Dr Suzanne Zeedyk: Expert misses the point on child screening

Dr Suzanne Zeedyk is Developmental Psychologist & Honorary Fellow, University of Dundee
Dr Suzanne Zeedyk is Developmental Psychologist & Honorary Fellow, University of Dundee
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In response to the statement from Dr John Marshall, trauma expert Dr Suzanne Zeedyk challenges the call for screening children for ‘psychopathic traits’ in the wake of Alesha MacPhail murder.

It comes as a surprise to many people that the way a person is treated as a child should have a lasting impact on their biology, their health and their behaviour. Let me put that another way: Scottish society is still caught off guard by the idea that a young child’s relationships could have a fundamental impact on the way they develop. We can’t quite believe that the way we treat our children matters. Not that much.

I know that can be hard to hear, and some people may bristle at such a claim. But unless we are willing to be curious enough to consider whether it could possibly be true, we cannot figure out what cultural changes are needed in order to give children what they most need: warm, loving, emotionally secure relationships.

That description of ‘warm loving relationships’ can sound trite. It’s too sweet, too twee, too ordinary. And yet that description intersects with public debate about the horrendous case of the rape and murder of six-year-old Alesha MacPhail by 16-year-old psychopath Aaron Campbell. It also intersects with the controversial statement made this week by Dr John Marshall, the psychiatrist who examined Aaron Campbell for the court, when he called for national screening of all young children to identify those with early psychopathic traits.

• READ MORE: Calls for children to be screened for ‘psychopathic traits’ in wake of Alesha MacPhail murder

Over the last two years, Scotland has found itself in the middle of a grassroots movement tackling Adverse Childhood Experiences (ACEs, for short). That has grown out of a seminal scientific study that investigated the long-term impact of childhood distress and adversity on physical and mental health. Tens of thousands of Scots are now involved in a national conversation about ACEs. That includes not just professionals and policymakers, but also ‘ordinary Scots’ – mums and dads and grannies and friends in cafes – who are having brave, reflective conversations about adversity, trauma, relationships and kindness. Those conversations sit side by side with conversations about Scotland’s soaring drug use and suicide rates, London’s knife crime, and the incomprehensible killing of this innocent little girl.

In his statement, Dr Marshall spoke of the importance of warm relationships for young children’s development, and he talked of the impact of early intervention. That puts him and me and the ACEs Movement on the same page. We are all speaking to the fundamental importance of relationships to human development.

• READ MORE: Nature v nurture battle rages over ‘psycho’ children

I know, though, that Dr Marshall spoke in an exasperated tone of the ACEs Movement. He thinks that the “gods of ACEs” are leading professionals (especially social workers) to focus on traumatic events in children’s lives, at the expense of focusing on genetic factors that can give rise to early psychopathic traits and behaviours, like callous unemotionality. He feels that colleagues who want to draw attention to genetic factors are being silenced by those who want to focus on traumatic experiences. He is essentially situating the issue within the age-old framework of nature versus nurture.

Dr Marshall’s statement has drawn condemnation from many in the child welfare arena. For example, the Centre for Youth and Criminal Justice released a statement arguing that his proposal for screening was supported neither by research nor his professional association’s guidelines.

In my view, this debate about screening misses the point. The real concern is that our Scottish culture does not recognise sufficiently the importance of warm, loving, secure relationships for children. That doesn’t mean just with parents. It means all the adults and systems with which they come into contact: nurseries, schools, hospitals, the care system, strangers, etc.

We don’t invest our money in the right places, and we don’t put relationships at the heart of every single one of our policies and our professional practices. We don’t do that because, somehow, even with our good intentions and ambitious aims, our cultural values block us from seeing how significant relationships are.

Economist Alan Sinclair demonstrates this in his 2018 book Right From the Start: Investing in Parents and Babies with this statement: “The way in which tax money is spent in the UK and Scotland flies in the face of all early years science. In education, most money per head goes to university education, then secondary school, followed by primary, and last of all pre-school. In health spend, it is the same. Little is spent on the first thousand days of life, with most spent on the last days of life.”

The ACEs Movement is shining a light on the way we currently organise our society, spend our money and structure our services. It gives us a new lens for making sense of human behaviour, and a new language for talking about it. To my mind, this means not that the ACEs Movement occupies an oppositional position to Dr Marshall’s. In fact, I see it as the converse. If an ACEs lens can help the public and professional sectors reach a deeper appreciation how relationships buffer children’s distress, that would assist his hopes for establishing routes to early intervention.

Our country’s conversations about ACEs sit alongside other national campaigns and policies – like equal protection from smacking, children’s rights, the importance of outdoor play, the Care Review, and the framework of Getting It Right For Every Child (GIRFEC). More of us are taking notice of things we previously overlooked. More of us are stemming our natural defensiveness, allowing us to think more compassionately about the experiences of our children and the adults who care for them.

If we are very determined, we might even find the courage to wonder about the childhood and the genetics of a boy who has committed an act so heinous and incomprehensible that most of us cannot bear to contemplate it. We might stand a chance of recognising that we turn to blame and vilification because it protects us from the terror that our child, too, could be snatched from us and harmed. The ironic thing is that our cultural tendency to search out monsters rather than get to grips with developmental processes actually leaves our children at greater risk of harm.

Dr Marshall is correct. You don’t become a psychopath on your 16th birthday. Psychopathic behaviour does lead to staggering human costs. Psychopathic traits do start in early childhood -- whether their cause is attributed to nature or nurture or, indeed, to the intersection of the two via epigenetic pathways (which Dr Marshall never touched upon).

The answers we need do not lie in debates about screening. It is fascinating to me that controversy over screening is central not only to reactions to Dr Marshall’s proposal, but also to critiques of the ACEs Movement itself.

The answers we need lie in debates about how to put emotional connection at the core of our culture.

Dr Marshall said that he offered his proposal because he was determined that “some good [should] come from this tragedy for Alesha’s family, in the form of raising awareness of the need for early prevention.” I wrote this piece for the same reason. We are starting to see increased awareness of children’s distress and a greater willingness to respond with care. If controversial discussions are needed to help us along that road, then I welcome them. The ACEs Movement offers the best chance I have ever seen for the Scottish public to understand why relationships are key to preventing and healing so many forms of human suffering.

• Dr Suzanne Zeedyk is Developmental Psychologist & Honorary Fellow, University of Dundee, founder of the organisation Connected Baby and a leading voice in the Scottish ACEs Movement