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our research work so far

big toes little toes exists to improve the life chances of vulnerable children through translating the most recent empirical attachment research findings into playful, kind and effective practice. A series of evaluations, case studies and publications has now been completed.  This includes a randomised controlled trial (RCT) which reported positive findings in 2020.  All of the work is evidence-based and theory-driven and a brief history of how the work was developed through research follows.  

After initial creative community and school-based work in the 1990s, the organisation's founder, Debi Maskell-Graham, began to realise that support for children’s optimal outcomes necessitated support for the quality of the parent/carer-child relationship. Specifically, she had a hypothesis about the link between sufficient attachment security in the parent-child relationship and a particular philosophical stance, skill or orientation in parents and carers.  Could this stance or skill be learned or grown?  


A Masters in Practice-based Play Therapy followed in which the observable relationship dynamics between groups of mothers and their newborns utilising play, gentle touch and lullaby practices were evaluated.  The study showed that parental capacity to think about and respond to infant signals and needs could be improved.  However, at this point, only a generic reflective parental capacity was identified.  Questions around the specifics of its operational mechanisms remained.

Debi was then privileged to work as a researcher for Loughborough University’s world-renowned Centre for Child and Family Research (CCFR).  She worked on key government research projects and saw first-hand the devastating impact on infant and child outcomes of parental substance and alcohol misuse, domestic violence and other stressors on family life.  She kept returning to key questions.  What can we do about this?  How can we intervene positively to prevent such lifelong disadvantage for children?  UK-registered charity big toes little toes was then established as a vehicle for delivering ongoing relational research into practice. 


Seminal papers were beginning to be published identifying the parental reflective capacity in the parent-child relationship as Reflective Functioning (RF).  Over the next few years, Debi was able to identify approximately 150 papers articulating the function of RF within the parent-child relationship.  She conducted her own synthesis of these papers and found a set of common operational mechanisms necessary to see improvement in parent-child attachment security.  She then designed four innovative and playful interactive programmes for children and their parents/carers specifically to activate, facilitate and nurture these operational mechanisms.  As such, the programmes are mechanised rather than manualised.  With a nuanced understanding of the operational mechanisms, practitioners can make informed choices about how best to use the programmes in a range of contexts. 



By early 2019, the charitable mission work of big toes little toes had largely been fulfilled with the programmes gaining national and international recognition and use in many countries.  Debi retired and Clear Sky Children's Charity took over delivery of the training programmes. big toes little toes closed as a charity and continues as a resource hub, offering books, research briefings, creative resources and web-based programme resources for practitioners. 

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