Shrink grows kids: One year on

One Year on

Shrinkgrowskids is officially a year old, and I am so glad that I have made it to this milestone! Thank you to the 117 subscribers and the many more regular visitors. Shrinkgrowskids is being read in 102 countries worldwide, and especially in the UK, USA, Australia, France and Brazil. If you are reading this in Brazil, “Hello!” I do not know who you are but thanks for your time!

When I started writing a year ago, part of the impetus was as I was frustrated that a Consultant Child Psychiatrist was unable to find work that fit in with parenting responsibility. During the school day I wanted to do something with my knowledge, not just the dishes. I would meet up with other women (lawyer, business consultant and tech consultant) in local coffee shops complaining about the career paths that we had given-up out of necessity, not truly free will. Over the year, I have come to realize that times-they-are-a-changing and that there is nothing that can hold back the tide of change for equality any longer.

Employers will increasingly be encouraged to promote women

Men will become increasingly involved in parenting

Men and women will become treated more equally at work

Parents will not automatically be assumed to be mothers

Children will be happier raised by parents of both genders

I am finally seeing and living through change. I might get to witness the end-game of feminism in my life-time. Thanks to the major research funding bodies colluding to only fund research in institutions that are putting in place strategies for gender equality, over the last year, my University has been falling over itself to send women like me on Women’s Development Programs and Mentoring schemes. Although some schemes need fine tuning and we are yet to confirm if lip-service converts into true commitment; with a gun-to-its-head it really looks like progress is going to be made on this. Thank you funding bodies!

This leads me to believe that progress and change can and will eventually filter to all professions, we just need more “financial-guns-to-heads”. Many of my friends in the city say “yes, but it won’t work in banking/ law/ accountancy/ consultancy”; because “of the nature of their work” and “client expectations”. Yet, who dictates “the nature of their work” and why do “clients expect” things to be delivered at awkward times of the day (or rather night)…? We as a society do not have to accept the status quo. We can press for change. Given incentive everything can change.

It reminds me of the arguments made by people opposed to the European Working Time Directives (EWTD; European laws that prohibited doctors from working more than a 48 hour week) for doctors when I was a trainee. In those days, we worked 96 hours a week. On some weekends, we worked Saturday 9am through until noon on Monday. I’m telling you the sleep deprivation of motherhood was nothing compared to this and after this experience all-night breast feeding was a doddle. Believe me, it is far easier to wake up and slap a baby to your breast than it is to wake up to catheterise a gentleman. It was thought “impossible” for the system to change to allow doctors to work less because of the “vital” work that we doctors were doing. How could patient care be transferred safely from one doctor to another? Impossible!

Well, as it turns out, all doctors have now moved to shift work without a massive rise in the death rate of patients. Indeed arguably care is better as doctors have had a decent amount of rest. I can never forget the poor patient that sat in hospital for a whole week without being seen by any doctors as my colleague on a weekend shift had forgotten to put his name on our patient list. The medical system was forced to change by financial penalties for non-compliance, bringing with it a surge of female applications to medical school. Medicine is still not ideal, men still dominate the upper echelons and prestigious specialties, but at least the days of long hours culture is gone. It is not beyond the wit of man to change systems in other institutions to afford their employees a better work-life balance; their talented junior women a real shot at success and their talented junior men a shot at being a decent father. They just need the financial incentives, because at the end of the day, money is the only cattle prod that works.

Indeed, it is money (or rather lack of it) that will likely be the solution to my other bug-bear: the lack of high-functioning part-time jobs in medicine. After struggling to find a position in London happy to take me on a part-time basis, it turns out that the NHS are so short of money that they are now happy to employ part-time Consultants. Not because they value retaining female staff or work-life balance, but because they no longer have enough money to pay for full-time consultants. Either way, it is good for me and other parents who wish to work part-time as a Consultant in the NHS. Fingers crossed that over the coming years something will turn-up for me. In the mean-time I’m thoroughly enjoying my University position that allows me to interact with some of the greatest minds in Child Psychiatry, and on my days off, as waiting lists have exploded in the NHS; private practice is booming. It is hard to argue against well-paid work that can easily be fit in between the school drop-off and pick-up. It’s sad that this can only be done in the private sector, particularly for a die hard NHS supporter like me.

What of my coffee-morning compatriots? After a period of part-time work at a lower level, the lawyer has succumbed and returned to full-time work at Big Law Firm and has employed a nanny. The business consultant has set up her own successful business, which operates on her terms within school hours. The tech consultant moved out of London and is content to be a stay-at-home mother. We all moved on, and its now pretty hard for any of us to find time for a cuppa. Maybe its that the children are growing, maybe its a sign of the times, but good women can no longer be kept down.

The other day a younger male friend who just got engaged told me he was thinking about taking his wife’s name…

Who knows where we will be a year from now?

In the meantime, I hope you will continue to read my blog. Here are some of my reflections on parenthood from the last year.

mum

Mothers and Motherhood

Did you get Maternal Adjustment Disorder (MAD)?

_GSB5183

The changing role of fathers

swimming

Pass on a passion

How to choose your child’s nursery

Nursery

It is ironic that for many of us one of the first major choices we have when we become a parent is about who else is going to “parent” our baby. If you are going down the nursery route, this decision often has to be made prenatally depending on the length of time you wish to take for maternity leave and the waiting list time on your local nurseries.

When I first went about looking for a nursery for Big Sis, I didn’t have a clue what I should be looking for. Inevitably, I made a wrong decision and I was unhappy with the nursery (Nursery A) that I initially chose for Big Sis. The problem being that when you are required to make this decision, you are still in the mind-set of someone without children, someone whose priority is themselves and their work. Not yet a parent, whose priority is their child. With this hat on, decisions regarding childcare are made with the priorities of cost, convenience and ease of getting to and from work, not necessarily the priority that you have once you actually ARE a parent.

I had chosen Nursery A as it was close to the tube station, was located in a beautiful Victorian house, was brand new and had designer furniture for children, a computer room, a sensory room, a music room and offered baby yoga and science lessons. I was given my own electronic fob to get in and out of the nursery building and on-line access to the nursery’s CCTV cameras allowing me to see what Big Sis was up-to from the comfort of my computer at work. Formula milk, nappies, sun screen etc. were all included in the fees meaning all I had to do was drop off my baby in the morning, and the nursery operating hours were long (early drop off and late pick-up) so I could meet my work commitments. Staff advertised themselves for evening babysitting sessions. Oh, and there was an organic kitchen on-site. Why wouldn’t any working parent choose this nursery?

It was only when I realised my mistake (that I had been woo-ed by aesthetics and meeting my own needs) and moved Big Sis along with Lil Bro to a different nursery (Nursery B) that I realised what a nursery was supposed to be about. The child.

Nursery B was further from the tube station, had more modest grounds, smaller and more old-fashioned classrooms, no designated music room or computer room, no electronic fobs or CCTV, late drop-off and early pick-ups (making getting to work on time pretty hard) and the requirement to provide your own milk, nappies, and sun screen (such that there were regular rebukes from staff when you forgot one thing or another). Yet it had a waiting list a mile long. Both nurseries had a similar fee. I realised that none of the “extras” were relevant. The management and staff at Nursery B were excellent. That is all that matters. Nursery B’s operation was aimed at the children, not designed to suit and woo parents. But how can you tell this when you visit?

Here are my tips for what to look for so you can get it right first time:

Standard no-brainers:

“What is the atmosphere like?”

“Do the children there enjoy going to the nursery?”

“What is the food like? Is it cooked on site?”

“What activities do the children do?”

“What are the facilities like?”

“Where do the children sleep?”

“Are the premises clean, safe, inviting and child friendly?”

“What is the policy for children with special needs/ allergies/ medical conditions?”

“What are the policies for if your child is sick?”

“What are the nursery opening and closing times and how many days of the year is the nursery open?”

“Do the staff appear warm, competent and knowledgeable?”

“Is there any outdoor space?”

“What are the fees?” – I don’t think you’ll forget this one. Remember to bring a hanky as the response will be eye-watering.

Additional gems:

Check the Ofsted Report

I cannot stress the importance of checking out a nursery’s Ofsted report and rating. Ofsted is the government agency that inspects all schools and childcare provisions in the UK. They report on all manner of things from the built environment, health and safety procedures and management. This might all seem extremely mundane and irrelevant when all you want is lovely, bubbly, staff that are going to welcome and cuddle your baby, but for anyone that has worked for any type of institution or business before, the competence of management matters. Within the NHS, it is evident that competent managers can instil high service standards, efficient service and good employee morale. The reverse is also true, and this is as true for nurseries as the NHS. If you can, go for an Ofsted Outstanding nursery. Big Sis’s first nursery had newly opened and had not been inspected at the time Big Sis started, but when it was inspected, it achieved a “satisfactory” ranking (two levels below “Outstanding”) which confirmed my doubts about it and precipitated my moving her to Outstanding nursery B, which lived up to its Ofsted rating. Prior to experiencing first hand the difference between “satisfactory” and “outstanding”, I thought – it can’t make much difference – “good” is “good” right? Well orange squash also tastes pretty good until you try Champagne. As most people choose a nursery and stick to it, they never usually get to know just what a difference a nursery can make. If you feel you have made a wrong choice like I did, it is ALWAYS worth changing.

Experience the management

As well as checking out the objective management ratings on the Ofsted report, check it out for yourself. A well-managed nursery would ensure that the phones were answered promptly and that if they say they will get back to you, they do. How well organised and managed is the viewing that they give you of the nursery? How senior are the staff that are showing you around? If you do not think that these administrative things matter, then think about how much they would matter if your child were at that nursery. What if no one answered the phone when you were ringing the nursery to convey an important message about your child? What if staff tell you they will do something for your child, but they don’t? If senior staff are not there to show you around, are they ever there? The best functioning services are ones where administration and front line staff are both working efficiently under effective and accessible senior management. At nursery B the senior manager was on site every day and knew the name of every child.

Ask about staff turnover

In my mind, effectively looking after young children is not something that can easily be done if you are not happy (if you don’t believe me you can extrapolate this from lots of post natal depression literature). If a nursery has high staff turnover then I cannot imagine that the staff can be very happy working there. During Big Sis’s 18 month time at nursery A, her “mentor” or “Key worker” changed 3 times because of staff resignations. The nursery manager also changed 3 times. This discontinuity of staff cannot make for stable attachments and relationships with the children and indicate that there is something unsatisfactory systemically that is preventing people from wanting to remain employed there. If staff are unhappy in their jobs, how can they provide the highest standard of care for your child? The average time that the key staff had been in place at nursery B was 9 years. As the fees for both nurseries were the same, it was clear that where one had chosen to spend the fee on aesthetics and extras to woo parents, the other had chosen to spend on training, valuing and retaining key and experienced staff. I know which matters more to me.

Ask about incident forms and how they manage difficult children

Big Sis was bitten or scratched by other children in her class at least 10 to 15 times in her 18 month career at nursery A. Other children in her class were also being bitten and scratched and we parents almost had to form a line to sign the incident forms when we collected our children. We would be told that a new toddler had been admitted to the class who had not yet been “socialised” by the nursery but that they would get the child under control soon. Only then, they would admit another “unsocialised” child. Eventually I had to sign an incident form saying that Big Sis had bitten another child (although she never bit anyone at home), and to tell the truth, I was rather glad that Big Sis was retaliating rather than being a teething ring for the other children. After Big Sis transferred to the nursery B she was bitten once and scratched once in a period of 28 months. She didn’t bite anyone. Lil Bro, who has only known the outstanding nursery has never been bitten or scratched and has never bitten another child at nursery. He has bitten his sister at home so it is not as if he is a particularly placid non-biting child. In my experience, biting is a very normal aggressive reaction in children and most children in the 0-3 year age group will do it at some point. Initially when Big Sis was being bitten at nursery, I was sympathetic to the nursery as I am aware that “all children bite”, however, on witnessing how much less this type of behaviour was occurring at a well- run nursery I am pretty sure that the level of biting was related to the nursery’s care (or lack of).

The nursery may not tell you, but it is worth asking about the level of incident reports as this is data that they are obliged to collect, so they should have it (although of course bear in mind that the very worst nurseries will have the lowest levels of incident reports, as they will be negligent on keeping up their reporting).

Examine how well the staff know the children

It is difficult to assess this. All nurseries will put forward their best people to do viewings with prospective parents. It is important to view as many staff as possible and be able to quiz them, and ask them questions, rather than limit questions to the member of staff showing you around, who will have been selected as knowledgeable. In real life, this person will likely have little to do with looking after your child as they are too busy showing other prospective parents around. Try and ask a random member of staff questions like:

“Do you like working here?”

“How long have you worked here?”

“How many children are in your class?”

“How many children are you directly responsible for?”

“How many children in your class have got food allergies, who are they and what exactly are they allergic to?”

Point at a random child and ask: “What’s this child’s favourite activity?”, “Who are his friends?”, “What makes him upset?”

If you have a child with food allergies like I have, it is absolutely paramount that all members of staff know who your child is and their allergies. I have heard of nurseries where children have been given foods that they are allergic to. Nursery B went the extra mile. Not only did all staff know Lil Bro and his exceptional dietary requirements, rather than excluding Lil Bro from cooking activities on account of his dairy, wheat and egg allergies, they bought him his own mixing bowl, and baking utensils. It’s this attention to detail that makes a nursery “outstanding”.

Interrogate parents of children that already attend

As well as confirming the standard information, find out how well the staff know the parents. At nursery A, the majority of staff, aside from the staff in Big Sis’s room had no idea who I was even though I dropped off and picked up Big Sis almost every day. I would have to say “I’m Big Sis’s mum” daily. At nursery B, everyone from manager, kitchen staff, to receptionist to teachers in other classes knew whose mother I was on sight. This is really good, and a credit to the management. You might think this is irrelevant, but it shows stability of staff and how aware staff are of the children in their care. Knowing who mothers and fathers are is important as it shows that they are interested in the children they are looking after and their families. Your child is not just “a child” that they are paid to look after.

Another difference that I found between the two nurseries was that many parents were coming from a very long way to drop their children at the nursery B, whilst most at the convenient nursery A by the tube station lived in close proximity. This makes sense, as if a nursery is very good, then people are willing to travel long distances to go there. If a nursery has many parents travelling a long way to attend, you can take it that this nursery is good.

Ask about the Early Years Foundation Stage

All childminders and nurseries are required to provide “early education” in line with the Early Years Foundation Stage document. If you want to be very mean and test the nursery’s knowledge, you can read the document and test them on it. I personally wouldn’t, but I might just want to check that staff don’t look at me blankly if I mention it .

These are just a few suggestions. In the end, you will have to make up your own mind, but bear in mind that early childcare is an important decision. Many parents spend much time and many sleepless nights researching and visiting a child’s secondary or primary school options, but just put their babies into the nearest nursery to allow them to get to work. I know; I did this. In addition, the research, visits and crucially the decision is often one made single-handed by a heavily pregnant woman who really would rather a sit down and a nap.

Yet if you work full time, like I did, your children will be spending more hours per year at nursery than at any future school in their life. Further, brain development is at its maximal in the preschool years, meaning the child’s learning potential from its environment is maximal at this age and may have long lasting impact on brain development. Time and time again, research has shown that it is not the “type” of childcare (childminder, nanny, nursery) that matters, it is the QUALITY (see my paper: Liang, 2013).

Shouldn’t choosing a nursery be a serious consideration for both parents rather than a quick decision made by a brain addled, third-trimester mum? Hopefully my tips will help.

Reference:

Liang, H., Pickles, A., Wood, N. & Simonoff, E., (2012) Early Adolescent Emotional and Behavioural Outcomes of Non-parental Preschool Childcare. Social Psychiatry and Psychiatric Epidemiology , 47, 399-407.

Why there is no autism epidemic

ICD

Strictly speaking, the term “epidemic” should be reserved for infectious diseases. I realise that the term has now bled into everyday language to mean a large rise in prevalence rates for anything (e.g. obesity epidemic), but the original clinical definition was to describe the spread of infectious diseases (e.g. ebola epidemic). I’m a clinical terminology pedant; I lose sleep over people that call a “fascination” an “obsession”, so you can imagine my loathing of the headlines of “autism epidemic” to describe the increased numbers of people being given a diagnosis of autism. The reported autism prevalence rates have increased from around 1/100 to 1/68 (that’s about one child in every 2 state school classrooms). However, even if the lay terminology is accepted, the rise in numbers of people diagnosed with autism has more to do with changing diagnostic classifications and awareness than an environmental hazard that shock-headlines would like us to anticipate. There are many press and internet articles that discuss this, but I didn’t feel that they fully explored the territory, so here is a researcher and clinician’s view of the reasons for increased rates of autism.

Why do boundaries in classification change?

Autism is primarily a genetic disorder and the genetic basis of autism is pretty much undisputed now. Although environmental hazards may play a role, these are generally on the basis of a pre-existing genetic vulnerability. There are several known genetic disorders already identified that highly predispose to autism (e.g. Fragile X, tuberous sclerosis, neurofibromatosis), but these disorders account for only a small proportion of the total incidence of autism. The bulk of people with autism have what is called “idiopathic autism” the genes for which have yet to be identified (although several genes are suspected and are undergoing rigorous going over by scientists, none have been conclusively proved).

The identification of genes for autism is a tricky problem, as it is not a single gene that is wonky in autism. If it were, then it would have been identified long ago, like other single gene defects (cystic fibrosis, tuberous sclerosis) and we would be able to test for it readily with a genetic test. It is likely that there are multiple genes, say 6 (this is an educated guess), that are all required in order to generate the disorder. These genes are common, and both you and I are probably carrying several of these genes right now and have already handed them over to our children. Like in the National Lottery though, it is quite common for individuals to have a few of the numbers that come up, but it is much rarer to have all 6 numbers together. In the case of autism, only the people with all 6 genes get autism. Also like in the National Lottery where 5 numbers will get a small pay-out, people with 5 genes may get a watered down version of autism.

Scientists have been using all the tricks available to them to try and elucidate the precise gene combination. A few years ago, the computer capability to do Genome Wide Association Studies (GWAS) (where you sequence the entire genome of subjects with autism and the entire genome of subjects without autism, bung the lot in a very big computer and get it to output the combinations of genes that are common to people with autism but not present in the people without) was supposed to lead to a major breakthrough in autism research. It didn’t. The reason being that as all scientists know; if you put sh*t data in, you get sh*t data out. The conclusion amongst researchers was this: the people that we are defining as “autistic” and “not autistic” are wrong. If there are non-autistic people in the “autistic” group; or more likely, autistic people in the “not autistic group”, this will mess up the results.

How are we currently diagnosing autism and is it correct?

The current classification manuals for diagnosing autism (and other mental health problems) are the DSM (used in the USA) and ICD (used in Europe) manuals. My husband has a similar book for “diagnosing” if a mushroom that he finds on the heath is poisonous or not. There is no blood test or scan, only the basic science of observation and interrogation. You might, (and some do) dispute the validity of such classification manuals, but it has thus far served my husband, who has a penchant for putting foraged fungi into his mouth, well (i.e. he has correctly been able to avoid the death cap by consulting his book). A hundred or so years ago, manuals like these were used to diagnose everything from brain tumour to Down’s syndrome (doctors of old diagnosed brain tumours from symptom check-lists including things such as headaches and vision problems, and having round faces and “Mongolian eyes” suggested Down’s syndrome). By fine tuning the classification and studying the people identified, it has become possible to find causes and cures. If classification had not initially taken place, cures would not have been found. This is where we are currently at with autism, fine-tuning the classifications based on new research findings, the precursor to elucidating cause and generating treatments and cures.

The by-product of fine-tuning the classification manuals is a change in disorder prevalence rates. Old classification manuals stated that all children with autism had a learning difficulty, this was found not to be true and newer classifications reflect this. Older classifications state that autism is largely a disorder that only affects boys; newer classifications describe what symptoms may look like in girls. In previous classification manuals, it was stated that if a child had ADHD, they could not have autism, this is now known not to be the case and indeed 30%-50% or so of children with autism have ADHD. New classifications allow this diagnosis to be made. Thus, over the years, with increased research pointing to a wider distribution of the core symptoms of what “we” scientists and clinicians see as autism, and with each revision of the classification manuals, the description of “an autistic child/ person” has changed vastly. An intelligent, inattentive girl with core features of autism, diagnosed with autism today would not have received a diagnosis even 50 years ago, and I am pretty sure that our current classification will not be the last revision.

Some might call this changing boundary of diagnosis pharma and clinical collusion to “medicalise natural variation”; but as I mentioned previously, I prefer to see it as a scientific journey we are halfway/ dare-I-even-believe three quarters of the way through, towards an understanding of aetiology and generation of treatment and cure. Who knows, when aetiology is found, the boundaries may yet shrink back.

The conclusion to the journey may not be far off. Whilst geneticists are relying on better patient classifications to do genetic studies on, neurophysicists are relying on better patient classifications to do neuroimaging and functional neuroimaging studies on. We are already almost at the stage where a computer can accurately predict if a person has autism or not based on their brain scan (Ecker 2010). It may be within my life-time (my grandpa lived to 104 years so I have an optimistic life-expectancy) that the diagnostic classification manuals can be ditched for a brain scan or set of genetic tests; just as has already happened in the case of brain tumour or Down’s syndrome.

Improving awareness

Raising awareness of health conditions is a great thing. Many people have benefitted from the increased awareness of autism over the last 10 – 20 years. Autism is a condition that babies are born with and that they will grow and live with life-long. There is no current treatment for the core symptoms, let alone a cure, but the correct support for the child, family and school, can have a significant impact on outcomes. Improving awareness encourages people to come forward for assessment and diagnosis and access support; improving awareness leads to requests for more and better services; improving awareness leads to higher profile and political will to spend on autism; improving awareness leads to better acceptance and understanding of people with autism. I can say nothing but good things about raising the profile and awareness of autism. In 1988 when Rainman was first released, I had never heard of autism. I think if a film about autism was released now, the majority of people would have heard of the condition. Without a doubt, the number of families seeking autism assessments for their children has increased, and this can only mean increases in diagnostic rates.

An epiphenomenon to improving awareness that has also contributed to increased prevalence rates is due to what can be discretely called “diagnostic inflation”; or what can be better understood as “overdiagnosis” or “misdiagnosis”. It is an unpopular but real notion. It is one thing to “raise awareness” of autism, but it is another to educate about autism. I think if I surveyed a group of 100 parents, they would all have heard of autism but I think that only a handful of the 100 parents surveyed would be able to give a passable definition of the core symptoms of autism.

Why stop at parents? Teachers, GPs, paediatricians, child psychologists and child psychiatrists, especially those that trained ten or twenty years ago when autism was relatively unknown and unsexy may not be up-to-date on autism and certainly many fewer will have completed and maintained specialist training on autism diagnosis. Couple this with the improved awareness from parents of the diagnosis and the political will to allow access to substantial resources (welfare and educational) only for a diagnosis of autism and you have a system that will favour increased diagnosis.

I think that now that the job on awareness has been done, we need to work harder on the education front.

Has there been any real increase in autism at all?

This was the topic of discussion at the last Royal College of Psychiatry conference I went to. The consensus was that there was, but that this real increase was much less dramatic than the increase accounted for by classification changes and increased awareness. Many studies have focused on insults in pregnancy and environmental toxins. The research on these has yielded minor or inconsistent results, certainly nothing that alone would account for the real rise seen. The only factor that was given significant credibility was that of the increased age of the mother AND FATHER of autistic children.

Whilst awareness of the effects of maternal age on children’s outcome has been well-publicised (increased risk of Down’s syndrome as one well-known example), the risks of older dads has been less so. Yet, paternal age has long been established as a risk factor for schizophrenia (Malaspina 2001), and there is now emerging evidence for association of paternal as well as maternal age with autism (Reichenberg 2006; Durkin 2008; Sandin 2012).

It is ironic that many people sought to blame a vaccine for increasing levels of autism, in some instances sparking fears of a real epidemic (of measles), when in fact, like so many other health problems, the cause may prove to be within our own life-styles.

References:

Ecker C, Marquand A, Mourão-Miranda J, Johnston P, Daly EM, Brammer MJ, Maltezos S, Murphy CM, Robertson D, Williams SC, Murphy DG. (2010 ) Describing the brain in autism in five dimensions–magnetic resonance imaging-assisted diagnosis of autism spectrum disorder using a multiparameter classification approach. Journal of Neuroscience. 11;30(32):10612-23.

Malaspina D, Harlap S, Fennig S, Heiman D, Nahon D, Feldman D, Susser ES. (2001) Advancing paternal age and the risk of schizophrenia. Archives of General Psychiatry, 58(4):361-7.

Reichenberg A, Gross R, Weiser M, Bresnahan M, Silverman J, Harlap S, Rabinowitz J, Shulman C, Malaspina D, Lubin G, Knobler HY, Davidson M, Susser E. (2006) Advancing paternal age and autism. Archives of General Psychiatry. 63(9):1026-32.

Sandin S, Hultman CM, Kolevzon A, Gross R, MacCabe JH, Reichenberg A. (2012) Advancing maternal age is associated with increasing risk for autism: a review and meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry. 51(5):477-486.

Durkin MS, Maenner MJ, Newschaffer CJ, Lee LC, Cunniff CM, Daniels JL, Kirby RS, Leavitt L, Miller L, Zahorodny W, Schieve LA. (2008) Advanced parental age and the risk of autism spectrum disorder. American Journal of Epidemiology. 168(11):1268-76.

My Cape Town Top 10 for Families

Cape Town 1

After a busy year, we felt like taking it easy over the Christmas holidays and guaranteeing ourselves a “White Christmas”. That’s white sand, rather than white snow. Banker and I lived and worked for a while in Cape Town some 12 years ago. He was already a banker and I was doing psychiatric research surveying adolescent experiences (of sex, drugs, bullying, self-harm) in high schools throughout the Western Cape. It’s like a second home and we still have a lot of friends there.  When we lived there, it was all reading books on the beach, drinks at sunset (sundowners) and clubs, but nowadays with the kids in tow, we find that Cape Town still has a lot to offer both parents and children as a holiday destination. As an ex-resident and regular visitor, here’s my Top 10 to do in Cape Town.

 1. Table Mountain & Lion’s Head

Cape Town 9

Table Mountain is the city’s icon. A massive mountain slap bang in the middle of the city. Traditionally, you should climb it, but with kids in tow, it is acceptable to take the cable car. Kids love cable cars so it’s a sure fire winner. Think fantastic views of the whole city. Ring ahead to check the cable car is operating to avoid disappointment though, as in strong winds it shuts down and if clouds are on the mountain (the table cloth) you won’t be able to see anything. If, like us, you have children old enough to do some walking and climbing, try climbing Lion’s Head instead (the smaller peak next to Table Mountain). It is a shorter climb and still extremely satisfying in terms of the view and sense of achievement. Our 5 year old made it to the top with only a bit of help, but make sure your children are ones that like scrambling up rocks and don’t mind the occasional scraped knee. Most children I know like this sort of thing, even our Princess who whinged and complained up the first short section that is gravel road hitched up her skirt and scrambled and climbed in delight up the remainder which is bare rocks with the occasional ladder. Finish off with drinks and gourmet picnics on the lawns of the roundhouse (www.theroundhouserestaurant.com) nestled in the foothills of the mountain.

2. Clifton and Camp’s Bay

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Cape Town is a good family beach holiday destination despite the cold Atlantic water. There are 4 beaches at Clifton and 1 at Camp’s Bay. Traditionally each has it’s own atmosphere. Dogs are allowed on 1st beach, 2nd and 3rd are more secluded and therefore more partial to romantics and 4th is the trendy beach for beautiful people. I’m not keen on the beach – like most Chinese people the idea of turning browner has no appeal, but Banker is a typical South African sun worshiper and in his youth he was a Clifton life guard. I accept that beaches are good for children and so I do occasionally make a beach sojourn, but all-day, every-day grates against my Chinese genes which require me to see local sites and take selfies.Over the years, Banker and I have therefore reached an agreement where we rent a flat right on the beach so he can take the kids there every morning while I have a lie-in (bonus!) and we can DO something for the main part of the day. So he and the kids build drip castles, explore rock-pools and jump waves daily. He even did a science experiment with the kids by hauling back a litre of sea water in an empty bottle and boiling it on the stove until all that was left was salt (in-situ educational activities – I know I have trained him well haven’t I? FYI Clifton sea water has a salt concentration of 40g per litre). He and the kids even go and pick mussels right off the rocks. They get enough to make Christmas lunch of Moule et frites. Seasoned with sea salt.

3. Penguins at Boulders

Cape Town 6Penguins are such comical creatures; kids cannot help but love’em. See all the African penguins you could ever wish to see at Boulder’s Bay near Simon’s Town.

4. Kalk Bay & Olympia Cafe

Cape Town 7Nostalgia always takes us back to Olympia Cafe at Kalk Bay, a great little bakery and restaurant where hippies have been using the side door for decades. It retains it’s shabby chic Bohemian feel, whilst always serving great food. It’s right next to the harbour where the catch is brought in, so fresh line fish is always on the menu. If you visit the toilets, you have to overlook its proximity to the kitchen, but in all my years dining there I have never had food poisoning. Here’s the kid-friendly part: if you take a wander to the dock, you will be sure to encounter the sea lions. If you are lucky, they might even come out of the water to say “Hello”. There is a nice parade of quirky shops along the main street and plenty of Zimbabwean street vendors selling the beaded or wood crafted curio of the year. We already have the giraffes and hippos (so last decade); this year, thanks to an on-line comparison website, it is meerkats. It’s amazing how many shops you can browse pester free if you promise a kid a Meerkat at the end of the day. We each pick our own rodent likeness in Jacaranda.

5. The Old Biscuit Mill

Cape Town 10OK, this one is more for the parents, especially ones that like to shop and eat. But at R18 to a pound at the moment making everything extremely cheap for Brits, it’s got to be done! The Old Biscuit Mill was an empty old Mill in an arty but down at heel area of Cape Town called Woodstock when I lived here 12 years ago. It’s now gentrifying rapidly and the Old Biscuit Mill with it’s quirky and arty homewares shops and internationally ranked restaurant “The Test Kitchen” is central to the area’s rejuvenation. Book well ahead for “The Test Kitchen”, Banker called up a few weeks prior to our trip to make a reservation and was told they were fully booked till May. Other good food is also available, and on Saturdays there is a Neighbourhood Market where local produce and all manner of yummy food is sold from stalls to be eaten off lines of “tables” made from front doors on trestles.  

6. Victoria and Alfred Waterfront

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This high end shopping mall just keeps getting bigger and better. Shop till you drop to your heart’s content. There are plenty of children’s clothes shops too so the kids are now set for summer clothes and Crocs and I stock up on MAC make-up. The favourable exchange-rate and the 14% tax back for tourists makes shopping guilt-free. There is also a fantastic Aquarium, one of the best that I have been to with kids, and other venues for child friendly activities. When we were there “The Art of Brick”, which we missed in London was on and so we went to see that, but there was also another installation on at the same time called “Dinosaurs Live”, so there is always plenty for children here. Eat sushi and drink £3 Mojitos upstairs at the Harbour Restaurant. The boats that go out to Robben Island also go from here. As we are regular visitors to the Cape, we are saving this for when the children are old enough to understand, but if it’s your one time out, you shouldn’t miss it.

7.  City Centre and Green Market SquareCape Town 12

Take a walk around the city centre to really get a feel of the city. See part of the Berlin Wall that stands near Green Market and have a go at haggling at the main curios market in Cape Town. The children’s favourite eaterie in Cape Town was “The Food Lovers Market Cafe”, a large canteen selling everything from pizza, burgers to sushi in the old Offices of the Cape Argus Newspaper. The food is not exceptional, but there is a large sweet pick-n-mix and dip your own donuts into your choice of sprinkles stand which may have swung it.

8. The Winelands and Spa!

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Drive out of Cape Town into the Winelands and there are plenty of beautiful wine farms. The child friendly flavour of the moment for those in the know is Babylonstoren (www.babylonstoren.com), a wine farm, hotel and spa halfway between Paarl and Franschoek. Pictureseque vineyard set within acres of laid gardens growing everything from papaya to lawns of camomile and thyme which you are encouraged to prance over barefoot. Book early for the Hotel, we couldn’t get a booking but managed to come for the day-spa. Banker and I are great fans of spas, but most do not welcome children or have nothing for them to do. I am not keen on sending children to creches on a family holiday, so Banker and I always take turns for treatments and childcare, and here there is a child friendly swimming pool, acres of garden to explore, a fake beach, a coffee shop and free roaming animals – so there is no need to fret that the children are not having fun when its your turn to indulge in your Dr Hauschka facial.

Of course, there is also the wine!

In the evening, I thought it only fair to give our children a “spa” treatment in our flat. They get to lie under a towel with a face-pack while I trim their finger and toe nails. They have a great giggle and love it so much they are urging us to go back to the spa – WIN-WIN!

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9. Kirstenbosch Botanical Gardens

We didn’t get to go this year, but I love this place, it is like a Southern Hemisphere Kew Gardens, plenty of the national flower the Protea. The gardens are strewn with African sculptures and in Summer there are concerts in the evening. Guinea fowl roam the grounds and its a lovely place to take a picnic.

10. Cape Point

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This is an old photo from a previous trip. If you are only visiting Cape Town once, it is worth coming to see where 2 Oceans collide. There are plenty of baboons and buck to spot too.

Further Afield:

Township tours are available and I do think that people visiting South Africa should be conscious of South Africa’s past and continued inequalities. I am not personally keen on making a “tourist attraction” out of poverty and inequality, but the income generated may be helpful to populations in poverty. I have visited several Townships in Cape Town when I worked there and it is pretty sobering stuff and although I wish my children to learn how lucky they are, I’m not quite sure they are at the right age or maturity for it yet.

If you are planning for a longer trip, take a drive along the Garden Route. There is whale watching in Hermanus, and there are Ostrich farms where you can feed, ride and eat ostrich (tastes like beef, but much healthier). Further along the coast towards Knysna, the Knysna elephant park is great for kids and allows adults and children to feed, touch and walk with elephants (www.knysnaelephantpark.co.za) and at Plettenberg Bay, there is Monkeyland (www.monkeyland.co.za), both of which are great for kids.

Cape Town Further Afield

Cape Town is a great place to holiday. I know that for many people the security is a concern, not one South African I know does not know someone personally that has not been affected by violent crime. However, the South Africans know that tourism is its major industry and relatively few tourists come to harm. Petty crime is common, my bag got stolen once from the back of my chair in a nice restaurant so you do have to be a bit careful, but if you are sensible and stay in the touristy areas then chances are you will be fine. Just say “No thanks” if your husband tries to tempt you into dinner at that “great restaurant” in the townships…

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Happy New Year

2015

(Apologies to subscribers who have seen this post before, I posted it by mistake in December when I only meant to schedule it ….doh!)

New year’s is a time for reflection on the past and the future. My new year’s resolution this time last year was to get around to putting down my thoughts on motherhood and spreading some of the fascinating stuff that I experience and learn about in my unique job. I thought maybe I would run out of things to write about, but on the contrary great research is coming out all the time and it’s more a lack of time to tell you about it that is a hindrance, what with work (albeit part-time) and the children keeping me busy!

Like Professor Lumby who came to tell my department about her research into childhood depression and how predictive factors were present at age 3 years (yes, I did not miss a “1” in front of the “3”, I do actually mean 3 years), like the whole raft of work that Professor Plomin (who works in the same building as me and with whom I co-authored a paper a while back) has done on intelligence, the current thinking behind the “explosion” in numbers of autistic children – from the mouth of Professor Michael Rutter (credited as being the founding father of Child Psychiatry and still to be found knocking around my department despite being an octogenarian), and the tranche of work of particular interest to me, the feminist, by my colleague at Imperial College Dr Ramanchandri on the important role of Fathers. All this as well as the tales and funny things that happen with or come out of the mouths of my babes!

If you found me over the last year, I’m so grateful for your visits. If you like what you read, please tell others about it as I really hope to be able to continue! You can also help by “Liking” and/or following my site and/or my Facebook page at Shrinkgrowskids.

Here are some of the most widely read posts from the last year. Hope you will carry on visiting in 2015!

Love
All You Need is Love

Social hierarchy
Social Hierarchy in 4 Year Olds

gender
Why I Hate Raising Boys

tigger
The Battle Hum of the Tigger Mum

Planes ADHD
What is ADHD?

Exploding the myth of Santa

Wind-up santa

I was not brought up to believe in Santa. Being from Taiwan, Christianity and Christmas were not as prevalent as in the West. Once we moved to the UK, my family joined in with the festive spirit with a plastic tree (Made in Taiwan) and a large meal (non-turkey Chinese food), but we never had stockings and Santa never visited. Once or twice, I remember wishing on a star on Christmas Eve that Santa was real and that we would get presents from Santa, but it never happened.

As teenagers, my sisters and I even had a bet that my mother didn’t know what the festival of Christmas was celebrating. We were right, my poor mother put on the spot muttered something about Jesus on a cross, to which there were many peals of laughter and shrieks of “That’s Easter!”. This Christian festival confusion amongst the Chinese may explain why one time in Hong Kong I saw a Christmas decoration being sold at a market stall that depicted a cheerful Santa Claus figure on the crucifix…quite bizarre to say the least!

Remembering my Santa-less childhood, I was quite certain that my kids would have the full Santa experience. Letters would be written and posted, mince pies and carrots would be left out at the fire place (and duly consumed leaving a designer sprinkling of crumbs), stockings would be filled and gifts delivered under the tree. When Big Sis was almost 2, she had requested a new play kitchen from Santa. As we were celebrating Christmas with grandparents in France, and were not lugging a wooden play stove and sink unit on the plane, we recorded video footage of Santa (who bore more than a striking resemblance to Banker) delivering her kitchen to our flat to be played to her on Christmas day so that she knew that Santa had delivered it! Santa’s wrapping paper was always bought separately and hidden lest a clever brain wonder why Santa has the same wrapping paper as Mummy and the whole Santa build up would be flawless with meticulous attention to detail. I have even gone so far as to shake bells gently next to the sleeping heads of my children on Christmas Eve so they may subliminally hear Santa’s sleigh bells in their sleep. I’m so sad, I know.

In all honesty though, the upside of the myth of Santa is so great, I can’t see why people complain about him and the commercialisation of Christmas. Without Santa and the Easter Bunny, I don’t know how I’d get my children to eat their greens, stop having tantrums and generally behave themselves. The threat of “Santa/ Easter Bunny is watching” is enough to stop my kids, in their tracks and reconsider their actions. Coca-Cola, Clintons and Americans in general should be given a medal from all parents in my book for the invention and popularisation of these characters as the good behaviour of my children from October to March is basically down to these two characters. If only someone could invent a fictitious character for the summer months, then the calendar year could be covered.

However, now that Big Sis is seven, I am beginning to wonder when the penny will drop. I have heard varying ages for the “Santa realisation” moment, ranging from 5 to 10 years. Some of Big Sis’s friends are already “non-believers”, but given that earlier this year I overheard Big Sis and Lil Bro having an existential conversation regarding Harry Potter, God and Santa, and coming to their own conclusion that only Santa was real as they had received physical presents from him, I’m reckoning on belief still going strong. I’m starting to worry though about Big Sis’s cognitive capacity if at the age of 7 years she can continue to believe that some old geezer can fly around the world delivering presents to all the children in the world overnight. I suppose though, that it is only slightly less plausible than the entire adult world telling her consistent lies and making her write and post letters and leave food out for non-existent people and sneaking around behind her back. Maybe I should be grateful that she finds it more plausible that Santa is real than that her mother is deceitful. Maybe I’m just too good at “being Santa”.

That is until now. In my old age, I am getting sloppy. Lil Bro asked for a watch from Santa for Christmas and I ordered it off Amazon to be sent to Banker’s office. He duly brought it home and showed it to me and left it on the coffee table. I went to bed forgetting to put it away. The next morning, remembering my mistake, I rushed downstairs, snatched up the watch and hid it. The kids, as always were up before me and were having breakfast with their father. Throughout the day, no one mentioned the watch so I thought I had got away with it. Then, the next morning Big Sis out of nowhere says “It was very strange, yesterday Lil Bro and I saw a watch on the coffee table. Then it disappeared.”

“Hmpff” I said, “I don’t know what you are talking about.”

I will repackage the watch and hope for the best, but I think my cover may be blown. I thought about returning the watch and swapping it for another one, but maybe this is how all cons fail, myths explode, truths get outed; the inevitable slip-up made from complacency over time. And maybe it’s time that Big Sis realises the truth, and I realise that we can’t hang on to our children forever. At some stage they wise up for better or for worse.

We’ll see what happens…

Does your school Nativity role predict your future life chances?

Nativity

As parents the world over are turning tea towels into head gear for shepherds and scampering to source angel’s wings for their children’s star turns in Nativity plays, here’s something that might make you think.

Once, before I had my own kids I mentioned to my then Professor (a world class Child Psychiatrist) that my niece had just been selected for the second year running to play “Mary” in the school nativity. “Well” she said “That’s it then, she’s bound for greatness with a start in life like that!” It was a joke of course, but it did make me wonder if there was any truth in this. Does your infant school Nativity role predict your future life chances?

I myself was a Narrator and then a Wise Man in my own school nativities and looking back, I think this is quite apt for who and what I have become, so maybe I have an intrinsic bias to believing that there is some truth. But beyond that, I think that there is actually some scientific basis.

Firstly, the casting of the nativity school play is not a random process, but a choice made by a teacher who knows your child. The teacher will know the personality and developmental ability of your child and will be consciously or unconsciously using this knowledge to cast the play. As personality and ability show some stability over time and are strong predictors of future outcome, it would make sense that your role in the school nativity play has some predictive power over future outcome.

Lead roles will usually be given to “pro-social children”. A pro-social child is basically the opposite of an anti-social child, thus pro-social children are well-behaved, do as they are told, seek to get along with other people, and are polite and helpful. They are usually the class role models. Having pro-social children in the lead roles makes sense as it makes the teacher’s life easier if the children they are relying on to hold the play together can be relied upon to learn their lines, rehearse and critically, turn up on time on the day with their costume! Casting an anti-social child or an anxious child in the lead role is more of a risk as who knows what they will do on the day! The last thing you want is the lead role to burst into tears or have a strop on stage. Sometimes casting an anti-social or marginalised child in a lead role is used as an “intervention”, whereby in the act of instilling the responsibility and limelight of the lead role, the teacher hopes to turn around a troubled child or child lacking in self-esteem. In this circumstance the teacher will have done a lot of background work to ensure that the child is up to the challenge. This doesn’t tend to happen very often.

Depending on the version of the nativity play that is being produced, the “lead role” is variable. Traditionally the “lead roles” are that of Mary and Joseph. Sometimes Mary and or Joseph are required to say many lines and may even need to perform a solo song. In this instance, it is clear that not only does the child need to be pro-social, but they also need to be able to sing and crucially be able to perform in public confidently. Here, therefore you are already selecting for a pro-social, confident child with the cognitive ability to memorise song lyrics, dedication to rehearse, low anxiety levels and likely extrovert nature. These personality factors are likely to be important in predicting future occupation and “success” outcome.

In some versions of the nativity play, Mary and Joseph are diminutive characters that take centre stage, but say very little with the majority of the speaking roles given to narrators who will tell the story. In plays like this, the Mary and Joseph characters are still prized, but the qualities required then are somewhat different. These roles tend to still go to prosocial types; children who are well behaved, look good and are well-liked by others, but are more likely to be anxious about speaking in public; as the extrovert, confident children will be reserved for the speaking roles.

Casting is additionally influenced by personality fit with the available parts. Which teacher could have resisted casting my bespectacled, Chinese, 5-year old self with a penchant for maths as a “Wise Man”? Blondes are more frequently cast as the Angel Gabriel. “Good sports”, “the class clowns” are more frequently cast as the donkey (as others may object to this role and turn it down).

Big Sis is following in my footsteps as narrator in her school nativity. I’m over the moon, not because she may end up as a doctor, but because I don’t need to make a costume.

Hurrah!

Please let me know your previous nativity roles and how you have turned out. It would be really interesting to see if there is truth to any of this!

Shrink Wrap!

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The kids and I had a great afternoon recently with our friends at Wrapsody Gift Wrapping Service making bespoke wrapping paper. No, this is not a sponsored post just two friends getting together to do something crafty with their kids. If you have a spare hour to kill, here’s a great art activity which will save you money in the run up to Christmas, looks good and is great fun!

Step 1. Making a snowflake. Fold a piece of scrap paper into half, then quarters. Fold this again into half, but this time diagonally so you end up with a triangle shape. Get your children to draw some shapes in the triangle shape to resemble a snowflake if possible, but any shape is fine.

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Cut out the shapes preserving the main integrity of the cone shape so as to preserve the paper in one piece, albeit with patterns cut out of it.

Step 2. Open it out. Kids love this part.

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Step 3. Sticking down the templates. Spread a sheet of cheap brown paper on the floor over newspaper and use blue tac to stick down all the snowflake cut outs on to the paper. Lay them out in an irregular formation.

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Step 4: Now for the fun bit. Use a spray paint (£6.50 for a large can that can spray reams and reams of paper – available from any art shop) in white, silver or gold and spray all over! It doesn’t matter if the spray is uneven, it adds to the effect.

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Step 5. Leave the paint to dry. Then peel off the paper snowflakes!

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Step 6. Et Voila, beautiful, original, hand-crafted wrapping paper. So fool-proof even children can make it.  Ready to make Christmas gifts look just lovely!

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Present

 

 

Happy Christmas Making!

 

 

 

What’s the problem with maths?

Maths

I know, I know, it’s so cliché. Another Chinese nerd banging on about boring maths. Believe me; I have fought hard to escape this stereotype. Banker and I didn’t get off to a good start as when we first met as students he guessed that I was a maths student. Maths meant to me geeky Asian with no social skills, so I wasn’t much impressed.

However, now as an adult in the working world I am thankful for my maths skills and am only regretful that they are not better. As a mother, I positively lament the lack of emphasis on maths in the infant school curriculum and I think that this is of detriment to our children and indeed our country. Britain has produced some of the world’s best scientists, engineers and economists so it is not for want of genetic stock or tradition. Yet why does the Far East continue to dominate the international student abilities (Pisa Test) League tables for maths and science? Nosing around Russell Group Universities, I found a higher proportion of Asians lurking in the corridors of Maths, Engineering and Science departments than in the Humanities departments. Why?

From my own up-bringing which I may be erroneously extrapolating to the rest of Asia, education is extremely highly valued. Within that, maths and science is valued above other subjects. So much so that my parents dictated to my sisters and me that we had to limit our A-Levels to 3 of: Maths, Physics, Biology and Chemistry. Despite having achieved better marks in Art and History at GCSE than science, I was to be a scientist. Mad and maddening maybe, but my parents had seen a national focus on science, maths and engineering education allow their country (Taiwan) to gain economic wealth, and unprecedented development within their lifetime. On the backs of engineers, Taiwan is now a developed country and a world player in technology, despite being the size of Wales and having started in the 1940s from a much more disadvantaged base.

From a cultural origin of mathematical reverence it is quite bizarre to experience the irreverence to maths in the UK. Whilst an engineer is admired in the Far East, they are depicted as “Anoraks” in the UK. Whilst maths is a subject that both boys and girls are expected to excel in, maths in the UK is for boys, and even then – just for the boys who are born with “that logical, mathematical mind”. Whilst inability to do mental arithmetic is associated with derision and sympathy in the Far East, it is expected, sometimes even boasted about in the UK. I was shocked to find that many fellow well-educated mums were openly admitting that they would struggle to help their children with 11+ maths revision. The reason they were openly admitting this was because they were somewhat proud and not the least bit ashamed to be weak at maths, whereas I doubt anyone would openly admit to struggling to read or write at the level of an 11 year old. This would be regarded as shameful. It has become socially acceptable among the well-educated to be bad at maths. Surely this should not be?

Whilst reading is heavily pushed in infant schools, maths seems to be relatively neglected. In the UK reading and debating is cool. Law and politics is aspirational. PPE at Oxford is the Holy Grail. I have no problem with that, but why does it have to be at the detriment of maths and science? If we are a country that believes that children should be allowed to flourish and become what they want to be, doesn’t this include parity of encouragement for numeracy and literacy so that there is a level playing field of areas within which to flourish?

From a basis of low National aspiration in mathematical ability, it is no wonder that Banker states that the majority of banks are recruiting their quantitative skills staff from Asia. These skills are so sought after that my sister (who possesses a maths PhD) had no problem acquiring a highly paid job within 2 weeks of arriving back from the USA after deciding to return to the UK to be a more present Auntie. I am sure she would have found it harder to find a highly paid job had her PhD been in English Literature/ Greek Philosophy/ Viking History. At the population level one wonders whether the average Joe and Joan Blogs could calculate their expected monthly increase in mortgage repayment if the Bank of England were to increase interest rates by .5%. Yet these sorts of calculations are vitally important to keep roofs over heads and food in mouths. Maths is a vital and sought after skill, why are we not investing in it at the very grass roots?

Probably it is because the people in power don’t value or understand maths and science. Shockingly only 1 MP out of 650 has a background as a primary science worker as reported by The Guardian, and headlines of “Only scientist in Commons alarmed at MPs ignorance [about science]” in The Independent say it all. Only 70 out of 650 MPs are even registered as having “an interest” in science at all (reference here). That’s probably less than the number of MPs who are actively writing history books alongside their Parliamentary careers. I am a great supporter of the arts, but am also a strong believer that the basic level of maths and science needs to be raised and society can change this. As a social observer I see that a culture that values maths produces a society with strong mathematical ability. As a psychiatrist I know that “intelligence” is more likely to have a uniform rather than varied profile (so most children who are good at English should be as good at maths). Children with a varied profile are more likely to encounter difficulty and see a Child Psychiatrist, but over the general population they are a minority. As a researcher in behavioural genetics, I know that “g” (geneticist’s annotation for genetic “intelligence”) is generalist meaning that it applies across the board for all areas of intelligence and children who are genetically advantaged in English are also genetically advantaged in maths. Specialism or differentiation on the other hand is environmentally mediated (Kovas et al 2007). This means that in general, whether an intelligent child chooses to specialize in maths or English is due to its environment (parents, school, society); and even more crucially, where a child performs well in English but does less well in maths, this is also due to the environment (parent, school, society).

Back in the Shrink household. Big Sis’s state primary school pushes reading. So they should. All parents are expected to read with their children every night. The school challenged Big Sis at reading so much so that in Reception she was given “chapter books” to take home for her to read to me. At 5 and a half she was expected to read books containing the word “obsessed”. She could read the word but had no clue what it meant nor was she able to understand it when I tried to explain it to her. Big Sis began to hate reading and cried every night when I asked her to read to me. I persisted in thinking “if her teacher has given her this book, she must be capable of reading it”. After a few weeks of this, I gave up and thankfully went with my own judgement that these books were frankly too hard. I must be the only “Chinese Tiger Parent” to have written to the class teacher to say “Excuse me, but I think that you are over-estimating my child’s ability, can you put her reading books down 3 levels please”.  At the same time, while we parents were expected to battle to help children achieve advanced literacy, there was no expectation on us to do any numeracy with our children regularly. I don’t blame the school (it’s a great school), it’s not in the National Curriculum, no state school that I know in the UK encourages numeracy in this way, but I am pretty sure it happens in the Far East.

When I received Big Sis’s report card from Reception, she achieved “exceeding” scores in literacy but achieved “expected” scores for maths. My initial response was “How is this possible? She comes from a family of scientists and mathematicians! Maths is a family tradition.” Truth be told, I would have been happier with “expected” scores for literacy. To make matters worse, when I asked Big Sis if she was struggling with maths, she said “Maths is too hard. Maths is for boys”!

Rather than accept that “maths is hard, and she has not been born with a mathematical mind (she is a girl after all)” I set about setting Big Sis a few counting and maths problems every morning, to balance the reading that was set by the school every night. My view was that of course Big Sis’s literacy was better than her numeracy – I was required by the school to support her literacy on a daily basis but not required at all to support her numeracy. Since then, Big Sis’s maths has come along and she was rated of equal ability in maths and literacy by the end of Year 1. She will now confidently say “I am good at maths”, and attempt maths problems rather than avoid them. The solution was so simple, yet why are schools not breaking down maths to simple parts and pushing numeracy in line with literacy from reception? I’m not talking about solving quadratic equations, but if children are encouraged to count and add sweets/ pocket money/ count the number of days until Christmas etc. daily from a young age, does this not take the “difficulty” stigma out of maths?

I have found that the majority of children enjoy doing the things that they are good at. Some children are naturally good at certain things (Lil Bro is maths minded and will seek out for himself mathematical problems; he was a voracious consumer of jigsaws), however this is rarer and the majority of children become good at things. Once a child is good at something, then they will invest in doing these things and become even better at them. By the time that the National Curriculum suggests that children start doing the core of maths, their expertise and skill in literacy is far ahead of their mathematical ability. At one stage Big Sis was reading Roald Dahl’s “Fantastic Mr Fox” at school but did not know what 2 x 2 was- to me this seems completely unbalanced. Literacy and English become the favoured subjects and maths will be relatively challenging and therefore more unloved.  The opportunity to sell maths to children is hijacked by literacy being given the advantage of earlier exposure and active encouragement. In the Far East, 5-6 year old children will learn their times tables up to 12 by rote. Before you utter “We in the UK are not rote learners”, think about the reception classes up and down the land chanting their jolly phonics sounds “igh, igh, igh”; “Ph”, “Ph”, “Ph”; “ee”, “ee”, “ee”; “ai”, “ai”, “ai”. This is rote learning as who could fathom that “igh” is pronounced “i”?? Once the connections are entrenched by rote learning, it is possible to learn about the Latin and Greek from which words are derived, in the same way the meaning of relationships between numbers can be learnt. The rote learning gets you started.

I am pretty sure that had I not taken action to support Big Sis’s maths in the same way that I was required to support her literacy that Big Sis would not now confidently declare that she was “good at maths”. Without a sound understanding of maths, the enjoyment of the sciences would be in jeopardy. Isn’t it time that we put numeracy on equal footing to literacy in early years education, as only then can we really say that we are allowing our children equal opportunity to select for themselves their strengths be it science or the humanities?

References:

The Genetic and Environmental Origins of Learning Abilities and Disabilities in the Early School Years. Yulia Kovas, Claire Haworth, Philip Dale & Robert Plomin. Monographs of the Society for Research in Child Development, Serial no.288, vol 72, no.3, 2007.