selected by the U.S. Office of Juvenile Justice and Delinquency Prevention as an "exemplary" best practice program.

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

      Vulnerable Families Pathway

      This pathway aims to strengthen support for vulnerable children and families.

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

      WithScotland

      WithScotland supports child protection policy, practice and research. It provides a range of inter-agency research, policy and practice to support professionals, groups and organisations who work in child care and protection.

      • When was this published? 5/27/2013

    Information for the public

    • External Resource

      A guide for gay dads

      The guide has taliored information for gay men who wish to become parents. It contains information on adoption, fostering, surrogacy, sperm donation and parenting.

      • When was this published? 2/16/2011
    • 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

      Allergy UK

      A leading national charity dedicated to supporting the estimated 21 million allergy sufferers in the UK. Providing a dedicated helpline, support network and online forum for those with allergy and intolerance.

      • When was this published? 8/8/2014
    • 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

      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

      Care Coordination Network (CCNUK)

      CCNUK is a networking organisation promoting and supporting care co-ordination or key working for disabled children.

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

      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

      Doula UK

      The association of Doulas (an experienced woman who offers emotional and practical support to a woman (or couple) before, during and after childbirth) in the UK. Member areas for Doula professionals and advice for famlies on how to find a doula can be found here.

      • 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

      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

      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

      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

      NCT (formerly The National Childbirth Trust)

      The main website for the National Childbirth Trust provides advice and resources for parents and healthcare professionals.

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

      One Parent Families Scotland

      Being a lone parent can be a complicated business. This organisation provides a range of factsheets covering many of the issues faced by single parents. Individual copies are free to all.

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

      Parenting Across Scotland

      A partnership of adult relationship organisations and children's charities working together on issues affecting parents and families in Scotland. They run parent hotlines and have a professional remit coordinating and helping to impact policy.

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

      Parentline Scotland

      Parentline is a confidential helpline, email and web chat service for anyone caring for or concerned about a child.

      • 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

      Pregnant pause

      A guide for lesbians on how to get pregnant. This guide has been specifically tailored to the needs of lesbian women. It contains information on conception, looking after yourself during pregnancy, antenatal health care, giving birth, parental rights and responsibilties, looking after a new born

      • When was this published? 2/16/2011
    • 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

      Relationships Scotland

      Relationship counselling, family mediation, child contact centres and other forms of family support across mainland and island Scotland.

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

      Scottish Adoption Association

      This charity prepares, assesses and supports prospective adoptive parents who live within a 60 mile radius of its office in Leith (Edinburgh area).

      • When was this published? 8/17/2010
    • 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 Refugee Council

      An independent charity providing advice and information to people seeking asylum and refugees living in Scotland.

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

      Single parent families - Q&A fact sheets [857KB]

      Fact sheets providing information for single parent families on a range of subjects including money, childcare, education and employment.

      • When was this published? 5/27/2013
    • 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

      Take life on website

      This website contains handy tips to help you improve your health and wellbeing

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