Evidence from programmes that work
How is it that, despite of the enormous resources expended on the criminal justice system in South Africa, violence is increasing? The answer lies in the fact that while a strong criminal justice system is essential, it can do little to prevent violence in the first place. To prevent violence, we need, amongst other things, to support with parents and children. The ISS seminar on “Healthy childhoods for the prevention of violence”, jointly hosted by the Sexual Violence Research Initiative and the ISS, held on 3 November, focused on the importance of parenting for the prevention of violence and showcased two interventions that have been found to be effective in addressing early risk factors for violence in adolescence and adulthood.
Supporting parents through carefully designed programmes are a key element in preventing child abuse and neglect. This is important because children who have been abused are at risk of growing to be violent adolescents and adults, or being re-victimised.
Professor Lynne Murray’s research illustrates how what happens to us in the first two to three years of life can influence what happens in later childhood and even adulthood. Parenting and care-giving directly affect development and how a child engages with others and the wider world. Her research shows how relationships in these early years support child development in four key areas:
- Social: Learning to understands others, share and cooperate with others;
- Attachment: Supporting feeling secure and resilient;
- Emotion regulation: Learning tomanage difficult feelings and self-control;
- Cognitive: Developing skills, language, reasoning
By age 2-3, the extent to which a child is developing in relation to each of these four key areas predicts later child (and sometimes even adult) functioning. For example, social understanding at age 2 years predicts social competence in later childhood;
Insecure attachment in infancy is strongly associated with sexual abuse perpetration among adolescent boys
Aggression that is pervasive and persistent at two-three years predicts violence and aggression in adolescence;
andmemory/attention/IQ in infancy predicts academic achievement at 16 and 21 years
In short, our earliest life experiences have a profound impact on who we are and how we behave as adults.
Understanding this enables us to develop programmes that target the three early predictors of violence - infant attachment; cognitive development and child persistent and pervasive aggression.
Professor Peter Cooper, shared research evaluation findings for two interventions developed and tested in Khayelitsha, South Africa: the Thula Sana programme that fosters healthy bonding between mothers and infants; and a programmes that teaches mother’s to share a book with their infant which has been shown to stimulate cognitive development.
Thula Sana, is a 16 session home-visiting programme. Community workers visit the homes of pregnant women from late pregnancy and for six months after she has given birth. The community workers provide support and guidance in parenting. The aim of Thula Sana is to promote sensitive and responsive parenting and secure infant attachment to the main caregiver. Thula Sana was evaluated through a Randomised Controlled Trial. Mothers who benefitted from the programme were significantly more sensitive and less intrusive in their interactions with their infants. Being trained in Thula Sana was also associated with a higher rate of secure infant attachments at 18 months.
Book-sharing has been shown in high income countries to greatly benefit child intellectual development and language acquisition – all fundamental to success at school. Professors Cooper and Murray and colleagues recently evaluated a book sharing programme to establish the impact of the programme on language development and attention. Carers who took part in the programme reported significant increases in the number of words understood by their infants; the number of words that their infant could vocalize; and, substantial gains on a measure of sustained attention. This programme is simple and inexpensive to deliver, and can enhance child cognitive development.
These studies provide sound evidence for addressing two of the early predictors of violence in South Africa and the programmes have been shown to have a real and tangible impact on children and their families. More needs to be done to develop composite interventions targeting all early risk factors and effective interventions must be costed, and sustainable mechanisms for taking them to scale developed.