The Holyrood baby at three - Kirsty in the middle

Kirsty, the Holyrood baby, will be starting nursery this year. She is no longer a baby and fast emerging as a fully formed infant.

Drawing from the experiences and interactions of her first three years, her brain is now 90 per cent of the size it will ever be.

At three, Kirsty should be able to walk normally, both forwards and backwards, and use the stairs with ease. She should be getting more confident at running, be able to bend over without falling and kick, throw, and catch a ball.

But like many children in Scotland, she has never caught a ball. She may not be able to until well into her primary education.

These basic coordination and interactive skills are learned through free play, but much of Kirsty’s life is spent indoors.

And as research from Leeds University showed last year, children who struggle to catch a ball are less likely to perform well in reading, writing and maths exams as they get older. Kirsty has already fallen behind and her life chances have been impacted as a result.

Kirsty is a fictional child, born into one of Scotland’s most deprived communities on the day the current crop of MSPs took their seats in the Scottish Parliament for the new session in 2016.

She represents a conduit through which Holyrood magazine can examine the parliament’s progress in tackling poverty, early intervention and children’s rights to improve her life chances. 

With political consensus over tackling these issues and making Scotland the best place to grow up, Kirsty represents the gap between policy ambition and the reality for children in challenging circumstances.

By the time our politicians are seeking re-election, she will be preparing for school. And with closing the education gap a stated priority of the current First Minister, Kirsty’s future could also determine the future of Nicola Sturgeon.

As explored already in the pages of Holyrood, the fact Kirsty lives in one of Scotland’s most deprived communities is likely to have had an impact on her brain development already, as her mother Caley’s economic circumstances dictate her environment, life chances and choices. 

The stress of living on a low income also has a direct impact on the relationship between Caley and Kirsty, from before she was even born, which is the biggest single influence on her development and future health. 

ISD Scotland figures published in April show young children living in the most deprived areas of Scotland are more than twice as likely to have concerns raised about their development.

Some 22 per cent of children from the most deprived areas had a concern raised about their development during their 27-30 month health review in 2017/18, compared to just nine per cent from the least deprived communities.

The overall picture has actually been improving since the Universal Health Visiting Pathway was launched in 2015, but inequalities persist.

As a white female, Kirsty is likely to fare much better at this developmental stage. Boys are twice as likely to have developmental concerns than girls at this check-up. Black and ethnic minorities are also more likely to be falling behind.

However, Kirsty’s health visitor does have concerns. As well as being less active than expected, Kirsty is not very talkative, just like her mother. By this point, she would normally be expected to be telling stories.

Of course, if Kirsty had been getting free nursery education as a ‘vulnerable two’ then some of that would have included free play, helping her develop her social and motor skills as well as building resilience and enthusiasm to learn. But like most eligible parents in Scotland, Caley didn’t even know she was entitled to it.

Caley is not doing well. If Caley has spoken to anyone about her mental health, it is likely to have been her GP. And like many GPs, his or her response would have been to prescribe medication.

by Tom Freeman

Communities, Housing & Planning

A child's right to be seen - Kirsty in adversity

Isolated, stressed and increasingly paranoid, Caley cannot work, but the benefits system has not recognised that she is struggling to cope.

According to educationalist Sue Palmer, this could be having an impact on Kirsty’s development.

Because of her depression, Caley will find it “very easy” to give Kirsty screen-based activity to keep her busy rather than allowing her to learn through free play, she says.

Ultimately, children like Kirsty need “love and play”, says Palmer. “They have agency and we should be supporting that.”

The Universal Health Visiting Pathway means the health visitor can play a wider role, including as a gateway to other support services.

But at the 27-30 month check-up, Caley did not want interference. According to Jen Gracie, policy officer for the Child Poverty Action Group (CPAG) in Scotland, struggling parents can be kept silent by poverty.

“Parents will try really hard to hide their poverty from their children, and they will try just as hard to hide it from services, which has an impact on what support can be available for them,” she says. 

And the stigma is real. Gracie points to CPAG poll results which shows 29 per cent of people in Scotland believe child poverty is mainly caused by parental drug and alcohol misuse. 

While there have been some important policy announcements in this parliamentary session to address all these factors, including the new Best Start Grant – the second phase of which Kirsty will benefit from this year – the fact is, child poverty is rising in Scotland, as highlighted by a recent report by End Child Poverty.

The Scottish Government’s Child Poverty Act introduced ambitious targets to reduce the rate by 2030, by which time Kirsty will be 14. However, there has been no evidence of progress so far.

And merely getting more parents into work can no longer be regarded as a solution either, with the Joseph Rowntree Foundation’s Poverty in Scotland 2018 report revealing the number of children in poverty from working households has risen sharply in recent years and is projected to rise further. As many as 65 per cent of children in poverty in Scotland are in working households.

‘Austerity’ economics, the freeze on welfare spending by the UK Government and a rising cost of living is being keenly felt. 

In November, UN Special Rapporteur Philip Alston also revealed a rather bleak prospectus for Kirsty, warning UK welfare cuts were “punitive, mean-spirited, and often callous” and had caused a “social calamity and an economic disaster” in rising child poverty.
Alston is also expected to present a report on the corrosive effect of poverty on children soon.

But since his warning, the UK Government has not enacted a single piece of legislation while it has been locked in bitter in-fighting over the divorce from the European Union. 
By refusing to compromise, the Prime Minister has extended that hiatus several times.

And while Caley doesn’t care a jot about Brexit, it will have an impact on her and Kirsty’s life.

Even if it does not provide the kind of economic shock that many have predicted, Brexit – as it stands – will signal an end to the current legal protection of children’s rights under EU law.

In her speech to SNP conference last month, First Minister Nicola Sturgeon reaffirmed her commitment to incorporate the UN Convention on the Rights of the Child (UNCRC) into Scots law by the end of this parliament.

Scotland will meet the “UN’s gold standard on children’s rights,” she promised.

But according to Scotland’s children’s commissioner Bruce Adamson, Scotland has “a long way to go before we could ever hope to meet that”.

He said: “In several areas we lag well behind international norms.”

Under the terms of the legally binding UNCRC, governments are required to meet Kirsty’s basic needs and help her reach her full potential. 

The Scottish Government will open a consultation on incorporation “shortly”, according to Amanda Gordon, head of the Scottish Government’s Getting It Right For Every Child (GIRFEC) team.

“This will not be a consultation on why or if we should incorporate but rather to ensure we get the best outcome,” she tells Holyrood’s recent event on Kirsty. 

The UNCRC is about more than just keeping her safe and giving her an education, it is also about giving her agency. This is the aim of the multi-agency approach of GIRFEC.

However, as explored in the December issue of Holyrood, Kirsty has not benefitted from support through GIRFEC. Her voice has not been heard.

Children 1st’s Mary Glasgow told Holyrood: “What do we need to shift in a system that was built primarily before GIRFEC, particularly the child protection, care system and hearings system? 

“We need to think differently about these pre-GIRFEC things, and how can we shift towards something that works for all children and their families.”

Gordon says the aim of GIRFEC “is to help children grow up feeling loved, safe and respected, so they can realise their full potential”.

While the welfare system remained reserved at Westminster, the third sector has had to plug gaps in its support for families.

Gordon agrees with Gracie that many continue to miss out.

“Often people are in denial they even need help,” she says.

“Asking for help is a difficult thing for anyone to do, particularly when it’s trying to do the best for your child. Sometimes it’s a fear that ‘if I admit I’m struggling, what is the state going to do? Is it going to sweep in and interfere in my family in a way I don’t want them to?’”

Although the named person has been portrayed as such an intrusion, Gordon believes the consistency of having a single contact leads to better, more trusting relationships.

She also points to high take up of the new Best Start payments through Scotland’s new devolved social security agency.

“We are committed to making sure low-income families take all the benefits they are entitled to,” she says.

There has been increasing awareness of the impact adverse childhood experiences (ACEs) can have on long-term life chances. The research first came to Scotland via the Violence Reduction Unit and shows that the more childhood adversity is experienced, the greater the risk of harmful effects later in life. 

These include higher cases of ill-health and relationship problems, a higher likelihood of engaging in criminal activity and an early death.

The research focuses on specific cases of adversity including abuse and neglect, as well as issues in the home environment like divorce or separation, substance abuse and poor mental health.

Kirsty has already experienced ACEs.

There is some debate around the ACEs movement, however, with some concerns raised that it is too deficit-focused, pigeon-holing those with ACEs into a life of adversity. 

The key, according to public health specialist Pauline Craig, population health lead at NHS Health Scotland, is to keep the focus on prevention rather than stigma. 

“This isn’t about ‘problem families’ or ‘troubled families.’ It’s actually about everybody,” she says. “We are all at risk in some way of experiencing some kind of adversity. The risk, of course, is greater, if you are experiencing poverty.”

Craig warns about seeing ACEs as a “tick-box exercise”.

“Social media is going mad with it, saying everyone is wanting to put a tick box in. Actually, most of us aren’t. 

“It’s just not appropriate, particularly with children. So, there’s something about being careful with this. We don’t want to stigmatise people. We don’t want to raise things in an inappropriate way, it has to come from the people themselves.”

The level of prevention required, then, for children like Kirsty, is at a societal level. For services, it is about trauma-informed practice for every practitioner who is working with families. 

Frontline services need to understand their social responsibility rather than engaging in ‘othering’ people in challenging circumstances, according to Craig. 

Bill Alexander, a Children in Scotland associate working with the government on GIRFEC, argues it is time to revisit the principles of the Christie Commission, which in 2011 recommended that public services needed to work more closely together and focus on prevention in order to meet Scotland’s population and public spending challenges. 

“Kirsty embodies the challenge and the opportunity in Scotland. A young child in a disadvantaged community, in a family experiencing stresses, facing the realities of adversity and austerity,” he says.

“Five years before Kirsty was born, I think the Christie Commission very much had her in mind. It said: ‘Scotland’s public services are in need of urgent and sustained reform to meet unprecedented challenges…unless Scotland embraces a radical new collaborative culture throughout our public services, both budgets and provision will buckle under the strain.’ Don’t we just know that.”

The “enormous ambition” of GIRFEC has been recognised by other countries, according to Alexander, “but as Kirsty’s story reminds us in a compelling way, we need to do much better. We need to continue to sustain that commitment to change and improve”.

While GIRFEC encourages early intervention and collaboration between agencies, Alexander says the focus must remain on the child.

“The child is at the centre of our concerns,” he says.

“It is the child which motivates us, leads us to make Scotland the best place to grow up, but we have to always remember that children grow up in families. 

“Even those children we take out of families, and it’s a very small number, the vast majority of them go back to their families when we fall out of their lives. 

“We need to know how to support families to support children. 

“And families live in communities. The impact of the community on the capacity of the families to support their child is fundamental.”

However, although Kirsty is already falling behind, although she is living in adversity and in poverty, research shows there many interventions that can improve her prospects.

“Although risk factors play a significant part and a critical role in the early life of any child, it is never too late to develop protective factors, to work on protective supports that can tip the balance so we have a child and adult with positive outcomes,” says Alexander.

“Just because a child might not have positive experiences by the age of three, just because a child might not have had positive experiences by the age of 15, it doesn’t mean they are doomed. We can always work to tip that balance.”

And tipping the balance in Kirsty’s favour has to be the challenge that our politicians aspire to meet ahead of 2021.