Introduction
Social inequality can be broadly defined as the unequal distribution of income, wealth, power, prestige, and privileges, as well as the existence of social boundaries between classes.(Bapuji, Ertug, & Shaw, 2020). This essay will explore the role that social inequality can have on the ‘school readiness’ of children as they enter the education system between the age of 4 and 5 years old. Its main focus will be on families living in poverty and specifically those living in the United Kingdom.
Income inequality is the extent to which income is distributed unevenly among members of a group; most commonly conceptualized at the country or state level (Bapuji, Ertug & Shaw, 2020). Income inequality has increased in many developed countries and over the past 10 years, the UK has seen a significant increase in the number of children entering poverty. In 2020, there were more than 4.5 million children living in poverty in the UK (The Social Metrics Commision, 2020) with many of them having inadequate food to share within the family (Children’s Commissioner, 2021) The Social Metrics Commission recently estimated that 2.3 million children are affected by persistent poverty, that is, they have been living in poverty for at least two of the previous three years. The profile of child poverty has also changed over time, with almost three-quarters of children in poverty now living in households where at least one adult is working. (The Social Metrics Commission, 2020)
In 2010, The Marmot Review (Marmot et al., 2010) was published to outline health inequalities in England. It highlighted some key issues in relation to early child development and child poverty. Notably, its highest priority recommendation was to ‘Give every child the best chance in life’, citing that the close links between early disadvantage and poorer outcomes through life can only be broken if intervention begins before birth. An updated review, Marmot 10 years on, was released in 2020. In this, it was noted that since 2010 there had been limited progress and some negative outcomes in achieving the recommendations. Regarding ‘school readiness’ it seems there has been some progress, but socio-economic inequalities persist and there are wide inequalities in outcomes between regions (Marmot et al., 2020). Since 2020, the impact of Covid 19 has likely deepend inequality further, with differential impact in diverse communities and areas where poverty was already rife. (Children’s Commissioner, 2021; Institute for Fiscal Studies, 2021, Social Metrics Commission).
This essay will look specifically at how family income impacts on school readiness for children at 4 years of age. This focus was chosen due to the fact that the degree to which children have the skills necessary for thriving in school has very strong correlations to their later educational achievements and well-being outcomes. (Boivin & Bierman, 2013; Marmot et al., 2010) Indeed, the capabilities that children possess at the start of school are associated with a range of outcomes, including academic and social competencies, language and literacy development, health and socio-emotional well-being (Christiansen, 2020). Conversely, children who start school with fewer of the skills and attributes for success are at increased risk of falling further behind with each year of school, which can then lead to worse long-term outcomes in areas such as educational attainment, employment, risky behaviours, mental health and crime. These long term outcomes can keep children trapped in the intergenerational poverty cycle (Christiansen, 2020, Marmot et al., 2020)
School readiness has been defined as the basic skills that children need to possess at school entry in order to adapt successfully to the school environment (Boivin & Bierman, 2013). Measures of school readiness assess a variety of cognitive, language, behavioral, motor, and social- emotional skills. These various components are correlated, but each contributes in some significant and unique ways to school readiness. (Boivin & Bierman, 2013) There is a broad consensus that school readiness includes a variety of capacities that will support a child at school, such as early academic ability, learning engagement, social-emotional skills and low aggressive–disruptive behaviour (Abenavoli et al. 2017). All of these skills can be impacted on by living in poverty.
Outcomes of inequality
Early child development (ECD) is regarded as a critical time in a child’s life and refers to the process of cognitive, physical, language, temperament, socioemotional and motor development of children that starts at the time of conception until 8 years of age. (WHO, 2020) The earliest years are especially important, being the time when the brain rapidly changes through neuro-synaptic pruning over the first months and years of a child’s life (Minh et al., 2017; WHO, 2020). These changes, combined with the accelerated growth experienced, make infant brains particularly susceptible to environmental stimuli both positive and detrimental to development (Irwin, 2007; Minh at al., 2017; WHO, 2020) Through a process called biological embedding, social and environmental experiences in a child’s early years can have lifelong protective or detrimental effects on children’s learning, behavior, health and wellbeing (Berens, Jenson & Nelson, 2017; Minh et al., 2017).
Inequalities in key aspects of a child’s early care lead to inequalities in child development. This includes the influence of the family, e.g. the physical and emotional care provided as well as the influence of the State e.g. parental access to employment, healthcare, early childcare and education, and access to appropriate housing. Studies have shown low household income to be the strongest predictor of poor mental health problems in children (Law, 2021; Roberts, Dorkin & Marmot, 2016). In addition, children living in poverty may have the compounding influence of other co-occurring factors influencing their development. For example children who experience poverty are also more likely to experience adverse childhood experiences (ACEs) such as abuse or neglect which can have significant ramifications on mental health and development (Roberts, Dorkin and Marmot, 2016). Neuroscience has been able to confirm the strong association between poverty and brain growth in the first three years, resulting in differences in gray matter volume between children in families of varying socioeconomic status (Hanson et al., 2013).
Longitudinal studies show that at least half of the long-term educational achievement gaps between poor and nonpoor children exist at school entry, and this “achievement gap” associated with poverty widens over time (Janus & Duku, 2007; Ryan, Fauth, & Brooks-Gunn, 2006). Educational outcomes in adolescence and even beyond can be traced back to academic skills at school entry which can, in turn, be traced to capabilities seen during the preschool years and the experiences in and out of the home that foster their development. (Marmot et al., 2010; Shonkoff, 2000).
Risk and protective factors
Despite the growing evidence base of the link between household income and brain development, the causal factors in play remain unclear and fragmented. Many agree that children’s development can be better viewed from an ecological perspective which demonstrates the complex and interrelated spheres of influence impacting on development. Brofenbrenner’s ecological systems theory (Brofenbrenner, 1998) can serve as a powerful tool to analyse potential risk factors to well-being and can be used to see how socio-economic disadvantage can cause risk at multiple levels of a child’s life.
Bronfenbrenner’s model views child development as a complex system of interrelated spheres of influence. A child is affected by multiple levels of the surrounding environment, from immediate settings of family in the microsystem to broad cultural values, laws, and customs in the macrosystem (Brofenbrenner, 1998). Income inequality may be regarded as a distal factor which can have a direct effect on the family by affecting their health or the way they provide food, healthcare or education for their children. Income inequality can be reduced or aggravated by socio-political factors in the macrosystem. The next section of the essay will explore the influence of the family sphere and the socio-political sphere in greater depth.
Family sphere
The family is the most significant relationship in the microsystem and has a particularly large impact on ECD (and therefore ‘school readiness’). A child’s family not only provides food, shelter and basic needs but they are also the primary source of experience. Family members have the largest share of contact with the child and mediate a child’s contact with the broader environment (Irwin, 2007). Longitudinal studies have suggested that the strong association between economic disadvantage and psychosocial difficulties may be ascribed to the fact that poor families are at higher risk to a number of disadvantages that would impact the home environment and childrearing quality (Law et al. 2021). These risks will be discussed below.
Prenatal and perinatal health
The brain is at its most sensitive in the early years of life so factors such as low nutrition, toxins or low stimulation in prenatal and perinatal stages have life long impacts (Irwin, 2007; Minh at al., 2017). The risk that low family income has on ECD has been well documented and can begin as early as conception depending on the health and environment of the expectant mother (Irwin, 2007; Shonkoff & Phillips, 2000). During pregnancy, regular prenatal health checks; not smoking, drinking or taking drugs; and consuming adequate healthy foods are all protective factors. Infant breastfeeding also helps to support optimum infant health (Maggi et al., 2010). On the contrary, exposure to toxins, stress and malnutrition can have a detrimental effect on ECD.
Household income has also been shown to a strong predictor of antenatal maternal mental health (Law, 2021). Mothers on a lower income are much more likely to suffer from depression or other mental health difficulties which can have significant consequences on their child’s development. While in utero, infants can experience changes in brain structure as a result of maternal stress, leading to long-lasting consequences later in life (MacKinnon et al. Shonkoff et al., 2011). The link that this has with infant brain development has important implications for school readiness’. In a longitudinal study, data from 505 mother-child dyads was collected, examining household income; maternal mental health until two years postpartum; as well as a range of child behavioural, socio-emotional and cognitive outcomes from 2 to 6 years of age. 40% of the women studied reported high antenatal mental health symptoms and these symptoms independently explained 13–44% of the income-school readiness gap (Law, 2021).
Although there have been some notable links between prenatal maternal stress and infant brain development (MacKinnon et al. Shonkoff et al., 2011). The effects of maternal mental health after birth are less clear. Maternal mental health is likely to create higher risks across a range of factors influencing ECD. One notable factor may be the ability with which parents are able form secure attachments with their infant. Miller and David (1997) suggested that parent-child interaction and involvement could be one of the key components through which income levels have an impact on children’s outcomes.
Attachment with a Caregiver
Sensitive and responsive parenting is strongly associated with positive outcomes for children as infants learn about their own world, and their reactions through their interactions with their caregivers (Stern, 2016). Attachment is universal to all mammals and it supports a range of outcomes, including interpersonal and emotional development. Positive interaction with a caregiver forms the basis of infant’s discovery of their own internal world and is crucial in guiding psychological development (Bowlby, 1979; Shroufe, 2005).
Studies have shown that attachment can be impaired by caregiver stress and financial worries (Repetti et al., 2002). Moreover, numerous studies have demonstrated that children living in poverty are more likely than their wealthier peers to develop insecure attachment relationships (Aber et al., 2000; van Ijzendoorn et al., 1999). However, interventions that focus on supporting secure attachment (not just focusing on maternal mental health) have shown promising results. In a study which sought to support the mental health of 193 women through PND- routine care, CBT, counselling, psychodynamic therapy, it was found to help depression in mothers but didn’t show any significant impact on infant behaviour (Murray, 2003). However, another study with an attachment focused intervention delivered in Khayelitsha, South Africa found significantly more sensitive interactions and stronger attachments in both a 6 month and 12 month follow up (Cooper et al., 2009). It would be helpful to see the results of similar studies within different cultural contexts.
The development of secure attachment relationships can act as powerful buffers of stress for children at all income levels (Gunnar, 2017). Attachment security has been shown to buffer poor school-aged children from depression as well as moderating the relationship between prenatal stress and anxious behavior in early childhood (Johnson et al). Supporting caregivers in creating secure attachments could therefore be an effective way to help mitigate a variety of stressors that may come from poverty; both from maternal mental health as in the Khayelitsha intervention, and other stressors that result from growing up poor.
The Home Environment
The home environment in which a child grows up in can have pertinent effects on ECD. Indeed, the quality of a child’s early environment and the availability of appropriate experiences at the right stages of development are crucial in determining the strength or weakness of the brain’s architecture. This, in turn, determines how well he or she will be able to think and to regulate emotions. Household income has been linked to lower levels of language and cognitive ability (Children’s Commissioner, 2021; Shonkoff & Phillips, 2000). In the USA, significant differences have been found in the richness of the language environment for children from economically disadvantaged families, resulting in the children having poorer language acquisition (Maggi et al., 2010). Although potential causes for this have already been outlined above, another factor at play could be the amount of stimulation an infant receives in their environment.
As well as attachment and attunement with a caregiver, children also seem to have the best developmental opportunities when parents offer proactive teaching and a sensitive approach to discipline (Maggie et al., 2010, WHO, 2020). The WHO guideline for improving early child development outlined some key research that had been found to be supportive of early learning and development. These included (1) interventions in caregiver-child book sharing, (2) interventions that provide developmentally appropriate learning and play materials, (3) interventions that support general caregiving competencies. In addition to this, the report also noted that the promotion of positive behaviour management techniques, such as establishing daily routines, praise and appropriate discipline could support young childrens’ socio-emotional and behavioural development.
It is worth noting that not all of the child care received in early childhood is provided by an infant’s primary caregivers. Families will often need to access childcare which can be of varied quality, especially for low-income families. In many cases, families who are not able to afford childcare will make use of family or friends to look after infants. This is often linked to lower outcomes (Duncan, 1997).
Socio-political sphere
The family sphere can be supported or aggravated by its socio-political context. Being the outer sphere of the ecological model, the political sphere influences everything else within it. Policies can either serve to improve or worsen family circumstances through effects both at the familial level and the wider community they are situated in.
The Social determinants of health
As the social determinants of health have greater effects at the societal level, one could argue that they can be most effectively addressed through changes in public policies and social norms (Compton, 2015) The social determinants of mental health can be described as being underpinned by unequal distribution of opportunity and, more deeply, by public policies and social norms. Therefore, as demonstrated in Figure 1, the greatest population-based impact for improving mental health and reducing risk of mental illnesses could be achieved by optimizing public policies and altering social norms (Compton, 2015).
Figure 1: Conceptualizing the social determinants of mental health (Compton, 2015)
Socio-political factors in the UK
The UK government has shown some recognition in the importance of the early years for child development as highlighted in the Marmot review 10 years on (Marmot et al., 2020). One response to this has been the ‘Healthy Child Programme’ (Public Health England, 2016). In this, there are mandated visits from Health Visitors to identify and treat problems early with an emphasis on parenting support, particularly in promoting sensitive and attuned parenting. Although this is not specifically aimed at lower income families, the hope would be that any additional needs that may be present as a result of having a low income, would be identified and addressed by the programme.
Many current UK policies focus on getting people into work with the view that ‘work is the best route out of poverty’ as outlined in the report: A New Approach to Child Poverty (Department of work and pensions, 2011). As a result, the government has prioritised funding for working but lower income families to have up to 30 hours of free childcare a week (Department for Education, 2019). Although this may be of help to many families, the government also needs to ensure the availability of ‘good work’ (Marmot et al., 2010) Parents, especially mothers, often need to work part-time or flexibly to manage childcare alongside paid work. This restricts them to lower paid jobs, often in sectors such as retail and care, where there are high levels of poverty, insecurity and less chance of training or progression to better paid work. They also face growing difficulty finding enough hours or secure and predictable work patterns (Children’s Commissioner, 2021). In addition, it should be recognised that not all families will have the capabilities to access work for various reasons. Therefore it is important for their own challenges to be recognised and supported.
Although spending on early childhood care and pre-primary education has increased, there have been severe cuts in other services providing for disadvantaged families. One notable example being the Sure Start Children’s Centres which were set up to support disadvantaged communities. Since 2010, the funding for Sure Start centres has reduced by two thirds with an estimated 1000 centre closures (Institute of Health Equity, 2020). These cuts are likely to have had a detrimental impact on the outcomes of disadvantaged families who relied on this support.
Implications for mental health policy and interventions
The importance of the early years for development is now widely recognised with many studies highlighting the critical nature of the first two years in particular. Therefore, policies that are put in place should reflect this research and prioritise interventions with this age group accordingly. As ECD begins before birth, it is essential that maternal health is also prioritised in policy and intervention as well as the early years after birth. Evidence shows that effective early intervention can significantly reduce the impact of poverty on children’s development when it is sufficiently intensive and reaches the families who need it most. One such intervention is the Parents as First Teachers trial in Zurich (Schaub et al., 2019). This study focused on children from the city’s 10% most deprived families from birth until age three and found marked improvement in language and self-regulation: key skills for ‘school readiness’.
The Marmot review (Marmot et al., 2010) also recommended the use of parenting programmes, children’s centres and key workers, delivered to meet social need via outreach to families. Some of these suggestions have already been reflected in Scotland’s own policy ‘Getting it Right for Every Child’ (The Scottish Government, 2012). The policy emphasizes the need to ensure anyone providing support to disadvantaged children puts them– and their family – at the centre. Its approach values joined up services and achieves this through ensuring Getting it right for every child is threaded through all existing policy, practice, strategy and legislation affecting children, young people and their families.
Early intervention services are likely to be more effective when they are combined with measures to reduce poverty (Molloy, 2019). This could include measures such as providing paid parental leave in the first year of life with a minimum income for healthy living (Marmot, 2010) or supporting parents to access work, training or improved community resources (Molloy, 2019). A study involving the nurse programme in the USA found an increase in mothers joining the workforce when policies ensure that education and training opportunities remain available (Olds et al., 1988). Studies also show that family stress and children’s achievement improves when policies increase parents’ access to employment and higher wages (Molly, 2019). In a report from the Early Intervention Programme, Molloy stresses that effective early intervention is needed alongside new efforts to reduce child poverty. These two courses of action are not alternatives, we need to do both (Molloy, 2019).
Conclusion
In conclusion, the relationship between child poverty and ‘school readiness’ is strong; yet it is also multifaceted and complex. It is clear that there are multiple risk factors that living in poverty can have on early child development. To best support families, it is important to have an understanding of the different factors that may be at play. However there do seem to be some key risk and protective factors that should be taken into account in policies and interventions. Firstly, it should be understood that development begins at conception so maternal health should be prioritised in order to support infant health. The protective effects that secure attachment has on health and wellbeing should also not be understated. Secure attachment has been proven to have lifelong effects and could be an important way of mitigating any negative effects that may have occurred in utero or immediately after birth. It is also apparent that stimulating environments are essential for healthy development to occur. Parental support and universal access to high quality child care are important methods of supporting this. Finally, such a complex problem can only be addressed by a combined and whole-picture approach; it is only through working together across networks and agencies, that we can hope the risks associated with poverty can be effectively addressed.
References:
Abenavoli, R.M., Greenberg, M.T. and Bierman, K.L. (2017) ‘Identification and validation of school readiness profiles among high-risk kindergartners’, Early Childhood Research Quarterly, 38, 33–43.
Aber, J L., Jones, S., Cohen, J. (2000) The impact of poverty on the mental health and development of very young children. C.H. Zeanah (Ed.), Handbook of Infant Mental Health, Guilford Press, New York pp. 113–128
Bapuji, H., Ertug, G., & Shaw, J. D. (2020). Organizations and societal economic inequality: A review and way forward. Academy of Management Annals, 14(1), 60-91. https://journals-aom-org.ezproxy.is.ed.ac.uk/doi/10.5465/annals.2018.0029
Berens, A. E., Jensen, S. K. G., & Nelson, C. A. (2017). Biological embedding of childhood adversity: from physiological mechanisms to clinical implications. BMC Medicine, 15(1). https://doi.org/10.1186/s12916-017-0895-4
Bowlby, J. (1979). The Bowlby-Ainsworth attachment theory. Behavioral and Brain Sciences, 2(4), 637-638. doi:10.1017/S0140525X00064955
Boivin, M & Bierman, K. L. (2014). Promoting school readiness and early learning : implications of developmental research for practice. The Guilford Press.
Children’s Commissioner. (2021). Child poverty: the crisis we can’t keep ignoring. https://www.childrenscommissioner.gov.uk/wp-content/uploads/2021/01/cco-child-poverty.pdf
Christensen, D., Taylor, C. L., Hancock, K. J., & Zubrick, S. R. (2020). School readiness is more than the child: a latent class analysis of child, family, school and community aspects of school readiness. Australian Journal of Social Issues. Published. https://doi.org/10.1002/ajs4.138
Compton, M. T., & Shim, R. S. (2015). The Social Determinants of Mental Health. FOCUS, 13(4), 419–425. https://doi.org/10.1176/appi.focus.20150017
Cooper, P. J., Tomlinson, M., Swartz, L., Landman, M., Molteno, C., Stein, A., McPherson, K., & Murray, L. (2009). Improving quality of mother-infant relationship and infant attachment in socioeconomically deprived community in South Africa: randomised controlled trial. BMJ, 338(apr14 2), b974. https://doi.org/10.1136/bmj.b974
Department for Education (2019). Government Response to Report on Tackling Early Years Disadvantage. www.gov.uk/government/publications/government-response-to-report-on-tackling-early-years-disadvantage.
Department of Work and Pensions. (2011, April). A New Approach to Child Poverty: Tackling the causes of disadvantage and transforming families’ lives. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/199952/National_Service_Framework_for_Children_Young_People_and_Maternity_Services_-_Core_Standards.pdf
Duncan, G. J., & Brooks-Gunn, J. (1997). Consequences of Growing Up Poor (1st Edition). Russell Sage Foundation.
Gunnar, M. R. (2017). Social Buffering of Stress in Development: A Career Perspective. Perspectives on Psychological Science, 12(3), 355–373. https://doi.org/10.1177/1745691616680612
Hanson, J. L., Hair, N., Shen, D. G., Shi, F., Gilmore, J. H., Wolfe, B. L., & Pollak, S. D. (2013). Family Poverty Affects the Rate of Human Infant Brain Growth. PLoS ONE, 8(12), e80954. https://doi.org/10.1371/journal.pone.0080954
Institute for Fiscal Studies. (2021). Living standards, poverty and inequality in the UK: 2021. https://ifs.org.uk/uploads/R194-Living-standards-poverty-and-inequality-in-the-UK-2021.pdf
Irwin, L. G., Siddiqi, A., & Hertzman, G. (2007). Early child development: a powerful equalizer. Vancouver, BC: Human Early Learning Partnership (HELP).
Irwin, LG, Siddiqi, A, Hertzman, C. (2010). The equalising power of early child development: from the commission on social determinants. Child Health and Education, (1) 3-18
Janus, M., & Duku, E. (2007). The School Entry Gap: Socioeconomic, Family, and Health Factors Associated With Children’s School Readiness to Learn. Early Education & Development, 18(3), 375–403. https://doi.org/10.1080/10409280701610796a
Johnson, A. B., Mliner, S. B., Depasquale, C. E., Troy, M., & Gunnar, M. R. (2018). Attachment security buffers the HPA axis of toddlers growing up in poverty or near poverty: Assessment during pediatric well-child exams with inoculations. Psychoneuroendocrinology, 95, 120–127. https://doi.org/10.1016/j.psyneuen.2018.05.030
Law, E., Aishworiya, R., Cai, S., Bouvette-Turcot, A., Broekman, B., Chen, H., Meaney, M. (2021). Income disparity in school readiness and the mediating role of perinatal maternal mental health: A longitudinal birth cohort study. Epidemiology and Psychiatric Sciences, 30, E6. doi:10.1017/S204579602000102X
MacKinnon, N., Kingsbury, M., Mahedy, L., Evans, J., & Colman, I. (2018). The Association Between Prenatal Stress and Externalizing Symptoms in Childhood: Evidence From the Avon Longitudinal Study of Parents and Children. Biological Psychiatry, 83(2), 100–108. https://doi.org/10.1016/j.biopsych.2017.07.010
Maggi, S., Irwin, L. J., Siddiqi, A., & Hertzman, C. (2010). The social determinants of early child development: An overview. Journal of Paediatrics and Child Health, 46(11), 627–635. https://doi.org/10.1111/j.1440-1754.2010.01817.x
Marmot, M., Allen, J., Goldblatt, P., Boyce, T., McNeish, D., Grady, M., & Geddes., I. (2010). Fair Society, Healthy Lives. The Marmot Review. https://www.instituteofhealthequity.org/resources-reports/marmot-review-10-years-on/the-marmot-review-10-years-on-full-report.pdf
Marmot, M., Allen, J., Boyce, T., Goldblatt, P., Morrison, J. (2020). Marmot Review 10 Years On. Institute of Health Equity. www.instituteofhealthequity.org/resources-reports/marmot-review-10-years-on
Minh, A., Muhajarine, N., Janus, M., Brownell, M., & Guhn, M. (2017). A review of neighborhood effects and early child development: How, where, and for whom, do neighborhoods matter? Health & Place, 46, 155–174. https://doi.org/10.1016/j.healthplace.2017.04.012
McEwen, C. A., & McEwen, B. S. (2017). Social Structure, Adversity, Toxic Stress, and Intergenerational Poverty: An Early Childhood Model. Annual Review of Sociology, 43(1), 445–472. https://doi.org/10.1146/annurev-soc-060116-053252
McGilloway, S., Mhaille, G. N., Bywater, T., Furlong, M., Leckey, Y., Kelly, P., Comiskey, C., & Donnelly, M. (2012). A parenting intervention for childhood behavioral problems: A randomized controlled trial in disadvantaged community-based settings. Journal of Consulting and Clinical Psychology, 80(1), 116–127. https://doi.org/10.1037/a0026304
Murray, L., Cooper, P., & Hipwell, A. (2003). Mental health of parents caring for infants. Archives of Women’s Mental Health, 6(0), s71–s77. https://doi.org/10.1007/s00737-003-0007-7
Olds, D. L., Henderson, C. R., Tatelbaum, R., & Chamberlin, R. (1988). Improving the life-course development of socially disadvantaged mothers: a randomized trial of nurse home visitation. American Journal of Public Health, 78(11), 1436–1445. https://doi.org/10.2105/ajph.78.11.1436
Public Health England. (2018). Health Matters: Giving Every Child the Best Start in Life. www.gov.uk/government/publications/health-matters-giving-every-child-the-best-start-in-life/health-matters-giving-every-child-the-best-start-in-life.
Repetti, R. L., Taylor, S. E., & Seeman, T. E. (2002). Risky families: Family social environments and the mental and physical health of offspring. Psychological Bulletin, 128(2), 330–366. https://doi.org/10.1037/0033-2909.128.2.330
Ribner, A., Fitzpatrick, C., & Blair, C. (2017). Family Socioeconomic Status Moderates Associations Between Television Viewing and School Readiness Skills. Journal of Developmental & Behavioral Pediatrics, 38(3), 233–239. https://doi.org/10.1097/dbp.0000000000000425
Roberts, J., Donkin, A., & Marmot, M. (2016). Opportunities for reducing socioeconomic inequalities in the mental health of children and young people – reducing adversity and increasing resilience. Journal of Public Mental Health, 15(1), 4–18. https://doi.org/10.1108/jpmh-08-2015-0039
Ryan, Fauth, R. C., & Brooks-Gunn, J. (2013). Childhood poverty: Implications for school readiness and early childhood education. In Handbook of Research on the Education of Young Children (pp. 301–321). https://doi.org/10.4324/9780203841198
Schaub, S., Ramseier, E., Neuhauser, A., Burkhardt, S. C., & Lanfranchi, A. (2019). Effects of home-based early intervention on child outcomes: A randomized controlled trial of Parents as Teachers in Switzerland. Early Childhood Research Quarterly, 48, 173–185. https://doi.org/10.1016/j.ecresq.2019.03.007
Shonkoff, J. P., & Phillips, D. A. (2000). From Neurons to Neighborhoods : The Science of Early Childhood Development (1st ed.). National Academies Press.
Shonkoff, J. P., Garner, A. S., Siegel, B. S., Dobbins, M. I., Earls, M. F., Garner, A. S., McGuinn, L., Pascoe, J., & Wood, D. L. (2011). The Lifelong Effects of Early Childhood Adversity and Toxic Stress. PEDIATRICS, 129(1), e232–e246. https://doi.org/10.1542/peds.2011-2663
Stern, D. N. (1998). The Interpersonal World of the Infant : A View from Psychoanalysis and Developmental Psychology(Paperback) – 2016 Edition. Taylor & Francis Ltd.
Sroufe, L. A. (2005). Attachment and development: A prospective, longitudinal study from birth to adulthood. Attachment & Human Development, 7(4), 349–367. https://doi.org/10.1080/14616730500365928
Stockman, J. (2007). Association of Television Viewing During Childhood With Poor Educational Achievement. Yearbook of Pediatrics, 2007, 78–79. https://doi.org/10.1016/s0084-3954(08)70044-7
The Scottish Government. (2012). A Guide to Getting it right for every child. https://www.webarchive.org.uk/wayback/archive/20180602041533/http://www.gov.scot/Topics/People/Young-People/gettingitright/publications/practice-guide
The Social Metrics Commission. (2020, July). Measuring Poverty 2020: A report of the Social Metrics Commission. https://socialmetricscommission.org.uk/wp-content/uploads/2020/06/Measuring-Poverty-2020-Web.pdf
Van Ijzendoorn, M H. Schuengel, C. Bakermans-Kranenburg M. (1999)
Disorganized attachment in early childhood:meta-analysis of precursors, concomitants, and sequelae Dev. Psychopathl., 11, pp. 224-249
World Health Organization (WHO). (2020). Improving early childhood development: WHO Guideline. https://apps.who.int/iris/bitstream/handle/10665/331306/9789240002098-eng.pdf
