The Holyrood baby turns one - developing understanding

Kirsty, the Holyrood baby, has turned one.

Born as MSPs took their seats for the start of the Scottish Parliament’s fifth session, Kirsty has spent her first year in one of Scotland’s most deprived communities.

By the time these MSPs will be seeking re-election, she will be entering the school system.

And while Kirsty is fictional, the Scotland she is growing up in is not. 

It is not a Scotland after independence or federalism, not a Scotland that knows the outcome of Brexit negotiations with the rest of Europe, nor is it a Scotland which has yet succeeded in fulfilling the Scottish Government’s long-held aspiration of becoming “the best place in the world to grow up”.

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Kirsty is living in this Scotland, the Scotland of the here and now, where the number of children who, like Kirsty, are living in poverty, is rising.

Latest Scottish Government figures show 260,000 children are living in relative poverty in Scotland, up from 220,000 last year.

And as Holyrood has explored during the year, Kirsty’s outcomes, life chances, health and attainment in the future are already having an impact due to her circumstances and relationships, from before she was even conceived.

We know that Kirsty was fortunate to have been born a healthy weight, fortunate to have avoided health complications in the first weeks, fortunate that her mother, Caley, tried to breastfeed in those early stages.

Kirsty is lucky she has not been one of the 3.7 per cent of babies in Scotland who die in their first year from, among other things, complications arising from premature birth and cot death.

But she is still far less likely to perform well at school or be offered opportunities to fulfil her potential than children from more advantaged backgrounds.

She is more likely to be obese, have serious illness or suffer from mental ill-health by age three.

By the time she is five, at the end of this parliament, research from the Growing Up in Scotland study shows 39 per cent of children, like Kirsty, from the poorest income quintile, have a poor diet, 54 per cent have below average vocabulary, and 53 per cent have below average problem-solving abilities.

She is slightly less likely to have been immunised, and there is a greater chance that Caley is a smoker.

And Kirsty will probably live almost a decade less than a girl born at the same time into one of Scotland’s wealthiest communities.

Kirsty has been lucky that she has parents who love her and want the best for her. Secure attachment with a caregiver will have a positive impact on Kirsty for the rest of her life in terms of how she relates to others, how confident she is and how she can resolve and recover from conflict.

But for Caley and Scott to provide that security, the last year has been anything but easy.

They do not live together and have had to manage care of Kirsty between them. If they are working, they will have been doing so through a period of sluggish wage growth. If they are not, they are living through a period of some of the biggest cuts to benefits in decades.

But as child psychologist Dr Christine Puckering told Holyrood in November, Caley’s capacity to make a strong loving bond with her daughter will count for more than her economic situation.

“Caley’s wellbeing, her capacity to use social support and the availability of the right kind of support are key to Kirsty’s future. Caley needs to be free to see, read, and respond to Kirsty’s physical and emotional needs,” she wrote as Kirsty turned six months.

And what stage is Kirsty at now, as she prepares for her first birthday party? 

She has begun to imitate Caley, her tone of voice and the way she speaks to both Kirsty and others. She shakes her head for no, and the moment she first said ‘Mum’, Caley cried. 
She has also started to become a little bit shy around strangers.

In development terms, Kirsty should be starting to use objects correctly, like putting a cup to her mouth. She should be starting to look at the right picture when objects are named and she should be exploring objects by playing with them, banging them and shaking them.

She should be communicating using verbal or physical communication, like pointing and poking at things.

Her motor skills should be developing so that she is beginning to pull herself up and get around. She should be trying to stand and even walk.

She should be reaching these stages.

But it is likely the only person who will know whether she is developing well is the person who spends the most time with her, Caley. 

In terms of services and support, one year old is a tricky age to assess because it falls after the initial support from midwives and health visitors has thinned out but before a child enters formal schooling and state-run childcare.

Aside from an casual 13-month visit from the health visitor, her next big formal assessment will be at the 27-30 month age, where development matters will be clear. There is a good reason for this: at one year old, babies’ development naturally varies quite a lot, so even if Kirsty isn’t doing some of the things outlined above, it might not be cause for concern.

The onus, then, is on parents to flag up any concerns about physical or emotional development to their health visitor or GP. More affluent parents are more likely to do this, whether the concerns are genuine issues or not.

But although specific data on one-year-olds is scarce, one insight is the Growing Up in Scotland (GUS) study, which is tracking 10,000 children across the country in two cohorts.

Funded by the Scottish Government, GUS is carried out by ScotCen Social Research, in collaboration with the University of Edinburgh’s Centre for Research on Families and Relationships and the MRC Social and Public Health Sciences Unit at Glasgow University.

In 2013, the study reported results from the first year, when the participating families of the second cohort were surveyed when their child was 10 or 11 months.

This showed parents from disadvantaged families are far more likely to experience stress while parenting, more likely to have negative feelings about it and less likely to seek help.

Family disadvantage and a lack of social support were both associated with less frequent activities vital to Kirsty’s development, such as reading books, singing nursery rhymes and visiting other young children.

The study also suggests Caley is less likely to attend a parent-baby group or parenting classes or programmes. As such, Caley will be more dependent than ever on the support of family and friends.

However, when it comes to the development milestones, respondents to GUS offer a more positive indication of where Kirsty might be at.

As a first child, Kirsty is less likely to have missed milestones in motor skills developments than second or subsequent children. 

As a girl, her communication skills are already likely to be more advanced than boys.

And interestingly, GUS suggested children in the most deprived areas of Scotland were more likely to display good communication skills at age one than those from the least deprived areas.

However, the lead author of the report, head of ScotCen Paul Bradshaw, says researchers are “cautious” about the findings, particularly the last point, where all other trend data suggests the opposite. 

“The way early communication skills are measured at 10 months is we have to rely on the parent telling us whether or not they exhibit a certain communication behaviour,” he tells Holyrood.

“Something we suffer from in all survey research is ‘social desirability responses’, so if an interviewer is in that household and that parent thinks ‘maybe my child should be doing that therefore I should report that they’re doing it’.”

It is not until age three that survey researchers can assess children by speaking directly to them, he adds. 

The gender gap, however, is clearer. GUS and other studies show girls do better than boys when it comes to health and development throughout childhood.

Kirsty is therefore advantaged at this stage because she is a girl, but it remains to be seen whether by the time she is entering adulthood that advantage is maintained or reversed.

The gender pay gap has been highlighted recently by new rules forcing companies to publish data on the topic. 

A recent report by the Resolution Foundation revealed the gap has closed for every generation of women since those born between 1911 and 1925, and has done so at every age of their working lives, so perhaps by the time Kirsty grows up she will not be disadvantaged by being a woman.

However, the report’s author, Laura Gardiner, said persistent issues remain around part-time penalties, opportunities for promotion and cultural issues like business being done informally in the pub that will need to shift if further progress is to be made.

“While we should celebrate generational gender-pay progress, a continued focus on gender differences at all stages of careers – and in particular, action to address the sharp and long-lasting earnings penalty post-childbirth – remains a key challenge of our times,” she said.

The fact Kirsty is born into deprivation also presents a clear challenge to her development, but Bradshaw says that doesn’t “automatically” mean she won’t do well.

“A large part of what we try to do with the longitudinal element of Growing Up in Scotland is try and understand what it is about those children who, despite the circumstances, seem to do well,” he says.

“Can we tease out and understand the factors associated with that resilience? That’s where we try and focus the policy recommendations.”

Parenting support was a key part of those recommendations, when disadvantaged parents are less likely to attend classes or establish support networks. 

“Different types of parents need different types of support, and in delivering those services, there’s got to be an understanding that if you want to help a parent with particular characteristics or circumstances, you’ve got to be prepared to direct them to the type of support that’s most likely to be amenable to them,” says Bradshaw.

But as Holyrood has already explored, Caley’s stress levels are likely to be high, and her mental health will have a direct impact on the way she relates to services – and to Kirsty. 

When Kirsty was born, Mary Renfrew, Professor of Mother and Infant Health, told Holyrood: “In Scotland we have generations of habits, and generations of poverty, we have to break: bottle feeding, too much sugar, alcohol, smoking. For some women, not enough support for their own mental health, nutrition, or difficult social circumstances.”

At the same time, Chief Medical Officer, Dr Catherine Calderwood, told Holyrood that if Caley had anxiety during pregnancy or post-natal depression, it would have a direct impact on Kirsty’s chances of suffering from mental illness in later life.

At six months, Holyrood explored how Caley is at a higher risk of stress than other mums, which in turn is likely to interfere with the way she interacts and plays with Kirsty. 

And at 10 months, GUS also finds an association between maternal mental health and children’s outcomes. 

“It’s one of the key influencing factors that we’ve found from GUS so far,” says Bradshaw.

Although no association between maternal mental health and cognitive development was found, he says, “children whose mothers had good or average mental health throughout the survey period had better social, emotional and behavioural outcomes” by age three.

“Mental health is such a big thing for everyone, at all stages in life, but when you can demonstrate that link between a parent’s mental health and a child’s outcomes then it just adds extra motivation to try and address some of those issues,” says Bradshaw.

Stress at this stage is less likely to be about post-natal depression but outside factors such as income, relationships and financial pressures, all of which Caley is likely to be experiencing, do have an impact.

One of the biggest financial pressures encountered by Caley, and an important factor in Kirsty’s health and development, is the house they live in. 

Poverty is measured both before and after housing costs, and if Caley lives in an area not yet using Universal Credit, she may receive housing benefit. According to NHS Health Scotland, in 2014/15 an additional 130,000 people experienced absolute poverty once housing costs were taken into account.

Caley could be part of a sharp rise in the number of people experiencing poverty living in the private rented sector. She will almost certainly be part of more than a third of Scots who struggle to pay their fuel bills.

Growing Up in Scotland’s two cohorts were born six years apart, in 2004/05 and 2010/11, and there were few major differences between the cohorts at 10 months old. 

What differences there were can be attributed to big UK-wide or national policy changes, like the extension of maternity leave and changes to benefits. The financial crash of 2008 had an impact too.

Will the policy choices of the current government be reflected in future studies? Bradshaw tells Holyrood the older group are currently in their first year at secondary school and ScotCen are “collecting lots of interesting data”.

A question-mark hangs over the second cohort, however.

“What the Scottish Government are saying is they can’t, in the current climate, maintain the two cohorts going forward,” Bradshaw tells Holyrood.

A third cohort would be justified by a “macro-level shift” such as the aftermath of Brexit or Scottish independence, he says.

“I would be very surprised if there’s an independence referendum that goes in the SNP’s favour that there isn’t a sort of independence cohort as a result.”

But Kirsty, first imagined during the last referendum campaign for independence as being born into an independent Scotland, was born anyway into this Scotland, and like the children of the second GUS cohort, the country’s politicians are still responsible for her now.