Using Rivers of Life to understand lived experiences of parents and carers

Led by the Institute of Development Studies, the Enabling Early Child Development in Ealing (ECDE) project explored the perspectives and experiences of parents/carers with children aged 5 and under, alongside insights from staff from key services on early child development, with the aim of enhancing support in Ealing borough, London.

While Ealing is home to a range of formal and informal assets for families and children, there is room to improve, particularly in the wake of the Covid-19 pandemic which has had a negative impact on the proportion of children meeting key developmental milestones.

This study took a qualitative research approach, meaning the focus was on gaining a ‘rich picture’ of the lived experiences and perspectives of Ealing families through methods which are more open-ended than traditional surveys. This allowed for unexpected insights, nuances, complexity and connections to emerge.

In all, the study engaged 77 diverse parents/carers and 10 children through participatory focus groups, and interviewed 13 key informants from across children’s services, health services, and community and voluntary sector organisations. The team grounded their approach in a holistic ecological model, recognising that many levels and areas of life influence children’s development.

For analysis, the team also drew on the Harvard Center for the Developing Child’s three evidence-based principles for supporting early childhood development.

These stipulate that enabling responsive relationships; supporting core skills; and reducing sources of stress in the lives of children and families are critical to ensuring children have the best start in life.

The research was funded by the Ealing Borough Based Partnership, and the Arts and Humanities Research Council. It was also supported and co-produced with a range of stakeholders from across the community and voluntary sector, Ealing council, and the NHS. The study took place over the course of 2023.

What happened

To ensure this study was grounded in existing expertise and in the specific place-based context of Ealing, the team consulted a range of experts in the inception and design of the research. This included national experts, a local professional steering group, and representatives of local community organisations that work with families with young children. Together, they developed and refined the research questions, approach and tools.

The team conducted 13 in-person focus groups with a total of 87 participants. Eleven groups were held with adults who were parents/carers of children aged 0–5 (64 mothers and 13 fathers), held at and/or recruited by 5 children’s centres, 4 community organisations and 2 primary schools. Many became first-time parents during the height of the Covid-19 pandemic. The team attempted to engage parents/carers from diverse backgrounds, including those less likely to access formal services like children’s centres.

They achieved this by engaging a range of community and voluntary sector (CVS) organisations, including ones specialised in working with people from ethnically minoritised and migrant backgrounds, parents/carers of children with additional needs, and women and girls experiencing domestic abuse.

The two remaining focus groups were conducted at primary schools with 10 children, aged 8-9, all of whom had younger siblings under the age of 5. To complement the focus group discussions, the team conducted semi-structured one-on-one online interviews with 13 key informants involved in early years service provision from the council, NHS and CVS organisations. A community-based researcher, herself an Ealing parent, was also engaged to support the research activities, and develop research capacity within the local community and voluntary sector.  

Adult focus group participants were asked to reflect on their experiences of raising young children in Ealing through drawing a ‘River of Life.’ River of Life is a story-based method that facilitates both personal and group reflection. The participants used symbols to represent positive experiences and enabling factors, as well as challenges encountered in relation to supporting their young children’s development from pregnancy to the age 5.

Facilitators prompted them to think about their own practices, as well as the people, services, neighbourhood, and community assets which supported them and their child’s development, or which were barriers to this. Participants represented their key experiences visually as rocks, flowers, crocodiles, boats, waterfalls, windmills etc.

Each participant then presented their river and story to the group, after which discussion opened for collective reflection, follow-up questions and more structured inquiry from the research team.

While the River of Life activity facilitated with adult participants generated a wealth of detail on many aspects of the inquiry, due to its open-ended and participant-led nature, other areas of specific research interest, such as the home learning environment and experiences with services such as health visiting, did not come out as strongly. In the last few focus groups, the team shortened the River of Life activity and added a participatory matrix-based activity to directly elicit responses in these other areas of research interest.

Recognising children’s rights to participate in research about them, and also their expertise in being children, the team also held two focus groups in primary schools in Southall and Acton. The topic of these groups was centred around school readiness, as each participant (aged 8/9 years) had a younger sibling due to start school in September 2023. The facilitators asked the children to think about what skills their younger siblings needed to succeed at school and what they might find difficult.

The facilitators guided the children to work together to create an advice guide for parents focused on how they could best support young children be school ready. The sessions were informal and geared toward the children having fun.

With participant consent, all focus groups were recorded and transcribed. The data was then organised into a spreadsheet using pre-determined themes based on our research questions and conceptual framework (see next section). New themes were added inductively as necessary.

Analysis of the data led to identification of several primary themes which the team presented at a validation event held for participants and supporters of the study in Ealing.  

Findings and new knowledge

In the adult focus groups, the River of Life activity enabled the sharing of personal, often emotional experiences, which quickly built rapport among the group and with the research team, and supported more open and involved discussion amongst group members.

In the children’s focus groups, the team found the children were relaxed and happy to share their thoughts when encouraged to consider themselves as school-readiness experts. First, children developed a mindmap of all the different aspects of school that were new compared to pre-school or staying home. Second, they worked together to think how their siblings could be prepared for these changes with support from their parents/carers or by building their own skills. Finally, children took this consolidated information to write guides for parents and siblings on getting ready for school. This allowed a unique insight into the transition-to-school experience through eyes of the children themselves. More in depth findings from children’s focus groups are presented in a separate briefing.

Findings revealed the value Ealing families place on parental wellbeing, a safe and adequate home, children’s play and social interaction, and experiences outside the home.

Although facing frustratingly long waiting times to access some specialist services, families generally had good experiences with services such as perinatal mental health and children’s additional needs support. Key sites like nurseries were also valued, although experiences varied. Experiences with individual service providers, such as health visitors, social workers or various others were also mixed.

Families faced a range of challenges, with some straining under multiple layers of adversity. These included social isolation and poor mental health, unmet housing and other basic needs, language and cultural differences, and critically, a fragmented service and information landscape which often felt overwhelming and unnavigable, especially for families with limited English, digital skills or other resources. Overcoming these challenges could take up scarce family resources. This was heightened for families with children with additional needs.

Using the River of Life method in this project gave parents/carers the opportunity to decide what was important to them in relation to caring for their children. Instead of focusing on assets which are normally considered early childhood services (such as children’s centres or health visiting) many parents instead focused on their experiences of housing insecurity and feelings of isolation. These themes helped to illustrate a rich picture of parent/carer lives and the complex intertwining of multiple inequalities when viewed together across a story. Furthermore, through the process of storytelling and listening to others, parents/carers were able to engage deeply with one another – and many shared that the process had been helpful for them as they do not often have opportunities to connect and share with other parents. They especially appreciated being able to locate their experiences in the experiences of others, recognising that they were not alone.

Despite a context of constrained resources, the results highlight strategic opportunities to strengthen support for early child development at the local level in Ealing – you can find out more in this briefing.  

Below is a fictional River of Life illustrating the journey of a family in Ealing, showing common challenges. Click here to download the image or click on the image to enlarge.

Lessons

Most participants spoke English well enough to participate, but translators were engaged in two focus groups, while parents/carers also provided informal translation to some other parents/carers in the groups as needed. That said, the sample remains limited given the exceptional diversity of Ealing’s population.

We found it particularly challenging to engage with fathers and male carers – as demonstrated by the limited number of men who attended our focus groups. Our experience mirrors that of the father’s themselves. In the father/male carer group, the men shared that they often felt marginalised from childcare activities due to schedules and attitudes. Because we were working with children’s centres, we held our focus groups during business hours which were not convenient for working parents.

Providing childcare for participating parents/carers was essential to their participation. Given the focus on early years, many children accompanied their parents to the focus group discussions. We were fortunate to work with children’s centres and community organisations which provided support so that parents/carers could take part in the discussions with limited interruptions. However, in one group we were not able to organise care, and this affected the ability of the parents/carers to give their full attention to the exercises.

At the end of the data collection phase, we held a validation workshop. We hoped to engage with parents/carers who had attended our focus groups, but unfortunately only a couple parents attended. Also, due to limited resources (and perhaps short-sightedness on our part) we did not plan further engagement activities with parents/carers and the children who took part of the study. However, during the FGDs, attendees shared their eagerness and desire to play a greater role in the operation of the services that they utilise. Building in opportunities and connections for them to do so would have been valuable and future projects should keep this option open.

An ethics review was undertaken and approved by IDS, taking into consideration and establishing protocols for ensuring consent, confidentiality and safeguarding.