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Seeds of hope. Twelve years of early intervention in Africa

br2002_023FSKlein, Pnina S. (Ed.) (2001). Seeds of hope. Twelve years of early intervention in Africa.
Oslo: Unipub forlag.

Reviewed by Randi Rolvsjord, Sogn og Fjordane University College, Norway.

Seeds of hope is a report of a research project on early intervention in Africa. The book contains of articles that describe several aspects of a larger study carried out in Ethiopia during a period of twelve years. The first chapter in the book is a presentation of the project written by professor Henning Rye who was also a coordinator of the project together with the late professor Lakew Voldetekle and professor Tirussew Teferra. In chapter 2, the editor of the book, Pnina S. Klein presents the theoretical foundations of the research project. The last four chapters in the book are articles that present in more depth the different facets and results from the research project. These chapters are written by researchers from Addis Abbeba university: Professor Tirussew Teferra, Dr. Fantu Melesse and Dr. Zelalem Fekadu. One of the most interesting chapters in the book is the last chapter that discusses more broadly the conditions and the problems of welfare experienced by children in Ethiopia. This chapter is written by Zelalem Fekadu and one problem she discusses is the adolescent girls’ pregnancy, a problem that causes rapid population growth and economical poverty.

The project, which is presented and discussed in this book, was carried out in Ethiopia. A pilot project was carried out in 1991, with the main study conducted in between 1992 and 2001. The project is carried out in very poor areas in Ethiopia, where families live their lives under very difficult conditions. The interventions were home-based and group-based with the intention to improve the interaction between mothers and children. The interventions lasted for three months and were based on the MISC method. Local health and social workers were trained to carry out the interventions using video-recordings of situations from daily life and group discussions. As a research project, the study is carried out with an experimental group design, including a control group. The efficacy of the interventions are studied by test performances of the children, measuring their cognitive abilities The cultural considerations are carefully taken care of in the methodological approach as well as in the theoretical material presented in the book. It is stressed that the goal is not to teach the mothers a new way of raising children, rather to promote the aspects of child-mother interaction that promotes the child’s development. The importance of acknowledging cultural values of raising children is stressed, but it is also important that these values are made more conscious.

MISC, A Mediational Intervention for Sensitising Caregivers, is a specific model for early intervention that is developed by the editor Pnina S.Klein. MISC is developed as a mean of effecting flexibility or plasticity of mind in young children. The program focuses on the cultural resensitisation and establishing emotional literacy as a prerequisite for cognitive development. Through sensitising and enriching both mothers awareness for the interaction with their children and better conditions for the Childs development is promoted. The concept of mediation is essential to the MISC program. According to Klein, mediation represents an alternative to stimulation. Mediation is achieved through the parents matching of the child’s responses to objects or incidents in the world. It implies that the adult helps the child to experience meaning. The concept of mediation includes affect regulation, sharing of a common focus, explaining, rewarding and making plans for actions.

The results presented in this book are remarkable. Early interventions using MISC directed toward mothers and infants living under such difficult conditions have proved to be effective. The study finds a relationship between the maternal mediation behaviours and the children’s cognitive measures. It is also found that mother’s mediation improves the children’s ability for expressions of affect. It is also interesting to notice that the mothers are reporting that their improved skills for mediation is important in other aspects of their social life as well, such as communication with husbands, teachers etc. In a “spin off ” study it is also demonstrated that use of the MISC method decreased the rate of school “drop-outs for children. This book documents that interventions on the parent-child interaction can improve the cognitive and affective functioning for the children experiencing conditions for development that are not already good enough or adequate for the child to develop.

My critique of the book will mainly be on a formal level. First, an overall view of the project is presented in the first chapter, but despite this it was not very clear to me the connection between the studies described later in the book and the big project described by Henning Rye in the first chapter. Secondly, as a book it seemed unnecessary to describe in detail the MISC program that was used in the projects in every article. In this manner this is a collection of articles more than a book. But I found it a bit boring too read about the MISC the fourth time in one book. Third, some of the references in the text are not in the reference list in Klein’s chapter, this was annoying to me because there were some interesting references cited.

As a mother, I was very touched by this book through reading about the living conditions of these very poor children and mothers. It filled me with respect and acknowledgement for how these mothers cope and how they make use of little interventions and take care of their children. The book is illustrated with photos illustrating the living conditions and pictures of people, and as the pictures grasp the beauty in the relationship between mothers and at the same time so clearly reveal the poverty, they seemed very expressive and important for the book.

Reading this as a feminist I felt angry for the conditions these woman and children must live in. Secondly, I am noticing that this is another example of the usefulness of giving women opportunities for developing themselves, their children, and their countries. Some of the mothers even gave examples of how their new knowledge about communication and relations have made it possible for them better to assert themselves in other situations. As presented in the book, women’s responsibility for the children is part of the cultural tradition, and the authors underline that taking fathers directly into the project was not possible in this culture. Some fathers were however observed observing and learning by being in the same room. In this book it seemed relevant and appropriate to focus on mothers and children, but more in general I doubt that this focus on parent gender is very useful. When reading recent developemental psychology it seems to me that emphasising communication between mother and child, often using mother as a synonym for an adult in general, is very conservative or preserving to the traditional concepts of gender roles.

Reading this as a music therapist, I find the book first of all interesting because of the theoretical approach. The theories of children’s development and research on infants and mothers and child interaction have influenced our thinking of music therapy. Music therapists like Mercedes Pavlicevic (1997), Gary Ansdell (1995) and Rolvsjord (2002), have pointed to the similarities between the musical interplay in music therapy and the interplay between mothers and infants, and these similarities have become a rationale for the dynamics of music therapeutic improvisations. Trevarthen and Malloch’s (2000) theories of inborn communicative musicality, the capacity for sympathetic human company and the importance of this musical communication as motivated by needs in the human brain, can be said to represent a theoretical foundation for the idea of music therapeutic improvisation being able to promote development. The key-concept of this book “mediation” is very understandable and will be an important aspect of the interaction between the music therapist and the client. Secondly, this book also emphasises the importance of early intervention, and the aspects of preventative health work. Working with mothers and infants, and to intervene to improve the quality of their interaction, is a way of working that some music therapists have already been engaged with (Trolldalen 1997, Oldfield and Bunce 2001). This book is providing new documentation, theoretical considerations and an example of a possible research design for those music therapists working in this area of practise.


Ansdell, Gary (1995). Music for life. Aspects of Creative Music Therapy with adult children. London: Jessica Kingsley Publishers.

Pavlicevic, Mercedes (1997). Music Therapy in Context. Music, Meaning and Relationship. London: Jessica Kingsley Publishers.

Oldfield, Amelia and Bunce, Luce (2001). “Mummy can play too… Short-term music therapy with mothers and young children”. British Journal of Music Therapy 15(1) pp.27-36.

Rolvsjord, Randi (2002). Når musikken blir språk. Oslo: Unipub Forlag.

Trevarthen, Colwyn and Malloch, Stephen N. (2000). “The dance of wellbeeing: Defining the Musical Therapeutic Effects”. Nordic Journal of Music Therapy 9(2) pp.3-17.

Trolldalen, Gro (1997). “Music therapy and Interplay”. Nordic Journal of Music Therapy 6(1) p.14 -27.

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