By Sue Younger MCW (Hons), MA (Hons), DipProfEth, DipTchg, Brainwave Trustee
Early childhood matters
What happens to a baby and toddler can have a lasting influence on them for the rest of their life. That much is agreed. But the way this works can be hard to pin down.
What are good outcomes?
Every person’s idea of a good outcome for a child can be a little different. However, it’s easy to name what almost every parent wants. We want our children to be healthy and happy. To fulfil their potential. To have positive, healthy relationships with others. We want them to turn out as good as they can. Many parents want their children to do well at school, find jobs they like, obey the law and stay out of trouble.
No-one knows exactly how to make sure that each child grows up like this. And there seems to be so much information coming in, and so much conflicting advice.
But we do know some things that help and some things that don’t.
Risk factors and protective factors are a good way to understand the complexity
One thing that has really helped us make our way through all this at Brainwave Trust is the concept of RISK and PROTECTIVE factors. This is the knowledge that some things make kids more vulnerable, and other things make them more likely to turn out well. Each child has their own unique set of risk and protective factors.
Risk factors – the bad guys
Do you know people who smoke? They are far more likely to get lung cancer. But they are not definitely going to get lung cancer. Some individual smokers are ‘lucky’ – they may die at 85, still puffing away. But everyone who smokes has a HIGHER RISK of getting lung cancer, simply because they smoke. So it’s best not to smoke, right? (It’s really hard to give up, of course.)
So this is how RISK FACTORS work. They increase the risk. They don’t always make things turn out badly. But they do make it more likely.
When we are talking about raising children, risk factors are the things that make them less likely to be healthy and happy throughout their lives.
Some of the things we know put children at risk are:
- parents with depression
- badly stressed parents
- family conflict
- family violence
- emotional neglect
- alcohol and drug use in pregnancy.
You could probably have listed them yourself. It’s not brain science – but it is.
Protective factors – the “good guys”
The good news is that other things about their lives can PROTECT children. Even if they have some of the risk factors above, we know something about what can help to lower that risk again.
Imagine a set of scales. On one side are the RISK factors for kids. Are they poor? Do their parents fight a lot? Did Mum drink when she was pregnant? Each of these things add more weight to the risk side.
On the other side of the scales are the PROTECTIVE factors in their lives. What we really want is the scales over-balancing in the positive direction if possible. Sometimes there are risk factors we can’t do much about, when children are born into a family facing difficulties, or they go through traumatic experiences.
It may help, of course, if families seek to improve the things in their lives that are putting their children at risk, such as Mum receiving treatment for post-natal depression, or Dad being treated for his substance abuse issues. It is important that we all try to reduce the risk factors in a child’s life in this way.
We can do our best to reduce these risks, of course, but we can also add some protective factors onto the other side of the scales. So what do we mean? Which things are protective?
Both risk factors and protective factors are complex. Some protective factors are things that you are either born with, or not, such as intelligence and personality.
When it comes to the things that we can change, however, things that people can do something about, positive relationships are powerful indeed. It’s about the other people in your life. (In fact it is so much about relationships, maybe we should call these ‘cuddle’ factors rather than protective factors?)
- People around you who listen to you.
- People who talk with you in a positive way, in language you can understand, and who encourage you when you do something good.
- People who sing to you.
- People who read to you.
- People who spend time with you.
- People who play with you, and make you laugh.
- People who laugh at your jokes (even when they are hearing them for the tenth time).
- People who cuddle you.
- People who talk to each other, and to you, in a nice way, and can resolve conflict without violence and abuse.
- People who let you climb a tree when you are ready to climb a tree, but are there at the bottom just in case you do make a mistake and fall.
- People you can trust.
If a child has at least one person they have bonded with, who thinks they are special and makes them feel safe and cared for, then that is called “a secure attachment” to that person. It needs to be someone they can rely on most of the time. Someone who has their back. (Children often feel strong ‘love’ for people, but that is not always protective if the person they love is not trustworthy and reliable, or does not ‘have their back’. In the same way, parents can love their child dearly but, for complex reasons, may be unable to show their love to the child. The child may not ‘feel loved’.)
If we think of protective factors and risk factors as boxers fighting in a boxing ring, a secure relationship with even just one other person will deliver a mighty strong right hook to even the meanest of those risk factors.
Breastfeeding can be a protective factor too. For example, children whose mother smokes are more likely to have asthma. But if they are breastfed, that reduces their risk of asthma again, although by how much will depend upon the individual. Those scales tip back and forth in this way.
And if mothers are depressed, breastfeeding can mean they have more time holding their baby and touching him or her. They can feel good about feeding their baby, so this can mean they have more positive feelings towards the baby. The depression puts the child at higher risk, but the breastfeeding can lower that risk again. It’s complicated, and every relationship is different.
This makes breastfeeding a perfect example of the way risk factors and protective factors work. The set of scales is moving up and down on each side, it’s not the same weight on each side all the time.
Not everyone who is breastfed turns out perfect! And plenty of bottle-fed babies turn out to be wonderful. (This writer knows that, as she was a bottle-fed baby.) The thing is breastfeeding is not everything, but it can work as one of the ‘good guys’. It’s one thing parents can do, if they are able, that puts more weight onto that positive side of the scales.
That’s how risk and protective factors work.
How do genes fit in with all this?
Of course, genes matter too. Children are born with a set of genetic factors that will influence the way they turn out.
And, it turns out, genetic factors fit into ‘risk and protective’ factors as well. Some genes will put babies more ‘at risk’ and others will help to ‘protect’ them from harmful things.
Let’s think about that lung cancer again. If members of your extended family have had lung cancer, you are more at risk of lung cancer, whether you smoke or not. This is genetics in action. But if you have those genes AND you smoke, you are really taking risks with your health.
So we can add these genetic things onto the scales. However, our knowledge about these genetic factors, and the way in which they affect individuals, is still limited which makes it all the more important to protect ALL children from the risks we do understand as much as possible.
Children have their own unique genetic potential. But loving, nurturing care, and avoiding the risks where possible can protect against some of the ‘risky’ genetic potential. And it can encourage the ‘protective’ genes to do their work.
Risk factors pile up on each other
Really important, but something we don’t often think about, is the way in which these RISK factors PILE UP ON EACH other; the more of them a child has, the riskier each of them is. Let’s think about our lung cancer example again. If a person smokes, AND they were exposed to passive smoke when they were growing up, AND they have family members who have had lung cancer, then they are way, way more likely to get lung cancer, than people who have only one of those risks in their life.
When children have a poor start, and have many difficult things to face, not just one or two, then their risks start to go sky-high. If their Mum is depressed AND they live in poverty AND their parents are alcoholics AND their Dad is violent towards their Mum, then their risk of being unhappy and/or unhealthy in later life is skyrocketing. It’s still not definitely going to happen; but it is much more likely. That risk end of their set of scales is getting mighty heavy.
One example of the way Risk factors and Protective factors work: Poverty
A lot of us already understand the way risk factors and protective factors work. We just don’t always think about it that way. The tragedy of children living in poverty provides a clear example.
We all know growing up in poverty will put children at higher risk of poor health and poor achievement. We don’t want children growing up in poverty at all. It would be better if no-one suffered poverty.
However, doesn’t each of us also know people who grew up extremely poor, yet turned out to be fantastic?
How does that work? if some people can overcome a difficult early life, why can’t everyone? Chances are, those people that do well had at least one loving, caring parent and probably a whole loving, caring family. Maybe even a whole community that was loving and safe. (Older people scratch their head at this ‘poverty as a risk factor’ thing, especially if they lived through the depression.) Although it is not ideal, plenty of people from a poor background have survived, even flourished. They probably had relationships with family, or with teachers or sports coaches or church communities that worked as ‘protective’ factors in their lives. Genes can play a role too, as we have seen.
Yet some people who grow up poor struggle to escape poverty and to overcome difficulties. Have a think about the other risk factors in their lives, and maybe the lack of positive and protective things around them. You just may be able to see risk and protective factors in action. The poverty itself does put them at higher risk. But it’s much worse if they don’t have some protective factors to work against it.
Similarly, growing up wealthy tends to provide children with opportunities but they can still be ‘at risk’ from other factors such as family conflict, emotional neglect, abuse, poor health. So not all people who grow up wealthy have happy, healthy lives. We’ve all seen examples of that.
The most interesting thing about this way of looking at children’s lives is how one-off each child is. By the time we think about their complicated genetics, their individual risk and protective factors, their unique experiences and the many different relationships in their lives, we can see why there are so many different outcomes. Each child has their own set of scales. Even members of the same family can have very different experiences, depending on the age they were when certain things happened, their own individual relationships with the adults in their lives and their own genetic make-up. This fits with what we see in the people we know.
We know that certain things will put children at higher risk and that we need to reduce those risks as early as possible, while children are very young.
And we know that loving care and positive interactions with the adults in their lives are very powerful protective factors for all children.
For every protective factor we add and every risk factor we remove, the life of a child is likely to improve. The scales will be tipped more favourably, even if just slightly.
This article is based on, From Certainty to Complexity: Risk and Protective factors in child development.
This article was first published in the Brainwave Review, Issue 25, July 2017