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Conception to age 2 - the age of opportunity Key Conclusions and Recommendations.

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Presentation on theme: "Conception to age 2 - the age of opportunity Key Conclusions and Recommendations."— Presentation transcript:

1 Conception to age 2 - the age of opportunity Key Conclusions and Recommendations

2 Pregnancy Maternal stress, smoking, diet, drug, alcohol consumption in pregnancy can: –Lower IQ, create ADHD, conduct disorder –Severely impair child’s mental functioning –Adversely impact child’s health through to middle age and early death

3 Nutrition Adequate early nutrition crucial to a child’s physical and intellectual development: –Breastfeeding protective for both mother and baby –Hygiene, home safety, immunisation also important

4 Adverse Childhood Experiences Abuse, neglect, domestic violence, growing up in household with alcoholism, drug abuse can lead to: –high levels of heart, liver, lung disease –depression, suicide, poor work prospects –alcoholism, drug addiction Peak age for child abuse, neglect is 0-1

5 Mental Health Risks 144 thousand babies under 1 in UK live with parent with mental health problem Significant cross-over between mental health issues and alcohol/substance abuse

6 Primary Prevention Core message: ‘Primary Prevention’ – prevent harm BEFORE it happens. It is crucial to –intervene early to promote infant mental health –protect babies from abuse and neglect –prevent damage from poor early parent relationship

7 Primary Prevention: Three Essentials Assess and identify where help is needed Provide adequate support when needed Ensure early years workforce have requisite skills, training and supervision

8 Assess, identify where help needed Mental health risk assessment as early as possible in pregnancy –Edinburgh Post-Natal Depression Scale –Hospital Anxiety and Depression Scale –Other risk factors (domestic violence etc) Neonatal Behavioural Assessment Scale 3 weeks after birth

9 Assess, identify where help needed In addition to 6 week Health Visitor assessment: 3-4 month assessment of parent-child attunement –Parent Infant Observation Scale –KIPS –The CARE-Index Attachment assessment at 12-15 months –TAS-45

10 Provide adequate support Full implementation of Healthy Child Programme Promote attunement, secure attachment: –Video Interactive Guidance, VIPP –Watch, Wait and Wonder –Circle of Security Family Nurse Partnership

11 Provide adequate support Parent-Infant Psychotherapy –support systems such as Oxpip, Norpip 8% of pregnant women warrant a referral to specialist perinatal mental health services –these focus on restoring maternal mental/emotional health and parent-infant relationship

12 Provide adequate support High quality health-led Children’s Centres –Potential for health visitors to act as team leaders, supervisors and/or mentors High quality outreach to engage most vulnerable families Follow principles of highly successful multi-agency work –Integrated services model, Highland Region of Scotland –Local integrated partnerships, Brighton and Hove, Warwickshire, etc.

13 Early years workforce: requisite skills Health Visitors trained to evaluate mother-baby interaction (e.g.VIG), motivational interviewing All practitioners have awareness of risk factors that can jeopardise infant mental health Domestic violence - prioritise identification and support by midwives, GPs, other professionals, especially in pregnancy

14 Early years workforce: requisite skills Good understanding of pre-birth to 3 child development, attunement and attachment Emotional intelligence, skills to form empathic relationships with parents Good quality reflective supervision

15 … and finally Health and Wellbeing Boards prioritising infant mental health, wellbeing in JSNA Provide clear guidance to practitioners on importance of very good support from 0-2 Financial returns on well-designed early years’ interventions far exceed stock market returns, other public policy investments

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