Literature Review - KidsMatter · KidsMatter Early Childhood Component 3 Literature Review 6 3. WORKING WITH PARENTS AND CARERS ECEC services and families can

08 Fall

Literature Review

Component 3: Working with parents and

carers

KidsMatter Early Childhood Component 3 Literature Review 2

www.kidsmatter.edu.au

© Commonwealth of Australia 2012 Important Notice

KidsMatter Early Childhood Australian Mental Health Initiative

and any other KidsMatter mental health initiatives are not to

be confused with other businesses, programs or services

which may also use the name ‘Kidsmatter’.



Contents

Component 3: Working with parents and carers 5

Background Information on KidsMatter Early Childhood ....................................................................... 5

Working with parents and carers 7

Collaborative partnerships ......................................................................................................................... 7

Connecting families ................................................................................................................................... 11

Supporting parenting ................................................................................................................................ 13

Summary and Implications for Practice .................................................................................................. 16

References 18





Component 3: Working with parents and carers

Background Information on KidsMatter Early Childhood

KidsMatter Early Childhood is a national mental health promotion, prevention and early

intervention initiative developed to support the mental health and wellbeing of young

children in early childhood education and care services (ECEC). It has been developed in

collaboration with beyondblue and Early Childhood Australia, with funding from the

Australian Government Department of Health and Ageing and beyondblue. It involves

families, early childhood professionals, and a range of community and health

professionals working together to make a positive difference to young children’s mental

health and wellbeing during this important developmental period of birth to five years.

KidsMatter Early Childhood uses a risk and protective factor framework to focus on four

components that ECEC services can use to strengthen the protective factors and

minimise risk factors for children’s mental health and wellbeing.

All four components are outlined below.

1. CREATING A SENSE OF COMMUNITY

within ECEC services by focusing on

belonging, inclusion, positive relationships

and collaboration.

2. DEVELOPING CHILDREN’S SOCIAL

AND EMOTIONAL SKILLS is fundamental

to children’s mental health. These skills

are developed through adults’ warm,

responsive and trusting relationships with

the children in their care, as well as

through constructive peer relationships.



3. WORKING WITH PARENTS AND CARERS ECEC services and families can

establish collaborative partnerships in the interests of their children. ECEC services

can support families by helping them to connect with other families and by providing

access to parenting support.

4. HELPING CHILDREN WHO ARE EXPERIENCING MENTAL HEALTH

DIFFICULTIES. ECEC services are well placed to recognise when young children

may be experiencing difficulties, to implement simple strategies to assist children,

and to support families to seek additional help.

Definitions of terms used in this document

Children: Children from birth to five years unless otherwise stated.

Culturally and Linguistically Diverse (CALD): A broad concept that encompasses individual differences,

such as language, dress, traditions, food, societal structures, art and religion.

Early childhood education and care (ECEC) services: Preschools, kindergartens and long day care

services.

Early childhood staff: Educators, teachers, day care staff, integration aides, assistants, and other staff that

are based within ECEC services.

Externalising: Disruptive, impulsive, angry or hyperactive behaviours (i.e. where the child ‘acts out’). These

behaviours are generally readily observed and therefore are relatively easy to detect.

Internalising: Inhibited or over-controlled behaviours (i.e. where the child ‘holds in’ their difficulties),

including withdrawal, worry, and emotional responses that primarily affect the individual child rather than

having effects on others.

Mental health: Early childhood mental health involves being able to experience, manage and express

emotions; form close, satisfying relationships; and explore and discover the environment.

Parents and carers: This includes biological mothers and fathers, parents of adopted children, GLBT

parents, foster parents, grandparents, aunties and uncles. The primary caregivers of a child/children and are

usually the child’s legal guardians.

Protective factors: Strengths that enable children to maintain positive mental health and wellbeing, even

though risk factors for mental health problems are present.

Resilience: A person’s capacity to adapt to adverse situations in ways that enable them to cope positively

and reduce or minimise negative impacts on mental health and wellbeing.

Risk factors: Factors that increase the likelihood that mental health difficulties will develop. The presence of

particular risk factors does not necessarily mean a difficulty will develop. The presence of multiple risk

factors usually increases the likelihood of difficulties developing.

Temperament: Individual characteristics and style of behaviour that a child is born with, now considered to

have a basis in both biology and environment.



Working with parents and carers

ACHIEVING THE BEST OUTCOMES FOR CHILDREN IN ECEC SERVICES OCCURS

WHEN STAFF AND FAMILIES WORK IN PARTNERSHIP. A large body of research

evidence points to the influence of family factors on children’s mental health and

wellbeing. ECEC services can make a positive difference to children’s mental health and

wellbeing by working with and supporting their families. The literature highlights that

effective ways to collaborate with families include forming partnerships with parents and

carers, arranging opportunities for families to connect with each other and form support

networks, and providing parenting support.

Component 3 of the KidsMatter Early Childhood initiative: Working with parents and carers

focuses on three target areas selected because of their impact on children’s mental health

and wellbeing: collaborative partnerships with families; connecting families; and supporting

parenting. Each of the target areas is discussed in detail below. The numbers appearing

in the text are linked to references listed at the end of the document. If you would like more

information about the ideas presented in this paper, the reference list is a starting point.

Collaborative partnerships

COLLABORATIVE PARTNERSHIPS WITH FAMILIES require positive relationships

where both parties work together toward a common goal and feel a sense of shared

responsibility in reaching that goal (e.g., supporting children's mental health and

wellbeing1,2). In a partnership, each person is valued by the other person and seen as

having a unique perspective and contribution to make.

Collaborative partnerships are

a strengths-based approach to

working with families and are

one of the ways that ECEC

services and families can

effectively work together to

support children’s

development. These

partnerships are protective of

children’s wellbeing because

they encourage important

elements in children’s relationships with others, such as respect, valuing of one another,

trust and understanding.3 Furthermore, partnerships between families and staff act as



protective factors to children’s mental health by helping children adjust to new

environments (i.e. home versus early childhood service) and ensuring that children’s

experiences in both settings are in synergy.4 Partnerships also promote an understanding

and acceptance of differences in childrearing approaches between families and ECEC

services and create a sense of value for the other’s opinion.4

ECEC services can work towards developing collaborative partnerships with families by

taking a family-centred approach. Family-centred practice seeks out and incorporates

parent expertise and knowledge within an early childhood setting. This can include more

than parents acting as helpers at the service, it can also involve families and staff planning

activities and programs together at the early childhood service.

Family-centred practice is an approach to working with families based on

empowerment, and focuses on the strengths, capabilities and individual needs of

parents and carers.5 This approach is defined by the following principles:

Recognising and respecting one another’s knowledge and expertise.

Sharing information and two-way communication.

Sharing power and decision making.

Acknowledging and respecting diversity

Creating support networks.6

Family-centred practice may look different in various settings, depending on the

environment and the people involved. For example, for some families there may be a

greater emphasis on acknowledging and respecting diversity because of their cultural

background and beliefs, whereas for others it may be that there is a greater focus on

sharing information and creating support networks because of their remote rural location or

lack of informal supports. Two-way communication occurs when both parties are able to

pass information back and forth and can achieve two-way dialogue successfully in every

form of communication.6 This requires both parties to make time and space for the

communication to happen.6 Communication

between families and ECEC staff might occur

in an interactive journal where information

about the child in both environments is

shared, or at a parent-staff meeting where the

child’s experiences at home and the service

are discussed.

As an approach to working with families, family-centred practice moves away from the

expert model where service providers decide what services are in the best interest of the

family and families are passive receivers of this information.7. In a collaborative

partnership and within family-centred practice there is a ‘sharing of power’. A sharing of

power allows for partnerships to form and promotes mutual respect amongst both parties.

Despite the sharing of power, an imbalance of control between the families and ECEC

Collaborative partnerships are

based on a sharing of knowledge,

trust and mutual respect.



services is typically present, where one party gives up some control to the other.1,7 While

each other’s opinions are still heard and valued, power and decision making may shift

between the parties.

In the field of early childhood education and care, collaborative partnerships are best

practice for working with parents and carers. Collaborative partnerships with families and

communities is included as one of the quality areas in the National Quality Standard for

Early Childhood Education and Care, and School Age Care.8 This quality standard

promotes respectful and supportive relationships, family involvement, parenting support,

and respect for family values and beliefs regarding child rearing.8 In addition, Partnerships

is one of the five principles of The Early Years Learning Framework (EYLF) in Australia.

The EYLF highlights the importance of partnerships in successful outcomes for children.2

When families and early childhood staff work in partnership with each other, there are

many positive effects on children, families and staff, such as supporting the child-parent

and child-staff relationship and actively working together to help children develop good

mental health.1

A core set of characteristics and skills in early childhood staff are considered essential for

building effective collaborative partnerships with families.9,10 These include a positive

attitude towards families and relationships with families10; approaching families as

partners11; and a commitment to communicating effectively with families, a skill that

is considered particularly important to building partnerships.1,12,13 This set of skills

and knowledge are strongly linked to staff values and beliefs about families.9 It is difficult to

form partnerships with families if negative attitudes, beliefs and judgments are made about

them.1

Building partnerships with families can be a challenging task. Family life can be complex

and chaotic, and often the parents who find it most difficult to work in partnership are in

greatest need of support. By engaging in feedback, reflective thinking and practising skills

with colleagues, staff can continuously develop and improve their skills and understanding

of working effectively with parents.9

Collaborative partnerships are facilitated by family involvement.1 When parents are

involved in their child’s activities and experiences at the service and have an opportunity to

contribute to the organisation and direction of the service, partnerships can be fostered.1 A

successful partnership will often begin with family involvement, which develops into a

stronger relationship where there is a shared sense of responsibility.

By engaging in feedback, reflective thinking and practising skills with

colleagues, staff can continuously develop and improve their skills and

understanding of working effectively with parents.



Creating a sense of community and connection within the service, encouraging families to

feel comfortable and to communicate with staff, and providing opportunities for families to

get to know other families at the service are all beneficial to promoting family involvement

and creating partnerships.1,6 All of these strategies help collaborative partnerships form

and subsequently create an environment where children can thrive in their development.

Friendliness, sincerity and open-mindedness have also been identified as

characteristics that support collaboration. Certain family-centred beliefs and values

such as genuine interest, commitment, acceptance, sensitivity and concern have been

identified as important factors that help families and ECEC services develop positive

collaborative relationships. These characteristics play a key role in establishing protective

factors (such as positive relationships) for children’s mental health and wellbeing in early

childhood.14,15 Surveys of parents and professionals working in an early intervention

context identified communication between parents and professionals and good

interpersonal skills, such as sharing information, sensitivity, openness and listening, as

essential factors in building collaborative relationships.16

Barriers to collaborative partnerships include time constraints, staff turnover, parent’s work

hours, conflict or disagreement between families and service staff, negative beliefs about

disabilities and families who live a long way from the ECEC service. Particular

consideration needs to be given to families who feel alienated or unsure about forming

relationships, even within the ECEC service, based on their experiences or

circumstances.2 Although these barriers can pose challenges, they may be overcome

through a family-centred approach enabling a clear and cooperative communication

process between families and staff with openness to suggestions, responsivity and active

listening between both parties, and a willingness to share information.5,15

The importance of accepting diversity, which is essential to collaborative partnerships, is

outlined in the KidsMatter Early Childhood Component 1 Literature Review. When the

diversity of families, and the aspirations they hold for children are respected, staff can

support children’s rights to have their cultures, identities, abilities and strengths

acknowledged and valued, and respond to the complexity of children’s and families lives.2

Cultural competence is vital in building effective partnerships with families. Cultural

competence can be defined as being able to understand and interpret others in the context

of their culture, however similar or dissimilar to one’s own.17,18 Cultural competence is an

important skill to develop because culture shapes parenting beliefs, values and

practices.4,19,20 For ECEC staff, this means having the understanding, values, knowledge,

skills and behaviour needed to work effectively with people from cultures other than their

“Cultural competence encompasses:

being aware of their own world view;

Developing positive attitudes towards cultural differences;

Gaining knowledge of different cultural practices and world views; and

Developing skills for communication and interaction across cultures.”2 (p 16)



own. For services working with Aboriginal and Torres Strait Islander communities, being

culturally competent means recognising and respecting the central importance of culture

and identity in promoting social and emotional wellbeing.21

Australian research conducted in ECEC services with a high proportion of Culturally and

Linguistically Diverse (CALD) families enrolled, identified a number of factors that

facilitated the formation of partnerships and communication.22 Some of the key factors for

families were being shown appreciation, ECEC service and staff encouraging families’

confidence and assertiveness in communicating with the service. Staff members’

commitment to the development of relationships with individual families and family

members was also very important and was based on principles such as trust, respect and

openness to diversity. The research identified a variety of strategies that have helped

families develop partnerships with ECEC services when language was a barrier. These

strategies included families being given time to communicate with staff; staff verbally

communicating in the families’ first language whenever possible, or using different

methods of communication when this is not possible (i.e., visual representations); and

using written information in families’ preferred language. 22

Effective partnerships between staff and parents and carers have positive flow on effects

for children; this partnership is considered to be one of the most effective ways for staff to

support children’s mental health and wellbeing.23 Additionally, supportive partnerships

between staff and parents and carers also contributes to children’s adjustment to new

settings.4

It is fundamental that strong and effective partnerships are built between ECEC staff and

families to ensure good mental health in families and children in the service. A good

relationship between ECEC staff and parents

and carers is a protective factor for children’s

mental health, and is one of the factors that

has been targeted in selective prevention

programs for children who are at high risk for

mental health difficulties, such as serious

behaviour problems.24

Connecting families

Social connections are an important part of life. The quality of the relationships parents

and carers have in one domain influences the quality of relationships they in other

domains.25-27 Families who have good relationships with other families generally have

lower stress levels and more positive interactions with their children.22 When parents

experience positive relationships with others it affects their relationships overall,

particularly those with their children through modelling and demonstrating successful

partnerships.28

Good relationships between early

childhood staff and families is a

protective factor for children’s

mental health.



ECEC services are potentially places and spaces for building social connections

and a feeling of belonging to the community.2 ECEC services can support families by

providing opportunities for parents and carers to be involved in the service and to develop

relationships with other families. The development of connections between families has

many positive outcomes for children and families, both direct and indirect.22 Positive

effects of connecting families include the provision of support and information to families;

increased participation in ECEC services; increased self-esteem; reduced social isolation;

and increased children’s social networks.22

In contrast, a lack of involvement in children’s activities and family social isolation

are considered risk factors for mental health difficulties in children.29 For example,

primary carers who report receiving inadequate social support from family and friends are

more than twice as likely to report experiences of psychological distress than those

receiving adequate support.30 Furthermore, primary carers who are younger, single

parents, or born overseas are more likely to have low levels of community connectedness.

In some cases, primary carers with low levels of community connectedness were almost

twice as likely to report clinically significant psychological distress when compared with

those who had higher community connectedness.30

Assisting parents to develop support networks may reduce parental distress, which

has been shown to predict internalising behavioural difficulties in early childhood.31

In addition, some research suggests that

parental work stress influences the quality of

family interaction and children’s

adjustment.31,32 Helping families to develop

coping resources by decreasing their social

isolation has positive implications for

children’s mental health and wellbeing.

Social support is a protective factor that can have positive effects (e.g., improvements in

self-esteem, confidence and care giving) on parenting, family wellbeing, and children’s

resilience in families who have a child with emotional difficulties. Social support is

protective in that it helps parents build coping mechanisms and deal with their stress.33 It

has been shown that parents and carers who receive more social support from people in

their social network (i.e. friends and family) also receive more parenting support, which is

beneficial for children.30

Developing support networks for families may be especially important for parents

and carers who are experiencing mental health difficulties themselves. It has been

suggested that the presence of social support can diminish the relationship between early

childhood externalising behavioural difficulties and maternal depressive symptoms.34 In

the instance of severe maternal depressive symptoms, research has shown that child care

Social support can have positive

effects on parenting, family

wellbeing, and children’s resilience

in families who have a child with a

serious emotional difficulty.



attendance was linked to decreased internalising behavioural difficulties in children of

parents with depressive symptoms. This study indicates that social support and child care

attendance can act as protective factors for children who have parents or carers with a

mental health difficulty.34

ECEC services are ideally placed to facilitate social support for families because the

majority of children attend some type of ECEC service. Opportunities to become

involved in the service and meet and network with other families who have children

around the same age can be invaluable to families. Some of the formal and informal

ways that ECEC services can provide this support include having families help at the

service, having family gatherings and events, introducing families to each other, and

buddy systems where parents and carers who already use the service help orient new

families.22

Supporting parenting

Parenting is the most important influence on children’s development, and can be

supported by ECEC services. Parents are usually the primary caregivers of a child,

supporting their physical, social and emotional development through their daily

interactions.35 The parent-child relationship and parenting practices are critically important

for children’s development. The presence of consistent caring, responsive, warm, and

secure parent-child relationships have been well documented as supporting children’s

mental health and wellbeing.29,36-38 The attachment relationship between the child and

parent is a fundamental aspect of social and emotional development and impacts all of

their future relationships.39 Nurturing and responsive caregiving is the gateway to secure

attachment, and through promoting and modelling this relationship parents and caregivers

can establish a positive and secure relationship with their children.23

Research has identified a number of family-related risk and protective factors that

influence children’s mental health and wellbeing. Family-related risk factors for mental

health difficulties in children include negative parenting styles and lack of warmth and

affection in the parent-child relationship. 29,36,37,40,41

In contrast, family-related protective factors include parental caring, affection, secure

attachment, warmth, security and consistency, and experiencing positive

relationships.29,36,37,40-42 Providing children with a warm and secure environment

Surrounding children with positive relationships can act as a buffer

against the detrimental effects of stress.



surrounded by people that care and show affection assists them in developing good

mental health.

While warm, sensitive and responsive parenting supports children’s mental health and

wellbeing, poor parenting can lead to negative mental health outcomes. In a recently

published longitudinal study, low levels of maternal affection towards eight-month-old

infants were linked to greater level of distress 30 years later in adulthood, compared to

those who received higher levels of affection from their mothers.37 Harsh parenting styles

have been associated with children’s behavioural difficulties, including both internalising

and externalising difficulties.31,43

Negative parenting practices can create stress for the entire family and impact on

children’s mental health. Excessive stress in early childhood can have detrimental

effects on brain development, and place the child at risk of physical and

psychological health problems later in life.44,45 The detrimental effects of stress on

children can be long term, and difficult to reverse.39,44 The frequent activation of the brain’s

stress response systems can increase a child’s vulnerability to a range of mental health

difficulties (e.g., depression, anxiety and behavioural disorders) and can therefore affect

children’s overall brain development.44,46

Reducing negative parenting practices (such as harsh discipline and lack of involvement

with children) and increasing positive parenting practices (such as setting fair and

consistent limits to help children feel safe, and providing warm and responsive care) helps

support children’s mental health.47

ECEC staff can make a difference by:

supporting positive relationships between children and their parents or carers;

encouraging and modelling a caring and supportive approach to children;

setting consistent limits and fair consequences for children’s behaviour; and

supporting families to be involved in children’s experiences at the service.48

Surrounding children with positive relationships can act as a buffer against the detrimental

effects of stress.44 Positive relationships between parents, carers, and early childhood staff

can help families and staff to gain knowledge, and feel supported and better equipped to

develop supportive relationships with children. However, not all experiences of stress are

Positive relationships between parents, carers, and early childhood staff can

help families and staff to gain knowledge, and feel supported and better

equipped to develop supportive relationships with children.



detrimental to children. The presence of stress can help children build resilience and learn

self-regulation. A child’s experience of manageable stress, with the support of adult

relationships, is important for child development.44,45 Experiencing adverse life events

provides individuals with the opportunity to develop and practice coping strategies in a

supportive environment. ECEC services can be part of the support system for children

and families as they face life challenges, helping children build resilience and acting as a

buffer during life stressors. This may be achieved by supporting parenting during this time

as well as through the staff’s relationships with individual children.

Parents and carers of children who have emotional or behavioural difficulties may

need additional support with their parenting. An Australian survey of parents with

children under 12 years of age showed that parents who thought their child had an

emotional or behavioural difficulty reported greater amounts of stress in parenting and

were less confident in their parenting skills.49 ECEC services are in a position to support

the parenting process and, where possible, link families with health professionals. The

study also found that parents who viewed their parenting experience as positive reported

their child’s behaviour as less difficult.

In addition, the proportion of parents who thought their child’s behaviour was moderately

to extremely difficult was high (one quarter of parents in this sample) but only 33% of that

quarter had sought professional help for this issue. The two most common professionals

consulted by parents and carers were doctors and teachers,49 highlighting the importance

of schools and early childhood service staff in supporting families who may care for

children with emotional and behavioural difficulties.

It is important to note that optimal parenting practices may be different depending

on the temperament of the child.50,51 One of the challenges of parenting is matching

parenting practices with the temperament on an individual child. Parenting that is in tune

with a child’s temperament is beneficial to children’s wellbeing. Parents can be

encouraged to understand different temperament styles, and to use parenting practices

that are responsive to the needs of the child, based on their mix of characteristics.51,52

ECEC services are well placed to offer parenting support and education. Parents

and carers may feel more comfortable accessing informal information and support

in this environment than seeking it from health care providers and organisations

because of the relationships already developed.53 Staff can provide parenting support

in various ways through both general and systematic support.16 General support can be

provided during day-to-day interactions with parents and carers, for example using

opportunities to have discussions that build trust and empathy, reserving judgement and

communicating sensitively, explaining things from a child’s point of view, and purposefully

modelling specific strategies and thoughtfully approaching parents about these

strategies.16



One of the ways that ECEC services can provide systematic support for families in

their parenting role is through facilitating their access to parenting programs.

Strengthening positive parenting and reducing harsh parenting practices through parenting

programs can have positive effects on children, including enhancing children’s social skills

and positive affect, and reducing children’s conduct problems, negative affect, and non-

compliance.50,52 In addition, implementing parenting programs has been shown to

increase parent’s involvement in children’s education, another protective factor for

children’s mental health.52 For example, a parenting program designed for parents of

children at risk of developing conduct problems (known as Head Start) found that families

who participated in the program became more involved in their children’s education and

were more socially competent than parents that did not participate.52 There are a range of

programs that target parenting to support children’s mental health including Tuning in to

Kids,54,55 Triple P-Positive Parenting Program,56,57 the Incredible Years programs 58,59 and

the Exploring Together Preschool Program.60 Some research has shown that parenting

programs are most effective when children are aged under 9 years, reinforcing the

importance of maximising access to formal support during early childhood.50

A number of other resources available to parents have shown positive effects on parenting

support and education.61 These range from incidental or general information (e.g. tip

sheets, websites, online forums) through to more structured services and programs (e.g.

telephone advice lines, parenting information sessions and parenting programs).35 The

information and support provided can address child development, the parent-child

relationship, or issues residing with the

parent or carer that may impact on their

parenting capacity, such as anxiety about the

parenting role, stress, or financial

difficulties.62 Crucial to any attempts to

support parents and carers is recognition of

their unique needs and strengths.

Supporting parenting is an important part of

children’s mental health and wellbeing. Families are the most powerful influence on

children’s lives and positive outcomes are most likely to be achieved when staff and

families work in partnership. Each family’s wellbeing and, in turn, their capacity to nurture

and support their children is influenced by the community in which they live and the

resources and support available to them.63 Effective parenting with the support of ECEC

services assists both families and ECEC services in understanding their children and

providing a protective factor against mental health difficulties in the future.

Summary and Implications for Practice

Working effectively with parents and carers helps foster development and positive mental

health in young children. In Component 3 of KidsMatter, the target areas discuss the

Families are the most powerful

influence on children’s lives and

positive outcomes are most likely

to be achieved when staff and

families work in partnership.



importance of collaborative partnerships with families, connecting families and supporting

parenting. The aim of these target areas is to provide preventative strategies and options

for early childhood staff, families and parents/carers. In the literature these areas have

been identified as fundamental elements to children’s mental health and wellbeing. Both

the home and early childhood settings and are influential for a child’s development, hence

the importance of collaborating, connecting families and supporting parenting.

Linking families to appropriate information and education about parenting and child

development can assist them to move towards the common goal of improving children’s

social and emotional wellbeing and mental health. Early childhood staff play a critical role

in sharing important information with parents and carers about the experiences of the

children in their care. Overall, the research shows that the better a parent or carer is

supported, included within an early childhood setting and connected with the community,

the better the mental health outcomes of the child.



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