An Evaluation of the Sing & Grow Programme with Adoptive Families
Colette E Salkeld, Guy D HaywardNovember 2013
Introduction to Sing & Grow
Sing & Grow is an evidence-based[i] international music therapy project that provides services within the community for young children and their families who present with complex needs. Originating in Australia in 2001, where it is currently funded by the National Department of Social Services, Sing & Grow was brought to the UK in 2010. Programmes focus on strengthening family relationships, building capacity in parents to support their children’s development in the early years of life, and encouraging use of music within communities.
The Sing & Grow programme is a 10 week structured music therapy programme in which songs and improvisation encourage parent child interaction. (See Appendix 3) The focus of the music therapy is the parent child dyad and the music therapist acts as a facilitator in enhancing their relationship. Allison Fuller, the National Learning and Development Manager for Sing & Grow in Australia says that the Sing & Grow programme addresses attachment issues primarily by encouraging parental responsiveness within the music making and explaining that this same responsiveness can be applied in different situations. Parents are encouraged to ‘respond’ to their infant/ child in the cases of instrument choice, tempo, volume and rhythm – to musically match the mood of their child and to encourage them, musically, to participate.[ii] All programmes are carried out in collaboration with host organisations. The host organisation refers up to 10 families and they also provide a member of staff to work with the music therapist throughout the 10 weeks, attending each session. Each family who attends is given a CD that contains some of the material used in the sessions and families are encouraged to use the CD between sessions to build on their new knowledge and experience gained over the course of the programme.
Pre and post observations are recorded by the music therapist on each programme. Using a 5 point system the music therapist rates a parent’s sensitivity, engagement with and acceptance of their child and the child’s engagement in the session, their responsiveness to their parent and their social engagement with other children and adults in the group. These evaluations take place in weeks 1 and 2 and then again in weeks 9 and 10.[iii]
Introduction to the Evaluation Study
Since the first Sing & Grow programme was delivered in 2001, the positive impact and effects on participating families and their children has been noted in a range of papers and research documents, however there has not been any specific evaluation of the programme with adoptive families. It is known amongst professionals working within the field of adoption that adoptive families are some of the most vulnerable families in our society due to the compound losses that each party bring into the new relationship. With this in mind Sing & Grow UK, in collaboration with Essex County Council Adoption Support Services, decided to carry out a small scale evaluation into the effectiveness of the Sing & Grow programme with adoptive families.
The relationship that a child has with their parents is the foundation from which all other relationships are built however adopted children who have had a number of attachment and loss experiences in their early lives may experience difficulties trusting the emotional availability of their adoptive parents. The purpose of this evaluation therefore was to see if the Sing & Grow programme had the capacity to impact adoptive families as previous research and evaluations suggested it could impact birth families. Bowlby (1988) says that for a person to know that an attachment figure is available and responsive gives him a strong and pervasive feeling of security and so encourages him to value and continue the relationship.[iv] As an attachment based programme that focusses on the relationship between the parent and the child Sing & Grow aims to enhance parent/child interaction, build parent confidence, enhance social connectedness and improve child development outcomes. The evaluation looked at these aims in relation to adoptive families. This was a small-scale evaluation, a single case study design. As with all other Sing & Grow programmes standard pre and post evaluations were taken of this particular group and the results of these can be read in Appendix 1.
Essex County Council wanted to see if the Sing & Grow programme was effective:
•In enhancing attachment between adopted children and their adoptive parents?
•In giving adoptive parents new skills to play with and nurture their adopted child?
•In enabling adopters to gain insight into their adopted child?
•In successfully supporting peer relationships between adopters?
•In determining at what stage in their placement adoptive families should attend a Sing & Grow programme?
The format of the evaluation was a combination of questionnaires and focus groups. An initial questionnaire was given prior to the Sing & Grow programme starting; a second questionnaire was given to the group immediately following the completion of the 10 week programme of music therapy; this was followed by a focus group discussion facilitated by an independent researcher; another focus group was carried out 3 months after completion of the programme facilitated by the same independent researcher. In this way the outcome results of the evaluation study reflect the adoptive parents’ satisfaction with the programme. It was felt by Essex County Council that this would be the most valuable way of evaluating the programme because, if it was found to be effective, Sing & Grow would be offered to adoptive parents as part of Essex County Council Adoption Support Service’s package of support.
“If parents are satisfied with the nature of the intervention, they are more likely tomaintain their involvement in the program and benefit from the experience.Therefore, parent satisfaction is important in its own right, and because it may relateto other family outcomes, such as increased empowerment, enhanced parenting self-efficacy,reduced parental stress or parental depression.”[v]
Prior to attending the research programme all families received an information sheet outlining what to expect during the 10 week programme. (See Appendix 2) There was then an opportunity for the families to meet one another, the music therapist, the independent researcher and the support worker from Essex County Council to ask any questions they had regarding the programme, the research and to fill in consent forms.
Who was referred into the research programme?
Essex County Council referred nine families into the programme and after three weeks one of the families left the programme for personal reasons. Eight families completed the programme with very few absences. This was an 89% retention rate. Five of the families had been together for 1 month at the start of the programme and the other three families who completed the programme had been in placement for 4, 6 and 14 months at the start of the programme. In total there were nine adults and eleven children who attended the programme.The children were aged between three and four years old.
90% of attending families had no previous experience of attending music groups. All of the adoptive parents said that they sang with their children and allof the adoptive parents listened to music with their children prior to attending the Sing & Grow programme.
During the initial questionnaire the adoptive parents were asked what they hoped to achieve from attending Sing & Grow:
Help you to learn new ways to play with and teach your child?90%
Help improve your relationship with your child?90%
Learn more about child development?90%
Enable you to meet and talk with other adoptive parents?70%
Enable you to have fun with your child?70%
Find new ways to nurture your child through music?60%
They were also asked what they would like their adopted child to gain from attending the Sing & Grow programme:
Find new ways to express emotions?90%
Increased social and communication skills?70%
Develop interaction with peers?70%
Respond to boundaries created by adults?50%
Become more playful?20%
Become more responsive to being nurtured?20%
50% of the adoptive parents had met some of the other parents prior to the programme through their preparation groups.
Outline of the results of the Evaluation Study
Results of both the questionnaires and the focus group data will be presented within this report.
Here are the results of the 2nd questionnaire which the adoptive parents completed immediately following the end of the final Sing & Grow programme:
How well did Sing & Grow ... / A Lot / Some / A Little / Not at alla. Help you to understand about your child’s development? / 12% / 63% / 25% / 0
b. Help you to learn new ways to play with and teach your child? / 50% / 50% / 0 / 0
c. Enable you to meet and talk with other adoptive parents? / 63% / 38% / 0 / 0
d. Help improve your relationship with your child? / 25% / 50% / 25% / 0
e. Enable you to have fun with your child? / 75% / 25% / 0 / 0
f. Help you to learn new ways to nurture your child? / 38% / 38% / 12% / 12%
g. Meet the needs of your family at this point in time? / 12.5% / 75% / 12.5% / 0
How well do you feel your child was helped by Sing & Grow ... / A Lot / Some / A Little / Not at all
a. increased social and emotional skills? / 62.5% / 12.5% / 12.5% / 12.5%
b. greater interaction with peers? / 50% / 25% / 0 / 25%
c. Emotionally more contained? / 0 / 63% / 37% / 0
d. Increased play skills? / 50% / 25% / 25% / 0
e. Greater capacity to accept adult boundaries? / 0 / 63% / 37% / 0
f. More responsive to nurturing situations? / 25% / 50% / 25% / 0
All of the families
- Wouldrecommend Sing & Grow to other adoptive families
- Agreed that they liked that the programme was specifically for adoptive families, focussing on attachment
- Noted Sing & Grow helped them to learn new ways to play with their child
- Noted Sing & Grow enabled them to meet with other adoptive parents
- Used the CD at home to have fun together
- Felt it was best to attend a Sing & Grow programme within 4 months of the placement
Parents particularly liked that this Sing & Grow group was being run specifically with their needs in mind and that they were able to share their experiences as adoptive parents together. It became quickly apparent that adoptive parents can feel sensitive when they are amongst birth families, especially if their adopted child is not behaving as they would wish. As the group was solely for adoptive families the parents experienced it as an understanding environment both for them and also for their children’s early attachment behaviour to be reflected upon. Parents felt that the group had a relaxed atmosphere and it was non-judgemental, supportive and secure. It felt safe to share their experiences with one another and one mother reflected that it helped her to keep ‘sane’.
‘I felt far less anxious in this environment with my children, so when my child was really disturbed I felt that I could handle her behaviour without having to justify it, whereas I feel far more anxious in an environment with birth parents and their children so maybe I don’t deal with it quite so well. I’m much more anxious about how she is being perceived and how I am being perceived whereas here I’m not anxious at all and so it kind of helps me to do better work with her in an adoptive situation.’
Another parent felt it was good for the children to be in a group of other children who are adopted. ‘They have all been removed from their parents, they’ve all gone into foster care and they are now all with forever mummies and daddies. It’s important for him to be able to see that he is not alone in this situation, other children have been through it.’
At the start of the programme 90% of families wanted Sing & Grow to help them improve their relationship with their child. The pie chart below demonstrates that all of the attending parents felt that Sing & Grow enhanced their relationship with their child.
Parents liked that the programme focused on attachment and on enabling them to learn practical play skills which they could incorporate into their daily activities at home. Parents spoke of the difficulty of setting aside time in the day to sit and play with their child, especially when they may be one of 2 or 3 children that they had adopted. Sing & Grow provided purposeful time that they could spend with their child, without the distractions of things needing to be done at home and the needs of other children. Sing & Grow enabled them to concentrate on their relationship, playing music together.
‘Well, I suppose Sing & Grow just focusses the two of you together and you know that you are here to try and engage with your child and to attach. It focusses your mind on doing that, whereas when you leave here you do more natural things like putting them in the car and going to the shops. You wouldn’t be in Sainsbury’s marching around singing, but Sing & Grow focusses you to do that.’
At the start of the programme 90% of families wanted to learn new ways to play with and teach their adopted child.
In the post questionnaire 50% reported that the programme had helped a lot with this aim and 50% felt that it had been some help to achieving this aim. 75% noted that the programme enabled them to have lots of fun with their child while 25% felt that the programme had helped them to have some fun with their child.
- How well do you feel your child responds to nurturing situations as a result of attending Sing & Grow?
The results show that all of the adoptive families felt that their child responded better to nurturing situations as a result of attending Sing & Grow. Through the questionnaires 85% of the parents felt that Sing & Grow helped them to learn new ways to nurture their child. This is highly significant as the importance of a warm nurturing environment has an impact on a child’s sense of wellbeing and the ability to build trust in their adoptive parent. It was a common theme from the questionnaires that during the course of the programme the children began to show more affection towards their adoptive parents. As attachment is reciprocal this is a particularly significant outcome. As adoptive parents feel able to nurture their adopted children, so they will feel good about themselves as parents and this feeling will be projected into their adopted child. This mirrors a healthy bonding cycle and has the potential to bring about reparation in the lives of the children who may have experienced poor attachment in their early lives.
Touch is an important part of nurture and the psychologist Margot Sunderland (2006) stresses the importance of touch for children saying, ‘When you hold your child, love him, soothe him, rock him in your arms, delight in him time after time, a strong bond will develop between you. Any tender loving contact will release natural opioids and oxytocin in your child’s brain . . . then your child will be in a wonderful state of oneness and contentment.’[vi]
Years of brain research have shown us that the brain has the capacity for immense change, healing and reparation and Cozolino[vii] (2006) believes that healing relationships, both personal and professional, can facilitate the healthy development of the ‘emotional brain’, despite previous impairment caused by trauma.[viii]
In this way, playing and nurturing are important aspects of building attachment and strengthening relationships. One of the families referred into the programme had a child diagnosed on the autistic spectrum and his mother wanted to find a way to bond with him and wondered if music might address this. In the event her son’s interest in music and playing instruments grew over the course of the programme and he enjoyed sharing this with both his adoptive mother and father, playing and singing together with them. This correlated with him becoming more affectionate towards his adoptive mother and allowing her to comfort him when he became distressed.
One of the parents had adopted 2 brothers and she had been concerned about their relationship with one another. In fact one of the boys had asked if she could find another mummy and daddy for his younger brother. Over the course of the programme she had observed that he had become more nurturing towards him, they had begun to share with one another and she felt that sharing in the music had developed their relationship.
- How well do you feel your child’s play skills were increased by Sing & Grow?