2. KEY CHANGE WORKSHOP ATTACHMENT Early Years Collaborative: Learning Session 4

3. WORKSHOP OBJECTIVES Build a common understanding of the operational definition of this key change area. Present emerging learning in this key change area, including both evidence base and new learning that will advance our knowledge in this area. Introduce concept and opportunity of a “Pioneer Site” Discuss current or potential work within your CPP in this area and generate themes across CPPs. Brainstorm change ideas to bring for discussion with your CPP colleagues during the end of day CPP Planning Session. Have fun!

4. SOME IMPORTANT NOTES All feedback will be gathered after the session by the Early Years Collaborative team and made available on the Extranet. Our discussions today are about learning, not about performance, so sharing your challenges and failures can be just as important as sharing your wins and successes.

5. MEETING NORMS REFRESH Suspend judgment as best you can. Respect one another. Seek to understand rather than persuade. Invite and honour diverse opinions. Speak what has personal heart and meaning. Go for honesty without going on and on and on.

6. KEY CHANGE WORKSHOP – ATTACHMENT Early Years Collaborative: Learning Session 4 Elizabeth N King Principal Psychologist South Lanarkshire Council Dr Helen Minnis Senior Lecturer in Child and Adolescent Psychiatry University of Glasgow Shirley Paterson Depute Principal Psychologist South Lanarkshire Council

7. OPERATIONAL DEFINITION We are all born with attachment seeking behaviours such as crying, clinging, imitation and smiling. These behaviours are designed to keep carers close ensuring that the baby’s needs for survival, safety and sensitive care are met. Attachment is a process. When a baby needs something – food, comfort, play – he feels stressed and signals his discomfort through, for example, crying, seeking to have his needs met. Parents/carers ‘tune in’ (attune) to their baby’s unique cries and signals for different needs. This ongoing attachment process, in the first few years of life, is crucial in shaping how we grow and develop through childhood and into adulthood – neurologically, physically, emotionally, socially and psychologically.

8. REVIEW OF EMERGENT LEARNING IN THIS AREA The brain is “the most complex structure, natural or artificial, on earth” (Green et al, 1998) Human brains develop rapidly: our brain doubles in weight in first 12 months (Sunderland, 2007) We can’t do what makes us human from within the womb – it has to be done in the context of attunement with special adults Harsh parenting in the early years is associated with conduct disorder and later crime (Moffitt and Caspi, 2001)

9. REVIEW OF EMERGENT LEARNING IN THIS AREA Developments highlighted in the Themed Breakout ‘Understanding the Emergent Learning in Attachment’ at Learning Session 2 Scottish Attachment in Action Attachment Matters For All - An Attachment Mapping Exercise for Children's Services in Scotland, commissioned by the Scottish Government 2012 Research and developments in Glasgow Developments and research plans in South Lanarkshire Council

10. Scottish Attachment in Action Scottish Attachment in Action (SAIA) is a multi-professional group constituted in August 2009. It is committed to promoting better experiences of attachment in the Scottish population and effecting positive changes in social policy, education and mental health. The group believes that altering the existing understanding of, and attitudes towards attachment, is essential for improving Scotland’s current record on poor health and socially destructive behaviours. SAIA aims to:  promote positive experiences of attachment in Scotland.  advocate for attachment theory and practice to be a fundamental element of the education of all professionals.  develop training opportunities on attachment.  advance effective attachment-informed practice.  develop, promote and disseminate research into attachment. http://www.saia.org.uk/

11. REVIEW OF EMERGENT LEARNING IN THIS AREA Developments within Scottish Attachment in Action Attachment Matters for All – An Attachment Mapping Exercise for Children’s Services in Scotland: Following the successful publication of this joint report by SAIA and CELCIS, further discussions have taken place with CELCIS on plans to develop the themes and recommendations identified in this report - Full report available at http://www.celcis.org/media/resources/publications/Attachment-Matters-For-All.pdf Executive Summary available at http://www.celcis.org/media/resources/publications/Attachment-matters-for- all-summary.pdf 2013 Annual SAIA Conference in December 2013 – It can’t be too little and it is never too late: Why Attachment still matters beyond the early years Network seminars in February and September 2013 – Foetal Alcohol Syndrome and Foetal Alcohol Spectrum Disorder (February) and Why Attachment Matters when children have to move – the emotional journey for us all (September) Contribution of members of SAIA Advisory Group to associated groups and organisations – The Child’s Curriculum; Maternity Public Health Special Interest Group Attachment Subgroup; The ‘Jeely Piece’ Learning Together About Making Choices Advisory Group

12. REVIEW OF EMERGENT LEARNING IN THIS AREA A total population of children aged 6 and 7 in 29 Glasgow primary schools were screened for attachment disorders. Very deprived part of the city Despite this, the great majority of children had normal mental health The prevalence of attachment disorder was 1.4% - much higher than previously realised Minnis et al 2013 Used similar measures in the Growing up in Scotland cohort – prevalence approx. 0.7% Research on Attachment Disorders in Scotland

13. REVIEW OF EMERGENT LEARNING IN THIS AREA Update of developments and research in South Lanarkshire Council How Early Attachment Relationships support Transition (H.E.A.R.T)  Steering group and a national critical friends group  Flowchart for home to nursery transition process  Research report on best practice in home to nursery transition Launch of ‘A-Z of Attachment and Resilience’ Workforce research led by Principal Psychologist – What is the most effective way we can support practitioners to become knowledgeable, skilled and confident in Attachment Informed Practice? What is the impact of a workforce which is knowledgeable, skilled and confident in this area? ‘Our early years journey’ – a film currently being developed by the Early Years Collaborative Programme Manager – theme of attachment will be embedded throughout the film For information, please email enquiries@slcpsych.org.uk

14. REVIEW OF EMERGENT LEARNING IN THIS AREA What’s new? Useful publications Age of Opportunity by Wave Trust (2013) Sabre Tooth Tigers & Teddy Bears by Suzanne Zeedyk (2013) National developments National Attachment Round Table discussion planned for 3 February 2014 – chaired by the Senior Health Improvement Officer - Maternal and Child Health

15. REVIEW OF EMERGENT LEARNING IN THIS AREA What do we know in this key change area that will make a difference? Ensure that ALL frontline professionals working with children are trained in Attachment Informed Practice Ensure that ALL parents communicate with their babies from birth Ensure that health visitors have contact with ALL families across ages 0-5 Ensure that social workers identify, as early as possible, families in which attachment is not working well Ensure that transitions of ALL children with an adverse attachment history are carefully managed.

16. BECOMING A “PIONEER SITE” IN THIS AREA A Pioneer Site is an area (specific geographical location, nursery, clinic, school, community centre etc.) that has: 1.The local will and interest to work on this important issue with their community. 2.Leadership support to be the CPP’s Pioneer Site for this issue. 3.Adequate resourcing to do the work required for testing in this area. 4.Some existing work in this area. 5.Willingness to share their data and learning with the Collaborative, warts and all!

17. CURRENT WORK IN THIS TOPIC AREA STEP ONE: With your table, reflect on what you are doing within your CPP, or could do in this area: – Who are individuals and/or teams currently working on in this area? What are they doing? Be as specific as possible. – Be sure to generate as many ideas as you can and write each idea on a post-it note.

18. CURRENT WORK IN THIS TOPIC AREA STEP TWO: Reflect on your ideas and identify emerging themes from your table. – Write the 3-5 largest themes on post-it notes and bring to the front of the room. – Facilitators will review all table themes to find the top 5 themes from the room.

19. REPORT OUT What surprised you in your discussions? Are there any immediate ideas you want to take back to your home team given what you discussed?

20. THEMES FROM THE ROOM PLEASE INSERT HERE (DURING SESSION): – Top 5 emerging themes based upon facilitator themes from tables.

21. THEMES FROM THE ROOM With your table, review top 5 themes from the room on wall posters: – Discuss with your table where your specific idea post-it notes might be placed within each of the 5 themes. – Designate 1-2 people to place specific post- its on poster paper.

22. FINAL REFLECTIONS What are 5 change ideas you could work with in your community you can bring to your CPP planning meeting?

23. PARTING THOUGHTS We need Pioneer Sites! Remember, a Pioneer Site has the will and interest, the leadership support, some existing work in this area, resources (people) to adequately do the work, and a willingness to share their data and progress. Do you think your CPP could be a Pioneer Site? Express interest with one of your facilitators and the EYC team will follow up to explore this opportunity with you.

24. THANKS FOR A GREAT SESSION!