Sue White is Professor of Social Work at the University of Sheffield. For over two decades, her research has focused on the detailed analysis of professional practice and decision-making in child health and welfare, in the context of organizational and technological systems.  She is currently conducting research on technological biology and its impacts on social policy and public discourse. She has examined how simplified readings of science have created an imperative to screen families for future risk of harm and intervene quickly to change parenting behaviours, This risks further overwhelming child protection systems and eroding the category ‘normal’. Alternative ways of providing help would attend to building community resilience and strengthening families.

 

Sue served on both the Social Work Task Force and Munro Review of Child Protection on which she led the technology stream.

 

Her most recent and forthcoming books are: White, S.; Gibson, M. Wastell, D and Walsh, P (forthcoming Dec 2019) Reassessing Attachment Theory in Child Welfare, Bristol: Policy Press.

Wastell, D and White S (2017) Blinded by Science: Social Implications of Epigenetics and Neuroscience. Bristol: Policy Press

Featherstone, B.; Gupta, A.; Morris K. and White, S. (2018) Protecting Children a Social Model. Bristol: Policy Press.

 

 

Writing Deprivation in the Body: Are all the Cards ACEs?

 There is currently an emphasis on promoting “targeted early intervention” to improve the lives of disadvantaged children suffering from Adverse Childhood Experiences (ACEs). There are many hopeful and helpful aspects to the ACE narratives. They may, for example, invoke ‘buffers’ to ‘toxicity’ in the form of relationships with adults, they invite an appropriate interest in social history and early experience in clinical work, which is wholly compatible with social work’s history. However, in their popularised form, which differs markedly from primary epidemiological work, they have pathologizing potential as well. They could be used to bolster arguments for family support, and this is the intention of many proponents. However, they also have net-widening potential, where up to half the population may be pulled into the ‘suboptimal’, toxic childhood category. Some models encourage the use of ACE scores to assess risk and target services. This is understandable in the current climate, but is the news that one is biologically broken likely to be received well? What has happened to the well-established sociological notions about the impact of labelling and self-fulfilling prophesies?

ACE narratives make significant use of neuroscientific and epigenetic arguments to support claims about both the soaring potentialities and irreversible vulnerabilities of early childhood. Whereas genetics has conventionally focused on examining the DNA sequence (the genotype), the burgeoning field of epigenetics examines additional mechanisms for modifying gene expression in manifest behaviours, physical features, health status and so on (the phenotype). It provides a conduit mediating the interaction of the environment on an otherwise immutable DNA blueprint.  This invites an interest in the impact of adverse conditions, such as deprivation or ‘suboptimal’ parenting, which has far-reaching implications.

That gene expression is not immutable means it can be changed, for the better or worse, at the molecular level. But what happens if certain behaviours are designated as toxic, on the precautionary principle that a variety of quite ordinary ‘choices’ might be damaging the epigenome for the next and even subsequent generations? Political positions are already emerging. Epigenetic arguments about biological damage potentially engender newly stigmatised identities consequent on epigenetic ‘damage’, and the moral imperative to ‘optimise’ the uterine environment. These developments can expose disadvantaged communities to increased surveillance and spin hopeless stories of biological damage.

We therefore need to ask, where are these developments likely to lead and is this what we want? The dominant ACEs approach focuses on intra-familial relations at the expense of considering adversity and its effects on health and education outcomes.  The challenge for the system is to harness the curiosity about, and sensitivity to, antecedents of children’s behaviours, emotions and difficulties, without using crude ACE scores and the contestable and emergent primary work that underpins them to screen and intervene coercively in already disadvantaged families. It also requires that adverse environments are taken very seriously indeed and these hurt parents as well as children.

 

These arguments are developed further in:

Featherstone, B.; Gupta, A; Morris, K. and White, S. (2018) Protecting Children: A Social Model, Bristol: Policy Press

Wastell, D. and White, S. (2017) Blinded by Science: Social Implications of Neuroscience and Epigenetics, Bristol: Policy Press.

White, S; Edwards, R, Gilles, V. and Wastell, D. All the ACEs: A Chaotic Concept for Family Policy and Decision-Making? (2019) Social Policy and Society, 1-10.

White, S. and Wastell, D. (2016) Epigenetics Prematurely Born(e): Social Work and the Malleable Gene, British Journal of Social Work. doi: 10.1093/bjsw/bcw157

White, S. and Wastell, D (2016) The Rise and Rise of Prevention Science: Surveillance goes Under the Skin, Families, Relationships and Society ISSN 2046 7435 • ISSN 2046 7466 • http://dx.doi.org/10.1332/204674315X14479283041843