To be really cross that David Cameron wants to limit useage of Sure Start Centre to families on low incomes.

[Housewife2010]

I have used them for the last 3 years & the majority of the mothers there are middle class. If they didn't go, the places I go to would be almost enmpty.
I use them a lot and my children have got a lot out of the classes/events there. We may not be poor, but our household income has dropped a lot since I gave up work to bring up our children. It is very helpful to be able to take them to some free classes and meet other local families.

Okay, so, this morning I went to my local CC Stay and Play and - mindful of this thread - took a long look around at who was using this service and what it entailed.

The session cost 50p to cover the cost of tea, coffee and snacks - so if everyone paid, should have netted £15.

There were about 30 families at this session.
About 7 were South East Asian mums that I recognise from the local estate, mostly speaking their own language but also speaking to other mums
There were 2 other Asian mums speaking their own language
There were about 4 Eastern European mums
There were about 3 what you might call "MC mummies" (including me)
There was 1 "MC daddy" (I think!)
There was 1 dad who seemed to take a large role in organising the group who had old track marks in his arms and was covered in tattoos
There appeared to be a few grannies/childminders/other I couldn't quite work out
There were about 10 other mums from our estate - who looked mostly under 21.
There were (I reckon) 4-5 kids with easily identifiable (for me) special needs.

The session consisted of about an hours play, then a snack and water and nursery rhymes with props at the end of the session.

I have been to many of the local church groups and the local NCT group and there is nowhre near this level of representation of people who are not middle class.

Of the middle class 'representatives' (all four of us e.g. about 13%, probably representative of how many people in the area are 'middle class' by occupation etc) I didn't hear anyone talking about second homes or ski lodges - mostly mums talking about sleeping and weaning and kids starting nursery. People spoke to and smiled at eachother.

I wonder how much this session really cost to run? What would really be saved by cutting it? What would happen to the equipment, the room etc? I wonder if there's really such limited social value in this type of activity that it is an outrageous endeavour in a time of recession.

I think of all the late-talking 2 year olds who come to community clinic to access SLT at a reference cost of £70 per hour and really think that general language stimulation and play advice is much better presented and accessible in the weekly 30 minutes nursery rhymes/magic bag/story activity at the end of the session (and modelling using sign etc during the snack session) than in a more expensive SLT intervention and make no mistake, there were definitely toddlers there at risk of language delay.. if that's true for my niche service, then why not for other areas of need e.g. PND, giving women at risk/suffering domestic violence a point of contact etc. (At the Bumps'n'Babes group earlier in the year, one of the local mums came in in floods of tears having just been beaten and steps were taken to support her to seek refuge; another mum came in looking for support from her partner to abort their second child).

Should "middle class mummies" really just carry on attending Water babies and Gymboree away from the realities of life? If there really are women who are MC out there gushing on about bloody ski lodges in groups like these, then maybe this is the wake up call they need..

Transform overall CC services yes: restrict some groups to certain people who need them e.g. PND groups, SN groups, dad's groups etc but 1-2 Stay and Play sessions a week for the entire community is not going to break the national bank (nor is cutting these sessions going to drag us out of recession).

Guess it depends on your area but totally agree that the majority of families who use them are middle class.

I don't use them anymore because I am back at work but whilst on maternity leave they were a bit of a life line - helping us all to get out a socialise. I did get annoyed at the time that it was fairly obvious we were not the target audience and it was not really meant for us.

There would not have been many in attendance if non target audience families were excluded.

I always assumed they were built in areas they were needed .certainly the ones I know of are attached to primary schools on council estates and very well used by the target groups ..

Arses, re this

'I think of all the late-talking 2 year olds who come to community clinic to access SLT at a reference cost of £70 per hour and really think that general language stimulation and play advice is much better presented and accessible in the weekly 30 minutes nursery rhymes/magic bag/story activity at the end of the session (and modelling using sign etc during the snack session) than in a more expensive SLT intervention and make no mistake, there were definitely toddlers there at risk of language delay..'

You do know that a recent Cochrane Review headed by James Law (no less) concluded that there is insufficient evidence for most paediatric SALT do you?

I'm sorry if i missed the point but if all the MC mummies and children were not at CC then i would not want my DC to go there. I have PND, my husband is disabled and we are poor but i come from a middle class background and want to give my child what i had. If the CC had only drug dealing, smoking, swearing and little thug children there i would not want you DC going there. Surly he would turn out worse!

I think that CC should be for the community and people who care about there children should have an opperetunty to meet like minded pearents.

My CC is great, i have a family support worker and she is a nice woman and the other mums in the playground i go to are nice and some have PND so we help each other. I have done a peareanting class, baby massage, childrens first aid course and a cooking course. All the things i need to help look after my Child. Also my DS is 18 months and not talking but he could just be dyslexic like me but going to these classes hopefully help him to develop more.

I want the CC to be accessable by everyone.

That's not strictly true moondog, is it? Which review are you speaking of?
There was one about intervention for speech in the under 5's vs watchful waiting that demonstrated that six hours of therapy was not enough; there's one on dyspraxia that says the studies are poorly designed; one that suggests that there may be some support for the effectiveness of speech and language therapy for children with expressive phonological and expressive vocabulary difficulties but there's limited evidence for interventions for expressive syntax and none children with receptive language difficulties.

Predominantly, the reviews say that there has been very little research conducted of at sufficient quality to make a judgement. And you should know, as any SLT does, that the reasons for the poor evidence base are many and diffuse, with primary considerations being a poor research culture (specifically with reference to intervention) and significant constraints on resourcing.

For example, our trust has an incredibly involved speech disorder pathway that is based on evidence on intervention that suggests that a child with inconsistent speech disorder should have a minimum of 12 (or is 16? I can't remember) sessions twice weekly for core vocabularly following intervention descriptions and children with dyspraxia should have ongoing therapy without a break. Try resourcing that one..
attempts to use the evidence that exists have been extremely difficult to operationalise...

Unless you were making a different point? Do you think SLT should just pack up shop too? I would say the majority of SLT work in the country is about assessment and identification of need and reportin that to parents/carers and schools vs intervention, due to the difficulty in resourcing complex gold-standard interventions. I, for one, would love to see kids with basic language delay screened and dealt with in CC's vs in clinic to free up time for more prolonged and complex interventions that work.

Also, despite what I said elsewhere about my concerns about data collection in the language unit I work in, there has been great local evidence of our interventions working: last year, all 8 children with severe and specific language disorder making statistically significant gains on formalised standardised assessments and 3 with dyspraxia who had been totally unintelligible on entry the previous year returning to their local mainstream schools. Where input is intensive, the gains are made and most units have evidence to prove it.

You have basically paraphrased what I said Arses (in more detail). I write extensively about this stuff for different professional and academic audiences so I have spent a long time and put a lot of work into this.

I can't give you my references as I am in a different country at present on a wheezing creaking laptop, plagues by constant powercuts to boot.I have many however and would be happy to supply at a later date.

Do I think SALTs should shut up shop? No, not at all. (Incidentally I love the idea of SALT drop ins at CCs, as a way of sifting out the 'worried well' and identifying those at risk.

I think SALTs are great at identifying problems and less good (through no fault of thier own-not enough time, not enough knowledge about basic data collection and intervention design and evidence based practice) at actually putting it right.

What is indefensible I feel is current practice of hour long clinic sessions with individual kids, most of whom have relatively insignificant global language or phonological problems. We all know that the kind of people generally speaking, who turn up to this sort of thing are the MC 'worried well'.

Meanwhile, kids in real need (and moreover, kids who, if they are not dealt with effectively as kids will end up costing SS in particular an absolute fortune at a later date) are fobbed off by peopel who genuinely believe that 'contact' equals effective intervention.

Check out 'Special Needs' section and curl up with shame at how our profession has failed these families over nad over again.

Oh I know.. I know.. long before I ever knew much about SLT, I used to go on ABA-UK and shake my head.

I don't necessarily agree that SALTs are poor at putting things right where they have sufficient contact with their clients to do so: I do agree that we don't do very much of anything at all where "intervention" amounts to 4-6 sessions a year.

Language units with small cohorts and intensive SLT inputs are examples that it's not necessarily the profession that's the issue. We had a student who was nonverbal at 9, and with a mere 50 words on entry to secondary at 11, who left at GCSE able to speak in sentences. Not always the best sentences, mind you, but sentences none the less and using an AAC device effectively and with a number of entry-level GCSE's to his name.

Interestingly, one of the breakthroughs with this particular student was reducing prompt dependency in a group situation which involved choosing activities for the group- communication temptations for the 14 year old...

Given that he had been in SLT since he was 3, you have to wonder what might have been if his intervention had been as intensive from 3-11 as it was from 11-16. Sigh.

I got out of clinic for the reasons you mention, although I have to say we had very few of the MC 'worried well' as the population was too poor, really. We did have a lot of kids with global developmental delay in homes where speech and language concerns were the least of anyone's problems.

I've spent the clinic part of my job for the last few years diagnosing ASD and hating the fact that the only outcome I can feasibly offer is a yay or nay with no follow-up. I'm giving this part of my job up when I return to work after mat leave later this year. I don't really know how to do an effective intervention for a young person with autism in a clinical setting in 4-6 hours a year of which 4 are taken up with diagnostics, though, does anyone?

wanttofly you do realise the working class (or the non middle class) are not all drug dealing, smoking, swearing thugs don't you?! My god what a horrible comment you make!

Just because the middle class might not attend you would remove your child to avoid them being exposed to the working class?! My parents were working class and poor. They worked hard, loved harder and gave me the best childhood anyone could want. Compared to my wealthy friends I am the one who always remembers their childhood with the most fondness, it was filled with learning, patience, fun and good health and good moral lessons! We did not smoke or do drugs. Instead my parents taught me about tolerance. You might want to teach your children the same. Incidentally my working class upbringing took me all the way to Oxbridge, a city job and a wealthy adulthood...it has given me advantages in life I may have taken for granted had I been MC all my life. It has also taught me that you get lovely people who are MC and horrid ones, and the same goes for any other class, you cannot generalise how a person will act by which "class" you think they are.

Now as i look at these surestart centres I realise they will not be for my children, I can afford to pay for them to access similar support without wanting to deprive someone else access. BUT I am grateful for all the subsidised activities that were made available to me when I was the child that needed them. I firmly believe that all kids deserve an even footing in life, and if this means my taxes go towards ensuring the poorer chilren get to play tennis subsidised by the council, or cheap swim classes at the public pools, I will never complain. I know how these activities helped me and my family and I hoep others get to experience the same.

Your attitude has angered me beyond reason

wanttofly ..I certainly wouldn't want to attend a cc if people with your ignorant views attended ..Im raging!!!!!!!

Hmm i had a different experiance.

My Dad was a lorry drive my mum a cleaner, i grow up in a small village and most were council house and the children in my secondary shool is the only experiance i can go on.

The smoked sware had sex at 12 years old, had fights, hanged around stree corner drinking at 13 and were generaly not nice people. There pearents smoked, was on benefits and did odd jobs for cash and did not give a Sh**t about their kids. The girls i hanged around with all had children when the were between 15 and 18 to get council houses.

I have a degree from Glamorgan university and had a city job and moved away and lived in the city when i was 22.

I want to give my child more than that.

Also its not the middle class i had a go at its not even the working class it the new cluture of benefits and council houseing yobs that i went to school with.

Yes i agree there are decent people who have benefits and live in council houses. But its a different mentallity form just living of the state.

I live on a council estate and I'm fucking offended by your posts

Surestart centre are there for everyone to help their children and the mums and Dads. Why limit there use at all.

If you are putting activites on for one then it costs the same for everyone to attend.

So you judge an entire class of people by your experience on 1 estate. How very fair of you.

Furthermore, when those girls you describe have kids, do you not think they too might want to give their kids a better life than they had?! Do they not surely comprise one of the most crucial groups to target with mother and baby support, to ensure they do not fall into the trap of not caring for their own kids and carrying on this chain of neglect you describe? I know they deserve the free or subsidised classes a hell of a lot more than I do! The thought that on more deprived estates mothers might be taught how to view their children in a more inspiring manner, providing them with opportunities they may have not had thelmselves, and arming them with information about health and welfare their parents probably lacked seems far more worthwhile than ensuring the MC kids all play together nicely.

You are not the only mother who wants the best for her children. Just because someone is on benefits, in a council flat, a smoker, a swearer does not mean they are automatically a bad parent, and it does not mean they cannot become a better one with help.

My sister is a single perant who lives in a council house and is on benefits and does not work.

Im not generaling to EVERYONE who is on benefits or who live in council houses or who is poor.

Your right. They need help but they need to help them selves too by going to the CC. Is it not ok to have other women there that can give them a good role modle and advice?

It is hard to break the cycle but most of them dont even think there is anything wrong with it in the first place.

I had lots of bad experiance and i have form my opioions based on them and the world is a very dark place for some people and i do not want my child going throu that.

i would really like to meet one of these mythical grabbing middle class mummies who has trodden all over some poor (through no fault of her own), desperate to educate her child, but no idea where to start mummy, because tbh the stereotypes just lead to nastiness not progress. What the hell is middle class? Is it nicely spokem , aspirational, but possibly up to eye balls in debt due to mortgage/other personal issues, but able to understand and source assistance/ activities, so yes, does take her dc to slt? And all these poor, down trodden working classes? on this type of thread, they are all portrayed as poor lost souls who can't afford anything, but struggle valiantly to put food on the table, and on others they are feckless types, unable to walk into Tescos without stuffing a pkt of B and H in their Lidl carrier bags.

There comes a point, under attack, where i admit to thinking why should people who don't work to support their children get all this free stuff anyway - this sort of aggression to me, perceived middle class, just makes me defensive, surely not good?

Before i get massively flamed, or ignored, i am well aware of those who are unable to work - obv a valid target audience for surestart?

Perhaps part of the difficulty is that as a society we view those on benefits/in council estates as 'problems' to be 'fixed' rather than as a pool of huge potential that just needs to be tapped in the right way?

"Your right. They need help but they need to help them selves too by going to the CC. Is it not ok to have other women there that can give them a good role modle and advice?"

That is incredibly arrogant to think that richer women are some how a role model for the poor to emulate.

Some middle class and wealthy parents are completely shit. Ie. they believe that their little Hubert is misunderstood and exceptionally bright. They are not prepared to discipline Hubert when he brings his brattish ways to school. They argue that Hubert has all kinds of labels rather than being prepared to get off their fanny and discipline their kids.

Many low income families are honest and hard working. Their children are bright and do well, but find it hard to go to uni or buy a house.

I think we need to think what we are trying to achieve. How do we achieve mobiltiy between social classes.

Gosh i wouldnt want the parents i used to do babysitting for to be "role models" for any of the working class attendants at S.start! Those who had nannies 5 days a week, babysitters on weekends, and holidayed with childcare so they could avoid seeing their kids when on "their holiday". Whilst i can also think of hundreds of great MC parents surely you realise there are just as strong role models within the working class as any other class?

Well, maybe one way would be to do something to improve the self-esteem of those our society repeatedly writes off.

BA- delicate flowers who need the service?

What, like someone there to see a SLT, CAB outreach worker or a specialist DV support worker?

(only came back to C&P Moondog's excellent N Wales advice anyway)

Arses, the work your dept. is doing sounds great, it really does. I don't think there are many SALTs working in such a fashion though.

I know what you mean by this bit. it'sso bloody depressing. I sometimes feel we are employes just so the mandarins can say they provide a SALTsefvice. What it achieves is probably neither here nor there.

'hating the fact that the only outcome I can feasibly offer is a yay or nay with no follow-up.'

But I am going to suggest that there are actually enough SALTs if we radically change the way we work and help the people we work with to take more control over what is going on, specifically by teaching them about how to design intervention (eg baselines, andoutcomes) and crucially, how to take and analyse data which, as you know, is not only not rocket science, it is bloody good fun.

I also think (contrary to popular opinion) we need to be more prescriptive, not give bog standard wishy washy advice on 'talking more' 'singing nursery rhymes' and 'encouraging eye contact' . Means nothnig to the average mystified parent who leaves thinking 'Yes, I know that but how exactly'.

The book 'The Checklist' by Atul Gawande (a suregon and big mate of Lord Darzi) has influenced me enormously in this sphere recently. Have tried to link but laptop protesting under demands placed on it (ie anything more than breathing on it.)

I don't really know how to do an effective intervention for a young person with autism in a clinical setting in 4-6 hours a year of which 4 are taken up with diagnostics, though, does anyone?

SANCTI
Forgot to mention the beach of Morfa Bychan near Porthmadog too. Pay it a visit-it is lovely.
Also, go to Cricieth a lovely little town outside Porthmadog. A delightful beach and prom with agreat faded Art deco cafe where, if it is raining, kids canrun riot on jungle jymn stuff and you canwatch the waves pound the shore.

v. interesting points from arses and moondog about SALT, (and tips on N wales v useful too!), thank you arses and moondog.

arses - I went to the sort of SS stay and play you describe, which was run by a strict but fair retired primary teacher - I don't think it was any substitute for SALT, BUT useful as a gentleish low pressure introduction to encouraging kids to sit and focus and behave in group snack/craft/storytime activities.