The Guardian recently published a commentary piece entitled “Is misused neuroscience defining early years and child protection policy?” which, at the time of writing, has received over 300 comments. For an article involving child protection and / or neuroscience, this seems a relatively high degree of engagement (by way of comparison, at the time of writing, three other neuroscience articles linked to from this one have received 96, 91 and 36 comments and two relatively recent pieces on child protection have received 2 and 5 comments). In other words, this article has attracted some attention (and not only on the site itself – twitter was also fairly busy in response to the article, at least amongst the social work academics, practitioners, commentators and policy makers that I happen to follow).
The thrust of the article – for anyone who has yet to read it – is that neuroscience has had a significant influence on early years thinking in England and that the resultant social policy changes have (or soon will) “justify the removal of children (from their homes)”, as well as providing the basis for such interventions as the Family Nurse Partnership scheme. The article goes on to ask – what if the application of neuroscience is ‘over-baked’ and what if, in fact, “the claims made for neuroscience are so extreme that most neuroscientists would disown them”?
Unfortunately (for me at least), I am in no position to judge the relative merits of the various claims being made for or against neuroscience although I do accept there is always a risk when government policy is made on the basis of inexact science – although, having said this, it’s almost axiomatic that the science will be inexact to some extent due to the nature of scientific enquiry, which is ultimately not about ‘truth’ and ’certainty’ but about degrees of probability and confidence (I don’t think the article is arguing any differently). However, my concern is not with this debate per se but what it might suggest about practitioners in the field (not least because I am one) and although the article title refers to ‘early years and child protection policy’, the body of the article also refers to practice.
As an example, within the article it is said that some family nurses have reported “On their visits, they get a glass of water and put Alka-Seltzer in it, and say, if you do what you’re supposed to do, ‘That will be your baby’s synapses firing.’” The implication seems to be that this is something the family nurses should not be doing, as it is not based on any ‘objective science’.
My reflection on this is – doesn’t it depend, not on whether it is based on ‘objective science’ but on why the family nurses might be doing this and how? In other words, doesn’t it depend on what the family nurse is trying to demonstrate or communicate to the carer and what they mean by ‘what you’re supposed to do’? If they were trying to give a general idea that a baby’s brain is ‘alive’ with activity and that babies are (usually) very responsive to their environments, then I would have thought it could be – for some – a useful analogy (regardless of what an actual neuroscientist would think of it – after all, they’re not the ones sitting in the family’s front room). If by ‘what your supposed to do’ is all of the ‘typical’ things that babies need, such as food, cuddles, some level of stimulation, then again, I am not sure what would be so wrong with using the Alka-Seltzer analogy (although I have to say, when I visit families, I generally don’t take medication with me, not even over-the-counter stuff).
If, on the other hand, the family nurse is using the analogy to say that unless the carer does something ‘special’ – such as baby massage, maintaining eye contact at all times whilst breast-feeding exclusively for 12 months, giving the baby an exclusive diet of organic produce from Waitrose – then the baby’s brain will be more like the glass of still water than the glass with the Alka-Selzter, then that could be much more problematic. As I say, I think it depends.
Sometimes when I visit children, I ask them to draw a picture or write a story about how they feel when they are at their most vulnerable or scared. Sometimes the child might draw a picture (or write a story) of themselves in bed at night with monsters and demons all around them. Other times, the child might draw a picture (or tell a story) about how their carers always seem to be nearby when they feel afraid. Sometimes I tell the children that by doing this activity, it can help them to get their emotions out onto the page and turn them into something they feel less afraid of and more able to talk about with an adult they trust whether that might be a carer, an older sibling, a teacher or even me (I’m also using attachment-related ideas related to mentalization and of what the child expects from their carer during times of heightened anxiety). But of course, I am only using an analogy when I tell the children this. I do not really think ‘an emotion’ is something so easily defined or so easily managed but I use these kinds of techniques based on my (fairly vague) understandings of narrative therapy, even though I am not a trained narrative therapist and do not have a particularly good understanding of the research base (other than to know there isn’t much of one). However, I still use it because I find it sometimes works for me and sometimes seems to help the children and families that I work with.
I think the point I am trying to make is this – whilst there are, of course, legitimate concerns regarding the role of neuroscience in early years policy and of course we should be able to have an open and frank debate about this, the core activity of social work will always remain what happens within and because of the relationship between the practitioner and the family (or the individual, group, community, etc.). Some social workers are better at helping people than others and there does not seem to be a common pattern between those who are more helpful and their use of particular theories or research findings or between those who are less helpful and their use of different theories and research findings (in some ways, this reflects the still relatively poor evidence base for much of what counts as social work activity).
In other words, it appears as if there are helpful and unhelpful ways of using the exact same theories and research findings in practice, that Theory A can be used as the justification for providing more support to a family or as the justification for providing less, depending on who is doing the interpreting, not only of the theory or research findings, but also in relation to the particular family and their characteristics, the characteristics and experience of the practitioner and the influence of the organizational context and policy framework in which they are working.
Via my own research, I have been able to describe what I would consider to be some extremely positive ways of using the theory and research knowledge related to disorganized attachment in practice such as to help understand and make sense of (with a view to changing) the behaviour of ‘neglectful’ carers in order that their children can remain at home and can be well cared for. Of course, in the hands of other social workers, it is possible to imagine how the same theory and research could be used to argue that a child needed to be removed immediately and without further delay (although I have not found any examples of this in practice, which is not to say they do not exist).
At the risk of repetition, the ‘neuroscience in social policy’ debate is well worth having. But I would also like to re-assure myself that many social workers are active rather than passive consumers of research and that whatever the government-of-the-day might like the science to say, there are many, many good social workers (and family nurses) who find ways every day to help and support families, not because any particular theory tells them they should (or even despite a theory or research finding apparently telling them not to bother) but because they want to and because they know the (moral) value of doing so (perhaps that’s why they became social workers and family nurses in the first place).