So, Molly is in Year 6 now and I’m sure that I am not the only parent in the anxiety provoking situation of considering secondary transition. I am in the fortunate position (minus a few holidays and luxuries) of being able to consider a private education for my children. This rubs against my preference for all children, from any background, to be able to receive the best possible education, particularly as my siblings and I were all state educated. But where we live in London, in the vicinity of dozens of the top private schools in the country, the difference in available quality of education is all too stark. The draw of these selective schools to the local population, means that many academically able children are removed from the state education system with some demographic consequences for some of the local state schools. While we never considered a private primary education, a private secondary education was always on the cards. Of course, we also applied for the local grammar school for Molly, one that I myself attended in the 80s (see my blog on this), but unfortunately, Molly didn’t make it through the selection process (although I have managed to remain tutor-free). Not altogether surprising since we were told that there were 3500 candidates for 100 places – worse odds (35:1) than Oxbridge (10:1) but still far easier than getting on Love Island (2500:1)! The remaining selective school exam onslaught is in January with weeks required to be cleared from my diary for exams and subsequent interviews and my wallet some-what lighter for the registration fees.
I’m Chinese. I take education seriously. But equally, I am a child psychiatrist and I take mental health even more seriously. Optimal performance in any domain is impaired by poor mental health (as is happiness) and this consideration needs to come first and foremost. When Molly was told that she had not made it through the grammar school exams, she was understandably temporarily disappointed and subdued, but she was readily reassured, and within the hour was back to her usual happy self and has been looking onward and upward. There has been no dent in her self-esteem that I can discern, rather, there has been a smidgeon of increased effort in her work ethic. Given that we have come through and managed the first hurdle of school “rejection” relatively unscathed; I feel somewhat able to advise on some ways that I found useful in combatting rejection dejection.
- Start early and go slow:Adapting to big changes and making a big lifestyle change is always more stressful than making small, incremental changes over time. If you have the long term goal of children sitting selective school exams, I would always advise starting early with a small amount of work (30 minutes a day) up to Year 5 and building incrementally to a reasonable amount of work (1 hour a day) in Year 5 and Year 6. As our state primary school does not give much homework, this is very manageable. Children, who are not used to doing work regularly at home, will be more stressed if they are suddenly loaded up with tutors and work towards exam time, and this also emphasizes the fact that these exams are ‘super important’ which drives anxiety. If little and often has been part of life from the start, then exam preparation remains part of normal life and the attention and importance of exams (and therefore their outcomes) can be normalised.
- Let Life Go On:It is really important that children get selected into schools that are academically suited to them. If your child has extra-curricular activities that they enjoy as down-time, or that they would wish to continue in secondary school, then it is really important that these continue throughout the period approaching exams. If a child requires to stop everything else in their life in order to work towards exams, the likelihood is that they may be selected into a school where they cannot keep up with the class unless they continue to work at this heightened level. This leaves children in the stressful and vulnerable position of potentially giving up enjoyable extra-curricular activities forever. Extra-curricular activities are usually enjoyable and act as a source of stress release and social interaction. Some parents think that it is advantageous to ‘sneak’ spoon fed children into highly academic schools, but believe me, this is never advantageous. If children are unable to keep up they will be ‘managed out’ of these schools which can sometimes be ruthless about maintaining their league table status, and if a child has to work all-out to keep up, then this has consequences on their mental health.
- Realistic expectations and realistic explanations: I have a notion that self-awareness is the key to happiness. That if we understand ourselves and perform to our expectations then we are happy. Unhappiness arises when we do not know who we are or fail to live up to our own expectations of ourselves. This is of course more likely to happen if our expectations of ourselves are unrealistic. For many of us, myself included, I only truly felt that I started knowing who I was in my late twenties, and now in my forties, I am perfectly content with my own flawed self. Imperfect but comfortable in my imperfection – like an old pair of shoes. For the typical 11-year old child where identity is yet to be fully formed, ‘expectations’ are defined by parents. To prevent children feeling like they have fallen short, try to ensure that expectations are set at ‘realistic’. Asking school teachers, reviewing children’s independent work and having an idea of the academic level required for particular selective schools is important when choosing schools for your children. It is OK to be ambitious and choose some schools which may be a stretch, but if you are doing this, then explain it clearly to your child that there is no expectation to get into these schools, but that they are worth a punt. I take the school selection decision as a spread betting exercise and have opted for a selection of schools with varying academic vigour and will let fate decide. State school options are included in this spread bet and are talked up as being as appropriate as the private school options.
- Preparing for Failure:Children will always take things harder if they are not prepared. Many children, particularly the high-achieving and confident children that tend to apply for selective schools, have never experienced failure before. Make sure that failure is discussed openly well before exam time. Put your own failures on the table and demonstrate that failure is not something to be embarrassed about, but a normal part of life. Inculcate the mantras: “Strength is not in the never falling, but in the getting up after a fall.’ And “If you are not constantly failing, you are not really stretching yourself.” I will explain this latter statement. Children who participate in competitive sports will have a wealth of analogies that can be used to demonstrate this. Thankfully Molly does a spot of competitive swimming and is used to constant failure as the thing with swimming is that once you get to the top of a group, you get moved to the next group and start at the bottom again: succeed at school swimming, attend club swimming, succeed at club swimming, attend county swimming, succeed at county swimming, attend regional swimming and so on and so on. Unless you are Rebecca Adlington, somewhere along the line you will fail, fail, fail! What excellent life experience! I highly recommend this as an extra-curricular activity for acclimatising to failure! The truth is this: if you are succeeding easily constantly, your pond is too small. Of course, discussing failure openly can also bring up hiccups. During an explanation of why it was no problem not to get into the grammar school (before it actually happened), Molly pipes up: ‘You don’t think I’m going to get in do you?” – it’s always a good idea to answer these questions honestly: “You know what Molly? I think you have a good chance, but I really don’t know because there are a lot of other clever girls out there who all have a good chance. But it doesn’t matter if you don’t get in because it just means that the school is not suited to YOU, and there are other good schools that will be.”
- Contain your judgement.Children around this period are hawks to information and opinions about various schools. Much of it is hogwash because ‘one man’s beef is another man’s poison’. Literally. A highly-academic school can propel some girls to glittering careers, but the same school can contribute to a different girl to commit suicide. It’s all about ‘fit’. Therefore, it is no good listening to the judgements of other parents to make decisions about your own children, and its no good transferring judgements about schools to your children. They will take these comments from you as gospel and it will affect their mindset and they will tell their friends, spreading irrelevant judgements. Although I have chosen a variety of schools, I never talk of a preferred school and merely state that all of them are good. Other parents find this extremely frustration and keep pushing me with “But REALLY, which one is your preferred school?” and my honest-truth is REALLY– my preferred school is the one that offers a place to my daughter! It helps not to pay too much attention to the school propaganda machine and prospectuses which imply that they will be the only ones to hone and sculpt your child’s mind in the right way. In my opinion, there is no such thing as ‘one partner who was destined to be my lifelong love’ (sorry hubby) – there are many people in this world who we could each have fallen in love with; and equally there are many, many schools which will do a good job at educating my children. Unless you are an Oscar winning actor, if you have a ‘preferred school’ that you have singled out as being ‘the ONE’, it will be very difficult to hide disappointment from your children if they don’t get in. Anyone who has gone through the house buying process in the UK will have experience of the disappointment of being ‘gazumped out of our dream home’ and quickly realises that the scatter gun offering on many perfectly acceptable houses and THEN loving the one that you exchange on is a much better strategy.
Also – I am a control freak and if anyone is going to be ‘shaping my child’s mind and attitudes’ – it’s going to be ME! Mu ha ha ha ha. (For as long as possible anyway!)
- Contain your own anxiety. OK, I have to fess up that every 8-10 weeks I do have an anxiety wobbly where I worry that no selective school will take my money and accept my daughter to their school and that by some freak influx of 11 year olds to my local area, we will now live too far away to get into the good local state school. At least though, I recognise this anxiety wobbly for what it is and am able to mostly keep it to myself, give myself a good slap around the chops and saying: ‘stop catastrophising’. I doubt any parent can really get through this period without a stitch of worry and anxiety, but the best advice is to ‘Keep Calm and Carry On’ and preferably try not to show your anxiety to your children as your anxiety is fuel for their anxiety.
- Pride and unconditional love. If you are a bit shy about expressing your emotions to your children, now is a really good time to release yourself from your shackles. Go all out on expressing pride and unconditional love. This does not mean that you let children off the hard work that they are likely required to do, but that the effort that they put in is noted, praised and whole-heartedly appreciated, as well as their non-academic attributes that make them the lovable person they are.
- Silver Linings.When failure happens, make sure that you accept it. Highlight the silver linings to yourself and your child. It’s better that you actually BELIEVE these silver linings, other-wise your child will know that you are just trying to make them feel better and see it as fake. If you can, convince and accept it yourself first then you’ll be able to deliver the silver linings genuinely. You might feel some innate need to contest the failure and imagine some mistake has been made and feel a need to make an appeal. Alternatively, you might feel that it is necessary to make up an excuse as to why your child didn’t get in to a particular school or feel embarrassed to divulge failure to family and friends. All of these common parental behaviours meant to make your child feel better often have the paradoxical effect of making the failure hurt more for your child as they highlight your disappointment and disbelief in the legitimate outcome. As I said, unless you are an Oscar winning actor, try to be genuinely happy with the outcome as if you feel disappointed, your children will know about it however much you try to keep it from them. Many 10 year old children’s main wish is to make their parents proud. Conversely, feeling that you have made your parents ashamed or disappointed can feel like agony.
To all parents embarking on the same journey as me in the next 2 months:
To all girls and boys out there who are embarking on the same journey as Molly in the next 2 months.
You will be Brilliant wherever you go to school!
Today, I have been at the British Mecca for Psychiatrists, the annual conference of the Royal College of Psychiatrists. We have taken over the ICC in Birmingham where the entrails of the Tory party conference are still being tidied away. I did have a double take moment of “Lord, I’m at the wrong conference” when I was greeted with the “A Country That Works For Everyone” signage which dwarfed our college’s diminutive logo. The juxtaposition being even greater because within the medical profession, the psychiatrists are probably the most left leaning, our life’s work being in the care of some of the most discriminated and disadvantaged in society who are not usually the Conservative party faithful.
I’m not really a “conference” person. Brown-nosing and networking brings me out in hives, but I have been around long enough to know just enough people to make small talk to. At shrink-fest this usually involves grumbling about:
- Lack of in-patient beds
- Being mistaken for a psychologist
- Not being recognised as “proper doctors”
- Lack of medical students wanting to train in our wonderful specialty
Mostly, I am robust enough to endure colleagues darting-off mid conversation to talk to someone else of greater importance. Occasionally, I bump into old supervisors and I have to admit to them that I’ve chucked in my research and pretend to be blissfully happy about this decision. Other times I catch sight of another female ex-researcher and we indulge in metaphorical hand-holding and sighs of “it’s so hard with children”. If it gets too much, I hide out in the loos checking social media. People post me pictures of dead animals (anti-hunting friends – don’t ask).
It might sound awfully depressing, but I also learnt these amazing nuggets:
From the wonderful Dr Andrea Danese, an Italian contemporary who heads up the Stress Lab at the Institute of Psychiatry. He once gave me a good recipe for pesto and today, he taught me this:
- If you get a nasty cut that gets infected, the skin gets red and “inflamed”. If we took a sample of your blood, we would find raised levels of proteins e.g. C-Reactive Proteins which are called inflammatory markers.
- Stress can cause an inflammatory response, just like an infection in quality but milder. This is to prepare the body to fight stress, in the same way that your body prepares itself to fight an infection.
- Children and adults with depression have raised inflammatory markers.
- These markers are even more raised if there was evidence of early life stress such as childhood maltreatment.
- Adults with raised baseline inflammatory markers are more likely to have recurrent and chronic depression which does not respond to traditional anti-depressant treatments.
- Anti-inflammatory agents usually used as pain killers after surgery (COX-2 inhibitors) have been successful in treating depression, particularly in people with high baseline inflammatory markers.
I know, this sounds dull to you, but to shrinks this is like: Yay! Another drug (cheap too) – maybe they won’t confuse us with psychologists anymore?
I also learnt from Professor Ian Goodyear (Head of Child Psychiatry at Cambridge University) that in his longitudinal studies of depression he divides us parents into the following groups which form a measure of “suboptimal family environment”:
- Optimal (that’s me of course)
- Aberrant (well-meaning but missing in action or clueless)
- Discordant (bickering and self-interested)
- Hazardous (deliberately cruel and abusive)
- Not surprisingly, the majority of children raised by “hazardous” parents end up with all kinds of mental health problems.
And from Professor Eric Taylor, the grand don of my field neuropsychiatry:
- 20-70% of children with ADHD continue to have symptoms into adulthood.
- 50% have another psychiatric diagnosis by age 27 years (mainly anti-social behaviour, drug misuse or depression).
- Children with ADHD with no friends and unsupportive, hostile parents at age 7 years are more likely to develop conduct problems and antisocial behaviour.
- If a child with ADHD lasts to age 17 years without engaging in anti-social behaviour, their parents can heave a large sigh of relief because they will very unlikely ever engage in this type of behaviour (they may still be susceptible to depression unfortunately).
The best part of conference?
The hotel to retire to overnight. Totally kid-free: gym, luxuriating bath, telly, bed and totally guilt-free and legitimate because “I’m working!”.
Roll on day 2!
As we enter SATS season, I’m on my education rant again. In the Far East, six year olds know their times tables up to 12, a target that has been set by the UK government for children of 11 years. A target that has been required to be set as it has thus far been largely unmet. Growing up, my sisters and I were ridiculed on holidays back to Taiwan when our cousins (subject to the rigorous mathematics curriculum and public adoration of anyone deemed “good” at maths) performed long divisions in their head that had us reaching for our calculators.
“So what?” we would retort, “Why bother when we can use a calculator?”
Shamefully, this is the same retort used by the new tech savvy generation for whom spell-check and mobile phone calculators have deemed a brain unnecessary. Sure, I still agree to some extent that complex maths should be done using a calculator, but basic mental arithmetic and an understanding of mathematical concepts should be basic universal knowledge. A good friend of mine (who is an actuary) volunteers as a maths teacher to adults in a South African township as he believes that it is numeracy and mathematical ability that will take people out of poverty.
Why is the general level of maths so bad?
Actuary blames the lack of availability of good maths teachers, and Banker reckons this is as people that are good at maths can be paid more in the city than in teaching. I blame the bad PR that maths gets in general and society’s acceptance that “maths is hard” and “maths is for nerds”. This rep doesn’t exist in the Far East, as evidenced in the recent film ‘X+Y’, where the Asperger’s boy “anti-hero” who has a flair for maths and is an outcast in the UK, is viewed as a “Hero” and legitimate mainstream love interest by the Chinese girl when transplanted to maths camp in Taiwan. Maybe when we in the UK learn to fancy girls and boys that can solve quadratic equations as much as girls and boys that can write love poems in the manner of Keats, we could have a maths renaissance.
It seems though that things are changing and that I am not the only one disgruntled by the apathy and low expectations for maths even under the supposed hard target-setting “Gove-ian” government, as the number of Kumon centres spreading fast across the UK can attest. When posters at my local tube station are inviting me to set up my own Kumon maths teaching centre in order to earn shed loads of money, one can only imagine that the demand for better maths education is such now that the government should think harder about supplying more and better teaching lest the gap between the Kumon-haves and Kumon have-nots should widen.
The Pros & Cons of Kumon
For those unfamiliar with Kumon, it is a Japanese system of learning maths focused on daily practice of maths using generic maths worksheets targeted at your child’s level. You attend a special “Kumon Centre” to get your worksheets marked and some advice on corrections; then you get set more worksheets to do at home until your next attendance at the centre. For this you pay a not-insignificant subscription fee, albeit less than a personal maths tutor.
You might think that being a maths-ophile that I would love Kumon, but you’d be wrong. Whilst I am a fan of improving mathematical ability, and am in no doubt that practicing maths on a daily basis will significantly improve your child’s mathematical ability, I am not convinced by it enough to send my own children, although I have to admit that I have never set foot in a Kumon centre, but have spoken to many people that use Kumon and have investigated the website and promotional literature.
Can it be in any way fun?
The advertising may suggest that the “centres” are fun places of learning, and that the specially designed worksheets “will make maths enjoyable”, however from what I have seen, the centres are just rented halls where children sit and do worksheets. The worksheets are similar to any other worksheets printable from on-line sites or workbooks purchasable from WHSmiths. There is likely to be added value of having worksheets targeted at your child’s individual ability rather than their chronological age, but they are no more “fun”. Even the Kumon logo depicts an unhappy face. I always wondered if this was supposed to resemble the children going in or coming out of Kumon, neither seemed to send a positive message.
It still relies on parental discipline
I could see the attraction of handing over my innumerate child and being handed back a child that was numerate and confident at maths with no effort from me, but from my observations of Kumon parents, that’s not the case. No, Kumon mums (I don’t like to bring gender into it but I have only yet met Kumon mums and Kumon nannies) are frazzled as they are the ones that need to uphold the discipline to make the said innumerate child do the blessed worksheets throughout the week.
Evaluation is still teacher led
Whilst parents are required to nag children to complete their worksheets, it is the teacher that evaluates and monitors progress and sets the agenda. Maybe I am just too much of a control freak, but I think that parents should have a role in this. Some parents love Kumon (and maths tutors and private schools) and actively avoid “evaluating” their children’s ability. They see it as somehow making a value judgement on their child and this being somehow unhealthy as they should always believe that their child’s ability is SUPER. Some such parents get a nasty surprise if their children underperform and pass disappointment on to their children; others blame the teachers for not getting the best out of their SUPER-able child.
I believe in the reverse. I think that evaluating and monitoring your child’s ability is essential so that as a parent you have an accurate, realistic and evidence-based picture of your child so that you can guide them into the appropriate school/ university/ career. There is no value-judgement as your child IS SUPER no matter what their ability.
As I alluded to earlier, I believe that Kumon is just another way in which the middle-classes can pull away from the mainstream. We shouldn’t need Kumon; we should be putting pressure on the government for the betterment of overall maths education. The proliferation and promotion of “professionals” in maths tuition undermines the very real and practical advancements that can be made with primary maths learning by parental involvement in reinforcing school maths. Most parents who are sending their children to Kumon have at least primary school level education and should be able to help their children with maths at this level without the requirement of paid professionals. If increased efforts were made to educate parents on supporting their child’s education, children from all backgrounds would benefit.
What did I do?
I am speaking from the middle of my maths journey with my children. I cannot in all certainty confess ultimate success, nor admit to a pain and frustration free experience to date. Most of what I did and am doing is based on trial and many errors. I summate the optimum strategies that I have garnered not the entirety of my experience which contains many expletives, failures and revisions. Although I can confess that both my children are performing at the top end of their respective classes at maths, I cannot negate the real effects of genetics on this outcome. Irrespective of this, I am happy with the choices I made and so am sharing my limited insights with you, in case you may find it of value.
I introduced numbers to my kids at the same time that letters were introduced. Literacy and numeracy are to be given parity in my book. Children are just as capable of learning a sequence of numbers as they are a sequence of letters. From when my children were a young age I carried a notebook around with me and if there was a period of “waiting time”, for instance waiting to be served in a coffee shop, I would draw puzzles (mazes, matching puzzles, counting puzzles) for my children. If they were completed easily, I would make the next one harder. If they were too hard, I would make the next one easier.
As the children grew older, these puzzles moved towards proper mathematics. Rather than only being served up in “dead-time”, they were served up daily. Initially this was done in the evenings when I got home from work, but on finding the children (and indeed me) too tired at this time of day, I switched it to the mornings. This worked a lot better as the children were fresh and my over-enthusiastic tendency to set more and more work was naturally curtailed by the requirement to send children to school and get to work on time. The initial protests subsided and they came to realise this was the routine from now on.
Friends looked at me like I was bonkers when I told them that I wrote my own maths worksheets for the kids, but what better way to tailor work for your children? By having daily exposure to what my children found easy and hard, I could not only have an in-depth understanding of their precise ability, but also be in the best position to set and manipulate their next worksheet. If single digit additions were proving easy, then you can bet that double digit additions were thrown into the mix on the next worksheet. However, if there were too many tears and frustrations, the next few worksheets would be deliberately easy to restore confidence. By writing your own worksheets, you can not only tailor your child’s learning but heavily manipulate their confidence.
When abstract problems became taxing, I found that re-framing problems into applied mathematics sorted the problem. Big Sis struggled immensely with problems such as “What number is half-way between 26 and 36?” She cried. Many times. I tried to explain it many times unsuccessfully: “You can either add the two numbers together and halve the total; or, you can add to the smaller number half the difference between the two numbers”. Not surprisingly, Big Sis developed glazed over eyes and hands over ears “la-la-la – not-listening” pose much to my annoyance. Then one time, lashing out in desperation I happened to say: “I give you 26 sweets and I give Lil Bro 36 sweets…”, then before I could even finish my sentence, Big Sis declares “That’s not fair! He shouldn’t get more than me! We should both get…(counting)… 31 sweets each” and “Bingo”. The war was won. From then on, problems were made real and Big Sis relished calculating “real world” problems. When Banker ran the barbecue at the school fair, maths worksheets were laden with problems of “Your friend Henry wants to buy 3 hot dogs from your dad. Hot dogs are £3 each, how much does he need to spend? What change must your dad give him from a £10 note?” At birthday time when Digi-birds were requested, “How many Digi-birds can you buy with the £30 your grandma will give you?” Go-figure, self-interest really helps with maths. Maths was made useful if not fun. There were no more complaints.
Once confidence was gained at maths, we moved on to shop-bought workbooks. If workbooks were a struggle, then the same book would be reworked again, being very easy the second time around, not only to consolidate knowledge but to boost confidence. The message “Maths can be easy”. And because I am evaluating and monitoring progress, as well as her teacher, nothing said at parents’ evening surprised me. I can pick up a Key Stage 1 Maths paper and know almost exactly which questions Big Sis will answer correctly and which she will struggle with.
Why is this important?
When the 11+ exams come around and performance will matter, I don’t need to rely on the opinion of others, I can be (almost) confident about my children’s performance and if I do not think that they will succeed, then they will not sit the exam. The bar will be set at achievable. Expectations can be managed in advance, disappointments avoided, and crucially self-esteem preserved. Self-esteem, confidence and a continued keenness to learn always matter more than the final mark at this age, and arguably at all ages as life is a marathon not a sprint. Contrary to popular belief that children who are being set regular work are “pressurised”, I believe the reverse. The “pressure” comes from the weight of parental expectation not parental preparation.
If you have the time and inclination, give Kumon a miss, roll up your sleeves and give it a go. There are frustrations and discipline required (but this is required of Kumon too) but there is also satisfaction and delight when you witness the penny drop and the passing of knowledge and the instillation of confidence.
I remember fondly my mother teaching me maths (despite my tears and tantrums) and I hope as adults my children will feel the same way.
Over the last few weeks I have been asked by a few people to write something on managing behaviour of children. This is one of the biggest challenges for parents, and yet I had put off writing about this as it is not as easy to give advice on this as it sounds. The “tips” that friends were asking for basically amount to what we in the industry call “behavioural management”. Ways in which parents can magically “change” or “manage” their children’s behaviour. Sadly, there is no magic tip, only all the things that you have already heard of and tried. Behavioural management tries to spell out what is and is not desirable behaviour and strategies try to tip the balance of choice towards behaviours that are desirable. Well known strategies include “the naughty mat” or “time out”, “ignoring” your child’s mild bad behaviour and also the blessed “reward chart”. If you want to read up on behavioural management an excellent book is “The Incredible Years” by Webster-Stratton. I won’t précis what I feel is a thorough account of good behavioural management, but instead ask:
Does behavioural management work?
The answer in theory is unequivocally “yes”.
But, so often in practice is “no”.
This is because behavioural management is easiest to implement when your child is “typical” and has no other problems, and you (the parent) are brilliant, have no problems and are super consistent in everything you do both with your co-parent and school.
Which basically means “no” or only “a bit”– as when does the above situation ever happen?
Here are two reasons why your child may not be “typical”:
Neurodevelopmental problems, in particular learning difficulty can heavily impact behaviour. In young children, aggression and temper tantrums are typical responses to frustration, but by school age, some control should have been gained over these behaviours. If a child is developmentally delayed, then their ability to behave should be compared to their developmental age rather than chronological age. A 16 year old boy with the developmental level of a 4 year old; can be expected to behave in line with a 4 year old. For a four year old, temper tantrums and hitting out are common responses to frustration, the trouble is that being hit by a 16 year old boy in a temper tantrum has very different consequences to being hit by a 4 year old, and yet, the child “can’t” help responding in this way. These children are often clients in child mental health services as parenting children with severe learning difficulties can be extremely challenging. Other neurodevelopmental disorders also cause behavioural problems. In ADHD children with problems with attention cannot listen to or follow instructions as well as other children. They will tend to act without thinking and may do things that they regret later because they acted without thinking. Children with Autistic Spectrum Disorder may have behavioural problems as they are having difficulty in understanding what is being expected of them and poor social understanding can lead to many more frustrations on a daily basis. Standard behavioural management may not work in these groups of children and behavioural management needs to be adapted to the child’s difficulties. In general it is harder to implement and with more varied results than in children without neurodevelopmental difficulties.
Children who are having emotional problems may have difficulties in behaviour. Emotions and behaviour are inextricably linked. When we feel down or stressed out, our behaviour changes. Some of us reach for chocolate, some for alcohol, some people become withdrawn and unsociable, other people become irritable and angry. It is important to assess emotional aspects of your child’s life if their behaviour changes or deteriorates. Children may not always volunteer their states of mind to you. They may not be able to label their emotions, or to express themselves. They may be afraid to talk about these things. Their unhappiness and frustrations are displayed in their behaviour rather than in words. It is your responsibility as a parent to notice, to ask, to label for them, to give them words, to give them permission to talk about their difficulties. To guess and to investigate from asking teachers and friends if nothing is forthcoming. It may be that they are being bullied at school, it may be that they are picking up on the stress in your marriage, it may be something trivial, but if you don’t notice/ enquire, you won’t know and their change in behaviour will just be called “bad behaviour” or “acting out”. In these cases, behavioural management will not work well. Rewards will feel irrelevant, ignoring and punishment will feel like persecution, negative attention will be better than no attention and rejection is a welcome confirmation of their own self-loathing. Finding out what is wrong, offering security will work better here. Unattended emotional problems in children can impact personality and aid development of long-lasting traits that can lead to “bad behaviour” becoming habitual and “part of” a person’s personality that can no longer be easily mended.
In children without these additional problems, the limiting factor to good behaviour is usually the parent not the child.
Lack of sustained motivation:
In the defining clinical trial for children with ADHD where they compared medication to behavioural management (The MTA Study), behavioural management achieved equal outcomes compared to medication. But wait, here the behavioural management programme used highly trained psychologists to work with highly motivated parents and teachers to obtain this outcome. Real-life trials (what we call pragmatic trials) using existing services, which tend not to heavily involve the schools (as the Department of Education is separate from the Department of Health), and non-selected patient groups, that have looked at the efficacy of community parenting and behavioural management programmes have netted unimpressive results. It is not that children’s behaviour cannot be managed; it is that the will of society and parents, is insufficient.
I know this all too well. Big Sis has a weekly spelling test. On the weeks where I have my act together, we sit and learn the words and I test her on the words each day to make sure that at the end of the week, she gets full marks and I reward her for this attainment. This is basically behavioural management in action: co-working towards a set goal that is achievable, achieved and rewarded. This works fantastically well, thumbs up and smiles all around. Once she has done this for a few weeks, I get complacent and I think, well now – maybe I can just give it a skip this week, she and I can both have a relax and we’ll just have a quick look at the words the night before. She gets a couple of mistakes. That’s basically my anecdote for behavioural management. It genuinely works until one day, you can’t be bothered and it all goes a bit wobbly again. The limiting factor is me, not Big Sis.
Wobbles in my behavioural management can also be seen when I am stressed or distracted. One time when I was very stressed waiting for a phone call regarding a job offer; the children were extremely badly behaved – “for no reason”. I was snappy and shouted at them and they just wouldn’t do what they were told – “it was as if they knew exactly when to wind me up”. Eventually, the phone call came, and I had got the job. That afternoon, they were very well behaved. The change had been in me, and their behaviour merely reflected my state and parenting capability, not something innate in them.
Unrealistic parental expectation:
When we talk about “bad behaviour” we all mean different things and we all have different thresholds as to what is meant by “bad”. Some friends and relatives come by our house and make “tutting” sounds when they see our kids glued to the TV, leave the table at meal times on a whim to dance around the kitchen, bonk each other on the head with cushions and generally shout at each other and at us. To me, this is not bad behaviour – this is just life in our household! Equally, I raise a brow when I see children that never say “please” or “thank you” and run away from their parents on the street, while this is not something that bothers them. When parents complain that their children “Will not do as they are told”, the severity of the issue rather depends on what they are being told to do. If they will not do 60 minutes of piano practice every night, that is rather different from refusing to do their homework, or refusing to stop watching TV; and “good” and “bad” behaviour is sooo dependent on what the parental and school expectation is. Often there are cultural and generational expectations of how children should behave. A normal child in a school with high behavioural expectations may be deemed to have “bad behaviour”, a normal child in one culture may be deemed badly behaved in another. The behaviour is relative and in order to assess behaviour properly, it is important to first evaluate that the expectations are reasonable. There is a limit to how much a child can “change” and they will not bother to attempt to change behaviour if they feel that the bar is being set too high.
One of the main saboteurs of a good behavioural management programme is “other people”. The well-intentioned/ or not so well-intentioned other half who disagrees with what you are doing. By not supporting you, they are de facto sabotaging the behavioural management plan because children are such buggers that they can spot disagreement a mile off and work it to their advantage. Much like MPs claiming expenses and benefit fraudsters, they are not averse to trying to get away with as much as they can. Playing one parent off the other must be a favourite game for children. In my opinion parents who want to succeed at behavioural management need to get on board together, or not bother. A similar conundrum exists with the school. If children are told one thing at home and another at school, the “authority” of “the rules” is undermined. It is a good idea when implementing behavioural management to discuss plans with the child’s school so that the same message is delivered to the child.
So in summary, if emotional problems are excluded, behavioural management delivered consistently and well will definitely improve your child’s behaviour, even if they have additional difficulties; but it is by no means a magic wand. It takes hard toil, stamina, guts, persistence and tears, but can reward you with likeable human beings. Isn’t that the essence of parenting?
If you want to know more about behavioural management please buy/ beg/ steal/ borrow: The Incredible Years, by Carolyn Webster-Stratton. This is the programme recommended by my colleague Professor Stephen Scott OBE of the UK’s National Parenting Academy. I have read it cover to cover and it’s good common sense.
Carolyn Webster-Stratton. The Incredible Years. ISBN 978-1-892222-04-06. http://www.incredibleyears.com
The MTA Cooperative Group (1999) A 14-Month Randomized Clinical Trial of Treatment Strategies for Attention-Deficit/Hyperactivity Disorder. Archives of General Psychiatry. 56:1073-1086
This week I have been working on a resources page for the site as there are some great, free resources out there that I think are unknown to parents and under-utilised. The resources page will permanently feature on this site now, so please let other people know about it. I hope to continue to populate this resource page with new and wonderful things so do check back occasionally to the resource page.
Youth in Mind is a great resource from Professor Robert Goodman a fantastic researcher in epidemiology in children’s mental health who has taught and helped me with research in the past. The website is a bit basic, but don’t let this fool you into thinking it is not legitimate; it’s just that high-flying academics have more time for research than prettying-up a website. On the bottom of the home page, you can access a download of Goodman and Scott’s textbook on Child & Adolescent Psychiatry. All psychiatrists read this book for the Membership exams for the Royal College of Psychiatrists so if you digest this book, it is probably as much as most generic psychiatrists know. Unless you are a budding psychiatrist, I am not recommending you read this cover to cover, but if you want an authoritative and comprehensive view of a particular issue, it’s a really useful reference. And FREE. Robert is a truly generous academic and I know that he negotiated with the publishers for this content to be made free particularly for colleagues practicing in the developing countries, but it does mean that this resource is now available for everyone.
Also from Youth in Mind, you can navigate in your own language to an on-line questionnaire, the Strengths and Difficulties Questionnaire (SDQ) which you can complete on-line for your child. The SDQ is one of the most frequently used screens for mental health problems worldwide and will help highlight your child’s strengths and difficulties in key domains. The web-site will give you specific instructions and will also give you a feedback report about your child’s strengths and difficulties. A teacher version is also available, and the combination of both parent and teacher reports will give a more accurate summary. For teenagers there is also a child self-report version. Of course, no on-line questionnaire can replace a medical assessment if you are worried about your child, but it can prompt you to think about your child broadly and to consider if there are any concerns that warrant further exploration.
For teachers, social workers, youth group leaders and anyone working with children MindED is a great e-learning resource that will undoubtedly help you help the children you are working with. It was set up as a collaboration between the Department of Health and the Royal College of Psychiatrists as well as Paediatrics, so is a good resource.
For Young People
This is a website targeted at young people so that they can get informed about the medications that they may be being prescribed. It is funded by the charity Young Minds and is also very good.
Still the go-to site for autism information for parents. There are regional branches of the NAS and they will give you information about resources, services and support groups locally.
What would I do without the brilliant Book People? The majority of presents that we give to other children for their birthdays come from here (Sssshh – they are so cheap – don’t tell). Books make great presents, and the Book People even do cheap but beautiful birthday cards. I hate cheap plastic tat, and so we always give a book as the party-bag present at parties too. At a pound-or-so a book (including greats such as Roald Dahl and Diary of a Wimpy Kid), it beats plastic tat and a glow-stick any day. The full Roald Dahl collection (15 books, potentially a year’s worth of reading) can be purchased for the price of two cinema tickets, and the full set of David Walliams audio-books kept the kids quiet on many a long drive. Great adult and cookery books too!
A few weeks ago I had a conversation with a professor. She asked me how my children were. Being conscious that my part-time status should not account for nothing, I bragged:
“Oh, my daughter is in the final of the Borough Poetry competition and my 5 year old son is playing chess”.
What surprised me was her response.
“Oh – you see, that proves it’s all “G””
(G is the behavioural geneticists’ abbreviation for genetic effect – yes, we behavioural geneticists actually do talk in terms of “G” and “E” (environmental effect) in common parlance rather than actual coherent words).
“Oh” I said, “I was about to say that it proves it’s all “E””.
Of course, we all know that both “G” and “E” play an effect in outcome, but it is funny to see how (even in two people that study it) our interpretation of science is coloured by our own personal view; or perhaps rather, we skew the science to suit our own needs and to support our chosen behaviours.
My personal view is that parenting matters. I would not have gone part-time and sacrificed career advancement if I did not believe that I would be making a significant positive impact on the outcome of my children. I am more likely to see positive outcomes in my children as being directly related to my input, rather than what would have happened regardless if I was there or not.
If you believe that outcomes are solely genetically determined, then parenting no longer becomes important, and you may as well excel at work and farm out childcare. Equally, if you have chosen to excel at work and farm out childcare, it would suit you very well to believe that “it’s all about G”.
So here’s the route to Big Sis’s poetry success and how come Lil Bro is playing chess at 5 years, and you can decide for yourself on the G and E in these instances.
Big Sis is good with words. She is interested in them and from as young as 3 years she would always ask questions about the meaning of words:
Big Sis: What does imagination mean?
Me: It’s something that you think about in your head.
Later, when I asked her to concentrate on colouring within the lines:
Big Sis: What does concentration mean?
Me: It’s when you use your head to think about something.
Big Sis: No. That’s your imagination.
At that point, I bought her a dictionary so that she did not need to rely on my lack of defining prowess; the point being that she was interested in words and their meaning from a young age and I provided her with the tools to pursue this.
In addition, I read to Big Sis (and Lil Bro) every night from the age of 1 year, until they could read chapter books for themselves, and I will still read to them more challenging books when we are on holiday. I will define (to the best of my ability) difficult words and ask questions to check that they understand what I have read to them.
I have a book of poems my sisters and I wrote when we were Big Sis’s age. My father encouraged us to write them and he had them bound in a fancy book. They are absolutely hideous (all basic rhymes and no substance – “I love school. It’s so cool.” – you get the tragic idea) but strangely appealing to young children. Sometimes I would get this book out and read them to the children.
When I found out that Big Sis was studying poetry at school, I went to Waterstones to buy TS Elliot’s “Old Possum’s Book of Practical Cats”. We have a well-loved cat, and so I thought that this would be an accessible poetry choice for Big Sis. Indeed it was. We read all the poems together. Lil Bro takes to Macavity, Big Sis to the Pekes and the Pollicles. We will soon be taking advantage of the return of the “Cats” musical at the West End.
In one poem, TS Elliot says “How else can a cat keep its tail perpendicular?”
Big Sis asked for a definition of “perpendicular”.
I explained that it means when something is at right-angles to something else. I stand up and demonstrate with my arms perpendicular. At that moment, our cat jumps out from under the bed with her tail up. “There look” – I say pointing, “that’s what it means to have a tail that is perpendicular.” Big Sis understands.
“But”, I say to Big Sis, “I think that Mr Elliot has another meaning when he asks this.”
“Show me what you look like when you are sad or ashamed of yourself.”
Big Sis, the master of drama, slumps and hunches over; slinking away.
“Now show me how you look when you are proud.”
Big Sis sits up straight and tall.
“Look”, I say, “You are “perpendicular” to the ground when you are proud. I think this is what TS Elliot means; he is talking about pride rather than the position of the cat’s tail.”
Later, Big Sis is practising ballet moves in the hallway.
“Mum!” She shouts.
“My leg is perpendicular.”
Lil Bro has always had excellent spatial awareness. One Christmas just after his second birthday I thought about presents to get him. Being Chinese, the first toys that come to mind are educational ones. I thought I would get him a jigsaw, something he could realistically manage like a 3-piece. His Aunty, who is also Chinese and so of the same “educational toys” mind set also buys him jigsaws – Thomas the Tank Engine ones; only, she has no children and so did not appreciate how many pieces a 2 year old could realistically do – and bought him 6, 10 and 12 piece jigsaws.
One evening, I was cooking dinner so I put Lil Bro at the table with the 3 piece jigsaws. He wanted the Thomas ones, so I put those out as well, just to keep the peace while I cooked. The next minute, I turned around and there he was sitting with the 6 piece puzzle completed. I nearly dropped my saucepan.
“OK, then clever clogs” I thought, here’s the 10 piece.
That was also pretty much consumed.
My Christmas present was a complete waste of money, he never did 3-pieces. By the time he was 3, 24-35 piece jigsaws were no problem. We even played “Jigsaw-offs” – infant versus geriatric; where Lil Bro and my mother would race as to who could finish an identical 24 piece jigsaw faster. Lil Bro was victorious.
By 4 years old 50 and 72 pieces were fine. By that time, I had emptied out several toyshops of their jigsaws.
At weekends, when Big Sis was at her swimming lesson, Lil Bro and I would sit in the coffee shop next door and eat porridge. The coffee shop had chess and draughts sets for customers to play with. To kill the time, I taught Lil Bro to play draughts and then chess. I am not the greatest chess player myself. I tend to take pieces with no overarching strategy; pretty much ending most games with no conclusion as my bishop and king chase the opponent’s knight and king hopelessly around the board. Still, by 4 years, Lil Bro knew how the pieces moved. I installed a chess game on to the ipad at home and encouraged the children to play it.
By chance, there is a chess club that runs in the same community centre that the children go to Chinese classes at (they go to be at one with being “Chinese” – their Chinese is even more hopeless than mine). One day, Lil Bro, aged 4 years said “I want to go there and play chess”. Given that the time clashed with their Chinese class. I said it wasn’t possible, but when it came to the summer holidays, I asked if they wanted to go to Chess Summer Camp for a week.
Big Sis was not keen.
I said to Lil Bro, “Your sister doesn’t want to go. Are you sure you want to go, even on your own?”
He said yes.
I went to check with the Chess Camp leader – wasn’t he too young?
The Chess Camp leader said some of the best players in the club were 5-6 year olds. Still, I wasn’t happy to send Lil Bro on his own and I eventually managed to twist Big Sis’s arm to go with him.
After a week of chess camp, and the initial enthusiasm, we carried on playing chess occasionally now and then. I didn’t think anything further on it. Then 3 months later, Lil Bro says to me “I want to go to chess club”.
Man! I thought. I wrack the local websites for chess clubs that are not going to clash with their Chinese class and are not too expensive. Finally, I find a cheap club on a Saturday afternoon at the local library. It’s good, but there is one teacher to eight children at greatly varying ages and abilities. Plus, smack bang in the middle of Saturday afternoon is not the most convenient time.
I get the chess teacher’s contact details. I ring around a few mothers I know whose children might be interested in chess. I set up a chess club for 3 boys after school in a local coffee shop.
So…what do you make of it?
My view is this: clearly, both Big Sis and Lil Bro have genetic predispositions to be good at certain things. I come from a family of mathematicians and engineers; Banker from a family of lawyers and linguists. Go figure that these genes are knocking about our chromosomes.
But can that be all?
What if I hadn’t been there to notice?
What if I had noticed but done nothing about it?
What if I had noticed it but derided intellectual pursuits and tried to knock it out of them?
I am pretty sure that Big Sis would still have enjoyed and been good at writing and Lil Bro would have found chess by himself at a later age. But would they have been in the final of a poetry competition at age 7 years, and been playing chess aged 5 years?
Do these things matter?
Might they not reach the same end-point in adulthood?
That is the more interesting question that is so hard to answer because of the lack of the counter-factual. But my view is this: if life is a journey and your outcome is your destination; genes will drop you off at the airport. If you are lucky it will be London City Airport, if you are not so lucky it will be Luton Airport Parkway. Parenting provides your back-pack: it can be empty; or it can be full of maps, restaurant and hotel reviews, travel guides, good books, a compass, a thermos of cocoa and a bag of chocolate chip cookies. It might not be everything you need, but it sure helps you on the way.
Ultimately, where you go from there is up to you.
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:
“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.
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.
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.
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?
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.
This is part of the infant 360 degree appraisal series on social ability. This post follow’s on from last week’s post on basic social ability and will give you information about how to assess higher order social ability in 4 year olds.
Interaction with peers
As described in last week’s post, a child’s interaction with peers is more difficult for them to navigate than interaction with adults. A child that interacts confidently with adults may struggle to interact with peers. This is as 4 year old peers are immature in social skills and are themselves learning to acquire these skills. This is easy to understand if you think about tennis. A child beginning to learn tennis can play with an expert adult as the adult can direct balls at the child and return errant balls. Get two children who are just beginning to learn to play tennis to play with each other and it is much more difficult and frustrating for the children as neither can play properly.
Both Big Sis and Lil Bro went to nursery from a young age and so had much exposure to interacting with other children. From this I was able to get good accounts of their social ability with peers. Most nursery schools will be able to tell you if your child is able to take turns, share toys and join in with other children (for instance joining in with actions to songs such as “The wheels on the bus”, or a game of hide and seek). Most nursery schools will be able to tell you if your child is aggressive in interactions. If your child is constantly victimized (which you will know about as you are required to sign an incident form in a nursery if your child is bumped/ bruised/ bitten/ scratched or harmed in any way), as well as questioning what the nursery is doing about this, you should question what your child is and is not doing to end up in this situation so frequently. Children who are frequently victimised or frequently aggressive are more likely to need extra attention as they may be vulnerable to difficulties.
Most nursery schools will be able to tell you if your child is polite (says “please” and “thank you” – very important social skills that do require to be taught) and caring (what they do in response to another child that has fallen over). They should also be able to give information regarding play. If they don’t, you should ask about it.
The importance of play for children cannot be overstated. Not only as a means of relaxation and enjoyment, but it is in play that children are able to order, understand, rehearse and cement social understanding as well as be creative. Play is often heavily influenced by what the child has experienced in their social environment. It is sad, but no surprise that some children I know in South Africa, following an armed break-in started to play a game of “robbers” involving tying each other up. Back at home, I know children who are more likely to play “I’m mummy, getting ready to go out to a party”. What these children have in common is that they are all learning about their own social environments and about ways to behave in them. It’s no wonder that “play” with a dolls house and family characters is the preferred way that shrinks find out what is really happening at home when we assess children of this age group. If children play about the mummies and daddies shouting at each other, this doesn’t mean a direct call to social services, but does prompt questioning and assessment on the parental relationship and what bearing this may have for the child. Observing what my children play act left to their own devices is one of my favourite pastimes, and if it is about setting up a school and marking a register and reading stories to the assembled stuffed animals (which it is frequently), I can heave a sigh of relief. It’s no wonder that watching children play, and interacting in play with children is one of the main assessment tools in a child psychiatrist’s armoury.
As well as to gain insight into the child’s real social environment, children at this age will be beginning to develop imaginative and interactive play, both precursor skills required for good social ability. Dressing up and pretending to be a princess, a superhero or both is usually a good sign of imaginative play, in particular if they take on the roles, act out stories that they have generated themselves and if they play this with other children, each understanding what the other is pretending. Many adults may see this type of play as “silly” or a “waste of time”, but imagination and role playing is a rehearsal of the ability to think about how someone else is thinking and how this may affect their behaviour, the basis of “mentalization” the new buzz therapy in psychiatry.
Interactive games, such as hide-and-seek, allow observation of practical interaction skills between children. Is your child able to take turns? Will your child cry or get aggressive if they lose? Is your child able to follow and understand the rules? How does your child react if someone else transgresses the rules? Does your child take charge of the game or stand back?
Your child’s nursery can give you this type of information; else you can observe your own child’s play with their sibling (if they are close enough in age to play together) or at a play date.
If you want a real test of social skill, or are just a mean child psychiatrist like me, then you need to work in a few spoilers. Most children will be able to display good social ability when everything is hunky-dory and going their way. But what about compromise and negotiation? What about staying out of trouble? Most children are taught compromise when children are invited over to play and “Guests” are given privileges. “Let your friend go first, because they are the guest”, “Let your friend have the bigger slice of cake, because they are the guest” – this type of thing that happens all the time on play dates. If your children are able to accept this, chances are, they will be able to come to terms with compromise. They understand the social rules and etiquette and are able to conform to them. If they predictably have a tantrum, even when the situation is explained, then problems at school can be anticipated. Getting along with other people, good social ability; includes understanding that getting along with others is sometimes more important than the bigger slice of cake.
Other spoilers can be less easily arranged, but these situations arise all the time naturally and it is often a good idea to stand back and observe how your child deals with situations rather than to wade in and intervene at the onset of trouble. When I took Big Sis to a public sand pit one day, I noticed another child who was more boisterous and disruptive playing there. The boy approached Big Sis, clearly wanting to interact, but he had already disrupted the play of some other children. Big Sis turned subtly away and kept her head down doing what she was doing and saying nothing. The boy got tired of no response and went away to disrupt someone else. Big Sis had clearly clocked this boy was trouble but she managed to deal with the problem in a way that was not rude or confrontational and that achieved its objective with minimal fuss. She was able to see trouble coming and avoid it. It may not be the most obvious social skill, but it is a highly valuable one. We all know some children who are “always” involved in trouble even if they are not necessarily the instigators and I would argue that avoiding trouble is as much a social skill as the ability to make friends. I felt confident that Big Sis could handle herself at school after this.
What happens at the highest levels of social ability – the battle for social dominance? Next week’s post is the conclusion in this series on assessment of social ability and will answer this question. Later on, I will write about what can be done to help support children’s social skills.
 I say “sometimes” as children who always suppress their own needs for others will have other issues that need addressing, and being the class “doormat”, is also not particularly desirable.
Big Sis, Lil Bro and I have been doing a lot of cooking over the summer.
Both Banker and I love cooking and food. So, it is no surprise that we would want to share this with the kids. Banker likes his meat and fire, and has recently developed a craziness about bread. I like my cakes and puds. This division of labour is not a matter of happy circumstance, but a compromise between two bossy cooks who have now become highly territorial over their area of expertise. Lest Banker ever attempt another foray into the tarte tatin area, there will be full out war (his was way under-caramelised anyway).
My own love of food came straight from my mother, a talented cook of Chinese cuisine; she would taste something at a restaurant and then set about trying to replicate it at home from the memory of the flavours. Sadly this meant that we had no cook books whatsoever at home; my mother cooked fabulously on intuition. The smells of Taiwanese beef noodle soups, sesame broiled chicken and New Year cakes deep fried in batter always filled our home. I watched her cooking from a young age, and dumpling making was a family affair. Sadly though, I lack her flair and am woe-fully recipe bound in my own practice. In contrast to my mother’s still total vacuum of recipe books, my household has over-flowing shelves of them and they are always attempting to colonise tables and floors. I can remember from early childhood pouring over cook books from the local library. Although I was brought up on my mother’s excellent Chinese cuisine, it was Western puds that I craved: warm sticky-toffee pudding with ice-cream, brandy-laced chocolate mousse, apple-pie with vanilla flecked custard. The Chinese lack the key ingredients of cream and chocolate for desserts. Although I will be the first to stand up for red bean as a chocolate alternative, I cannot quite find a cream substitute and perhaps my love of dessert making arose from my cream-deprived childhood salivating over pictures of chocolate éclairs.
It is from this background that cooking with the kids has become a staple weekend/ holiday activity. It is great fun to cook with kids given the hands on mess-making that can be had; wonders of science and alchemy involved, satisfaction of making something from nothing and best of all the gobbling up at the end. If you are still sceptical, cooking involves mathematics (measuring and weighing, calculation if doubling or halving recipe ingredients to make more or less), chemistry (melting, dissolving, colloids, acids, boiling points and much more, especially if you attempt to make honeycomb), biology (nutrition, health), history (spices and the spice trade, origins of recipes), geography (where ingredients come from, food miles, farming practices), art (decorating cakes and plating up) and P.E. (try whipping a meringue by hand, and have you seen the size of a baker’s arms?). I cannot think of a more enjoyable and educational activity for children. What other activity can awaken all 5 senses as well as stir the imagination?
Yet why aren’t all parents doing this with their kids? It was a sorry state of affairs to see on Jamie Oliver’s TV program that British primary school children could not identify common vegetables such as a courgette and an aubergine. More depressing when you see excellent home cooks whipping up gorgeous food, but not having time to cook with their children, or for fear of the mess. Why don’t they pass on their passion? I know that in my generation of women, there are some that deliberately avoided learning to cook. “Home Economics” as it was then called at school, was a subject reserved for the non-academic; a “wood-work” equivalent for the girls on track to early motherhood and a life of domesticity. High-flying women feared that their ability to cook would mean enslavement to the kitchen; but personally, I think they were cutting off their noses to spite their face. Not only is cooking a highly enjoyable creative outlet, but an essential life skill, and given the rise in obesity levels, knowledge about food, healthy eating and cooking may save your and your children’s lives, and everyone should be taught to cook. A friend of mine has a lovely little business teaching little ones about food if you need inspiration.
Of course nowadays, food has had a reinvention and young men and women have become passionate about food and there has been a renaissance of fine eating in London. The depressing thing though is that I don’t think that it has filtered down to children. Although Jamie Oliver has done a sterling job in highlighting the atrocities of school dinners, what about the stuff we are serving to kids at home? I have found that many parents, even foodies (myself included at times), cook separate meals for their children (invariably pasta or chicken based); then sit down for their own dinner of something much more interesting. Children’s menus at restaurants dare not stray from spag bol and chicken nuggets; and yet how are children to learn of new flavours and textures? Worse still, the London restaurants serving the most interesting food discourage children, either by snooty staff/ clientele with intolerance for children, or sky high prices. Not so in other countries. In the Far East, eating is a family affair and for Dim Sum in Hong Kong, you’d be hard pressed to find a table for two. Dining is without exception en famille, with everyone sharing the same interesting food on a massive table laid to the brim served by a lazy Susan. Closer to home, on a recent trip to France, Big Sis and Lil Bro tried veal’s head truffle, cuttle fish balls and petit pois ice cream for dinner from a 12 Euro Menu d’enfant at a 1 star Michelin Restaurant. That’s roughly the price of a Pizza Express pizza and ice cream. Why can’t we get this in London? Contrary to popular belief, children can develop an interesting palate with exposure and encouragement, Lil Bro totally enjoyed guzzling down snails in France, and although Big Sis is less adventurous, she has developed a taste for a variety of interesting cheeses.
I hope that the new found British enthusiasm for all things foodie can find its way to our children. Now that schools have done their part; isn’t it time parents and restaurants did the same?
For those wanting a quick and easy starter recipe that’s great for kids, here’s Big Sis’s step by step guide to our version of Nigella’s Rocky Road. So easy Big Sis can make it herself (almost), pretty much mess free and devilishly scrumptious.
2. Put into a bowl with 125g of butter.
3. Melt the chocolate and butter together in the bowl over a pot of boiling water. (I’ve tried this part before in the microwave and it doesn’t work very well). If your butter was at room temperature, then you can actually get it to all melt together over a pot of boiling water from the kettle if you use a metal bowl, thus avoiding any requirement for an open flame for younger kids.
4. Add 3 tablespoons of golden syrup to the chocolate and butter, or, we have also used honey and that also works well.
5. Put 200g of biscuits in a plastic bag and bash it with a rolling pin. Kids love this. A mixture of crumbs and big bits is perfect. Nigella uses Rich Tea biscuits in her recipe, but we prefer digestives. You can also do ginger nuts or amaretti biscuits for a posher version.
6. Pour half the chocolate mixture into another bowl and put to one side. Pour the biscuit bits into the remaining chocolate mixture and add 100g of marshmallows. Or, what we do is to add 70g of marshmallows then throw in 30g or so of other stuff, e.g. raisins, cranberries, brazil nuts, pistachios, almonds, orange zest, Turkish delight, smarties, fudge bits, salted cashews, white chocolate chips, desiccated coconut, coffee essence, vanilla essence – whatever takes you and your kids’ fancy.
7. Mix up the goodies with the chocolate.
8. Spread the mixture into a container. A foil container that you can easily bend open is best, but we never have them in the house when we need them. We have plenty of plastic boxes from takeaways and they work just as well. They also have lids so you can stack your boxes up in the fridge to save space as well as carry the rocky roads with you for picnics easily.
9. Squash the mixture down with a spoon as much as possible, then pour over the remaining chocolate. Put it in the fridge to set.
10. Once set, cut into squares and sprinkle with icing sugar, or just gobble it up as is!