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Megan Eccleson Primary Mental Health Under 5's Specialist - Bristol

Review for AIMH UK Newsletter  (2008)

Life at Two: Attachments, Key People and Development

This 73 minute DVD follows on beautifully from the ‘Attachment in Practice’ film by the same company, reviewed in the last issues of this newsletter. In ‘Life at Two’ we follow an emotionally competent and resourceful little girl Ava through her third year, with footage alternating between the loving family home and the supportive nursery setting. The film provides fascinating observational material of her transition to nursery, which she will attend for two and a half days a week from the age of two, and of the potential for family and nursery care to compliment each other.

Ava lives with her mother Molly, maternal grandmother and uncle. We see Molly’s sensitive, unhurried mothering when she is able to give Ava time and encouragement to develop new skills for herself.

Interspersed with the film is an accessible commentary by Peter Elfer, a senior lecturer in Early Childhood Studies, in which he explains the original tenets of attachment theory. The key worker approach to nursery care is advocated, and some commonly expressed objections to it are considered. He conveys convincingly how attending to children’s need for security puts them in the best state of readiness for new experience and hence for learning. Ava is initially uncertain on arriving at nursery, when she is to stay without mum for the first time. The film helps the viewer to understand that protest on separation is normal. We are informed about the benefits of a secure attachment and about what nursery staff can do to help children as they begin to separate. Ava’s mum, Molly, shows her own anxiety about leaving her daughter and there is careful observation of the pair reacting to separation and reunion. The camera’s close and low angles optimise the viewers’ awareness of how Ava experiences the noisy bewildering newness of the nursery.  It is evident how much is required of a toddler to manage in a strange environment and ways in which this might impact on a young child. For instance Ava’s speech seems to become less clear at nursery.  Her comments and her play reveal that she is thinking a lot about her mother after she has left her.

Claire, Ava’s Key Worker, provides a bridge to the new environment. She focuses on Ava’s speech, uses repetition and clarifies what Ava is saying. In much of the nursery footage Ava seems to be identifying with her mother and copes with Molly’s departures by becoming a ‘mummy’ herself, in her play. Claire, the worker also attends sensitively to Ava’s doll baby. Ava’s relationship with Claire is affectionate and it is refreshing to see the closeness and cuddles which form an important part of infant care in the nursery setting.

In an interesting sequence portraying some of the common challenges of parenting a two year old, Ava and her mother are going shopping. Molly skillfully manages Ava’s strivings for independence. She set limits and manages to negotiate when Ava might have a temper tantrum in the supermarket, staying in control without heavy handedness and giving choice where possible.

Ava’s first full day at nursery is a highlighted and the key worker gives Ava time with her mother and then thoughtfully helps her to separate. Ava is not immediately pressurised to adapt or fit into the nursery group and her need for time in which to make the transition is respected.

This is a small nursery environment and Ava gets a great deal of sensitive attention. The key worker is patient, observant and flexible, striving to understand Ava. She guesses and she anticipates. Ava shows her own capacity to mirror and to attune to her carers, even tolerating small ordinary misunderstandings in interaction. Starting nursery is likely to be much more demanding for a child who is not so secure in her primary attachments. Ava is very obliging, articulate and rewarding and her ability to express her needs might make nursery care appear easier to provide than it actually is. However, there are many practical points about what nursery staff can do to reduce anxiety and facilitate children’s comfort and security; observant, sensitive care supports the emotional development including the development of empathy in the child. Over time Ava’s confidence is growing, aided by Claire’s willingness to follow Ava’s lead, illustrating how the presence and interest offered by the skilled key carer helps the child to think, explore and learn.

Six months on, Ava has become part of the nursery group. The film reveals how initial attachments form the basis for future relationships and how, with initial adult support, Ava can move through to parallel play and subsequently to cooperative play, sharing and dealing with conflicts herself. By now Ava is well attached to her key worker and it is a shock to recognise that Claire is pregnant and will be leaving Ava soon.

The film could be useful to show to parents before they introduce their children to nursery. I will certainly use this film with Early Years workers to introduce and explore some fundamental concepts relating to infant mental health. It comes with user notes which include frequent questions and discussion topics, further discussion of the Key Person approach and references and further reading.