Praises – five a day for young children

Let the master praise him, and say, 'Here ye do well'. For, I assure you, there is no such whetstone to sharpen a good wit, and encourage
a will to learning, as is praise.
(Ascham, 1570, The Scholemaster)

The network of Children's Centres across the country, established to support families in developing loving and effective parenting of their children, is under threat. Some Centres have already closed while others are offering reduced services. Despite injections of capital from central government in an attempt to maintain the Centres, large numbers of children are known still to be suffering from neglect and abuse, while the figures of those children permanently excluded from preschool and primary school provision continue to cause great concern.

Concerning abuse, 34,100 children were the subjects of a Child Protection Plan in England during the year ending March 2009, an increase of 4900 (16.8 per cent) on the previous year. In that period, and in each of the four previous years, approximately half of those children suffered from neglect, about a quarter from emotional abuse, about 2000 from sexual abuse while the remaining children experienced physical or 'mixed' abuse. Of the 34,100 children, 560 were unborn, 4200 were under one year old, 10,700 were between one and four years, over 9000 were between five and nine and a further 8600 were aged 10 to 15.

The remainder were 16 years and over (Department for Children, Schools and Families, 2009). Turning to children's experience at school, the statistics from the DCSF concerning permanent and fixed period exclusions in England during 2006/07 indicate that:
I    There were 8680 permanent exclusions from primary, secondary and all special schools, representing 12 pupils in every 10,000.
I    There were 363,270 fixed-period exclusions from state-funded secondary schools, 45,730 fixed-period exclusions from primary schools and 16,600 fixed-period exclusions from special schools (DCSF, 2008)

And as The Independent on Sunday for 6 November 2008 reports, 'Thousands of children aged five and under were suspended from schools in England last year for assaulting fellow pupils and teachers' (Kershaw, 2008).

These data are deeply distressing. There are, however, some encouraging signs: the very fact that over 3000 Sure Start Children's Centres were built and staffed is evidence that governments are at last beginning to recognise the significance of the earliest years of life for subsequent development, and there is recognition by policy makers that in the fields of health, mental health, educational difficulties and offending, prevention rather than cure is the way forward. Moreover, the most recent evaluation of the Sure Start/Local Programme (SSLP) initiative (National Evaluation of Sure Start Research Team, 2008) found that children living in the SSLP areas, by comparison with those living in comparable areas but without SSLP provision, showed, among several positive outcomes, the following characteristics:
I    Parents of three-year-old children showed less negative parenting while providing their children with a better home learning environment.
I    Three-year-old children in SSLP areas had better social development with higher levels of positive social behaviour and independence/self-regulation than children in similar areas not having a SSLP.
I    The SSLP effects for positive social behaviour appeared to be a consequence of the SSLP benefits upon parenting (i.e. SSLP>Parenting>Child).

To support these moves towards a preventive approach, substantial further resources are being directed to the training and support of additional health visitors, towards the development of parenting programmes and towards the appointment of family aides and family support staff. Official government policy is one of support – witness for example, the recent government response to a parliamentary committee: 'We have ensured there is enough money in the Early Intervention Grant to maintain the existing network of Sure Start Children's Centres, accessible to all but identifying and supporting the most vulnerable and disadvantaged families' (tinyurl.com/6enaleo). Yet the news in local communities, for example, Haringey, is not as positive and Children's Centres in key disadvantaged areas may actually be cut (tinyurl.com/6bsezga).

An additional preventive aid

The invaluable interventions with individuals, families and groups which characterises the work of many practitioners must go on. Yet surely there is a need for an additional model of preventive practice, with potentially widespread impact.

In the field of public health the '5 a day' campaign surrounding fruit and vegetable consumption has become part of public awareness. I wish to make the case here that we need to take a similar proactive approach to encourage good mental health. Professor Martin Herbert and I are launching a campaign to disseminate the maxim 'Five praises a day'. This encourages parents to offer their very young children five positive messages or appreciations a day. We are deliberately echoing the number of fruit and vegetables recommended, so as to benefit from this popular association. As this maxim becomes commonly known, it can inform the child-rearing practice of parents who are struggling to bring up preschool children but who may seldom encounter – indeed may actively avoid – professionals or professional guidance.

At no age is this adage more relevant and important than in the first months and years of life. Yet parents who are struggling with the demands of very young children, sometimes with several toddlers under the age of five, may well be unaware that praise and delight in children contributes greatly to their well-being, not only at that time but as an investment in their future emotional health and accomplishments (Scott et al., 2001; Webster-Stratton & Herbert, 1994). Mothers on an East Midlands estate where I was introducing a parenting support package entitled Parenting Positively (Sutton & Hampton, 2009) were complaining recently about their young children's behaviour difficulties; when I asked if anyone had ever discussed with them how important and valuable it was to admire and praise little children, they said that no one ever had. It seemed an alien idea to them. It was this conversation which led to the decision of Professor Herbert and myself to develop the 'Five praises a day' campaign.

Underpinning processes of bonding and attachment

As we know from the work of neurobiologists and neuroscientists, vitally important pathways are laid down in the baby's brain during the early months and years which underpin that child's future health and mental health (Shonkoff & Phillips, 2000). Talk, touch and gaze are key means whereby parents and caregivers demonstrate their love for and delight in their babies and small children. Abundant studies have demonstrated that parents are usually predisposed to express admiration for and enjoyment of small children and that this elicits the smiling response from babies which gives such pleasure to the caregivers (Ellsworth et al., 1993; Sroufe & Waters, 1976). Clearly this is an emotional exchange, a dance, underpinned by natural processes, to enable baby and parent to fall in love with each other.

Research into the underpinnings of these natural processes, which include the neurobiological mechanisms associated with reward processing, are yielding a rich investment in further work. For example, Dillon et al. (2009), recognising that in animal studies early adversity is associated with dysfunction in key brain regions associated with reward, have extended the field into research with humans. This team worked with 13 young adults who experienced maltreatment before the age of 14 years and a control group of young adults who had not been maltreated. They found that childhood adversity in the maltreated young people was associated with so-called 'blunted' responses in the brain networks associated with reward-related learning and motivation. These neural circuits originate in the substantia nigra and ventral tegmental area and project to the prefrontal cortex and basal ganglia (Haber, 2003). Specifically, in the group which had experienced adversity, 'two structures in the basal ganglia were not responsive to reward cues', while the same structures in the control group were responsive. Further, Dillon's team went on to suggest that such circumstances may, with other factors, predispose children to 'multiple negative outcomes and psychopathologies', and that the symptoms of apathy, low ability to experience pleasure and reduced motivation, all features of depression, appear to be sequelae of maltreatment.

The studies of Hart and Risley (1995) in the United States are also of great importance here. These researchers gathered data over approximately two and a half years from 13 professional families, 23 working-class families and six families receiving welfare benefits. They coded the interactions between parents and their young children aged 10 to 36 months for an hour every month, examining vocabulary and the types of feedback offered to children. They found that the children in the families on welfare were not only deprived linguistically but were also disadvantaged with regard to the number of encouraging, as opposed to discouraging, messages that they received from their parents. The children in the professional families typically received 166,000 encouragements and 26,000 discouragements; the working class children experienced 62,000 encouragements and 36,000 discouragements while the children whose parents were receiving welfare benefits experienced only 26,000 encouragements but 57,000 discouragements in the course of a year. Hart and Risley report that 'The amount of children's experience with encouraging feedback was strongly associated with the magnitude of their accomplishment at age 3 and at age 9–10'.

In many families where parents are supported by relatives and friends so that they can go on responding to the babies' needs, a preponderance of positive over negative interactions ordinarily leads to the development of secure attachment in the baby or toddler to those parents and carers and to the bonding of mothers, fathers, siblings and other caregivers with the child. Sometimes, however, this process does not flow naturally – through exhaustion on the part of the parents, through stress, anxiety or postnatal depression. Here is a situation where the maxim 'Five praises a day' may help the parent to remember to focus upon and express delight in the baby's beauty, his tiny fingers or her soft skin, to draw others' attention to these features and to share enjoyment of the child with members of the extended family or social group. Of such simple interactions and processes maternal and paternal bonding and baby–parent attachments are composed.

However, as we know, a stage soon arrives at which toddlers typically begin to exercise independence, to say No! and to be reluctant to comply with instructions which only yesterday they were ready to obey. So many parents seem to lose confidence at this stage (Morawska & Sanders, 2007) and, under stress from multiple pressures, can in their confusion act randomly, erratically and inconsistently. As we know, these are the very responses which are most likely to maintain a toddler's noisy, disruptive and disorganised behaviour. It is at this 'terrible twos' stage that it would be so beneficial to have an adage, familiar to all, that prompts parents and caregivers to recognise the developmental stage which their toddler has reached, to redirect their attention from the 'naughty' behaviour towards what the child's accomplishments and to maintain positive, nurturing messages. Setting limits to the child's behaviour but 'catching the child behaving well' in order to reinforce this 'good' behaviour are core parenting skills which a familiar maxim can help to maintain.

Praise and play act to promote attachment

Despite all the efforts made by those engaged in disseminating parenting programmes, we still encounter many, many families to whom the notion of positive encouragement and praise for children is totally unfamiliar. Yet abundant research has demonstrated the helpfulness and effectiveness of praise and play to the point where, after full assessment, these elements are often central components of the parenting packages that have demonstrated effectiveness in responding to children's behavioural and emotional difficulties and in supporting their parents (e.g. Patterson, 1976; Patterson et al., 2002; Scott et al., 2001; Sutton, 1992, 1995).

In the course of my PhD research with parents who were asking for help with their unmanageable preschool children, I offered them personal support and parent training using cognitive behavioural principles in four conditions: visiting them at home; working with them as a group; by telephone with materials sent by post; and a control group. All three groups who experienced active intervention achieved almost identical results, both immediately at post intervention and at 15–18 months follow-up (Sutton, 1992). Because I was so astonished by the success of the group trained by telephone I repeated the work with a group of parents whom I never met but whom I supported and trained exclusively by phone. The results were as before: the children's behaviour actively improved and the improvement was maintained at follow-up. Moreover, the depression level of the mothers, measured by the Beck Depression Inventory, which had been at clinical levels pre-intervention, fell for almost all the mothers to within the normal range (Sutton, 1995).

Helping parents to praise desirable behaviour in their children appeared to elicit affectionate and loving behaviour towards these parents from some of the children – a phenomenon which surprised and delighted the parents. I called this 'the resurgence of attachment (behaviours)'. Thus a totally unexpected outcome of an essentially cognitive behavioural programme was the spontaneous emergence in some of the children of patterns of warm and loving interactions with their parents. This unsolicited information was given spontaneously by parents at evaluation. Readers can imagine the joy this produced among parents who had begun to feel acute stress, embarrassment and shame concerning their relationships with their young children.

This accords with the evidence that while some children maintain a constant pattern of attachment throughout their lives, others move in and out of differing patterns (Thompson, 2000). This appears to demonstrate that patterns of attachment may be more malleable than may have been formerly thought. If so, it behoves us to act as early as possible to promote those circumstances which can enhance attachment. The maxim, 'Five praises a day' could help hundreds of those children reported above as suffering from abuse and neglect.

Cautioning voices – and a response

There have of course been critics of the use of praise in bringing up children. Dweck (2007) has highlighted the pitfalls of allowing children to expect unwavering approval, especially when this is directed towards their intelligence rather than their effort. She is right: these pitfalls exist. Other critics, such as Baumeister et al. (1990), have demonstrated that giving praise to skilled practitioners has the effect of undermining those skills, not enhancing them. However, we are concerned here with very unskilled practitioners indeed, namely, toddlers learning to walk, to feed themselves, to toilet themselves, to dress themselves and to develop a sense of competence and self-worth. We are talking about very young children, those below the age of five and primarily their behaviour, rather than their intelligence or physical attributes. These are little children who need praise, both as a source of nurturance and as feedback, so that they may learn confidence and the conventions of their culture.

Accordingly, we have prepared a simple card, showing a range of cameos of children's behaviour: toddlers watering a flower, eating an apple, kicking a ball. Each of these cameos can remind parents to praise the child's effort or achievement. A grid on the reverse prompts parents to continue finding aspects of their children's behaviour or efforts which they can commend and appreciate. The slogan 'Remember to set firm limits too!'accompanies the positive message.

Carole Sutton is at De Montfort University
[email protected]

References

Baumeister, R.F., Hutton, D.G. & Cairns, K. (1990). Negative effects of praise on skilled performance. Basic and Applied Social Psychology, 11, 131–148.
Department for Children, Schools and Families (2008). Permanent and fixed period exclusions from schools in England 2006/07. DCSF.
Department for Children, Schools and Families (2009). Referrals, assessments and children and young people who are the subject of a child protection plan, England – year ending 31 March 2009. DCSF.
Dillon, D.G.,Holmes, A.J., Birk, J.L. et al (2009). Childhood adversity is associated with left basal ganglia dysfunction during reward anticipation in adulthood. Biological Psychiatry, 66, 208–213.
Dweck, C. (2007). The perils and promises of praise. Educational Leadership, 65, 34–39.
Ellsworth, C.P., Muir, D.W. & Hains, S.M.J. (1993). Social competence and person–object differentiation. Developmental Psychology, 29, 63–73.
Haber, S. (2003). The primate basal ganglia. Journal of Chemical Neuroanatomy, 26, 317–330.
Hart, B. & Risley, T.R. (1995). Meaningful differences. London: Brooks Publishing.
Kershaw, A. (2008, 6 November). Thousands of under-fives suspended for school assaults. Independent on Sunday..
Morawska, A. & Sanders, M.R. (2007). Concurrent predictors of dysfunctional parenting and maternal confidence. Child: Care, Health and Development, 6, 757–767.
National Evaluation of Sure Start Research Team (2008). The impact of Sure Start Local Programmes on three year olds and their families. Nottingham: DfES Publications.
Patterson, G. (1976). Living with children: New methods for parents and teachers. Champaign, IL. Research Press.
Patterson, G., Barlow, J., Mockford, C. et al. (2002). Improving mental health through parent training programmes. Archives of Disease in Childhood, 87, 472–477.
Scott, S., Spender, Q., Doolan, M. et al. (2001). Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice. British Medical Journal, 323, 194–203.
Shonkoff, J.P. & Phillips, D.A. (Eds.) (2000). From neurons to neighborhoods: The science of early childhood development. Washington, DC: National Academies Press.
Sroufe, L.A. & Waters, E. (1976). The ontogenesis of smiling and laughter. Psychological Review, 83, 173–189.
Sutton, C. (1992). Training parents to manage difficult children: A comparison of methods. Behavioural Psychotherapy, 20, 115–139.
Sutton, C. (1995). Parent training by telephone: A partial replication. Behavioural and Cognitive Psychotherapy. 23, 1–24.
Sutton, C. (2001). Resurgence of attachment (behaviours) within a cognitive behavioural intervention. Behavioural and Cognitive Psychotherapy, 29, 357–366.
Sutton, C. & Hampton, D. (2009). Parenting positively: Information and materials for the six-day training module (3rd edn). Leicester: De Montfort University.
Thompson, R.A. (2000). The legacy of early attachments. Child Development, 71, 145–152.
Webster-Stratton, C. & Herbert, M. (1994). Troubled families – problem children. Chichester: Wiley.