New Royal Foundation Shaping Us Framework and film: prioritising social and emotional development

The Royal Foundation Centre for Early Childhood has today (2 February 2025) published a new framework aimed at improving awareness of and knowledge about social and emotional skills to inspire action across society, as part of The Princess of Wales’ mission to create a happier, healthier society.

At the iHV, we feel honoured to have been involved in supporting the promotion of The Shaping Us Framework and believe that it will be an invaluable resource for health visiting practitioners.

Alongside the Framework, The Royal Foundation Centre for Early Childhood has also launched a short film to bring the Framework to life which features our CEO, Alison Morton, speaking about the importance of social and emotional development in early childhood. And we thank the wonderful health visiting team at Guy’s and St Thomas’ NHS Foundation Trust for their support with this, and the parents, babies and children from South London who agreed to take part in the film – they were brilliant and bring the powerful messages to life.

Social and emotional skills are what shape who we are, how we manage our emotions and thoughts, how we communicate with and relate to others, and how we explore the world around us. They are fundamental to our future mental and physical wellbeing, shaping everything from our ability to form positive relationships, to our capacity for learning, working, and coping with adversity. They all have their foundations in early childhood and continue to be refined and enhanced throughout our lives.

In the foreword to today’s report, The Princess of Wales said:

“To create a physically and mentally healthier society, we must reset, restore, and rebalance…

“That means taking a profound look at ourselves and our own behaviours, emotions, and feelings. It means getting much better at acting with compassion and empathy towards one another… better understanding how we can protect and build upon what connects and unites us… and acknowledging that society is something we build together, through the actions we take every day.

“At the heart of all of this is the need for us to develop and nurture a set of social and emotional skills which we must prioritise if we are to thrive.”

The new Shaping Us Framework and film: prioritising social and emotional development, comprises thirty social and emotional skills grouped into six clusters:

knowing ourselves
managing our emotions
focusing our thoughts
communication with others
nurturing our relationships
and exploring the world.

These skills are the foundations of a happy, healthy life. The Framework has been developed to help those working across disciplines to communicate effectively, raise awareness, and build understanding of the critical importance of social and emotional skills – inspiring greater commitment, action and investment in their development during early childhood and beyond. The Framework can also have a tangible impact across society by being used to design and deliver programmes and interventions, to inform decision-making and support organisational development. It is by prioritising and nurturing our social and emotional skills, and our relationships with others, within communities and across society, that we can build resilience and hope for the future.

Christian Guy, Executive Director of The Centre for Early Childhood, said:

“It is time that we recognised and acted upon the undeniable significance of social and emotional skills and give them the recognition they deserve. Getting this right in early childhood, when we lay the foundations upon which these skills continue to grow throughout our lives – could have a truly profound impact on the future of individuals and of our society.”

Alison Morton, iHV CEO, said:

“This Framework is ground breaking, bringing together evidence from across the world on the importance of social and emotional development. As a resource, it has the potential to really transform how we value and nurture these skills throughout the life course. If we can support babies and young children in their learning and development in the earliest years of life, we set them up with valuable tools to navigate the ups and downs of life. Ultimately, they are the most important skills that we will ever learn – and health visiting practitioners can play a vital role in spreading the word and driving change.”

See The Shaping Us Framework here

Watch the Video - The Shaping Us Framework

iHV awarded funding from The Royal Foundation Centre for Early Childhood for Phase Two of the ADBB study

Thanks to the continued support of The Royal Foundation Centre for Early Childhood, the Institute of Health Visiting (iHV) is delighted to announce the start of Phase Two of the ADBB study. Following the positive results of the first study, which reported an increase in health visitors’ knowledge and skills in interpreting baby behaviour as a result of training in a new observational tool, this second phase seeks to evaluate the impact of the tool in more sites across the UK. The study will be led by the iHV, in partnership with Professor Jane Barlow at the University of Oxford and Dr Alexandra Deprez, Consultant psychologist and ADBB trainer, and will run until March 2026.

The tool, known internationally as the Alarm Distress Baby Scale (ADBB), focuses on a baby’s social behaviours such as eye contact, facial expression, vocalisation, and activity levels to help practitioners and families better understand the ways babies express their feelings. Phase Two of the study will build on the findings from the first study which sought to explore how acceptable and feasible health visitors found using the baby observation tool (the ADBB, and its shorter modified version, the m-ADBB) during their routine 6-8-week visits to families. If you are interested in the findings from the Phase One ADBB Study, please use the link to the pdf here: https://bit.ly/4a7z2hT.

Christian Guy, Executive Director of The Centre for Early Childhood, said:

“We know that warm, loving, responsive interactions with those closest to them during the earliest weeks and months of a baby’s life are crucial in promoting positive brain development.

“Health visitors do such a vital job in our communities. I am delighted that we are now able to give more teams across the UK the support they need to help thousands of families to better understand their babies and build nurturing relationships, laying the strongest possible foundations for all that is to come in the years that follow.”

The second phase will address a number of recommendations from the first study in the UK context, including:

The development and implementation of the expansion of the m-ADBB and ADBB training programme within health visiting teams in a number of different sites across the UK.
The evaluation of the impact of the above expansion on practice, outcomes of referrals, and acceptability to parents.

Alison Morton, Chief Executive of the Institute of Health Visiting said:

“We are delighted to have the continued support from The Royal Foundation Centre for Early Childhood to deliver the second phase of this exciting programme of work. As we know, babies can’t talk, but there is significant evidence that their early experiences influence their future outcomes.

“The expansion of the use of the modified ADBB tool in a wider range of health visiting services will allow us to consider its future implementation and sustainability, and ensure more families get the right support and babies can thrive.”

Following significant interest from several potential health visiting services, we are pleased to confirm that the following have been selected for participation in Phase Two:

Ayrshire and Arran Health Board, Scotland
Cwm Taf Morgannwg Health Board, Wales
Hampshire and Isle of Wight Healthcare
Humber Teaching NHS Foundation Trust, England
Northern Health and Social Care Trust, Northern Ireland
Rotherham Doncaster and South Humber NHS Foundation Trust – Doncaster, England
Rotherham Doncaster and South Humber NHS Foundation Trust – North Lincs, England
South Warwickshire NHS Foundation Trust, England

This grant from The Royal Foundation Centre for Early Childhood will continue to accelerate our work to support health visitors in promoting infant wellbeing and social development, and by enhancing health visitors’ ability to identify infants at risk. We thank The Royal Foundation for their ongoing support.

For more information, please contact [email protected]

The Royal Foundation Centre for Early Childhood announces new partnership study with health visitors to promote infant wellbeing and social development

Today, the Royal Foundation Centre for Early Childhood announced a new partnership study with the Institute of Health Visiting (iHV) and led by Professor Jane Barlow at the University of Oxford to support health visitors’ work with families to promote infant wellbeing and social development.

Across the world, thanks to advances in neuroscience, there is a growing body of research on the importance of the earliest years of life. During this period, from pregnancy to the age of five – and, in particular, during the “critical first 1001 days” – babies’ brains are developing faster than at any other time of their lives. They are shaped by early experiences as they develop socially, and learn to manage emotions and build relationships, develop resilience against adversity and trust in others.

Spearheaded by Her Royal Highness The Princess of Wales, the work of The Centre for Early Childhood seeks to raise awareness of why early childhood matters and to translate this evidence from neuroscience into practice. We are therefore delighted to have the opportunity to work closely with The Princess and The Centre to shine a light on the vital work of health visitors who have an important role to play in promoting infant wellbeing and social development. This grant from the Royal Foundation will accelerate our work to support health visitors in this area through a small-scale field trial across two sites to assess the acceptability and feasibility of implementing a new tool to support the promotion of infant wellbeing and social development, and by enhancing health visitors’ ability to identify infants at risk.

Alison Morton, iHV CEO says:

“We are delighted to be working with Her Royal Highness The Princess of Wales, The Royal Foundation Centre for Early Childhood, and Professor Jane Barlow on this exciting new programme of work with health visitors. Through working with Her Royal Highness, I know how committed she is to helping all children have a happy and healthy childhood and this can only happen if we have a much greater focus on the earliest years of life – everyone has a part to play to make sure that no child is left behind.

“It has also been an honour and a privilege for the Institute of Health Visiting to work with The Centre for Early Childhood and health visitors across England to arrange shadowing visits for The Princess over the last few months to enable her to see first-hand the important work of health visitors and hear parents speak about the difference that this has made to them. With more families struggling to manage with rising levels of mental health problems, poverty and other issues that can make parenting even harder, it is vital that all families get the support that they need at this time.”

Dr Jane Barlow, Professor of Evidence Based Intervention and Policy, University of Oxford says,

“This is a very exciting opportunity to focus on babies’ behaviour, using the new observation tool, the ADBB. This tool can help health visitors focus on the ways babies communicate, using eye contact, facial expressions and vocalisation etc. We can learn so much by using it and potentially help identify those families where additional support might be needed.”

Justine Rooke, General Manager, Children’s and Learning Disability Services, Humber Teaching NHS Foundation Trust, says,

‘‘We are delighted to be working with The Royal Foundation and hosting the ADBB study. Infant mental health, and the contribution Health Visitors can make to the development of longer-term health outcomes for children, is a key factor in how we transform our 0-19 service for Hull children and families and integral to the best start in a child’s life. The health visitors trained in the ADBB and Humber Teaching Foundation Trust are really proud to support this work.”

Nadine Anderson, Claire Townsend and Eileen O’Sullivan, Specialist Health Visitors for Perinatal and Infant Mental Health at South Warwickshire University NHS Foundation Trust, say,

“We are truly honoured to be invited to take part in a research project of this calibre. We have worked alongside the Institute of Health Visiting, striving for excellence in practice, for a number of years. We recognise that strong secure attachments in childhood are the foundations for good physical and emotional health moving into adulthood. Health visitors in Warwickshire, as highly skilled practitioners, are driving forward the Infant mental health agenda and the use of the ADBB as an assessment tool adds an extra layer of sensitivity and support to the families we sit alongside.”

Why it’s needed: ‘Babies can’t talk, but we now know a lot from scientific research that has been done across the world over the last 20 years on the many different ways that they can communicate through their behaviour – we can learn so much by just tuning into it better. Sometimes it is easy to tune into your baby – for example you may recognise that they may be tired, hungry etc… but at other times it can be much harder for parents to connect with their baby and getting help early to make those connections can make a big difference.

Why is this field trial needed? Babies are born ready to relate and interact with the world around them – the way that they communicate is through their behaviour. Health visitors are skilled in supporting parents to understand what these behaviours mean so that they can respond quickly to meet their baby’s needs, helping them to feel safe, loved and understood. There are lots of reasons why some parents and babies can find this much harder than others and getting help early can make a big difference.

While ‘supporting maternal and family mental health’ is one of the six ‘High Impact Areas’ for health visiting in England, there is wide variation in the approaches used and support offered to families. The National Commissioning Guidance for health visiting does not recommend the use of any specific tool, and this is left to local decision making. Whilst some areas use assessment tools/questions to support their clinical decision making, none of these have been designed specifically for health visitors’ universal work in the area of parent-infant relationships with all families, and tools developed in other countries have not been normed to the UK population.

What the ADBB is: Building on their existing skills, health visitors involved in this study will be trained in the use of the Alarm Distress Baby Scale (ADBB). This tool, developed in France, is well-validated and widely used internationally to promote infant wellbeing and social development with parents. The ADBB aids the observation and interpretation of different aspects of babies’ social behaviours, such as eye contact, facial expression, vocalisation, activity levels and how they connect with the people and world around them. It will be used as part of the health visitor’s routine visit with all families, helping practitioners and parents to better understand the ways babies express their enjoyment as well as the things that they are finding more difficult.

During her visit to Denmark in February 2022, The Princess was particularly interested in how the ADBB tool was being used with positive outcomes by frontline health visitors as part of their routine examinations of babies during home visits and was keen to explore with the iHV whether a similar approach could work within the health visiting service in England. The aim of this study is, therefore, to conduct a small-scale field trial across two sites to assess the acceptability and feasibility of implementing the ADBB into health visitors’ routine home visits with families in England.

The trial will involve health visitors working in the two selected sites of South Warwickshire NHS Foundation Trust and Humber Teaching NHS Foundation Trust who have been trained in the use of the ADBB scale. An Expert Advisory Group comprising senior academics, government officials and key stakeholders will provide expert advice on the study to enrich and enhance the project’s rigour and support dissemination of the learning in line with the national ambitions to ‘give every child the best start in life’.

The findings from this study will provide valuable learning on the implementation of the ADBB with families in England and has the potential to inform implementation in other sites looking to enhance their support to families across the UK.