A 'relaxed' attitude by parents to important developmental transitions such as potty training and weaning is generally held to be a positive thing, but some practitioners fear this may have gone too far. They are increasingly reporting that the children in their care are being kept in nappies too long and are not being given the opportunity to move on to other important stages because parents are either ill-informed or ill-equipped to support them.
At the London Early Years Foundation, chief executive June O'Sullivan reports that over the past ten years she has observed children being over-protected and 'babyfied' across all social classes.
She says, 'Most evident is very late toilet training and using pushchairs for far too long. There is certainly a lot of ignorance around potty training and what to do. Most parents are really grateful when we suggest that it is time to do it and what will be needed.'
Ms O'Sullivan belives that today's super-efficient disposable nappies do not help to encourage the toilet training process because children hardly feel wet or uncomfortable. 'Parents are fearful of getting toilet training wrong and having accidents in the car, house or in the street,' she says. 'They are anxious about ruining the car or carpet and being embarrassed about a public accident. Lack of time to sort out these kinds of problems is a factor.'
The trend towards keeping children in pushchairs is equally worrying. 'This can be due to parents feeling they are more able to easily manage children if they are in pushchairs, while some may lack confidence in their ability to manage their children walking independently,' says Ms O'Sullivan. 'Pushchairs can also remain very necessary for working parents who are always in a hurry.'
THE RIGHT BALANCE
At East Staffordshire's Children's Centre, health and family support team co-ordinator Sue Ramsay says she witnesses many examples of children being delayed in weaning and toilet training.
'Some parents just find it easier to continue to give children a bottle, even when they are past the weaning stage, and this is particularly relevant in certain cultures,' she says. 'We have come across an example of a six-year-old having a bottle when coming home from school. In this particular case Mum was suffering from depression and it was just an easy way to keep the child quiet. Conversely, we also come across a lot of parents who are trying to wean far too early, usually because of lack of knowledge.'
She adds, 'Some parents may have problems with language. We have an example of a Kurdish mother who just didn't know which foods the baby could be weaned on to and couldn't understand the health visitor's advice, but convincingly said yes to everything. Other parents simply do not understand and long after lumps should have been introduced, they will continue to give pureed food. Similarly, the parent may be afraid of the child choking.'
On the subject of potty training, Ms Ramsay says that she often comes across parents who are too eager to potty train. 'That's to say, their expectations of their child are not correct and we are often advising to wait a little until the child is able to communicate their needs. Again, conversely, we have recently been involved with a Common Assessment Framework where a three-year-old was attending a nursery and hadn't been potty trained. This was because of her parents' lack of understanding due to some learning delay on their part.'
While Ms Ramsay believes these examples could be linked to an intent to 'babyfy', she feels more evidence would be needed to support this.
CO-DEPENDENCY CULTURE
Child psychotherapist Robin Balbernie corroborates that there is often genuine ignorance over the normal sequence and timing of child development, and this can be caused by the lack of extended family. But he cautions, 'There are of course huge variations between children that are not a cause for concern. On the positive side, children's centres in a way provide a statutory extended family, where parenting groups (not classes) come in, such as Mellow Babies that we run here in Gloucestershire. These enable some emotional sharing based on relationships.'
Delay of developmental routines has also been associated with cultures of co-dependency, where a parent might encourage a child to stay dependent on them in order to continue to feel they are needed.
At the Old Ford Primary School in Tower Hamlets, where no less than 22 different languages are spoken, there is a high incidence of three-year-olds who have not reached age-appropriate stages. Head teacher Amanda Philips says there is evidence that some young mothers seek their identity through having a 'baby' with them on the street or in the market.
She adds, 'Some families do not have the skills, resilience or wherewithal to wean, toilet train, play with a toy or encourage walking when the buggy is the easy option. In some cultures, it is believed that it is the practitioners' responsibility to teach play, speech, independence.'
Sue Ramsay highlights other ways in which co-dependency might develop. 'Some parents may have had a child later in life, or it may be their youngest/last child. They are then more inclined to "hold on" to that baby stage. This is shown in many examples, including letting the child sleep with them in bed as well as continuing with the bottle for too long.'
THE KEY PERSON ROLET
Experienced practitioners, and key workers in particular, do have a vital role to play in helping children hit their developmental milestones.
Child psychologist and early years consultant Jennie Lindon says, 'If a practitioner is going to help, they need to be sure of their own ground and have a sound underpinning knowledge of child development and intimate care routines.
'Advice on potty training does vary a lot and every era has different advice. Anecdotally, there is evidence that a lot of families have "relaxed" and embraced the idea that children will do it when they are ready.
'However, while a child will become more aware of the physical side of things, they will not take the lead in becoming toilet trained. Unless a child has disabilities that impact on this, by the age of three they should be becoming trained, otherwise parents are missing a window of opportunity.
'With weaning, the advice is again incredibly varied. If parents are unsure about this and have busy lives, they may leave it later than is desirable.'
Ms Lindon believes there may be all sorts of reasons why routines have been delayed. 'Some children may have a variety of care, including informal care, and routines maybe lacking. Sometimes parents are genuinely hard-pressed and keep putting things off until tomorrow,' she says.
June O'Sullivan believes that practitioners should be firm in their professional advice. 'Parents benefit from clear advice that says now is the time to begin toilet training,' she says. 'Nurseries can also emphasise the environmental issues with regard to nappies, and highlight that walking reduces the risk of obesity.
'Parenting skills are important, such as understanding that saying no to a child and meaning it is a good thing, when it is appropriate, consistent and kind. Parents can be helped in this through more support from children's centres and contacts with parents that include developmental advice. A nudge from a health visitor and consistent feedback to the nursery reduces mixed messages to parents.'
Sue Ramsay agrees on the importance of working in a joined up way to support routines. 'We would go into the home to give help with this, either because we've come across the parent at one of our groups or because the health visitor has asked us to support the advice she's giving, or as part of the action plan following a case conference.'
And Jennie Lindon emphasises that where there are real concerns, a proper key person approach and genuine partnership with parents is vital. 'If you are dealing with a family who takes the view that you sort it out, this has to be addressed,' she says. 'Practitioners can be helped to feel more confident in these circumstances, with a good key person system and good support from the senior team.'