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Testing times ahead for new mums

September 29th, 2006

Dr Petra

According to the papers today new mothers are to be given a 10-minute assessment to identify whether or not their baby is likely to develop antisocial behavioural problems in later life.

This assessment is described as a ‘questionnaire’ for health workers – although it’s not really clear exactly what form the test will take. It will be carried out on mothers and babies aged less than 6 months, and will apparently show where there are problems with bonding and where help is needed. The overall aim of the test is to stamp out antisocial behaviour in later life since it’s believed (by the researchers who created this assessment at least) mothers who don’t bond with their babies may produce antisocial children.

Psychologists at a Scottish university, who presumably consulted the evidence in this area before designing their assessment tool, have developed the test. Obviously from a newspaper report it is difficult to tell whether or not this is something that has been carefully developed and critically evaluated – or whether it’s a knee jerk response to wider government calls for tackling antisocial behaviour. At present the study is in a pilot phase, testing the theory that mothers who do not properly bond with their babies may lead to an increased risk of said babies developing aggressive or antisocial behaviour in the future.

Worryingly the researchers are quoted as saying they hope the tests will be implemented throughout the UK via health visitors. This isn’t good scientific practice during a pilot phase. Until the results of the pilot are known (and presumably considerable follow up of the babies concerned) it cannot be concluded the research has worked, nor recommended that other health visitors should implement such a tool.

This kind of assessment isn’t all that new, nor are schemes to identify ‘problem children’ (or ‘problem parents’). What is new in this case is the media coverage is already implying the scheme is a good idea and the assessment tool works – we simply don’t know that yet.

In order to know the answer we would need to see what happens to the children in the pilot and presumably follow them through to adolescence to identify if the intervention has worked. That’s a long way off.

We’re also not told from newspaper reports exactly how the assessment tool will be used. If a mother is identified as not bonding with her child what will happen? Will the child be removed from her care? Will it be placed on an at-risk register? Might the mother be offered more training, support and benefits if appropriate? Without these answers it’s hard to judge what this assessment will be for – and potentially difficult for mothers to agree to since they may fear for their child if they do (or do not) comply. And is such an assessment optional? Do mothers have the right to say no to being tested? What happens if they refuse the test?

Perhaps it’s just media reporting that is focusing on mothers, but in this era one would hope the research would not just focus on mums – for two reasons. Firstly dads have a unique bond with their babies just as mothers do (it might be a different kind of bond, but it is nevertheless a bonding experience). Secondly this kind of research allows for mother blaming – it’s her fault she didn’t bond and her fault that her kid’s grown up antisocial – nothing to do with the presence or absence of dads at all.

I’m sceptical of any assessment that purely looks at bonding issues. Whilst developmental psychology tells us bonding is important, it also tells us that many factors including a families income, health, education, housing, opportunities and support will play a role in a child’s development. Can a ten-minute assessment in the first six months of life adequately assess these factors?

Many mums (and dads) do not bond with their babies immediately. Some bond early on but life factors and other problems such as divorce, separation, bereavement or a change in family circumstances can lead to bonds being fractured. This type of assessment always favours the parents who can bluff the system, who are middle class and educated – yet we know such parents are still capable of producing antisocial teenagers. There’s a subtext of social and class control here that is uncomfortable – we can only hope the psychologists who designed this tool were aware of this and produced something that accounts for such potential biases.

Instead of such assessments I’d be more in favour of greater parental support, increased availability of childcare (which our government promised us long ago and never delivered), wider education and support for new parents, and an attempt to tackle our society to make it more ‘child-friendly’. Perhaps this ten-minute assessment will lead to some of these options being made available to parents – but from reports today that’s not certain.

The difficulty in hearing such research via the press rather than through other academic outlets means you often don’t get the real story. So this tool could be a lifesaver and it might be really ethical. But it could easily be something that’s used to blame mothers – particularly socially excluded, young, and low-income mothers. And if that’s the case you have to question the ethics of producing such an assessment – not to mention promoting it in the media before we even know it works.

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