Improving outcomes for young children in refugee families: lessons from somali parents’ experiences of play and social interaction in the UK

Aims
Adverse early child development and ill health risks poorer wellbeing, unemployment and criminal behaviour in later life. The children of disadvantaged migrants are at risk of delayed and disordered early development, with multiple factors potentially contributing to poor long term educational and social outcomes. Somali people are one of the world’s largest diasporas, following forced migration from conflict; in Bristol, Somali children are 5% of the child population – they have high attendance rates at Emergency Departments, do less well at school and are more often referred for help with developmental difficulties, including six times higher rates of referral for the possibility of autism. We explored psycho-social contexts for these challenges.

Methods
We asked six Somali mothers in Bristol about experiences of early childhood (both their own and subsequent observations) in Somalia and the UK, and of factors facilitating or restricting children’s early opportunities for play, social interaction and development. Qualitative semi-structured interviews were analysed using an interpretative phenomenological approach.

Results
In Somalia, mothers described a supportive, connected community and safe environment enabling children to play and learn together.

In the UK, by contrast, multiple local stressors affected family wellbeing and social networks, and constrained children’s opportunities to play and interact, which may limit children’s opportunities for early play and social experiences and influence health decision-making.

We have developed an Ecocultural model of challenges to young migrant children’s development, integrating epigenetics, psycho-social and cultural factors.

We describe policy recommendations - to tailor statutory early childhood interventions for disadvantaged migrant communities, and for improvements to local environments for play and social interaction.

We report case studies involving alignment of existing services, employing community link workers, hospital-community and statutory-voluntary sector collaborations, and Community Infrastructure Levy funding.

Conclusion
Our findings show how disadvantage can impair early child development and health in migrant families. Social isolation and lack of safe places to play are key points to address.

Building resilience, social networks and child-friendly communities in children’s early years is likely to be most effective (and cost-effective) for improving young migrants’ outcomes.