TY - JOUR
AU1 - Michael Garrett,, Paul
AB - Abstract Beginning with an interview with the then UK prime minister, Tony Blair, in 2006, the article critically explores how the discourse on early intervention has evolved over the past ten years. Ideas circulating around early intervention have been revitalised by neuroscience and the new prominence of what has been termed the ‘neuromolecular gaze’. This ‘gaze’, aided by new imaging technologies, is now playing a substantial role in promoting neuroscience. Moreover, neuroscience has been deployed by spokespeople from across the mainstream political spectrum and within academia to amplify the argument that early intervention into the lives of children and families is vital. At least two elements need further critical exploration: first, the assertion that a child’s brain is irrevocably ‘wired’ before the age of three; second, how this, apparently, ‘objective’ and ‘scientifically grounded’ approach is dialectically enmeshed with doxic and gendered ideas associated with attachment theory. Early intervention, neuroscience, attachment theory Introduction The year prior to being succeeded as UK prime minister by Gordon Brown, Tony Blair explained to a BBC interviewer that more consideration had to be given to intervening in particular families, before a child was born, ‘pre-birth’ (Blair, 2006). Expanding and frequently focusing on the figure of the ‘teenage mum’, he asserted that there were approximately ‘2.5 per cent of every generation … stuck in a life-time of disadvantage and amongst them are the excluded of the excluded, the deeply excluded’ (Blair, 2006). Given the number of ‘severely dysfunctional’ families with ‘multiple problems’, it was wrong to continue ‘pussy-footing around the issue’ (Blair, 2006). Being ‘hard-headed’ meant recognising that, from a very early age, there was scope for a ‘system of intervention’ where families were offered support, but also that there would be ‘some sense of responsibility and discipline injected into the situation’ (Blair, 2006). Whilst arguing that more ‘than anything else, early intervention’ was the crucial means to ensure social inclusion, Blair remained rather hazy about what this might look like in policy terms. Aside from his support for the Family Intervention Projects—which would provide the groundwork for subsequent UK governments’ Troubled Families Programme—there was little which was new or specific (see also Garrett, 2007). However, there was a re-energised focus on parenting and, in November 2006, it was announced that a new network of parenting experts was to be established covering over seventy areas. Midwives and health visitors were also exhorted to become more attentive to screening families regarded to be ‘at risk’. The following year, a National Academy of Parenting Practitioners was established, and the ‘Family Nurse Partnerships’ scheme devised by David Olds, developmental psychologist at University of Colorado, was introduced (Dodds, 2009). Even during the New Labour period, marginal, but lucid, criticisms emerged from within the social work literature challenging the over-emphatic and populist emphasis on early intervention in the lives of children and families (Gray, 2014). In a searing contribution, Andrew Pithouse (2008, p. 1537) criticised the ‘assumption that early intervention “will work” in tackling the multiple overlapping needs of children’. The whole idea that if ‘we tackle problems early, then there is more chance of success’ was typically cast as a fine example of ‘therapeutic good practice and common sense’ (Pithouse, 2008, p. 1537). Nonetheless, the available literature was simply unable to answer deceptively simple questions such as the optimal disposal of resource to deliver the desired impact, how to identify and prioritize sizeable numbers of users who will respond well to treatment, and whether interventions will achieve intermediate and long-term benefits (Pithouse, 2008, p. 1538). Relating his remarks to New Labour’s flagship ‘Sure Start’ programme, Pithouse argued that ‘extensive national evaluation after three years implementation showed very few significant differences compared to Sure Start-to-be areas’ and there was even ‘some indication of adverse effects in the most disadvantaged families’ (Pithouse, 2008, p. 1538). One of Pithouse’s main criticisms dwelt on the fact that those pressing for more widespread forms of early intervention rarely examined, or indicated any intellectual curiosity in, the normative underpinnings of such thinking. Strategies of early intervention should not be crudely and misleadingly perceived as a: … neutral ‘plug-in’ entity that can simply ‘work’ unproblematically wherever it is introduced. Our construction of childhood, our mores about learning to be a good citizen, the very purpose of our services and our attitudes to what is deemed ‘normal’ in matters of child development and parenting all permeate and influence our notion of what it means to intervene early (Pithouse, 2008, p. 1539). Furthermore, early intervention may not be welcomed by some intended recipients and could lead to labelling and stigmatisation. Turning to practical issues relating to the actual provision of services, Pithouse speculated that early intervention, in the form of targeted and specialized forms of practice, could undermine and dilute the resources available for more universal services. Hence, unproven early intervention schemes could siphon off resources and scarce skills for ‘no good purpose’ (Pithouse, 2008, p. 1544). Subsequently, Mike Stein (2011) echoed this criticism of ‘irrational, morally flawed and naïve’ early-intervention schemes for failing to ‘give equal recognition to the needs of vulnerable teenagers as to those aged three and under’. Despite such pointed criticisms, with the subsequent UK Coalition and Conservative governing administrations, advocacy of early intervention has been bolstered by the, seemingly, unequivocal scientific authority of neuroscience. This has given rise to developments, which, in part, replicate the ‘explicit linking of brain science claims and early years’ policy and practice’ promoted in the USA in the late 1990s (Edwards et al., 2015, p. 168). More generally, this ‘turn towards brain science’ can be perceived as international in scope (Edwards et al., 2015, p. 171; see also De Vos and Pluth, 2016; Rose and Rose, 2016). This article explores the revitalised discourse of early intervention. It begins by referring to the evolution, since the 1960s, of what Joelle Abi-Rached and Nikolas Rose (2010) term the ‘neuromolecular gaze’. Next, the role of new imaging technologies in promoting neuroscience is interrogated. Finally, the focus shifts to the UK, where neuroscience is being emphatically deployed across the mainstream political spectrum to amplify the argument for early intervention. The discussion section focuses on two elements central to this discourse: the questionable ‘brain science’ laying too great an emphasis on infant years; and how this, apparently, more ‘objective’ and scientifically grounded approach shares affinities with doxic and embedded ideas about attachment theory. The ‘neuromolecular gaze’ Neuroscience seems to provide a potentially alluring and ‘attractive grammar for living’ because it combines both ‘therapeutic and objective, scientific meanings, operating across moral, ethical, and scientific registers’ (Thornton, 2011, p. 408). Nevertheless, this is a relatively new field of scientific investigation, with the term ‘neuroscience’ only having been coined in 1962 (Abi-Rached and Rose, 2010). Allan Hobson, one of the key US figures associated with the rapid evolution of neuroscience, suggests that the development of the ‘new molecular style of thought’ was partly attributable to discontent with the dominance of psychoanalytical approaches and what was viewed as a lack of scientific rigour (Hobson, in Abi-Rached and Rose, 2010, p. 27). Throughout the 1960s, interest and funding in the brain sciences grew exponentially in the USA, endorsed by governmental agencies, philanthropic organisations and, significantly, the burgeoning corporate pharmaceutical industry (Abi-Rached and Rose, 2010). However, it was only in 1973 that neuroscience developed as ‘a discipline in its own right, when Amherst College became the first institution to offer an undergraduate degree in neuroscience’ (Abi-Rached and Rose, 2010, p. 28). Fifteen years later, the first UK undergraduate course was introduced at Cambridge (Abi-Rached and Rose, 2010). In 1990, President George H. W. Bush, responsible for fathering one of the less cerebral occupiers of the White House, designated the 1990s as the ‘Decade of the Brain’ (Bush, 1990). Abi-Rached and Rose refer to a ‘neuromolecular gaze’ to summarise a ‘hybrid style of thought, approach, language and perception that reduces understanding of complex phenomena to a molecular understanding gathered around the brain, and which means that intervention in the brain can shape behaviour’ (in Edwards et al., 2015, p. 172). This ‘gaze’ is increasingly omnipresent. Often crudely formulated, ‘biologised accounts of the formative impact of early experiences on brain development’ are called upon to ‘shape politics, key social policy legislation and early intervention initiatives, as well as … everyday practices among health care providers and early years educators’ (Edwards et al., 2015, p. 168). Nonetheless, a good deal of what is derived or ‘is “known” from neuroscience is speculative’ (Walsh, 2011, p. 22). Clearly, the ‘medical model’—including neuroscience and related discourses of early intervention—should not be pre-emptively rejected. We are, of course, ‘biological organisms … and our activities and thoughts can be understood only by situating us properly with a brain in a body in an eventful world abounding with objects and people’ (Dawson and Fischer, in Yaqub, 2002, p. 1082). Neuroscience may have much to offer and could, for example, contribute to mitigate harsh responses in the area of youth justice (Walsh, 2011). A US neuropsychologist, Gary Marcus, argues that: Our early-twenty-first century world truly is filled with brain porn, with sloppy reductionist thinking and an unseemly lust for neuroscientific explanations. But the right solution is not to abandon neuroscience altogether, it’s to better understand what neuroscience can and cannot tell us, and why (in Edwards et al., 2015, p. 174). Picture this: the visual and neuroscience As a number of commentators have suggested, neuroscience has been harnessed to support particular solution-focused social policies not necessarily on account of ‘its actual explanatory capacity, but for its persuasive value’ (Edwards et al., 2015, p. 175). Especially during periods of welfare retrenchment, this ‘persuasive’ aspect gives this range of ideas a certain appeal and, in this context, it is vital to emphasise the immense importance of the visual (Rose, 2016). Evolving technological transformations, particularly the introduction of functioning magnetic resonance imaging (fMRI), enable pictures of the brain to accompany early intervention’s new vocabulary. Brain images ‘shout science’ (Poerksen, in Wastell and White, 2012) but are, as Tallis charges, ‘a fast acting solvent of critical faculties’ (in Wastell and White, 2012, p. 280; see also Wastell and White, 2017). Many neuroscientists are alert to the limitations of brain-imaging techniques (Ramani, 2009): for instance, the fact ‘that blood flow[ing] in one part of a brain is shown as “lit up” on an fMRI scan does not mean that the rest of it is inactive’ (Edwards et al., 2015, p. 174). Images are far from the straightforward and unambiguous representation of the actual totality of brain activity. Moreover, brain science ‘findings’ may occasionally be inaccurate, misleading, inconclusive and shaped by implicit normative understandings. Such flaws, however, are often glossed over, when viewers are presented with brightly coloured, simplistic and, apparently, objective neuro-images. In this sense, pictures risk marginalising meaningful interrogation of the messy social world with its array of ethical and political dilemmas. Thornton (2011, p. 402), for example, is troubled by the ‘supreme status’ that brain imaging has achieved, yet who can doubt the ‘biological truths’ pictorially displayed for all to see? Stamm’s (2007),Bright from the Start, along with a spate of other popular guides, rely on brain images to convey, especially to mothers, how children’s ‘every mood and affection has an immediate, physiological impact that can be constantly visualized and measured’ (Thornton, 2011, p. 402). Diffusing neuroscience expertise and vocabularies, the aspirant mother is able to ‘look inside [a baby’s] brain’ in order to incessantly monitor and recalibrate how nurturing interventions can be maximised (Stamm, in Thornton, 2011, p. 410). Mothers on the lower rungs of the class ladder may face more emphatically severe interventions if they fail to learn from and act on this emerging knowledge. In the UK, Martin Narey, for example, advocates more strident policies of adoption, using neuroscience to support his assertions. Appointed as the Coalition government’s ‘adoption tsar’, he reportedly called for fewer efforts directed at ‘fixing families that can’t fixed’, advocating instead for more ‘children being taken away as babies’ and adopted (in McVeigh, 2009). Returning to the pictorial issue, Donato Ramani (2009) usefully delineates three dimensions relating to neuroscience imagery. First, he refers to ‘neurorealism’, which is a perspective in which the evidence emanating from neuro-imaging is perceived as real and objective—a sort of ‘visual proof … despite the enormous complexity of data acquisition and image processing’. In this instance, viewers are presented with, it would seem, final and compelling ‘proof’ of what people have always felt to be ‘real’ and ‘true’ but, until now, nobody had been able to visualise: ‘pain, feelings, fear, pleasure, even faith’—in other words, fMRI could function as ‘validation’ of what has previously been considered ‘evanescent and impalpable’ (Ramani, 2009, p. 2). Second, Ramani detects ‘neuro-essentialism’ in perspectives maintaining that, looking at the brain, we ‘should be able to catch the true essence of personality (i.e. “brain cannot lie”), the origin of individual differences (differences between man and woman, homosexuality, vices etc.) and so on’ (Ramani, 2009, p. 2). Third, ‘neuropolicy’ refers to the ‘political use of neuroimaging findings, to promote specific issues’ or policy solutions with the neuroimaging or ‘visual proof’ having apowerful influence (Ramani, 2009, p. 2). Each of these overlapping dimensions impacts on how strategies of early intervention are unfolding in the UK. Furthermore, within the international social work literature, this new interest in brain science is, on occasions, producing outlandishly incomplete and reductive accounts of the choices people make in the circumstances in which they find themselves. One contribution from Australia refers, for example, to the excess cortisol a baby received in her mother’s womb ‘causing her to develop an anxious temperament’ which ‘may lead her, as an adult, to move to a high security environment, such as a gated community’ (Cameron and McDermott, 2007, p. 37). Of more serious concern, Karen Healy (2016) communicates how the suicide of a fifteen-year-old Aboriginal boy was interpreted by the Western Australian coroner as largely attributable to neurological changes prompted by childhood neglect. Failing to use a more encompassing critical optic, there was little recognition of how the continuing ‘effects of European colonisation, institutionalised racism, violence and economic exclusion’ are also immensely significant factors contributing to high suicide rates among Aboriginal teenaged males (Healy, 2016, p. 1453). Unsurprisingly, given the narrowness of the focus, the coroner merely concluded her report by calling for child protection practitioners to better integrate recent ‘advances’ in neuroscience in their work with children viewed as vulnerable (Healy, 2016, p. 1453; see also Beddoe and Joy, 2017). In this way, neuroscience can be perceived as a ‘screen discourse’ functioning to hide an interrogation of structural questions circulating around power, domination and racialised subjugation (Bourdieu and Wacquant, 2001, p. 4). The narrow ‘window of opportunity’: neuroscience and early intervention Iain Duncan Smith (Secretary of State for Work and Pensions from May 2010 until March 2016) has been a significant figure promoting neuroscience within social policy discourses in the UK. Perhaps influenced by the assertions of Blair, the Duncan Smith associated Centre for Social Justice drew attention to brain science in Breakthrough Britain: The Next Generation published in 2008. Being reared in the context of a stressful or impoverished relationship, involving continuous criticism and verbal abuse, can, it is argued, damage brain tissue, due to the ‘toxic levels of stress hormones “cascading” over the brain’ (Centre for Social Justice and the John Smith Institute (CSJ/JSI), 2008, p. 43). As the field of epigenetics in physiology recognises the dynamic ‘interplay’ between genes and the environment is vital: In essence, some of our genes will be expressed in a particular way, depending on the environment in which we find ourselves. So for example, some of the genes which code for chemical activations that restore well-being after a stress reaction may be ‘tuned down’ by adverse parenting experiences in childhood. Similarly, genes which can place us at risk of later problems may only be ‘turned on’ by adverse parenting (CSJ/JSI, 2008, p. 44). According to the 2008 report, a ‘neuron footprint’ serves to reveal how this ‘interplay’ has unfolded for particular individuals. In the context of ‘everyday medical practice’, in fact, the ‘earliest years of infancy and childhood are not lost but, like a child’s footprints in wet cement, are often life-long’ (CSJ/JSI, 2008, p. 149). An emphasis on the very early years of a child’s life should not, moreover, be ‘confined to those children who are at most risk of social exclusion’ (CSJ/JSI, 2008, p. 133). This scientific revelation has, it is avowed, profound implications for how governments evolve social policy: In the same way that policy and society now support the notion that an individual must take responsibility for his or her contribution to global environmental problems, the campaign we envisage needs to encourage, help and qualify every contribution to neuronal pathway construction and therefore brain development in our young children (CSJ/JSI, 2008, p. 151). Rooted in neuroscience-based tutelage, a number of programme initiatives do, in fact, now highlight the importance of an infant’s brain development within the home. The Family Nurse Partnership programme, mentioned earlier, requires that practitioners raise the subject of brain development during the initial visit to a pregnant mother as a way of underlining the ‘crucial significance of participation in the programme and the associated imparted advice’ (Edwards et al., 2015, p. 179). Mothers are given a sheet entitled ‘How to build your baby’s brain’, which includes a list of activities claiming to ‘enrich neural connectivity’ (Edwards et al., 2015, p. 179). Programmes such as this establish a new ‘common sense’ around how—and why—the state intervenes in the domestic sphere. In this process, the state and its agents, such as social workers, doctors and health visitors, have the purpose and scale of their interventions and incursions into families recalibrated. Parents—more often mothers—are referred to in ‘flattering terms as “sculptors” and “architects” of the physical infant brain’ and are enjoined to become responsible for optimising the potential of their off-springs (Macvarish et al., 2015, p. 258). In 2010, following the assembling of the Coalition government, a policy focus informed by brain science continued to feature prominently with Graham Allen, the Labour MP, producing two reports published by the Cabinet Office (Allen, 2011a, 2011b). Each reiterated the point that the early years of a child’s life were crucial in that they furnished a narrow—now or never—period in which to get things right. Derived from a now ubiquitous image used by the American Psychiatrist Bruce Perry in an article six years earlier, the covers of the reports purported to reveal the difference in size between the brain of a ‘normal’ 3-year old and that of a 3-year old victim of ‘extreme neglect’ (Allen, 2011a). In one of the reports, alongside the former, one single gold ingot was used to represent the government’s resolute investment in ‘early intervention’. In contrast, an underdeveloped child’s brain was flanked by two stacks of ingots symbolising the purported excessive public cost of not intervening early: ‘Low Attainment’, ‘Benefits’, ‘Failed Relationships’, ‘Poor Parenting’, ‘Drug Abuse’, ‘Teen Pregnancy’, ‘Violent Crime’, ‘Shorter Life’, ‘Poor Mental Health’ (Allen, 2011b) (see also Figure 1). In short, an assortment of deficits associated with so-called feckless families. Figure 1 Open in new tabDownload slide Early intervention, smart investment, massive savings Figure 1 Open in new tabDownload slide Early intervention, smart investment, massive savings Those who are ‘neglectful or depressed parents (or suffering from mental disorders) or who are drunk, drugged or violent, will have impaired capacity’ to provide the necessary ‘social and emotional stability’ for their children (Allen, 2011a, p. 15). Such ‘insecure attachment’, we are told, ‘is linked to a higher risk for a number of health conditions, including strokes, heart attacks and high blood pressure, and suffering pain … from headaches and arthritis’ (Allen, 2011a). In contrast, ‘people with secure attachment show more healthy behaviours such as taking exercise, not smoking, not using substances and alcohol, and [somewhat oddly] driving at ordinary speed’ (Allen, 2011a, p. 15). Targeted at a niche readership of family justice professionals, Brown and Ward (2012) furnished an overview of ‘current research’ on child development and the impact of maltreatment. Their contribution argues that neuroscience-based developmental ‘time frames’ should guide court decision making in care proceedings. Here again the image used by Perry—so potent and influential within the semiotics of neuroscience—is included and the US psychiatrist is thanked, along with others, for his ‘expert advice’ (Brown and Ward, 2012, pp. 5, 66). Indeed, the authors convey a sense of pervasive anxiety about professionals’ disregarding the findings from neuroscience and failing, as a result, to intervene with appropriate alacrity. Readers are advised on no fewer than ten occasions, in a relatively short report, that there is a short ‘window of opportunity’ in which ‘decisive actions should be taken to ensure that children at risk of future harm are safeguarded’ (Brown and Ward, 2012, p. 72). In such instances, and gelling with the neo-liberal privatisation imperatives, it is confided that ‘independent social workers’ working outside the public sector can—because of their ‘manifest independence’, ‘skills and time’—be especially beneficial (Brown and Ward, 2012, p. 81). Brown and Ward draw heavily on USA-based research, particularly the working papers published by the National Scientific Council on the Developing Child (NSCDC). One of these papers compares the ‘executive function’ in the brain to ‘having an air traffic control system at a busy airport to manage the arrivals and departures of dozens of planes on multiple runways’ (NSCDC, 2011, p. 1). Since early experiences shape the development of the ‘executive function’, childhood is a crucial phase. Expertly produced and accessible, these reports contain useful information for social work practitioners. However, they verge on oversimplification and promote what Bourdieu (1994, p. 52) terms ‘false clarity’—a rhetorical strategy which is ‘often part and parcel of the dominant discourse, the discourse of those who think everything goes without saying, because everything is just fine as it is’ (Bourdieu, 1994, p. 52). This article lacks the space to explore this dimension in sufficient detail, but the NSCDC working papers, which Brown and Ward (2012) appear so reliant on, are riddled with unpacked normative assumptions about the type of society in which the expert discourse of neuroscience is produced and circulated. What is more, there is a lack of analytical and sociological curiosity about how children mature and go on to become ‘productive, contributing members of their communities’ (NSCDC, 2011, p. 1). For example, very crudely, what counts as ‘productive’ in a neo-liberal capitalist order will be very different to what is classed as such in an economic, social and cultural configuring which foregrounds collective interests. Moreover, the NSCDC perception of family dynamics appears socially and culturally narrow, emanating from a world where ‘we’ are expected to ‘prepare dinner while simultaneously helping our children with their homework and making notes about appointments we need to schedule for the week’ (NSCDC, 2011, p. 1). Having no need for recourse to public transport, ‘we’ all own cars and—thanks to a developed ‘executive function’—are able to ‘take a deep breath, rather than honk, if the car in front of us fails to move immediately when the light turns green’ (NSCDC, 2011, p. 1). Although seemingly benign and trivial, these examples conjure up a milieu insidiously assembled as the ‘norm’, against which the aberrant ‘abnormal’ can be delineated, assessed, monitored and acted upon (Foucault, 2016). However, in less abstract terms, such questionable research might still serve as ammunition for those local authorities, striving to meet imposed performance targets, which are left, in the words of Judge Scarratt, ‘gunning for adoption’ (Kent County Council v M & O, 2017, para 59). Certainly the research studies, amplified and insufficiently interrogated by Brown and Ward, could lead to the more rapid removal of children from families deemed ‘defective’ (see also Broadhurst et al., 2015). The media have also trumpeted the somewhat simplistic message propagated by primary definers within political and academic fields, with a columnist in The Daily Telegraph adumbrating that: … simply ensuring that mothers play with their children in the first three years of their lives, empathise with them and make them feel safe, makes a very significant difference to the physical architecture of the developing brain, which in turn can make the difference between whether a child develops into a normal, fully socialised teenager or an out-of-control hoodlum (Palmer, 2010, emphasis added). More expansively, international advocacy of neuroscience-based intervention has been dubbed the ‘First three years movement’ (Thornton, 2011). Comprising an alliance of ‘child welfare advocates and politicians’, it claims that ‘social problems such as inequality, poverty, violence, lack of educational achievement, mental and physical ill-health, can be ameliorated or prevented if policy can secure functional infant brain development’ (Macvarish et al., 2015, p. 253). In the lead-up to the 2015 UK general election, such thinking produced the Cross-Party Manifesto (2014) publication, The 1001 Critical Days: The Importance of the Conception to Age Two Period. Receiving support across the mainstream political spectrum, and even signed by the future Labour Shadow Chancellor John McDonnell, the manifesto highlights how the movement initially proposed by Blair is ‘increasingly extended back before year zero, into gestation’ (Macvarish et al., 2015, p. 257)—a development suggesting that expectant mothers, particularly those viewed as potentially ‘risky’, may become candidates for more ‘support’ and enhanced surveillance. The prime instigator of the Manifesto was Andrea Leadsom, former investment fund manager and unsuccessful candidate for the leadership of the Conservative Party in 2016. Leadsom advised The Guardian (in Rustin, 2012) that there was a need for ‘stiletto-sharp interventions’ which are ‘brief, sharp, very focused’ and which aim to ‘get mum, dad or carer to the point where they are good-enough parents’: The worst thing … is the parent who is inconsistent—you know: sometimes when I cry my mum hugs me and other times she hits me. That is where the baby develops an antisocial tendency. Kids who go and stab their best mate, or men who go out with a woman and rape and strangle her—these are the kinds of people who would have had very distorted early experiences (in Rustin, 2012, emphases added). Whilst questionable and incredibly reductive, such perceptions remain influential and have a serious impact on those whose parenting capacity is subject to scrutiny. Discussion In what follows, the aim is to articulate two core facets of early-intervention discourse. First, the focus is on the questionable science often deployed to rhetorically inflate the significance of early intervention: particularly the marked infant determinism and the stress usually placed on ‘early plasticity and later rigidity’ (Nadesan, 2002, p. 405). Second, it will be suggested that the perception that the early years are vitally significant is, perhaps, especially seductive for fields such as social work, because it coheres with the valorisation of more embedded, and traditional, ideas associated with attachment theory. Questioning ‘brain science’ The ‘most repeated claim about the infant brain is that it is distinguished from the adult brain by its capacity for extremely rapid “growth”’ (Macvarish et al., 2015, p. 257). As observed, the notion that the early years are, as Brown and Ward (2012) incessantly reiterate, the narrow ‘window’ available in which adult carers can fruitfully and productively intervene in the life of an infant, is central to neuroscience and its trumpeting in media discourses. However, the main criticism of this form of reasoning is that it places far too great an emphasis on early interactions and lends insufficient attention to a child’s—and subsequently adult’s—constantly evolving ‘habitus’ and fuller sense of their place in the world (Bourdieu, 2002). Moreover, as well as boosting the strategies of corporations to market developmental children’s toys at middle-class consumers (Nadesan, 2002), this dominant and increasingly dominating discourse can be interpreted as kindling a new nervous anxiety and guilt in all parents, but particularly those impoverished parents already subjected to the disproportionate surveillance of the state (Wastell and White, 2012). Here, one of the main criticisms is that the brain does not cease to exhibit plasticity after the first few years. Whilst accepting that brain development during this period is tremendously significant, it is important to recognise that patterning of brain development is ‘nonlinear, a complex web of recursive loops’ (Walsh, 2011, p. 35; see also Malabou, 2008). A young child’s brain is not irrevocably ‘wired’ after the age of three, with the very early experiences producing and determining the life course of an individual. Across a range of disciplines, including neuroscience, many researchers question the validity of such claims and express concern about the direction of policies. Here the focus is on the often fragile evidence base for the assertions made (see the Neurobollocks blog, available online at https://neurobollocks.wordpress.com/). One of the chief critics is the philosopher John Bruer, who maintains that the focus on early years and brain development is, in part, a public relations ploy to garner additional funding for research (in Edwards et al., 2015, p. 175). He also cautions that many of the findings are extrapolated from animal-based research and that there are clearly manifest ‘neurological differences between humans and the animal subjects that problematize the external validity of these studies’ (Nadesan, 2002, p. 406). While challenging uncritical reliance on animal studies, Bruer still points out that some animal-based studies indicate that adults can and do continue to learn throughout their lives and that there is no compelling evidence showing that ‘children do, in fact, learn more quickly or more deeply’ than adults (Nadesan, 2002, p. 406). Skills not untypically increase, in fact, over time. Sceptical about the normative assumptions embedded into current research and policy, Bruer suggests that there are too many generalisations made by ‘academics who have very little experience of what it’s like to be from a working-class home or an impoverished background’ (Bruer, in Smith, 2014, p. 36). For example, the so-called ‘rich, complex environments’ that parents and carers are exhorted to provide for children in their early years share many of the ‘features of upper-middle class, urban, and suburban life’ (Bruer, 1997, p. 10). Focusing on the class-based nature of the discourse associated with brain science, Bruer chides that it is misleading to privilege certain environments as more beneficial than others for neural development of sensory-motor and visual skills. Stimuli are ‘ubiquitous’ and … available in any child’s environment, unless that child is abused to the point of being raised in a sensory-deprivation chamber … .In short, experience-expectant brain plasticity does not depend on specific experiences in specific environments … .Cultural variations in child reading suggest that there are many equally successful ways to provide the normal environment needed for brain development (Bruer, 1997, p. 8). Back to the future: rebooting attachment theory? In some quarters within social work, there may be a tendency to frown upon, even to reject, what is loosely referred to as the ‘medical model’ in which neuroscience is located. Such a stance may be related to something of an inferiority complex within the ‘field’, grounded in the understanding that social work is unfairly bereft of the ‘symbolic capital’ associated with the medical professions (Bourdieu, 2002). Alternatively, this perspective can be understood as driven by a more potentially liberatory project aiming to free the profession, and the users of services, from the narrowness and insularity of aridly positivistic approaches to assessments. Indeed, science ‘with a capital “S” can sometimes be accredited with an explanatory power that it does not possess’ (Walsh, 2011, p. 35). Such a view is likely to be informed by recognition of just how damaging the dominance of the ‘medical model’ has been in the past, particularly for those using health and social services regarded as ‘deviant’ or ‘abnormal’. It would, however, be problematic to frame this issue within a crude binary logic—‘social’ versus ‘medical’ model—because, in most areas of their day-to-day work, practitioners will take a more hybrid approach. Moreover, neither the ‘social’ nor the ‘medical’ can be rendered as entirely fixed and static constructs. In discussing the cultural preoccupation with neuroscience and its impact on early intervention, it is also important to recognise how attachment theory remains influential and is dialectically enmeshed with these more contemporary ways of thinking about human development. This is apparent in the report by Brown and Ward (2012, p. 24) and their rather strident assertion that early secure attachments contribute to the growth of a broad range of competencies, which can include: a love of learning; a comfortable sense of oneself; positive social skills; multiple successful relationships at later ages; and a sophisticated understanding of emotions, commitment, morality, and other aspects of human relationships (Brown and Ward, 2012, p. 24). Articulated in the UK by politicians, such as Duncan Smith and Allen, and academics, such as Brown and Ward, the foundational discourse on early intervention is palpably informed by the ‘findings’ produced by cutting-edge scientific technology. However, when stripped down, neuroscience-driven strategies of early intervention can be read as a mere ‘reformulation of old and contentious tenets of mother–child attachment theory (Edwards et al., 2015, p. 176). What is more, whilst such strategies and approaches are often couched in gender neutral language with copious references to ‘parenting’, it still can appear that mothers—especially the impoverished—are the main targets of intervention, given they are seen as the ‘core mediators of their children’s development’ (Edwards et al., 2015, p. 176). In Allen’s reports, mentioned earlier, prevalent gender-neutral terminology is apt to give way to female pronouns and ample references to the role of mothers. In the first report, for example, he refers to the ‘emotions in the exchanges between mother and baby’ (Allen, 2011a, p. 13) and ‘the mother’s mental state’ features as a sub-heading for one section of his discussion (Allen, 2011a, p. 15). Elsewhere, he focuses on research which, readers are informed, has analysed and found a manifest ‘link’ between ‘low maternal responsiveness’ and problems with the behaviour of infants and young children (Allen, 2011a, p. 16). Pivoting on the mother/infant dyad, attachment theory and its lexicon have become ‘one of the most enduring discourses aimed at explaining and defining normal (and hence normative) maternal and child roles in the last century’ (Thornton, 2011, p. 407). Historically significant here are figures such as John Bowby. His understanding was that the first three years of a child’s life are the most important for the ‘bonding of an infant to their mother’ (Allen, 2011a, p. 73): these thirty-six months psychological development (see, for example, Bowlby, 1990). The insights of Bowlby should be historically situated in the hegemonic gendered order of ‘Fordism’ and a particular stage in the evolution of western capitalism (Hall and Jacques, 1989). His theorisation, and much of that founded on it, has been subject to sustained and convincing critiques from feminist scholars (Birns, 1999). Nonetheless, Bowlby’s views remain at the core of present-day education and practice as it relates to child and family social work. His work also continues to inform contemporary social theory, especially some of the strands associated with the politics of recognition (Honneth, 1995; see also Garrett, 2013, Ch. 9). In the context of the focal concerns of this article, attachment theory is now operating as an implicit resource for neuroscience-informed frameworks for intervention. This is not to argue that this body of theory merely replicates that of the 1950s and 1960s. In the past, the mother–infant bonding process was perceived as mostly biologically determined and a natural outcome of interactions between the normal mother and her child (Thornton, 2011). In contrast, according to some writers in the field of cultural studies, influenced by Foucauldian governmentality theory, contemporary attachment theorisation lays greater emphasis on the mother needing to constantly work on ‘the self’, primarily through ‘actions directed inward; toward feelings, attitudes, and desires’ aimed at achieving ‘personal freedom’ and ‘self-realization’ (Thornton, 2011, p. 409). Although these more recent renderings of attachment theory remain moralistic and sexist, the ‘good mother’ is not a ‘socially or biologically imposed norm to which women must conform; rather, mothering is a limitless pursuit of the self and its values of enjoyment, happiness, and fulfilment’ (Thornton, 2011, p. 413). Conclusion Arguably, the discursive hype surrounding early intervention in the UK does not always appear to be matched by investment in practice. For example, austerity-related cuts are adversely impacting on local councils’ ability to provide services. Action for Children, National Children’s Bureau and The Children’s Society (2016, p. 2) reveal that ‘between 2010–11 and 2015–16 spending by local authorities on early intervention services for children, young people and families fell by 31 per cent in real terms’. Nevertheless, it is still important to dwell on this ‘current vogue for tracing the origins of social failure’ to early-life factors (Macnicol, 2015, p. 5). Across an array of child-care discourses, concerns about the capacity of parents—usually mothers—to nurture their children are historically rooted, and clearly predate the emergence of neuroscience-based claims. Consequently, in trying to arrive at a rounded assessment, such claims need to be situated alongside earlier patterns of class-based and gendered modes of understanding and reasoning. Certainly, neuroscience ‘has latched very easily’ on to psychological ideas about child-rearing that have been hegemonic for decades (Edwards et al., 2015, p. 173). Early intervention, it is maintained, is a manifestly ‘smart’ and common sense approach. Moreover, due to its scientific veneer, this explanatory logic apparently transcends politics and is frequently deployed as a form of post political reasoning. How could any reasonable person conceivably dispute the solid ‘truth’ which is merely being objectively reported? More pointedly, despite the manifest affinities with neo-liberal forms of rationality, brain science tends to be presented as the antidote to ‘outmoded ideas about social class as shaping life chances’ (Edwards et al., 2015, p. 181). Within the evolving dominant paradigm, the parent–child relationship is constructed and calibrated as ‘both naturally foundational to society but also too risky and important to be left to the unseen vagaries of the private realm’ (Macvarish et al., 2015, p. 252). Furthermore, this furnishes part of the context for the centrality of early intervention, where ‘expert-led, neuro-scientifically-informed parenting support’ is seen to be ‘necessary to train the parent in the correct way to nurture the child’ (Macvarish et al., 2015, p. 257); see also Macvarish, 2016). Underpinning early years’ intervention is also a clear ‘cultural deficit model’ that tends to guarantee that it is the impoverished that are perceived in terms of ‘risk, with little consideration given to wider structural and economic factors’ (Edwards et al., 2015, p. 180). More broadly, early intervention discourse fuses a back-to-basics attachment theory-driven approach with a more ‘evidenced-based’, visualised and futuristic perspective. 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TI - Wired: Early Intervention and the ‘Neuromolecular Gaze’
JF - The British Journal of Social Work
DO - 10.1093/bjsw/bcx057
DA - 2018-04-01
UR - https://www.deepdyve.com/lp/oxford-university-press/wired-early-intervention-and-the-neuromolecular-gaze-VHm0PxcBI6
SP - 656
VL - 48
IS - 3
DP - DeepDyve
ER -