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A useful glossary of the key terms used
Core principles
Babies are born ready to relate. They are active communicators, and relationships are built through everyday interactions.
Practitioners support parents to:
- Notice
- Understand
- Respond
- Reflect
On this page
Core relational concepts
Parental (caregiver) sensitivity
Definition
The parent’s ability to:
- notice baby’s signals (cues)
- interpret them accurately
- respond appropriately
- respond in a timely way
Why it matters
- Foundation of attachment
- Helps baby feel understood and safe
- Supports emotional development
Explain to parents
“Your baby is communicating with you all the time. It can be helpful to understand your baby if you just take time to notice, think about what they might be communicating, and then respond.”
Key practitioner phrases
- “What do you think your baby might be telling you here?”
- “You noticed that really quickly — that’s sensitivity.”
- “That response really matched what your baby needed.”
Mind-mindedness
Definition
Seeing the baby as having:
- thoughts
- feelings
- intentions
So, an internal world — and these drive behaviour.
Why it matters
- Helps babies feel “known”
- Linked to secure attachment
- Supports emotional, social and cognitive development
Explain to parents
“Your baby isn’t just reacting — they’re having their own thoughts, feelings and experiences.”
Key practitioner phrases
- “I wonder how your baby is feeling right now?”
- “What do you think is going on in their mind right now?”
- “They might be feeling curious, tired or overwhelmed.”
Mid-range contingency
Definition
A balanced level of responsiveness:
- not too little (low contingency)
- not too much (high contingency)
Why it matters
- Babies need time and space to process
- Too little — baby feels ignored
- Too much — baby feels overwhelmed
Explain to parents
“Your baby needs you to respond — but also needs space to think and respond themselves.”
Key practitioner phrases
- “Let’s just pause and see what baby does.”
- “They might just need a moment.”
- “You don’t need to jump in straight away.”
- “What cues do you notice, and what may they be communicating to you?”
Repair
Definition
The process of restoring connection after a mismatch or rupture in interaction.
Why it matters
- Builds resilience and trust
- More important than being “perfect”
- Relationships are naturally “messy”
Explain to parents
“It’s completely normal to get it wrong sometimes — what matters is noticing and trying again.”
Key practitioner phrases
- “You noticed that didn’t quite work — that’s really important.”
- “Let’s try something different.”
- “You’re working it out together.”
Attachment and emotional development
Attachment
Definition
An innate, biologically driven emotional bond between an infant and a primary caregiver, designed to ensure the child’s survival and emotional development.
Explain to parents
“The relationship your baby has with you helps them feel safe in the world.”
Attachment styles
Secure
Baby feels safe, soothed and understood.
“They learn they can rely on you.”
Insecure (general explanation)
Develops when responsiveness is:
- inconsistent
- too low
- overwhelming
Disorganised
Baby does not feel understood or safe.
Key message
“This isn’t about being perfect — it’s about being there enough of the time.”
Communication and interaction
Baby cues
Definition
Signals babies use to communicate needs and experiences. All baby cues are meaningful and valuable communication.
There are no “good” or “bad” cues — only information. The most important factor is how the parent understands and responds to the cue, not the cue itself.
Engagement cues
Signals that indicate the baby is:
- ready to connect
- interested in interaction
- comfortable with the current level of stimulation
Disengagement cues
Signals that indicate the baby:
- needs a break
- is becoming overwhelmed
- needs something to change
Explain to parents
“Your baby is always telling you something with their face, body and behaviour. What is your baby showing you here?”
Mutual gaze
Definition
Eye-to-eye contact between baby and caregiver.
Why it matters
- Builds connection
- Releases positive brain chemicals
- Supports development
Explain to parents
“When you look at each other like this, it helps your baby grow.”
Contingent marked mirroring
Definition
Responding to baby’s emotions by:
- reflecting their feeling
- showing empathy
- containing emotions so they are experienced as safe by baby
Why it matters
- Helps baby understand feelings
- Builds emotional regulation
Explain to parents
“You’re showing your baby you understand how they feel — and that those feelings are manageable.”
Brain development
Born ready to relate
Definition
Babies are biologically wired to:
- connect
- communicate
- seek relationships
Explain to parents
“Your baby is already ready to connect and communicate with you.”
Synapses
Definition
Connections in the brain formed through experience.
Explain to parents
“Your interactions help build your baby’s brain.”
“Use it or lose it”
Definition
Frequently used brain connections strengthen; others fade.
Key phrase
“The things your baby experiences most are what their brain keeps.”
Stress and regulation
HPA axis
Definition
One of the body’s stress systems.
Toxic stress
Definition
Strong, frequent stress without support.
Buffering presence
Definition
A caregiver who helps regulate stress.
Explain to parents
“When your baby is upset, you help calm their body and brain.”
Emotional regulation
Definition
Learning to manage emotions (initially through caregivers).
Explain to parents
“Babies can’t calm themselves yet — they need you to help them.”
Relational practice concepts
Attunement
Being emotionally in tune with baby.
Rupture
A moment of disconnection.
Repair
Reconnecting after rupture.
“Good enough” parenting
Definition
Being responsive most of the time (not perfect).
Explain to parents
“You don’t have to get it right all the time — just enough of the time.”
“Wondering” (technique)
Definition
Using curiosity rather than assumption.
Key phrases
- “I wonder if…?”
- “Could it be that…?”
- “What do you think?”
“Not naughty”
Definition
Behaviour driven by:
- development — babies and small children don’t have the brain development for self-control
- a form of communication
Explain to parents
“Your baby isn’t being difficult — there’s a reason behind what they’re doing. I wonder what they are feeling and thinking — what do you think?”
“Your baby doesn’t have the brain development needed to exercise self-control. It takes a long time for the anterior cingulate cortex to develop enough for them to be able to do this — often they are more able to exercise self-control by the age of 6 years old. Self-control is hard work. Adults struggle too.”
Shared joy
Definition
Moments of mutual enjoyment and connection.
Why it matters
- Strengthens relationships
- Supports brain development
Explain to parents
“These moments of enjoyment really matter for both of you. They shape your baby’s brain — and yours too.”
Cornwall Council – training review
Test button
Marketing resources
R2R processes and resources
Tips for clinicians
Takeaways
Have a go! And then have another go!
Use it as a conversation starter.
Use it to support interventions.
If you deliver intensive interventions, it is still useful to share the relevant information first.
Don’t worry if you are a bit fumbly with the cards – parents are not expecting you to be perfect. The colours and section card can help you navigate the pack.
Make sure you sound interested – we can’t expect a family to be interested if you are not! We want to inspire parents.
Make sure you personalise the conversations, our research indicates that this is most effective.
As you can see the cards are just pictures on a key ring – but the conversations you have are well remembered and parents report changes in their parenting.
Reflect
1. When can you use the cards? Choose a time that is soon!
2. What may be an obstacle to this?
3. How can you manage this to enable yourself to have a go?
4. What are you most worried about?
5. How will you cope with this, should it happen?
6. What will motivate you to have a go with Ready to Relate cards and sharing the digital? Can you put anything in place to support you?
7. Please take a moment to think about the good work you have done to support parent-infant relationships. It is of great value. Thank you for your care.
Using Ready to Relate online resources – Digital introduction
By the end of the unit, you will:
- have ideas regarding how to use the Ready to Relate online resource to support the parent-infant relationship
- have some understanding of the breadth of topic included in the Ready to Relate online resource
- you will have spent time familiarising yourself with the Ready to Relate online resource so that you are able to incorporate this into your practice in ways that are beneficial to families.
You will need 20 minutes to complete this unit.
Please read, watch and engage with the information below
Take home
There is a lot of rich information available on the digital toolkit.
We aim for parents to introduce families to Ready to Relate conversations through the cards and then use the digital to support further interventions, the parents continued journey and to enable the parent to share information with significant others.
The digital toolkit does not replace the cards.
There is a growing body of research which you will be able to find at >>> on the website.
It is really important that you become familiar with the Ready to Relate digital companion to the cards as it will help you integrate this into your practice.
It is very helpful to help the parent to save the Ready to Relate on to their home screen so that they can easily find the resource whenever they need it. To do so on an Android phone, tap on the options menu (three dots or lines) in their browser and select ‘Add to Home Screen’ or ‘Add page to → Home screen’.
See how to add a website icon to your Home Screen in Safari on iPhone.
Interactive
1. Where is rocking the vomer suckling information?
Answer (1)
2. Where do you see the size of babies’ tummies?
Answer (2)
Dealing with difficult moments: Dealing with sleep.
3. Where is the marshmallow experiment?
Answer (3)
In the Not naughty section, Activity 1.
4. Where is attachment information?
Answer (4)
In the Parenting, families and relationships section.
5. Where do we remind people that being good enough is enough?
Answer (5)
In the Introduction – Being with your baby section.
6. Where is the attending exercise?
Answer (6)
In the Introduction – Being with your baby section.
7. Where is the true and false quiz?
Answer (7)
In the Your baby is amazing section.
8. Where is there a National Geographic video The Amazing Brains of Babies?
Answer (8)
The brain – What does this mean for your baby section, under Your baby is an amazing learner.
9. Based on the information, what activities could you do with a baby at 10 months?
Answer (9)
Our baby’s understanding of objects will be developing, and you can help them along with some play with toys.
With two plastic beakers, one each, experiment with putting different things in, and pouring them out again. You can try water, if it’s in the bath. You can try sand if you’re on the beach or in the garden. Or you can try any kinds of blocks if you’re indoors.
Rattle the beaker when it is full, and then pour it out making a funny noise. Help your baby to pour things from one cup to the other.
Which game is their favourite? Do they like doing this alone or with your help?
You don’t need to buy an expensive play house — most babies love playing in a cardboard box!
When you have a box at home, make sure there are no staples in it, and then sit it on its side so your baby can crawl in and out. Stay with them and play peekaboo by hiding your face when they go inside and then popping out to say hello. You can pretend it’s a house, or a car, and make funny driving noises.
Watch to see if they like these games. What do you think they are thinking when they go in the box? Do they know that you’re pretending?
Babies this age love putting things in containers and taking them out again.
Putting blocks or toys in to a cardboard box and spilling them out again can be really fun for the baby to play, and believe it or not it can help a baby to learn.
As you play this game with them, watch how they concentrate on what they are doing.
At all of these ages babies love rhymes, songs and rhythms. Any game you’re playing can be made better by adding a silly rhyme or phrase that you repeat, like ‘up, up, up and away!’ when you’re playing aeroplanes. Or ‘in we go’ and ‘weeeeee out they fall’ when pouring things out of containers.
This creates a sense of fun for your baby and the repetition also helps with learning language. See what best captures your baby’s attention as you play together.
With two plastic beakers, one each, experiment with putting different things in, and pouring them out again. You can try water, if it’s in the bath. You can try sand if you’re on the beach or in the garden. Or you can try any kinds of blocks if you’re indoors.
Rattle the beaker when it is full, and then pour it out making a funny noise. Help your baby to pour things from one cup to the other.
Which game is their favourite? Do they like doing this alone or with your help?
You don’t need to buy an expensive play house — most babies love playing in a cardboard box!
When you have a box at home, make sure there are no staples in it, and then sit it on its side so your baby can crawl in and out. Stay with them and play peekaboo by hiding your face when they go inside and then popping out to say hello. You can pretend it’s a house, or a car, and make funny driving noises.
Watch to see if they like these games. What do you think they are thinking when they go in the box? Do they know that you’re pretending?
Babies this age love putting things in containers and taking them out again.
Putting blocks or toys in to a cardboard box and spilling them out again can be really fun for the baby to play, and believe it or not it can help a baby to learn.
As you play this game with them, watch how they concentrate on what they are doing.
At all of these ages babies love rhymes, songs and rhythms. Any game you’re playing can be made better by adding a silly rhyme or phrase that you repeat, like ‘up, up, up and away!’ when you’re playing aeroplanes. Or ‘in we go’ and ‘weeeeee out they fall’ when pouring things out of containers.
This creates a sense of fun for your baby and the repetition also helps with learning language. See what best captures your baby’s attention as you play together.
10. When may babies become less interested in mutual gaze and where is this covered in website?
Answer (10)
3 months and in Mutual gaze and attending together.
11. Where are the benefits of skin-to-skin contact listed?
Answer (11)
On the Skin-to-skin contact page.
12. Where is there a baby showing time to change cues?
Answer (12)
In the Learning cues section.
13. What are three areas recommended for taking care of yourself?
Answer (13)
Three important aspects of looking after your well-being to focus on are:
- pleasure
- accomplishment
- connection
14. Where are the mindfulness videos?
Answer (14)
In the Taking care of yourself: Everyday self care section.
15. Where is the window of tolerance and information about how we may behave when feeling threat and exercises like shake it out and breathe, stop and grounding exercises?
Answer (15)
Making a difference
By the end of the unit, you will:
- know some of the evidence which demonstrates the positive impact that Ready to Relate can have for the parent-infant relationship
- understand the importance of sharing with families that relationships and interactions are supporting their infant’s development
- understand the importance of giving families permission to enjoy ‘hanging out with their baby’ and that this is valuable and productive
- realise how much parents are interested and take on board the information shared in Ready to Relate, with lasting outcomes
You will need 15 minutes to complete this unit.
Please read, watch and engage with the information below
Take home
Many parents are seeking information. It is important we share this with families.
For many families, better understanding will shift their behaviour with their infants. When parents understand that the relationship is part of the infants development, they recognise its value, when they understand mutual gaze, skin to skin, interacting and being with their baby is developing their baby, they will do it more. The Ready to Relate cards can be used to give parents ‘permission’ to just hang out and be with their baby – this is being productive and should be celebrated.
The Ready to Relate cards are accessible and seem to shift the dynamic so that parents are open to intervention – they seem to feel less like they are being told what to do and more like they are participating in discovering more about their baby.
The skill of the practitioner is to inspire the family, to personalise the conversation, and to meet the parent at whatever level best fits that parent.
Reflect
1. What stood out for you from the mum’s feedback?
2. What stood out for you from the dad’s feedback?
How to use the Ready to Relate cards (part 2)
By the end of the unit, you will:
- be familiar with every card in the second half of the pack, the cues section – this will help you to incorporate Ready to Relate into your practice
- understand the different Cues categories representing different babies’ states, and what are appropriate responses to these
- understand some of the cues that infant’s use to communicate their experiences
- understand how you can use some of these cards with families
- understand that the resource is used to affirm positives as well as to support parents to learn new ways of being with their infant
You will need 20 minutes to complete this unit.
Please read, watch and engage with the information below
What cards may you use to support the family. For example:
- A mum and baby gaze at in to one another’s eyes.
- A mum is worried about her baby crying but it said on Instagram that she shouldn’t respond to her baby as her baby would grow up spoilt.
- A dad asks is there any point in talking to his baby as she doesn’t understand what he is saying.
- A mum says she was separated from her baby at birth for 2 weeks due to her mental health crisis and she is worried she has damaged her baby and wants to know how to foster her relationship with her baby.
Take home
Spend time familiarising yourself with the pack – it will help you integrate the use of it into your practice.
Interactive
1. What are clear signs of engagement cues and what would be attuned responses?
Answer (1)
Answers to include: babbling, face gazing, smiling, reaching to parent, smooth cyclical movements of arms and legs, turning head to care giver, brow raising, eyes, wide and bright, facially bright, alert face, hands open and fingers relaxed or bent, head raising, ooo lips.
2. What are clear signs of disengagement cues and what would be attuned responses?
Answer (2)
Answers to include: back arching, coughing, moving away crying/cry face, fussing, halt hand, turning head away, looking away, pulling/pushing away, spitting up/posseting, whining, going to sleep, tray pounding, clinging to the air, grasping body or clothing, jerky, dull eyes, grimace/frown, eyes shut, finger extension, fast breathing, hand behind head/back of neck/to ear, to eye/ to mouth/to stomach, joint hands over stomach, kicking, head lowering, hiccups, pursed lips, pout, shoulder shrug, neutral face with little expression, tongue showing, ugh face, yawn, down turned mouth, worried/frightened look, stiff/straightened arms.
3. What would help the parent and baby in the ‘Too much’ section?
Answer (3)
For example, short breaks, a little space, calm space.
Reflect
4. Explain some ways you could use the Cues section to support parents understand their babies.
5. Try the Attending exercise as a simple intervention to support parents slow down and spot the baby’s cues. This is really useful in supporting parents to take time to notice their baby’s cues, it allows baby to have space to express themselves, and parent to respond in tune with their baby’s cues.
How to use the Ready to Relate cards (part 1)
By the end of the unit, you will:
- be familiar with every card in the first half of the pack – this will help you to incorporate Ready to Relate into your practice
- understand how you can use some of these cards with families
- find ways of using cards from different sections to link information together
- understand that the resource is used to affirm positives as well as to support parents to learn new ways of being with their infant
- be able to use the resource cards to convey key messages around the 4 key components and adapt the way you describe these to match the family’s interests you are with
You will need 30 minutes to complete this unit.
Please read, watch and engage with the information below
What cards may you use to support the family. For example:
- A mum and baby gaze into one another’s eyes.
- A mum is worried about her baby crying but it said on Instagram that she shouldn’t respond to her baby as her baby would grow up spoilt.
- A dad asks is there any point in talking to his baby as she doesn’t understand what he is saying.
- A mum says she was separated from her baby at birth for 2 weeks due to her mental health crisis and she is worried she has damaged her baby and wants to know how to foster her relationship with her baby.
Take home
Spend time familiarising yourself with the pack – it will help you integrate the use of it into your practice.
Think about how you would use the cards to demonstrate:
- maternal/parental sensitivity
- mind-mindedness
- mid-range contingency
- repair
Think about how you would use the key components and use of the resource cards to understand and describe the voice of the infant for record keeping and reports.
What sections do you think you would be able to relate back to the Brain section?
Interactive
1. What page is the picture of the brain synapses?
Answer (1)
Section 3, Card 4 The brain – Synapses, neurons and connections.
2. What page is the picture of the dad providing skin to skin?
Answer (2)
Section 6, Card 6c Skin-to-skin contact.
3. What section gives the rationale for soothing your crying baby?
Answer (3)
HPA axis, section 15.
4. What section encourages parents to simply spend time looking into their babies eyes and their babies looking into their eyes?
Answer (4)
Mutual gaze, section 7.
Moments of connection
By the end of the unit, you will:
- understand the power of connection
- recognise infant learning
- recognise infant pleasure in engagement and interest
You will need 5 minutes to complete this unit.
Please read, watch and engage with the information below
Take home
Moments of connection are very powerful. They help parents keep going during tough times, they shape pathways in the brain of the infant and the parent. They can be joyful, exciting and/or interesting.
This baby smiles with delight, shows interested focused concentration, and recognition of the song – demonstrating his knowledge!
We are often pleased to see a baby smile – we know they are experiencing pleasure. Take time to value babies interest – this can be a serious kind of pleasure and is really valuable too.
Reflect
We hope that you felt touched by this video, as we did.
1. Where in your body did you feel affected in response to watching this video?
2. What did you feel?
3. What did you think?
4. What do you think the dad experienced?
5. What do you think the baby experienced?
6. How may you use moments of connection to support the parent-infant relationship?
Key components
By the end of the unit, you will:
- know the 4 key components (all of which support secure attachment) that we recommend practitioners hold in mind in their work with families
You will need 20 minutes to complete this unit.
Please read, watch and engage with the information below
The Ready to Relate resource can be used to enhance these key components and demonstrate ways in which the key components can be observed, or broken down. The first half of the cards supports understanding that our babies are born ready to relate and that they are social, sensitive and interested people who want to connect with us, the cues section supports sensitively understanding our infants and making sense of their internal world.
Look at each section of the cards up to the Not Naughty section and, with the 4 key components in mind, note how you could use the cards to support the key components.
Make some notes on how you would share these concepts using the cards with parents.
When you are with families observe where you see evidence of a key component, share with the family the positives you have noticed, affirm the parent/caregiver and use Ready to Relate to show what they have done and why it benefits their baby.
If you have concerns, or notice that the parent is not noticing baby’s cues or responding in an attuned way which seems right for the situation, use Ready to Relate to support the parent/caregiver’s understanding of their baby, help them understand their infant’s signals better and support them to wonder about the baby’s internal world.
Interactive
1. What are the four components and what did they mean?
Answer (1)
Maternal sensitivity – aware the infant makes signals, interprets the sign
Mother’s sensitivity has four essential components: (a) her awareness of the signals; (b) an accurate interpretation of them; (c) an appropriate response to them; and (d) a prompt response to them.
Mind-mindedness – the parent’s capacity to treat the child as a psychological agent with their own mental states driving behaviour. Supports parents’ attunement to their babies’ thoughts and feelings.
Mid-range contingency – Contingency is about how close the parent tracks the baby and responds, high levels of contingency may be intrusive or inappropriate and are associated with communicative stress and hypervigilance (Beebe et al., 2008). Malatesta, Culver, Tesman, and Shepard (1989, p. 29) concluded “that even if maternal responses were in some sense ‘appropriate’ (concern to sad faces, smiling to happy faces), the sheer amount of stimulating activity might exceed the infants’ arousal tolerance”. Similarly, van den Boom (1994) contended that infant acquisition of self-reliance might develop under a mother who is responsive but who is not continuously attentive to every infant signal; a parent being totally responsive leaves little room for the development of child self-sufficiency.
Over contingent parenting is not focused on being appropriately responsive to a child, but rather on indiscriminately responding to all of the child’s needs and cries for attention.
Repair – mis-attunement happens to all parents. Being perfectly attuned just isn’t possible — nor would it be a good thing, anyway. What builds emotional security is a parent’s ability to repair ruptures, recognising mis-attunement and responding sensitively to the infant.
Mother’s sensitivity has four essential components: (a) her awareness of the signals; (b) an accurate interpretation of them; (c) an appropriate response to them; and (d) a prompt response to them.
Mind-mindedness – the parent’s capacity to treat the child as a psychological agent with their own mental states driving behaviour. Supports parents’ attunement to their babies’ thoughts and feelings.
Mid-range contingency – Contingency is about how close the parent tracks the baby and responds, high levels of contingency may be intrusive or inappropriate and are associated with communicative stress and hypervigilance (Beebe et al., 2008). Malatesta, Culver, Tesman, and Shepard (1989, p. 29) concluded “that even if maternal responses were in some sense ‘appropriate’ (concern to sad faces, smiling to happy faces), the sheer amount of stimulating activity might exceed the infants’ arousal tolerance”. Similarly, van den Boom (1994) contended that infant acquisition of self-reliance might develop under a mother who is responsive but who is not continuously attentive to every infant signal; a parent being totally responsive leaves little room for the development of child self-sufficiency.
Over contingent parenting is not focused on being appropriately responsive to a child, but rather on indiscriminately responding to all of the child’s needs and cries for attention.
Repair – mis-attunement happens to all parents. Being perfectly attuned just isn’t possible — nor would it be a good thing, anyway. What builds emotional security is a parent’s ability to repair ruptures, recognising mis-attunement and responding sensitively to the infant.
Reflect
2. How may you use the four key components to benefit your practice?
Interactive
The still face video demonstrates how an infant may react when her parent is not responsive to her.
3. Watch the still face video – what did you think and feel? How do you think the four key components relate to what you have seen in the still-face video?
Answers (3)
Lack of sensitivity;
Lack of mind-mindedness;
Low range contingency;
Repair is made at the end and the mum then demonstrates sensitivity and contingency.
It appears that mum recognises how difficult it was for her baby, indicating mind-mindedness.
Lack of mind-mindedness;
Low range contingency;
Repair is made at the end and the mum then demonstrates sensitivity and contingency.
It appears that mum recognises how difficult it was for her baby, indicating mind-mindedness.
Babies are born ready to relate
By the end of the unit, you will:
- understand that babies are born ready to relate
- understand some of the evidence which demonstrates that babies are born ready to relate
- revise some information about infant neurodevelopment
You will need 20 minutes to complete this unit.
Please read, watch and engage with the information below
Trevarthen explains that primary intersubjectivity refers to infants being born with awareness specifically receptive to subjective states in other persons. We can see this as the infant connects with the mother seeking mutual gaze and motivated to make conversation with her. Trevarthen also explains that infant are social and communicative.
Mutual gaze is very powerful. Schore explains that “Within episodes of mutual gaze, the most intense form of human communication, the intuitive mother’s and infant’s right brains engage in synchronized, spontaneous facial, vocal, and gestural communications of positive emotional states”.
Explaining some of the biology of mutual gaze, Gerhardt (2014) summarises Schore’s research and writes – “When the baby looks at the mother he reads her dilated pupils as information that her sympathetic nervous system is aroused as she is experiencing pleasurable arousal. In response his arousal occurs, his heart rate goes up and results in a biochemical response. A pleasurable neuropeptide called beta-endorphin is released into the circulation and specifically into the orbitofrontal region of the brain. Endogenous (opioids) are known to help neurons grow, by regulating glucose and insulin. They also make you feel good. At the same time dopamine is released from the brainstem and makes its way to the prefrontal cortex. This too enhances the uptake of glucose there, helping new tissue to grow in the prefrontal brain. Dopamine probably also feels good and it is energising and stimulating and is involved in the anticipation of reward. Thus the gaze is triggering off the pleasurable bio-chemicals that actually help the social brain to grow (Schore 1994).” (Gerhardt, S., 2014. Why love matters: How affection shapes a baby’s brain. Routledge.) Gerhardt has therefore summarised the chemical cascade triggered by mutual gaze and how this supports the baby’s brain development.
Joy is potent and it imprints on the brain. Schore points out that attachment is an interactive mechanism for generating very high levels of positive affect including enjoyment, joy, interest and excitement. Gaze is intense interpersonal communication and affects both parties. It is joyous, even if it can be overwhelming and baby needs to glance away to regulate their self.
In these moments of connection, both parent and infant feel the joy. As Schore explains “To regulate the high positive arousal, the dyad synchronizes the intensity of their affective behavior within split seconds. These episodes of “affect synchrony” occur in the first expression of social play and generate increasing levels of joy and excitement.”
Read more about Attachment and emotional regulation (PDF, francinelapides.com).
Take home
Trevarthen helps us shift our expectations from the old traditional story of our infants to an exciting new way of understanding our babies – babies seeking companions. He points out that infants are ready to be part of a communication – they engage in protoconversation and are communicating from birth as they are motivated to interact. Trevarthen states that babies have “Space in their mind” for another person and he has researched the innate musicality of communication based on infant’s communication.
Through understanding our babies’ communicative motivations, their interests and that they are seeking connection, our babies are more interesting to parents. Moreover, parents may better recognise their value.
The Ready to Relate resource reference the extraordinary brain development associated with infancy but we also recognise the plasticity of the brain, the opportunities of repair and that many things, for example, genetics, peer relationships, the wider environment, nutrition and social justice will impact brain development. We advise practitioners to help parents recognise the amazing learning of their infants and that they are really important influencers of this learning. Helping parents recognise how babies are taking in information and learning all the time, we can help parents recognise how valuable it is when they take time to simply be with baby, for example, chatting, singing, pointing out the everyday interesting things going by are all great for the relationship and their baby will be making meaning of all that is going on. Practitioner should help parents recognise the exponential brain growth associated with the early weeks, months and years, but also recognise that the story of the brain is a long and complex one.
Part of the reason why our early pathways may be so influential is that how we make sense of our self, others and the world affects how we interact with others, and this affects how others interact with us. How others interact with us influences our sense of self, of others and the world. However, we also know change and repair are possible.
Reflect
1. What did you think when you saw the dad and the premature baby chatting? How did it make you feel?
2. This dad recognised his baby trying to communicate. What would this have been like for him? What may it have been like for dad and for baby if dad did not recognise that his baby was communicating?
Interactive
3. What key messages did you take from Trevarthen?
Answer (3)
Infant are intentionally communicative, space in the mind for another, looking for a companion, recognises the other and want to engage (for example).
4. How do you think Trevarthen’s portrayal of the infant may help parents and infants in their relationship?
Answer (4)
Recognise the infant as a relational other.
Reflect
5. What opportunities do you have in your role to support parents to recognise how interesting and interested their baby is?
The importance of valuing parents
By the end of the unit, you will understand:
- some key aims of Ready to Relate
- some reasons why supporting the parent-infant relationship is important
- some of the impacts of poor perinatal mental health that are associated with the parent-infant relationship
- how an accumulation of ACES may impact an individual’s development
- how stress may impact an infant
- how the parent-infant relationship may mitigate the impact of stress on the infant’s development
- how Ready to Relate supports a practitioner to meet NICE CG192 recommendations in regards to the mother-infant relationship
You will need 15 minutes to complete this unit.
Please read, watch and engage with the information below
Take home
When a practitioner is using the ready to relate resource, the practitioner is aiming to inspire parents, they are helping parents recognise how valuable they are and they are aiming to enhance satisfaction and enjoyment.
We know from research that just telling parents what they should or should not do can be disengaging. The Ready to Relate resource is an engaging way to share information and open up discussion.
If you would like to read more about the cost of perinatal mental health and why it is so important to deliver good perinatal mental health care, please see follow the link for more information from Bauer et al. (2014).
There are many papers which indicate that poor maternal mental health is associated detrimentally with the mother-infant relationship. You can see a couple of these research papers here: maternal-depression and Harvard Review of Psychiatry
There is also increasing research about how fathers’ poor mental health is associated detrimentally with their relationship. You can see two papers here: Paternal depression: an examination of its links with father, child and family functioning in the postnatal period – Ramchandani – 2011 – Depression and Anxiety – Wiley Online Library and ukmss-3982.pdf
Felitti’s research found that many people have experienced ACES and that when a person has experienced 4 or more ACES their health is more likely to be detrimentally impacted. You can see Felitti’s research on this web link.
The research provides insight into how ACES may affect young children via the impact of stress and you can read more about how these impact children here.
Click on the hyperlink to see the Antenatal and postnatal mental health NICE guidance CG192.
Interactive
1. Bauer et al. (2014) estimated that perinatal mental health costs £8.1 billion pounds per cohort of infants. What percentage of this cost is associated with the infants across their life times?
Answer (1)
72%
2. In what ways may poor perinatal mental health affect the parent-infant relationship?
Answer (2)
Parents may be more intrusive or more disengaged, more hostile, more negative attributions, less sensitive, less able to respond appropriately to cues.
3. What sort of stress is considered concerning for infants and why?
Answer (3)
Toxic
4. What is proposed to mitigate the impact of stress on the infant?
Answer (4)
Buffering presence of a supportive adult
5. How may understanding your baby better help you be the buffer to your infant’s stress?
Answer (5)
Increased recognition of how the environment impinges on the infant, that they are a sensitive other, affected by their world and through this recognition the parent may be in a better position to be sensitive to the infant and to soothe and protect them.
Key research
By the end of the unit, you will:
- understand some of the research that influenced the development of Ready to Relate
- understand why it is important that you are supporting all parents/caregivers to expect their babies are ready to be in a relationship and to expect their babies to be sensitive, social and interested people
- understand that by changing the expectations/predictions of parents, the relationship with the baby is then able to shift
This supports you to understand why the resource was developed and areas that you are trying to influence in your work with families.
You will need 10 minutes to complete this unit.
Please read, watch and engage with the information below
Take home
Ready to Relate supports practitioners in their work with families.
Ready to relate is an inclusive, accessible and acceptable intervention to use with all families. It aims to shift expectations, to help parents recognise their infants for the amazing people that they are, to help parents be their baby’s companion, to help parents make sense of their baby so that their baby feels known and heard.
Reflect
In this video we shared some key research ideas.
1. What stood out for you?
2. How does this relate to your work?
3. A key idea of the Ready to Relate tool is that by changing parents’ expectations/predictions of their infants, we can shift relationships. What opportunities do you have to shift the way parents perceive their infants?
Introduction
Ready to Relate can help you in any field when working with parents and infants and can support universal and targeted approaches. It is a tool that fits across modalities and alongside other tools.
Part A
The first part of the training helps you understand the background, foundations and context of Ready to Relate.
- Why we developed the resource
- Amazing babies
- Born Ready to Relate
- Early Brain development
- Key concepts
Non-urgent advice: Context, background and evidence
Part B
The second part of the training focuses on the practicalities of familiarising yourself with the tool so you are better ready to use it.
- Using the cards
- Digital component tour
- Feedback
Non-urgent advice: Practical application
Non-urgent advice: Glossary
Take your time to answer the questions below
1. Confirm that your role is suitable for using these resources.
2. Reflect on when you would use Ready to Relate with parents of infants or infants.
3. Quickly list why supporting the parent-infant relationship is important to you.
Babies are amazing (the Hamlin experiment)
By the end of the unit, you will be able to:
- have evidence that challenges the ‘traditional narrative’ of the infant
- insight into some of the complexity of infant’s thinking and preferences
This supports you in your recognition of how amazing babies are.
You will need 10 minutes to complete this unit.
Please read, watch and engage with the information below
There is a traditional story of babies doing little more than pooing, weeing, sicking, crying and sleeping. Caring for a baby who only does this, sounds like hard work and as a parent this may feel demanding with little reward. If you would like to know more about this you can read a systematic review which showed that both practitioners, academics and families can overlook infants and that the traditional story of babies is very common. Here’s the web link to the research by Milne et al. 2018 on the topic.
Our brain is a predictive organ according to University Distinguished Professor of psychology and neuroscientist Lisa Feldman Barrett. If we change our predictions of our babies, we will change how we perceive and interactive with our babies and change our relationships with them.
The Hamlin experiment helps us to see how interesting and prosocial our babies are. Whilst babies needs lots of care, they are also interested and interesting people: they are ready to relate.
Ready to Relate aims to help families understand their babies better so they can enjoy the relationship more.
Reflect
1. What examples do you have of practitioners or families who believe the ‘traditional story’ of babies, that is that they just poo, wee, sick, cry and sleep?
Interactive
2. Hamlin et al.’s experiments can be interpreted to indicate that babies are: (what 3 things)
Answers (2)
Meaning making (they make sense of the ‘story’, empathising (making sense of the red circle’s feelings, innate altruism behaviour/prosocial (prefer the good shape to the bad).
Reflect
3. You may or may not have seen Hamilin et al.’s experiment before, but what did think when you saw it?