The scale of the challenge faced by settings offering 'out of family' care for children aged under two years has been widely acknowledged (Goldschmied and Jackson 2004; Biddulph 2005; Barnes et al. 2006; Gerhardt 2004). However dedicated practitioners are, and even when infants have regular contact with the same key worker, there will always be a 'familiarity gap' in their relationship, making primary communication more of a challenge. Where the adults are inexperienced, overstretched and undervalued, this gap can widen to the point where children and adults seldom experience relaxed, playful interactions with a familiar partner (Rolfe et al. 2002). If adults working with young children do not recognise how much primary communication contributes to children's growing ability to make sense of other people's behaviour, this gap may feel normal; an inevitable consequence of children's inability to express themselves clearly in spoken language.
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