Fiona McCracken: Supporting the Health and Well-being in Young Children (Case Study, University of Aberdeen)

Recently, I have been conversing with parents, children and my preschool colleagues about how we support children’s health and well-being both daily and long term. I have carried out a series of planned and spontaneous observations on two children in order to build detailed profiles. Observing in this way allows me to create a holistic, honest account of their overall health and well-being.

I have also looked at my personal general health. Maidstone-Cotton (2018, p10) suggests that “to really help the children we are working with, we need to first stop, look at ourselves and think about how we are, how good our well-being is”. I support her thinking and believe that to be a positive role model in developing the children’s attitude to their physical, intellectual as well as their social and emotional growth, I need to be sure that I am equipped and capable of delivering a high level of self-awareness and motivation. I completed an online well-being survey, offered by the NHS scoring above average which, reassuringly aligned with my positive, proactive yet reflective mind-set.

I looked again at Bronfenbrenner’s Ecological Systems Theory and created personal versions for the two children that I observed. This has allowed me to look at the wider environmental factors that may have impacted or affect their well-being to date. “The development of each child is the result of a unique interaction of experience with hereditary” (Fisher 2008, p2).
In order to gather greater detail of each child I sent questionnaires to parents before discussing their responses. I continue to view parents as the child’s first educator and therefore the experts. “Knowledge comes from home” (Fisher 2008, p23)

Case Study

Child: KO
Age: 4 years 2 months
Gender: male
Family background: KO is the younger of 2 children (older sister)
Overview:  
KO was born in Oslo, Norway with Norwegian as his first language. He is a preschool junior who attends the setting 5 days from 8:15am – 3pm.

Using the conversations, observations and questionnaire responses, alongside the diagram I produced illustrating his ecological system I was able to build a detailed profile/case study of KO.

“The whole purpose of observing, assessing and analysing children’s learning is in order to plan a learning environment that stimulates children in relevant and appropriate ways, and to plan for the needs of individual children within that learning environment” (Fisher 2008, P188).This case study has given me time to reflect and evaluate next steps for KO. by discussing my observations and assessments of his learning journey to date with his parents and my preschool colleagues.

KO was born at full term, without health issues with his mum feeling more relaxed during her second pregnancy. KO had some stomach issues from an early age and  his parents, taking medical advice, making sure his diet was rich in fibre with plenty fruits and vegetables. They also practiced exercises such as stomach massage but acknowledge that the best treatment was to give him plenty of fluids, although he needs lots of encouragement in this area. He has medicine periodically to prevent constipation and ease stomach pains but with limited success.

KO’s home language is Norwegian but he continues to learn and is becoming proficient in using the English language. This was largely helped by the fact that he attended a local nursery for 7 months when his family first moved to Aberdeen.

KO shared his ‘Special Person’ board with his peers when he first started preschool as a settling in/getting to know him activity and shared his knowledge of his home country, cultural experiences, although needed adult support to do so. During his first few weeks in preschool, he thrived on structure and especially enjoyed the repetition of the daily welcome song using the basket of international flags, which included his Norwegian one enabling him to make an initial connection with two other Norwegian boys in the group. His vocabulary, use and comprehension of the English language has developed greatly in the last 8 months meaning that he will now, with encouragement participate during group activities such as changing the calendar and daily timetable. His growing self-confidence and security means he is more willing to take risks with his responses without feeling anxious about getting it wrong. He has developed positive, trusting relationships with his preschool teachers as well as gaining a sense of belonging in his peer group.
With this increased confidence, KO was also able to consider making a ‘class rule’ that would help keep him and his friends safe.

KO, with English as a 2nd language was initially very reliant on his mum who would settle him at a familiar activity before saying goodbye. His first independent plan for play was connected to home and especially to his mum when he repeated the same baking activity on various levels for 3 planning cycles. KO needed ‘time’ to consider personal, independent interests and build confidence in his own abilities and this baking activity offered him that. He extended this further by requesting that his mum came to help bake muffins and then to celebrate his 4th birthday.

KO enjoys being with his familiar adults as he explores the preschool environment and can appear solitary in his play. He is quite reflective and observant preferring to be on the outside watching larger groups of children as they play although now less dependent on his teachers during outdoor playtime. Recently he has enjoyed using the double trike, which has encouraged positive, social interactions with his peers negotiating, taking turns and sharing resources. He is beginning to initiate simple co-operative games such as ‘Frisbee’,  and is attracted to a few children who appear to share his interests.
His recent interest in writing, especially his name has inspired a flurry of drawings and paintings of himself and his family. He asked to use the computer to “write words” and grew very excited pressing the keys, seeing letters, numbers and symbols appear on the screen. He focused his attention to work independently writing a ‘letter’ to mummy and daddy before asking for it to be printed.

KO has made huge progress in the 8 months since starting preschool using English as his main classroom language. KO’s mum is happy to be involved in the preschool programme but acknowledges his growing independence and self-confidence. He now waves goodbye to her in the main classroom before making his own choices for play.

Reflecting on KO’s case study which was based upon my observations, prior knowledge alongside information I gained from conversations with his parents in addition to their questionnaire responses I can clearly see that there are specific aspects of KO’s overall development that continue to benefit from the support offered to him on a daily basis:

• Nurturing the relationship and partnership with KO and his whole family
• Language development and acquisition of second language/cognitive growth
• KO’s social and emotional development/ general health; specifically bowel issues

Firstly, the most important aspect of supporting not only KO but every child’s health and well-being, whatever the early years setting is ensuring staff are qualified, highly motivated and registered with appropriate governing body. Parents should be aware of safeguarding and child protection policies within the setting and see them in practice. Although I am employed in an independent school we are still led by Education Scotland and the Care Inspectorate who hold us accountable for the care service that we provide. We deliver a child –led, play based programme using a modified version of the Curriculum for Excellence with dedicated outcomes for health and well-being. This is in accordance to The National Care Standards as well as our own values and preschool philosophy. As a practitioner, I work hard as part of a preschool team, to follow the G.I.R.F.E.C (Getting It Right For Every Child 2014) values and principles. We display photographs and engage with the children and their parents to build an awareness of our safeguarding procedures.

We welcome children such as KO by asking parents to complete an admission questionnaire prior to them visiting or starting preschool. It was not possible for KO to visit our setting before he started because he was moving from a different country. The questionnaire enabled us to build a picture of him and prepare for his start by setting out resources that we knew he already enjoyed using and were able to talk about siblings, family members as well as obtaining information on particular development and health issues to be addressed.  “Each setting needs to think carefully about how they help all parents and children to feel valued and welcomed at the beginning of their school life”  Fisher  (2008. P24)

Activities such as ‘Special Person’ as previously mentioned , give children an opportunity to share who they are and what makes them unique. This is especially important in my setting as we nurture and support the whole family as they settle into a new country, rent property and have personal possessions in storage. We operate a ‘buddy’ system for families, where they are assigned another family who share the same language, cultures and country. Our school also hosts a variety of whole school social events throughout the year giving staff and families the chance to get together in an informal way to chat, eat and generally enjoy getting to know each other outside of the school day.  Parents are invited to volunteer or take part in school events, help in the library or in the classrooms. KO’s mum has played an active part in his preschool journey by coming in to read in her home language, cooking favourite family recipes as well as accompanying us on field trips. We are committed to engaging and involving parents as much as possible in their child’s preschool experiences. Ron Best (2007) in his article about Pastoral Care summed it up when he talked about teaching and pastoral care being linked with a shared responsibility for ensuring health and well-being within the wider school community when he said, “dynamic communities are the setting for social life characterised by both enjoyment and achievement”. I believe my setting provides a positive, environment where parents can feel welcome during the day by using the library, street/cafeteria area to meet with other parents as well as the swimming pool after school and weekends with their family. It is much more of a small community than a school. If the partnership with parents is strong, their children’s experience is more likely to be positive.

KO came into our setting with very little English language although his parents did send him to a local nursery for a period of seven months when he first arrived in Scotland from Norway. This would have certainly given him an exposure to the English  language but in my setting we value and respect his home language in equal measure to the one used in the classroom. When KO first started in preschool, he had the security of having his mum close by for a settling in period, set to meet his individual needs. Using various visual aids such as a timetable, verbal greetings, displays and using text in home languages alongside photographs that illustrated foods, emotions and simple commands like hand washing or toilet enabled him to respond and communicate on a very basic level with nods or few words. I supported KO by creating a connection through my explicit facial expressions and body gestures, which helped to guide and nurture his sense of belonging and security. The consistency and structure of the preschool day incorporating song, rhythm and repetition also offered him reassurance. I believe that by modelling my expectations to KO such as singing ‘let’s make a circle’, (physically joining hands to make a ring) he had a greater understanding of the routine and could find success in his day by simply following his peers simple actions whilst also receiving adult affirmation. In the last 8 months he has been given numerous opportunities to explore language, express ideas and interests and has found the confidence to build positive relationships and friendships becoming the ‘expert’ of his own language, translating words from home to classroom  and becoming more independent of his parents. “Children are born into language using communities and they gradually learn to communicate and share the language of their social worlds” Whitehead (2010, p90).

KO needs some support in going to the toilet and can sometimes suffer from stomach-ache and constipation. His parents have tried ‘tummy massage’ as a form of pain and stress relief as well as some medication with varying levels of success. They ensure he has a healthy, fibre rich lunch from home and preschool staff encourage him to taste the fruit and vegetables on offer at snack-time. KO tends to wait until the last minute, doing a ‘jiggle dance’, before going to the toilet meaning he can suffer from some discomfort until instructed to use the bathroom. During group times, KO has participated in discussions that promote strategies on how they can listen to the messages that their brain is sending to their own bodies. During a recent project about our bodies, we talked about the journey our food takes after we eat. In discussing topics such as these openly and in a relaxed, trusting environment, KO has been less anxious, reassured  that  the pain he feels is merely be his body’s way of getting rid of the food it doesn’t need. I am aware that the relationship I have with KO and sensitive communication with his parents enables me to recognise his symptoms and respond to them promptly and appropriately.

Conclusion

To support the health and well-being of the children in my care I use a range of interpersonal skills in order to embrace and build partnerships with the whole family. I recognise that the EAL teachers, school nurse, counsellors and language specialists in the wider school are on hand to advise and offer strategies when dealing with specific challenges. Engaging and connecting with my preschool colleagues allows me to offer high quality, early years experiences that promote children’s lifelong academic learning that includes outdoor play which increases levels of overall health and wellbeing. At the end of each school year, I reflect on personal experiences, moving forward, armed with new ideas and energy for whatever lies ahead. My positive approach to providing a holistic preschool experience motivates my continued professional development.
“Ancora Imparo” – I’m still learning (Michelangelo 1562)

Aberdeen, June 2018

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