A study has linked the wellbeing of toddlers with their physical condition in later life, finds Helen Puttick

Two pictures of the brain are displayed on the screen behind Chief Medical Officer Dr Harry Burns - and the image on the left is much larger than the one on the right. This scan was taken from a typical, healthy three-year-old. The other, smaller and darker brain, belonged to a child of the same age who had suffered extreme neglect.

Dr Burns says: "There's increasing evidence that I think we have to investigate, that early-years neglect can have very profound consequences for children."

This is cutting-edge science. Of course, parents have been blamed for the behaviour of their children and their neuroses into adulthood for decades, but the research Dr Burns is highlighting does not just look at the impact of a chaotic childhood on mental wellbeing.

He is suggesting that the emotional experiences of babies and toddlers can result in physical changes which affect their health throughout life.

He says: "There is increasing evidence that the relationship between children and their primary care giver is of crucial importance to developing good mental health and good physical health."

Comforting a baby when it cries, returning its smiles with a smile and responding when it makes a sound are among the examples of supportive parenting he gives.

Such tender gestures are rarely discussed during press conferences at the Scottish Government. Colder relationships, such as the link between smoking and cancer or alcohol and violence, are more commonly aired in the media room at St Andrew's House.

However, Dr Burns's second annual report, published yesterday, ventures into new ground, dwelling on potentially controversial theories which tie emotional development and physiology.

In it, he calls for further study of the way adversity in infancy can cause disease in adulthood and for new parents who are struggling in Scotland, to receive more thorough support.

He explains: "What I'm really talking about is in addition to defending health in the traditional way, we need to think about creating positive health and we start doing that in early life."

A number of projects overseas have already shown the potential of this approach.

One programme in the United States found children in vulnerable families who received intensive support had higher IQ scores at the age of three, and better school grades at the age of 12, than families left without the help.

Another scheme, where nurses visited young mothers at home, recorded less antisocial behaviour among their children.

Dr Burns admits that Scotland does not have equivalent strategies at the moment and says one project tried in Glasgow did not show any benefit - perhaps because it provided the wrong level of support.

He says: "People are doing the best they can and they are doing things that are, in part, evidence-based, but I think the challenge that we have got is to really be quite rigorous in applying the evidence otherwise another three to five years will go by and we will say, That didn't work'."

For now, however, he cannot even say how many new mothers and fathers receive parenting assistance in Scotland. What we do know is the number of children with a mother or father who abuses drugs - up to 59,000 - and the number of children with a problem drinker for a parent - at least 70,000.

We also know parents feel isolated. Phone advice service ParentLine Scotland surveyed callers and found this was one of the most common problems. The helpline receives around 10,000 calls a year.

Tom Roberts, of Children 1st which runs ParentLine Scotland, said: "The service receives many calls from parents looking for support with their children and it is clear that there are not always local services available."

This does not mean no effort has been made. Agency NHS Health Scotland has published guides for new parents, including Ready Steady Toddler which includes advice on handling and avoiding tantrums. But Celia Gardiner, its programme manager for early years, agrees more could be done to assist those with very young families.

She says: "You are very well supported throughout pregnancy and suddenly the baby has arrived and you have this little bundle and there is no instruction booklet."

Scotland's Violence Reduction Unit, which is working to cut violent crime, also supports Dr Burns's approach.

Karyn McCluskey, deputy head of the unit, says: "Research shows that the most important years of a child's life are up to age three - this is when they learn skills like empathy, compromise and negotiation from the people who look after them, skills that will help them negotiate life successfully.

"Children who do not acquire those skills, who grow up in an environment where using your fists is the standard way of resolving conflict, will likewise imitate such behaviour, thus carrying a pattern of violence forward into the next generation."

Dr Burns believes breaking that cycle could also start to change Scotland's appalling health record.

They don't tell you when he should be smiling'
JULIA HORTON

"I HAVE not really had any support at all unprompted."

Married mother of two Jane DeMarco, from Cramond, near Edinburgh, is frank when asked about her experience of the help available to parents of babies and toddlers in Scotland - support that the country's chief medical officer said yesterday was paramount in securing children's future health.

That said, Mrs DeMarco, 32, is quick to add that she feels confident that the support from health professionals is there if parents ask for it.

She said: "I'm pretty confident my health visitor would be able to give me advice if I asked, but even with my first child when the health visitor was visiting regularly it was really only the basics that were covered like when to wean.

"There wasn't really anything in terms of mental and physical development.

"They ask if your baby is smiling, but they don't tell you when he should be smiling or what you can try if he isn't."

Mrs DeMarco, who has two sons, three-year-old Luke and Milo, four months, agrees that the early years are important for later life and would like to see new initiatives in Scotland, including a US scheme where dedicated nurses help support mothers from pregnancy through the early years.

There's a gap. It was daunting'
ALAN MacDERMID

THE Positive Parenting Programme has been pioneered in Scotland by Greater Glasgow and Clyde NHS.

Devised in Australia, the system involves teaching parents skills that enable them to become independent problem-solvers.

Amanda Caldwell, 32, who lives in Pollok, Glasgow, with her daughters Samantha, 12, and eight-month-old Summer, is among the hundreds to benefit from the programme.

"There is a big gap between my two children and it was quite daunting. I was suffering from post-natal depression and low self-confidence," she said.

Her introduction to the course was through Trish McMahon, her key worker in the Glasgow social services Pact (Parents and Children Together) team who help parents to access health, local authority and voluntary sector services.

Having been introduced to swimming with Summer and baby massage as a way to ease the bonding process, Amanda now attends PPP classes lasting two hours a week.

"I like to think of myself as a good parent but when you take part in the course you realise some of the things you have been getting wrong," she said. "But my problems were minimal compared to some of the mothers I was with, who had toddlers kicking and screaming.

"The important thing when applying sanctions to your children is that you can deliver them, and then stick to it."

Ms McMahon said: "This is promoting positive parenting, and hopefully the children will grow up to appreciate the values they have been given and hand that on to their own children."