Companionship and Health in the Early Years: Effects of participation in a nurture group on relational and attachment patterns of primary school children and their outcome.

Child health is identified as a priority area for action, based on the recognition of the influence of early years development and experiences on the lifelong health of our children, with the Scottish Government’s “Towards a Healthier Scotland” (1999) providing a framework for public health policy. The “Equally Well Review” (Scot. Govt. 2010) highlights key elements including the negative impacts of poverty in early life, the importance of attachment between an infant and their primary caregiver and the importance of early years in establishing neural networks in the brain. High quality early interventions are believed to offset the potentially negative consequences of adversity experienced in the early years, leading to long term health benefits (Scottish Govt., 2010).

Children who form secure or insecure attachments as infants process information in ways that suggest they have formed very different internal working models of self and others (Belsky, Spritz & Crnic, 1996). Stern (1985) describes the subjective sense of self which arises from a mutual, wordless experience between and infant and its’ caregiver as attunement, with Tronick (1985), Stern (1985) and Trevarthen (2001) showing us that it is the affective company of others that provides the fundamental primary intersubjective relation for learning and socio-emotional development. It is likely that children who are displaying social, emotional and behavioural difficulties could be missing an aspect of affect attunement.

The Nurture Group is an early intervention resource for children whose social, emotional and behavioural needs cannot be met in mainstream class. Nurture Groups were developed in the 1980’s, with a dramatic increase in the last ten years with the Scottish Government pledging support to improve young people’s life chances (Scot. Govt. 2012). Nurture Groups are informed by attachment theory (Bowlby, 1969) and are shown to have a positive effect in the areas of improved behaviour, improved social and emotional wellbeing, and improved academic attainment (Cooper & Ticnaz, 2005). Success is attributed to its theoretical underpinnings, with studies examining the impact of Groups on the inclusion of young children with SEBD in mainstream schools. Research includes the examination of profile scores (O’Connor & Colwell, 2003), qualitative interviews (Sanders, 2007) and ethnographic studies (Bailey, 2007) with calls for more in depth longitudinal research to understand why these groups work (O’Connor & Colwell, 2003). Outcomes within the home environment and the effects on parent-child relationships remain unknown and it is hypothesised that these variables may impact on the long term effectiveness of the intervention.

The aim of the research is to understand the effects of intervention by examining the relational and attachment patterns of primary school children in Nurture Groups. A longitudinal study will be carried out using video to capture interactions at home and in Groups. Levels of affect attunement will be measured, analysing interactions for dimensions of attunement using quantified measures of quality, rhythm and narrative (Trevarthen & Delafield-Butt, 2012). This study will improve understanding of means of affective attunement and efficacy of companionship in Nurture Group interventions to inform best practice in this and other domains.