Being physically healthy is about a lot more than having nutritious food and having no illness. Young children need to have a sense of being special, and if they do they are better able to respond positively to their environment, to people and to new experiences.
Emotional wellbeing requires relationships which are close, warm and supportive and being able to express feelings such as joy, sadness, frustration and fear. These lead to the development of ways to cope with new and challenging situations.
Ensuring that there is always someone who is special to a child to support them in the nursery has been a key aim of our project. By working closely with practitioners, children, families and other health professionals as part of our networking activities in the Southend-on-Sea area, we have been able to identify how key workers need to respond to individual children who are lacking in confidence. A lot of this work comes down to establishing shared understandings between home and setting, and finding appropriate ways of responding to children's emotions.
In one of our settings we had a child who had separation anxiety. When her mother tried to leave her, she would stand and shake her arms uncontrollably. Nursery staff had tried to console her and gave her a one-to-one key worker to help build that relationship.
We observed the child both in the nursery setting and visited the mother and child at home to discuss ways we could support the family.
Much benefit was derived from calling a meeting where everyone agreed a care plan to address her emotional anxiety, her dietary problems and the need to support her to interact with other children.
A key worker has since been assigned to work on a one-to-one basis with the child. Her mother stays for the first half an hour after she arrives at nursery to help settle her. The key worker helps her move around the various activities by encouraging her to play alongside her friends. She supports her at times of change in the group, for example at the snack table and during tidy-up time, to help reduce her distress. As the child becomes more confident, the key worker moves away for a few more seconds.
This approach gives staff the opportunity to gradually integrate the child who is not ready for all the activities on offer. As time progresses the nursery will review and update the care plan in co-operation with her parents.
My colleague Cathy Kennedy corroborates that when children first go to nursery, it is important that they have someone who will be there to help them feel secure and support them to express how they are feeling in a positive way. This will help them grow in self-esteem and confidence. It can be achieved with a key worker who understands their anxieties - whether they relate to the parent not returning, or their sense of being in an unfamiliar environment - and who can respond in an effective way.
Separation anxiety is just one of many problems associated with emotional stability and resilience. As children progress through nursery, practictioners need to be able to identify signs of low self-esteem, where children appear to view themselves and their achievements negatively.
Children who have high self-esteem are more likely to be enthusiastic, communicative and motivated and feel comfortable within group situations.
Their behaviour is generally good and they are likely to be able to exert increasing degrees of self-control as they develop.
Key workers partnering parents and other professionals are best-placed to ensure that all children can establish their independence in a positive way.
WELL AND GOOD
Emotional wellbeing focuses on:
* Being special to someone
* Being able to express feelings
* Developing healthy dependence
* Developing healthy independence
Work together
* Linda Bartholomew and Cathy Kennedy are health visitor assistants who work for Southend-on-Sea NHS PCT and have set up a project to pro-actively work with 31 pre-schools and nurseries to help with children's healthy development and their smooth transition to school. Contact linda.bartholomew@southend-pct.nhs.uk.
