iHV is proud to be working with The Royal Foundation Centre for Early Childhood as an early adopter of their new resources — six beautifully animated films that bring to life the science of early brain development.
These short films explain how everyday interactions between babies, young children and caring adults can support healthy social and emotional development. They unpack the brain science and explain key concepts behind the way nurturing interactions support the social and emotional development of babies and young children. They explain the science behind the everyday moments of connection that can have a long-term positive impact on a child’s life.
Building on the Shaping Us Framework, the animations and associated resources aim to help practitioners understand more about WHAT supports social and emotional development, and HOW they could promote better outcomes for babies and young children.
The films are designed to be used by people who work with babies, children and families, so that they are better equipped to have meaningful and consistent conversations with parents and carers about social and emotional development. The films are accompanied by practitioner guidance and science briefings.
Hilda Beauchamp, iHV Perinatal & Infant Mental Health Lead, said:
“The Institute of Health Visiting is planning to include the animations as part of our SEEN project, funded and supported by Kindred2. This is a project that aims to further equip health visiting teams in promoting babies’ brain development in their conversations with parents and carers. The iHV is engaged in robust co-development with parents and health visiting teams to shape a new e-learning programme and additional resources. This will ensure health visiting teams are confident and competent to apply their knowledge in their everyday work alongside families.”
Working together with The Royal Foundation Centre for Early Childhood, we can promote nurturing relationships and give every child the best start in life.
About The Centre for Early Childhood Explainer Series of films
The short animated films were developed because they are creative, accessible and engaging and can be used in a range of different ways with varied audiences – from showing the films to a parent 1:1, to embedding them in professional lectures or online training, to using them to aid discussions in team meetings.
The films were co-produced – the topics of the films were decided after iterative discussions with expert advisors and professional leaders. The Centre for Early Childhood then worked with a group of leading early childhood practitioners from around the UK to develop the scripts, which were reviewed by academic experts. The scripts were sent to talented illustrators and animators from around the world, who worked their creative magic.
There are six films in the Explainer Series, which show how everyday actions support the development of children in their earliest years. The films are also available in Welsh and with British Sign Language.
Each animation explores a different concept from the Shaping Us Framework:
How we grow an emotionally healthy brain – This film explains describes the rapid development that happens in early childhood
Noticing and navigating feelings – This film unpacks a concept called attunement.
Managing big feelings together – This film explains a concept called co-regulation.
Back and forth interactions – This film unpacks a concept called contingent responsiveness (also known as serve and return).
Supporting their learning – This film explains a concept called scaffolding.
Creating space for connection – This film explains a concept called pacing.
Practitioner guidance – Using the Centre for Early Childhood’s Explainers to support families is also available here.
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.”
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.
Today, the Institute of Health Visiting (iHV) is delighted to share the overwhelmingly positive findings from their mixed-methods feasibility study into the use of the Alarm Distress Baby Scale (ADBB) in routine health visiting practice in England.
The study, commissioned and funded by The Royal Foundation Centre for Early Childhood, was conducted in partnership with Professor Jane Barlow from the University of Oxford. It sought to explore how acceptable and feasible health visitors found using the baby observation aid, the ADBB, and its shorter modified version, the m-ADBB, during their routine 6-8-week visits to families.
During the ten-month study, health visitors trained in the ADBB and m-ADBB were recruited from South Warwickshire NHS Foundation Trust and Humber Teaching NHS Foundation Trust. Quantitative and qualitative data were collected over a four-month period, during which the trained health visitors used their enhanced skills and knowledge to observe babies’ behaviours and interactions and identify those in need of a more thorough assessment or additional support.
Health visitors described the ADBB approach as “hugely beneficial” and “of great importance” to their practice. Findings demonstrate that both training programmes (ADBB and m-ADBB) were rated highly by all study participants, giving a new theoretical perspective, additional knowledge and skills, and a new vocabulary for explaining their observations of a baby’s behaviour. The use of the shorter validated 5-item version of the scale, the m-ADBB, was found to require minimal additional time and was considered easy to embed into routine health visiting practice (for example, the observation could be undertaken when parents were undressing their baby, or the baby was being weighed). Using the m-ADBB in this way enabled health visitors to:
Have more meaningful conversations with parents and carers about the emotional wellbeing of their baby;
Promote positive parent-infant interactions, attachment, and bonding; and
Identify those babies and families in need of greater support during this critical period of development.
Dr Jane Barlow, Professor of Evidence Based Intervention and Policy Evaluation at The University of Oxford, who oversaw the evaluation of the trial said:
“Babies are born with amazing social abilities. They are ready to relate and engage with the world around them, communicating how they feel through their behaviours.
“Whereas previous approaches have focused on the parents’ perspective, this training has really helped health visitors to ‘read’ the baby during interactions and develop greater sensitivity in terms of the observation of potential attachment and bonding issues that would not have been identified without the training.
“The feedback from those involved has been overwhelmingly positive. It is truly exciting to think about the impact this could have on families right across the country as we enter the next phase of this research.”
Alison Morton, CEO of the Institute of Health Visiting, said:
“Babies can’t talk, but there is now good evidence that they can communicate their experiences of the world around them when we tune in to their behaviours. We are therefore delighted by the positive findings from this study which found that the modified ADBB tool was very workable within universal health visiting practice, providing an important new way for health visitors to observe babies interacting with the people around them. There are many reasons why a baby might be distressed or withdrawn. Spotting these problems as early as possible is important as it will enable health visitors to work with families to ensure that they get the right support and babies can thrive.”
During the study period, health visitors identified behavioural concerns in 23 (10%) of babies as a result of using the m-ADBB. Health visitors were then able to work with families to explore the many possible reasons for this and determine the most appropriate next steps. All identified families were offered additional support, ranging from follow-up visits, emotional wellbeing visits and video interaction guidance (VIG) as well as connections to Child and Family Centres and referrals to Specialist Perinatal Mental Health and other local support services where indicated.
Conclusions and next steps
The quality of interactions that a baby has with their parent or caregiver is associated with their long-term development outcomes. Health visitors have a key opportunity in their routine contacts with families to promote optimal parent-infant interactions and identify emerging concerns. However, assessing these interactions can be quite complex, requiring a robust theoretical understanding as well as sound clinical observational skills.
The ADBB training introduced health visitors to the concept of social withdrawal – a coping mechanism that babies may use if they are experiencing some sort of stress in the environment around them. The additional understanding gained from observing babies’ behaviour from this perspective sat very well alongside health visitors’ existing skills. It helped them to consider how babies let us know they are ‘here, and engaging with the world’ and identify where additional support may be needed.
Executive Director of The Centre for Early Childhood, Christian Guy, said:
“The quality of the relationships between babies and their parents or carers, during the first weeks and months of life, shapes their developing brains and lays the foundations for their future health and wellbeing. So, it is vital that we provide families with the best possible advice and support at this crucial time.
“The results of the initial phase of testing are so encouraging. We now want to move quickly to ensure we build on this work, bringing the benefits of this model to more health visitors across the country so that, ultimately, more babies and their families get the support they need to thrive.”
In light of the positive findings of this study, the report includes recommendations for a second phase of research and evaluation of the tool in the UK context. In addition to several suggested research strands, consideration should also be given to:
a UK-based training programme with amendments to the training to align with the UK context, incorporating the training improvement recommendations from this study
Evaluation of the impact of training in more health visiting sites across the UK
Support systems for health visitors if ADBB/m-ADBB are adopted within health visiting practice, to include continuing professional development, supervision, learning resources and practice opportunities
The iHV, in partnership with the University of Oxford, would like to express its sincere thanks to The Royal Foundation Centre for Early Childhood for funding this important study and for their support and oversight throughout the study period.
Training in the ADBB and m-ADBB was kindly provided by Alexandra Deprez and Jocelyne Guillon of Humagogie training centre. Further details can be found at adbb-scale.com.
The research team would like to acknowledge the governance and guidance of the Expert Advisory Group:
Alison Morton (Chair) – Institute of Health Visiting
Dr. Sarah McMullen – The Royal Foundation Centre for Early Childhood
Hannah Sereni – Start for Life Unit
Wook Hamilton – Parent-Infant Foundation
Professor Crispin Day – South London and Maudsley NHS Foundation Trust
Lynne Reed and Wendy Nicholson – Office for Health Improvement and Disparities
Sarah Muckle – City of Bradford Metropolitan District Council, Director of Public Health
Professor Carl May – London School of Hygiene & Tropical Medicine
And the dedicated health visitors, managers and research departments at the Humber Teaching NHS Foundation Trust and South Warwickshire University NHS Foundation Trust who participated in the study.
Watch Sky News article: ‘Overwhelmingly’ positive results for trial funded by Princess of Wales as part of early years work
The Duchess of Cambridge will host a roundtable at the Royal Institution today to mark the release of new research from The Royal Foundation Centre for Early Childhood.
A year on from its launch, The Centre for Early Childhood will be unveiling the findings of new research into early childhood development, as The Duchess of Cambridge and the Centre host a small roundtable to discuss the results and broader importance of early childhood development to society.
The roundtable will be attended by representatives from the early years sector; the Secretary of State for Health, Sajid Javid; the Minister for Families, Will Quince; and officials from the Department of Health and Social Care and the Department for Education. Together, they will discuss the findings of the research published today, and the huge opportunity that there is to shape the future of our society by focusing on the importance of early childhood to lifelong outcomes.
Conducted by Ipsos UK on behalf of The Royal Foundation Centre for Early Childhood, the research comes two years after The Duchess’s landmark survey – ‘5 Big Questions on the Under-Fives’ – which attracted the largest ever response to a public survey of its kind with over 500,000 responses in one month, sparking a national conversation on the early years. The research delves even deeper into public perceptions of early childhood, focusing on three key areas: the prioritisation of the early years; the link between the first five years of life and lifelong outcomes for mental health and wellbeing; and the support parents seek when raising young children.
Seven in ten people say the early years should be more of a priority for society.
Earlier this year, The Duchess travelled to Denmark where she learnt about how the Danish approach has created an enabling culture for early childhood development, specifically how it has promoted infant mental wellbeing alongside physical health, and how it harnesses the power of nature, relationships and playful learning in the first five years of life. The service in Denmark is modelled on the health visiting service in England. However, in contrast, the work to support families in the earliest years in Denmark is a national priority and the workforce is afforded much higher status and greater investment than their counterparts in England.
Today’s research also follows over a decade of work by Her Royal Highness in which she has seen first-hand how some of today’s hardest social challenges have their roots in the earliest years of a person’s life. The Duchess is committed to raising awareness of the importance of early childhood experiences and of collaborative action to improve outcomes across society. She launched The Royal Foundation Centre for Early Childhood in June 2021.
Speaking about the research published today, The Duchess of Cambridge said:
“Our experiences in early childhood fundamentally impact our whole life and set the foundation for how we go on to thrive as individuals, with one another, as a community and as a society.
“The findings published today present us with a huge opportunity and demonstrate there is real appetite from the public to bring this issue up all of our agendas. There is more we can all do – every member of society can play a key role, whether that is directly with a child or by investing in the adults around them – the parents, the carers, the early years workforce and more.
“If we come together to raise the importance of early childhood development, we’ll soon see that healthy, happy individuals make for a healthier, happier world. Which is why every second we spend with a child, is an investment in our collective future.”
Alison Morton, iHV Executive Director, says:
“The findings from today’s research, alongside the long-term commitment of the Duchess of Cambridge to raising awareness of the importance of early childhood experiences, provide an opportunity to shift the needs of babies and young children higher up the national agenda. With such a vast body of evidence making the case for investment in the earliest years of life, we hope that today’s Roundtable will ‘light the touch paper’ for the change that so many of us who work in this field have hoped for – but hope is not enough. In the words of the Duchess of Cambridge, there is definitely ‘more we can do’ and it starts in the heart of government.”
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