Human babies evolved to thrive in interactions with loving adult caregivers. Babies’ brain development depends on exposure to others and feedback on their actions.[1] They preferentially respond to their parents’ face, voice, touch and smell. Parents and other caregivers are likewise wired by evolution to be attracted to their baby’s ‘cute’ appearance [2] and respond to their crying.[3]
Kurismaa, A. (2021). Revisiting basal anthropology: A developmental approach to human evolution and sociality. In F. Jaroš & J. Klouda (Eds.), Adolf Portmann: A thinker of self-expressive life (pp. 89–118). Springer International Publishing.
Kringelbach, M. L., Stark, E. A., Alexander, C., Bornstein, M. H., & Stein, A. (2016). On cuteness: Unlocking the parental brain and beyond. Trends in cognitive sciences, 20(7), 545–558.
Witteman, J., Van IJzendoorn, M. H., Rilling, J. K., Bos, P. A., Schiller, N. O., & BakermansKranenburg, M. J. (2019). Towards a neural model of infant cry perception. Neuroscience & biobehavioral reviews, 99, 23–32.
Non-verbal interactions consisting of eye contact and responsive gestures during the first six months of life are ingredients for strong connections between parent and child. Yet sometimes parents need additional support and guidance to engage in the rich communicative interactions that underlie early cognitive and language development.
There are three main reasons for this. First, some infants may demonstrate developmental delays that make it difficult for parents to “read” them, resulting in anxious and frustrating encounters. Second, parents experiencing mental health challenges or struggling with substance abuse may find it hard to connect with their child. Unpredictable and inconsistent caregiving can have a confusing effect on a young child and lead them to withdraw. The third and most common reason is stress. In my work I have seen long-standing stress and withdrawal among refugees and families experiencing poverty in southern Africa and Southeast Asia. Severely affected caregivers appear hopeless and inert, unable to muster the energy to bathe, consistently feed or talk to a young child.[4]
Richter, L. M. (2004). Poverty, underdevelopment, and infant mental health. Infant mental health journal, 25(5), 440–452.
Principles to reinforce intuitive parenting
Working with Karsten Hundeide and other members of International Child Development Programmes (ICDP) in southern Africa, we developed principles for brief interventions to help activate and reinforce intuitive parenting among families affected by war, natural disasters and extreme poverty.[5][6] Our approach, which is designed to focus on parents and caregivers struggling to cope, including bonding with their child, differs
fundamentally from “telling parents” what is good for children and teaching them techniques to enhance their child’s development at each age or stage. We aim instead to enable the fundamental cultural and biological drivers of parenting and child development, awakening parents’ intuitive capacity to perceive and respond to their children in a sensitive and positive way.[7] When developing this approach we drew on our own experiences and existing perspectives from research (see box 1).
Hundeide, K. (1991). Helping disadvantaged children: Psycho-social intervention and aid to disadvantaged children in third world countries. Jessica Kingsley Publishers.
Hundeide, K. (1997). Programme for the enrichment of interactions between mothers and their children. World Health Organization.
Parsons, C. E., Young, K. S., Stein, A., & Kringelbach, M. L. (2017). Intuitive parenting: Understanding the neural mechanisms of parents’ adaptive responses to infants. Current opinion in psychology, 15, 40–44.
Box 1
Some perspectives that informed our approach to reinforcing intuitive parenting
- Donald Winnicott’s concept of the “good- enough parent”. Winnicott held that the foundations of health are laid down by the “ordinary mother in her ordinary loving care of her own baby”.[8] The mother herself needs a “holding environment” provided by a supportive other, not a person whose approach implies that she is uninformed and needs to be taught to be a better parent.
- Selma Fraiberg’s idea of “ghosts in the nursery”[9] – the influence of love, ambivalence or neglect that a person brings to their caregiving role from their own childhood.
- Colwyn Trevarthen’s work[10] on developmental processes in the first 18 months of life, in which pre-verbal communication – such as prolonged eye contact, imitation, responsive touch and voice – leads to incorporating “topics” into interactions, for example through repetition of simple rituals like waving bye-bye.
- Work by Lev Vygotsky[11] and Pnina Klein[12] on how cognitive and language development originates in the interpersonal exchanges between parent and child.
- An emphasis on touch, voice and eye contact as ways to express empathy and elicit trust.[13]
- Infant observation, as taught in developmental psychoanalysis, in which a parent simply watches their baby in a relaxed way and attempts to interpret their child’s feelings.
- The powerful influence of parental states of mind[14] and parental self-efficacy[15], and the deteriorating spiral of negative parental attributions to children’s motives and behaviour[16].
Winnicott, D. W. (1973). The child, the family, and the outside world. Penguin.
Fraiberg, S., Adelson, E., & Shapiro, V. (1975). Ghosts in the nursery: A psychoanalytic approach to the problems of impaired infant–mother relationships. Journal of the American Academy of Child Psychiatry, 14, 387–421
Trevarthen, C. (2001). Intrinsic motives for companionship in understanding: Their origin, development, and significance for infant mental health. Infant mental health journal, 22(1‐2), 95–131.
Wertsch, J. V., & Sohmer, R. (1995). Vygotsky on learning and development. Human development, 38(6), 332–337.
Klein, P. S. (2000). A developmental mediation approach to early intervention; Mediational Intervention for Sensitising Caregivers (MISC). Educational and child psychology, 17(3), 19–31.
Stack, D. M. (2004). Touching during mother–infant interactions. In T. M. Field & J. Freedman (Eds.), Touch and massage in early child development (pp. 49–91). Johnson and Johnson Pediatric Institute, LLC.
Dix, T. (1991). The affective organization of parenting: Adaptive and maladaptive processes. Psychological bulletin, 110, 3–25.
Albanese, A. M., Russo, G. R., & Geller, P. A. (2019). The role of parental self‐efficacy in parent and child well‐being: A systematic review of associated outcomes. Child care, health and development, 45(3), 333–363.
Miller, S. A. (1995). Parents’ attributions for their children’s behavior. Child development, 66(6), 1557–1584.
Initiating human connection through simple caring behaviours
We always begin by greeting and focusing on parents, before turning attention to their child. We ask about parental and family wellbeing and concerns in an open way. Listening to parents, and communicating compassion by physical proximity, eye contact, unobtrusive contact, and speaking in a soft, caring voice, helps parents feel accepted and understood, and helps to build trust.
We continually mention positive aspects of their child’s appearance and behaviour, remarking on similarities to the parents themselves. We especially comment on children’s communicative and affiliative gestures towards parents, for example: “see how she listens to your voice”; “he wants to sit close to you because you make him feel safe”. We encourage parents to observe their child and interpret their state of mind (“what do you think he is thinking?”) and their emotions (“what do you think she is feeling?”).
We use familiar age-specific routines to elicit a child’s interest. For example, depending on a child’s age, gently touching a baby’s cheek to elicit smiling; imitating gestures and vocalisations, even if unintentional, like a cough; initiating culturally appropriate games like “round and round the garden”, “pat-a-cake” and “where’s [child’s name]?”; waving hello; and pointing to and naming body parts. Such actions almost always elicit positive responses from a child after a while and, together with repetition, help to establish responsiveness and put children at ease.
As we do these things, we sit close to parents and slowly begin to use their hands or encourage their voice to accompany our own, until their interaction is independent of our participation. We provide a quiet and reassuring narration for the parent, observing and praising what they are doing and how their child responds. We suggest in what ways their child’s behaviour may prompt them to vary games, but we refrain from recommending specific actions or toys.
We use emotive language, stressing love and warmth, the joy of interaction, and the pleasure of sitting quietly together – singing, telling a story, or just enjoying holding one another. We encourage parents to feel proud of their ability to interact with their children and to elicit their children’s smiles and laughter; we reassure them that while such loving and learning interactions may be brief, because of young children’s limited attention span, they can take place at any time and in any situation.
With older children, we emphasise the importance of child-directed speech, talking with rather than at a child, taking turns, telling or reading stories, and commenting in response to children’s vocalisations. We model elaborated speech and the importance of enriching descriptions of objects and events and linking them to events and objects beyond the immediate place and time.
Interventions may continue over several days or weeks, depending on the severity of emotional and physical withdrawal of the parents and child. Encouraging evaluations of the ICDP approach [17][18][19], showing positive attitudinal and behavioural changes in parents and children, support our conviction that the key to long-lasting change in parental behaviour is igniting and sustaining their intuitive responsiveness to their child.
Dybdahl, R. (2001). Children and mothers in war: An outcome study of a psychosocial intervention program. Child development, 72(4), 1214–1230.
Sherr, L., Skar, A. M. S., Clucas, C., Tetzchner, S. V., & Hundeide, K. (2014). Evaluation of the International Child Development Programme (ICDP) as a community-wide parenting programme. European journal of developmental psychology, 11(1), 1–17.
Skar, A. M. S., Sherr, L., Clucas, C., & von Tetzchner, S. (2014). Evaluation of followup effects of the International Child Development Programme on caregivers in Mozambique. Infants & young children, 27(2), 120–135.
