Abstract
In 2015, the British government implemented a national Baseline Assessment policy for children at the start of their Reception Year (aged 4–5 years) in England. Adding further assessment to the national Early Years Foundation Stage, the Baseline policy was predicated on reform for improved school accountability, with a focus on measurement of both children’s outcomes and school readiness. This small-scale research study juxtaposes the dominant policy narrative that focuses on assessment for accountability, with the alternative lenses of relational pedagogy and care ethics. The study seeks to establish the extent to which an ethic of care is present or absent in policy texts and teacher talk on summative assessment in the Early Years Foundation Stage. Through a critical discourse analysis of government policy texts and a thematic analysis of teachers’ dialogue from a focus group, three analytical themes were identified: accountability, quantification of children’s development and the perceived impact of Baseline Assessment. Furthermore, the study explores the possibility that care ethics, while missing from policy, are backgrounded rather than absent in participant teachers’ dialogue and classroom life. While acknowledging the limitations of a small focus group and the novelty of the Early Years Foundation Stage Baseline Assessment policy, this study argues for a reorientation of the current ‘accountability’ discussion to one which foregrounds more care-full relationships in assessment policy and practice. Such a contention has implications beyond the single country focus of this study and contributes to international debate on the importance of care in testing times.
Keywords
Introduction
Early childhood education (ECE) has been subject to an intensification in accountability demands for children’s outcomes in recent years (Roberts-Holmes and Bradbury, 2016; Spencer-Woodley, 2014). While debates about the effects of such accountability continue (Haslip and Gullo, 2017), studies of the consequences of such regimes on the presence or absence of care in relationships between early educators and children are limited. In particular, a lack of critical attention to the impact of accountability on care in assessment practices is notable and provides the impetus for this study.
This article is based on a small-scale research study which sought to investigate the extent to which an ethic of care was present or absent in policy texts and teacher talk on summative assessment in the Early Years Foundation Stage (EYFS). The EYFS is the framework for children from birth to 5 years in England, which sets out areas of learning, Early Learning Goals, and assessment requirements (Department for Education (DfE), 2014c). In 2015, the British government implemented a national Baseline Assessment policy for children at the start of their first year in Primary school. This trajectory began in March 2014 when the DfE (2014b) issued a policy which introduced a new national Baseline Assessment for Reception Year (YR) children. Successive months saw the development of a baseline criteria document (Standards & Testing Agency (STA), 2014) which informed a commercial tender process granting successful bidders the right to deliver Reception Baseline Assessments to schools (DfE, 2014a) from September 2015. Predicated on reform for improved school accountability, the initial iteration of the policy was contentious and short-lived. Despite widespread opposition (Better without Baseline, 2015; NUT, 2015; Pre-School Learning Alliance (PLA) 2014; TACTYC, 2014), proposals to re-introduce the assessments emerged in recent government policy (DfE, 2017). The probability of this assessment manifesting as an online test in 2020 has been met with renewed consternation.
This study acknowledges critiques of recent summative assessment policies in England (Bradbury, 2014; Roberts-Holmes, 2015; Roberts-Holmes and Bradbury, 2017) analysis of escalating accountability in Australia (Kilderry, 2013) and the United States (Haslip and Gullo, 2017) and the imminence of the Organisation for Economic Development and Co-operation (OECD, 2017) International Early Learning Study (IELS), a transnational assessment of learning outcomes among 5-year-olds. I contend that the prevailing and increasingly explicit discourse of accountability in national and international policies has the potential to (re)shape relationships between teachers and children. In response to these discourses, this research draws on the alternative lenses of relational pedagogy (Papatheodorou and Moyles, 2008) and care ethics (Goldstein, 1998; Noddings, 1984) to critically examine the assessment relationship between adult and child. In so doing, I utilise definitions of care by Noddings (1984) – to attend to and to be fully present with another – in seeking the ‘care-full’ (Barnes, 2012) in policy and practice.
Through a critical discourse analysis (CDA; Hyatt, 2013) of policy texts and analysis of dialogue from early childhood teachers, I consider the research question: To what extent is an ethic of care present or absent in policy texts and teacher talk on Baseline Assessment?
Assessment and accountability: a current story
There is a growing corpus of research and policy critique focusing on accountability as a dominant discourse in ECE (Bradbury, 2014; Moss, 2014; Osgood, 2006; Roberts-Holmes, 2015; Spencer-Woodley, 2014). These critical perspectives are used to orient this study and to juxtapose the contrasting discourses of relational pedagogy and ethics of care. Ball (2003) and Dahlberg and Moss (2005) discuss the increasing prevalence of summative assessment being used for teacher and institutional accountability, marking a notable shift away from formative assessment for teaching and learning. With reference to ECE, this idea of assessment for accountability is seen in the numericalisation (Bradbury, 2014) of children’s development. Furthermore, Roberts-Holmes (2015) concludes that the ‘datafication’ of current assessments acts as a ‘meta policy’ shaping pedagogy ‘from a distance’ (p. 302) potentially constraining pedagogical values and thereby altering relationships between teachers and children. Such increased intensification in external accountability (to policy makers and regulators) is seen in direct tension with the quality of educational experiences for children (Hath, 2002) and is at odds with those who advocate for care ethics and a pedagogy of relationships in ECE.
Current assessment regimes which are dominated by universal standards and legitimated by accountability rationale have been critiqued as morally problematic (House, 2011; TACTYC, 2014). While it is important not to over simplify and create binary discourses of accountability and care ethics, it is clear that accountability is a dominant discursive frame in the EYFS. Additionally, such external accountability is manifesting as a global discourse, exemplified by the forthcoming IELS by the OECD (2017). Participation in the IELS study by English authorities appears to cement a commitment by the Government’s education department both to the benefits of international comparisons for measuring early education ‘effectiveness’ and to the principle of external accountability for children’s attainment. Given the critique of accountability in the assessment equation, relational pedagogy theory provides an alternative lens though which to consider the impact of such a regime on relationships between educators and children.
Relational pedagogy: a different story
Bingham and Sidorkin (2004) present a wealth of international research including a ‘Manifesto of Relational Pedagogy’, which opens with the observation that A fog of forgetfulness is looming over education. Forgotten in the fog is that education is about human beings. (p. 5)
The authors offer a provocation to reconsider democratic relations in an educational environment, based on ‘the assumption that relations have primacy over the isolated self’ (p. 2). Papatheodorou and Moyles (2008) further explore the ontological foundations of relational pedagogy in research which offers a definition of the concept and its implications for professional practice. They suggest that Pedagogy – by focussing on the individual as a human being … implies a relation, an obligation and the infinite attention which we owe to each other … (p. 5)
This conceptualisation conveys relational pedagogy as a discourse of relation, which recognises the mutuality, complexity and context of encounters over isolated, individual experiences. The educator is position thus: the dialogic dimension of relational pedagogy challenges teaching as a technical act. It resists the imposition of a priori beliefs of who the learner is or should be and as such challenges the functional and societal requirements of education and sets out the ethical grounds of education. (Papatheodorou and Moyles, 2008: 11)
Such resistance to assumptions about who the child is or should be marks a tension with an assessment regime predicated on accountability for predetermined outcomes. It is the interdependency and the mutuality that relational pedagogy advocates, which can be seen to be jeopardised by the technicity and instrumentalism of the Baseline Assessment policy.
An ethic of care: a missing story?
In terms of caring relationship theory, Noddings (1984) has identified the two individuals as ‘one caring’ and the ‘cared for’, claiming that both parties have an obligation to care reciprocally, albeit in a different manner. The relationship is characterised through concepts of engrossment and motivational displacement. It is suggested that engrossment occurs when the one caring acts with attentiveness, with regard and being fully present. Motivational displacement is described by Noddings (2013) as ‘more than feeling’ (p. 33) and a shift in energy towards the service of the cared for. Noddings (2013) has developed her definition as one of care being relational. That is to say, the one caring and the one cared for are ‘reciprocally dependent’ (p. 58). This notion of care, not as an attribute or disposition, but as a relationship reflects earlier discussions on relational pedagogy and the ideas of responsibility for and responsiveness to children.
Goldstein (1998) developed a conceptual framework based on Noddings’ ideas of engrossment, motivational displacement and reciprocity, operationalising these and analysing practice in an early childhood classroom. Goldstein’s study does not attempt to gauge the teacher’s degree of caring but aims to provide examples of how an ethic of care is actualised and how it shaped interactions in this particular context. This example prompts questions over the kind of policy and practice conditions which might be required for care to flourish in the context of early childhood assessment policy and practice. Given an assessment regime in which universal standards and accountability prevail, this research investigates the extent to which the reciprocity and responsiveness of care ethics, which Noddings and Goldstein advocate for, can be present in the ECE environment.
While literature on care ethics and assessment is limited and within recent Baseline Assessment policy is scarce (Clausen et al., 2015), this has opened up an opportunity to look anew at the assessment relationship and to explore an ethic of care in an English ECE context.
Methodology
Undertaken at the intersection of interpretivist and critical traditions, this qualitative research adopted a discourse analysis of policy texts and focus group methods to explore the topic. The policy analysis element of the study took the form of the CDA of English government policy documents which are key to understanding the policy narrative trajectory of early childhood assessment. This analysis utilised Hyatt’s (2013) CDA framework to analyse two policy texts: the Reforming assessment and accountability for primary schools (DfE, 2014b) and the Reception baseline: criteria for potential assessments (STA, 2014). For this analysis, the framework’s concepts of policy drivers and levers, warrant, legitimation, evaluation and lexico-grammatical construction were utilised.
Field work was undertaken in the months prior to the implementation of the Baseline Assessment policy as practitioners were preparing to undertake the assessments. One focus group, involving five early childhood educators from a number of settings in the north of England, was convened. Consent agreements were signed by participants in advance of data collection. The focus group interviews were audio recorded and transcribed for analysis.
In seeking the voices of teachers about the assessment regime, the research acknowledges the temporary, partial and situated nature of the stories being told by research participants. These stories, from practising teachers, are presented in contrast to the text of policy documents, to explore whether or not their stories concur with policy texts. Given the power and influence of policy production, this research also attempted to create a space for the ‘inhibited voices … depressed or inaudible voice[s]’ (Clough and Nutbrown, 2012: 69) which are often absent or muted in such policy formulation and enactment.
Analysis
In terms of understanding the origins and evolution of the Baseline Assessment policy, it appears that the most explicit drivers are perceived as low expectations of children’s attainment, a continued drive for information for parental choice and the need to demonstrate school performance. The rationale of accountability is unambiguous and appears several times in both documents creating a discourse in which assessment, accountability and increased expectations are positioned as inseparable. Policy drivers, levers and trajectories behind the policy texts can be perceived: the case for change is … our current expectations for primary school are set too low. (DfE, 2014b: 4) We will have national assessments at key points in children’s primary education. These have two aims – to provide standard information to parents and to give a picture of school performance. (DfE, 2014b: 5). The purpose of the reception baseline is to support the accountability framework and help assess school effectiveness. (STA, 2014: 1)
Hyatt (2013) cites Cochran-Smith and Fries (2001), detailing the concept of warrant as ‘the justification, authority or “reasonable grounds” … established for some act, course of action …’ (p. 839). These are, in turn, divided into evidentiary warrant (justification based on evidence), accountability warrant (grounds for action based on an outcome) and political warrant when a policy is ‘justified in terms of the public/national interest’ (p. 839). Each of these has relevance to the policy texts being analysed.
The evidentiary warrant is utilised in the policy text as a means of justifying the decision to introduce a national Baseline Assessment scheme: Many respondents to the consultation supported the principle of schools being accountable for the progress of their pupils and that progress should be measured from the earliest point in school. (DfE, 2014b: 6)
In terms of deconstructing the texts, Hyatt (2013) details four modes of legitimation originating in Fairclough (2003); these modes are (1) authorisation, such as institutional authority; (2) rationalisation, in terms of the value and usefulness of an action; (3) moral evaluation, which might appeal to a particular value system; and (4) myth creation, in terms of courses of action: Our current expectations for primary schools are set too low. (DfE, 2014b: 4)
The collective pronoun ‘our’ (which when contextualised does not further explain who ‘our’ includes) might be claimed to justify the policy through authorisation. The lack of explanation of who ‘our’ constitutes and the unequivocal statement about low standards are presented with an unchallengeable authority. It can be argued that this point is also presented as a natural assumption that a reader would agree with.
Hyatt (2013) also encourages analysts to consider the writer’s viewpoint on what is proposed in the text including examples of evaluation in which the text producer’s attitude is ‘covertly constructed’ (p. 841): Our current expectations for primary schools are set too low. (DfE, 2014b: 4)
This can be read as evaluation or attitudinal judgement through, arguably, including the reader’s expectations alongside those who deem expectations as ‘too low’.
The critical policy discourse frame also includes an analysis of lexico-grammatical considerations such as tense, voice and use of pronouns. Hyatt (2013) suggests that analysing text in this way can help to demonstrate how some of the more macro features of policy discourse e.g. warrant, legitimation … are constructed rhetorically. (p. 842)
The title of one of the texts provides the first opportunity to consider this: Reforming assessment for accountability. (DfE, 2014b: 1)
This title has been constructed rhetorically by including a present participle of an active verb: ‘reforming’. This verb is defined as ‘to improve by the correction of faults’ (OED online, 2015). In addition to the present participle suggesting an ongoing process of reform, the active verb might be read as decisive, conclusive action. Noticeably, there is a lack of agency in the title which Simpson (1993: 87) describes as passivation and gives prevalence to the necessity of the reform process rather than agents of reform.
… schools should have the freedom to decide how to teach their curriculum and how to track the progress that pupils make. (DfE, 2014b: 4)
This text can be read as the ‘manipulation of agency transparency’ (Hyatt, 2013: 842) suggesting that schools have autonomy on formative assessment for tracking progress. However, the lack of autonomy on the core policy development of new statutory summative assessment tools, including the Baseline Assessment, is not referred to in the context of this freedom.
Analysing the texts for discourses which might be implicit, backgrounded or foregrounded (Downing, 2000), I concluded that there was no evidence of the ethic of care in the policy texts.
With the focus group data, an inductive analysis using the framework approach (Bryman, 2012: 12) was utilised, with concepts and theories emerging from participants’ responses, and these generated a number of codes. This enabled the tabulation of interviewee text under thematic headings. Codes used were as follows:
External accountability;
Teacher acceptance/resistant;
Motivational displacement/care ethics.
Interview responses included several references to accountability from early in the discussion. It was clear that there was a heightened sense of intensifying accountability since the assessment regime of the 1990s: I think the language of accountability has been strengthened since then, so it was an undercurrent in the 90s, whereas now, I think people are much happier to talk about accountability and the need to be accountable and that being almost a blamey thing. (T2)
The potential impact of such accountability was detailed by one teacher who articulated a degree of powerlessness: There is a lot of fear though – the school around the corner went into special measures and the Head disappeared. What can we do? (T3)
This led to a wider discussion about to whom teachers should be accountable and by what means. There was consensus among the group that accountability should be to children and families: I think I do need to be accountable but the way I would use that word would not be about a test, but about being accountable personally to the families in terms of being true to what I believe about children’s learning, giving families confidence to question things. So, I don’t disagree with accountability, I disagree with it in that it can only be shown through an external test. (T2)
The focus group members articulated views about power and choice at different points throughout the interview. In relation to implementing the 1990s baseline: I don’t remember us having a choice about it. (T1)
This was coupled with a sense of lack of trust by Government of early childhood teachers: The Government push is literacy and maths and testing in a certain view and there is a view that teachers can’t be trusted to make a judgement and that’s why they have decided there needs to be a baseline. (T4)
Another participant described the policy in terms of whether a school should choose to undertake a baseline, the alternative being that they would be inspected against highly ambitious attainment targets at the end of primary school: It’s presented as if baseline is a choice, but it’s one of those no-choice choices … (T1)
Participants were asked about the potential impact, if any, of baseline on children’s experiences and/or relationships with key adults in the school. One participant commented that various locally determined baseline assessments had long been undertaken, usually by observation-based method and that in her experience, these had not impacted on children’s experiences or relationships. However, there was concern among group members about the broader implications of the current policy and its implementation, in terms of impact on children: If you don’t remind yourself what it’s [assessment] for, it can focus you on other things, as in doing things that will get them [children] into the next band [development stage band] and that will be wonderful – but you have to keep bringing yourself back to what we are here for – our whole purpose not just that little bit of what we do. (T2)
These comments, which consider the potential impact of the Baseline Assessment on children in terms of their experience in ECE and relationships with key adults in schools, might be read in terms of indicating motivational displacement (Noddings, 2013).
External accountability
Much of the data, from both policy documents and interviews refer to the concept of school and teacher accountability. Both policy texts which were analysed had frequent and explicit reference to an accountability framework as a policy driver. This perceived intensification of accountability, as explored by Osgood (2006) and Spencer-Woodley (2014), points to an increased managerialism and its resulting impact on children as asserted by Dahlberg and Moss (2005): Increasing institutionalisation of childhood may lead to a greater and more effective governing of children. This may happen in particular when early childhood institutions are understood as enclosures for the effective application of technologies to produce predetermined and standardised outcomes. (p. vi)
I discerned that while this concept of accountability was explicit in policy documents, it also appeared to be perceived by the participants in the classroom. Notions of accountability were experienced, often negatively, by the teachers I interviewed, as illustrated in phrases such as: … I think people are much happier to talk about accountability and the need to be accountable and that being almost a blamey thing. (T2)
In a similar way to a study by Bradbury (2013) in which research participants expressed ‘cynical compliance’ (Ball, 2003: 20), participants in my research referred to Baseline as a ‘no-choice choice’ (T1), perceiving accountability (at least to policy makers) negatively. The teachers in this study appeared to position themselves as unwilling actors in a model of summative assessment in which they perceived accountability as culpability. This is evident in discussion about the fairness and thereby legitimacy of the policy: It’s not about it being accurate or fair or what’s right for children it’s about taking Primary schools with a Reception class and holding them to account. (T1)
An important thread of discussion in the focus group centred on to whom teachers should be accountable. While baseline policy documents are clear that there are just two aims: ‘to provide standard information to parents and to give a picture of school performance’ (DfE, 2014b: p. 5), participants in this study thought differently. A discussion about accountability included the comment: I think I do need to be accountable but the way I would use that word would not be about a test, but about being accountable personally to the families. (T2)
Here, it would seem that this practitioner, at least, does not have a problem with the moral obligations of accountability, but that such accountability needs to be to children and families using the school. This idea of accountability to children is echoed by Spencer-Woodley (2014), who poses questions regarding practitioner values and how these are reconciled or not with accountability. It would appear, through analysis of both policy and practitioners’ experiences, that demands for greater accountability on early childhood educators for children’s outcomes (at least to Government and regulators) is in the ascendancy.
Rationale and impact of Baseline Assessment
The policy drivers of increased expectations, and indeed the overt attitude of ‘shared’ low expectations of schools as detailed in policy texts, make clear the official rationale for baseline policy.
Perceived impacts of baseline policy differed between the authors of policy texts and participants responses. The text in the two policy documents implicitly assumes increased expectations and thereby increased outcomes in terms of children’s attainment ‘… set high expectations so that all children can reach their potential’ (DfE, 2014b: 4). However, focus group participants felt that the national Baseline Assessment risked labelling children. One participant thought it would bring about a view that they want a pass/fail model – so you will now have families told that their child is not where they need to be – I wonder if that is setting up a pattern. (T2)
This view was shared among group members and elaborated on, with other participants who discussed the baseline score ‘bands’ which would be attributed to children’s attainment. This might be viewed in terms of Billington’s (2000) work on the pathologising culture of measuring, categorising and ranking children. Some studies have critiqued the potential consequences of this as resulting in a disproportionate focus on the attainment of children on the ‘borders of proficiency’ (Graue and Johnson, 2011: 65) in order to secure the achievement of some and a subsequent ‘educational triage’ (Roberts-Holmes, 2015: 308). Additionally, participants perceived the risk of a national Baseline Assessment limiting the experiences of children in both YR and in preschool settings. Concerns over the threat of downward pressure and the shaping of an overly deterministic curriculum were made. ‘The pressure always comes downwards’ (T3) is indicative of anxieties from participants and expresses a real concern about ‘the kinds of experiences younger and younger children will be having’ (T3). Thus, there is a clear divergence in perceived impact of baseline between policy makers who suggest they will create higher expectations and ‘results’ through school accountability, and practitioners who worry about the impact on children’s experiences. This is encapsulated in the question from one teacher, ‘Why are we doing this?’ (T2).
However, while participants did not reject the concept of baseline outright: ‘schools have always done a baseline though …’ (T3), there were clear frustrations about a perceived over formality, the risk of further accountability intensification and the potential negative impact on relationships with children.
The presence or absence of care ethics
This study began with a search for care ethics in early childhood assessment policy and practice. The discussion above which explores the analysis of policy documents focuses on accountability, a discourse of measurement, rationale, the impact and content of baseline. It would appear, based on this analysis, that an ethic of care is absent from these documents. Given the detailed exploration of policy drivers, warrant, modes of legitimation and lexico-grammatical structures, a CDA has highlighted no discernible reference to an ethic of care in the policy text – a discursive absence.
Discussion on analysis of practitioner interviews with regard to care ethics is more complex and nuanced, warranting further exploration. Although the field questions in the focus group interview were open ended, the focus of the questions was intended to gauge views of participants about children’s experiences and about relationships between early childhood educators and children. Very little of the data in terms of responses to the questions referred explicitly to the baseline in terms of children’s experiences, potential impact on relationships or teachers’ caring responsibilities. It was important to be open to the possibility that what I perceived to be a potential impact of Baseline Assessment on relationships between children and teachers was not perceived by the participants themselves.
I considered that care ethics were not necessarily absent but were implicit (Downing, 2000) in the teacher talk – an ‘unspoken’ discourse. Reference was made in the focus group data to the impact of assessment on children, in terms of potential labelling and also to the inadequacy of the truncated baseline technology in capturing children’s holistic development. These comments, which reflect a concern for the immediate and longer term effects of the Baseline Assessment on children, might be perceived to be underpinned by an ethic of care. Indeed, these considerations can be read in terms of motivational displacement, which Noddings (2005) identifies as a hallmark of care ethics.
Participants discussed accountability to parents and carers, as well as describing a vignette of children playing and learning outdoors which could not be conveyed through the Baseline Assessment scheme. Teachers’ perspectives on assessment were clearly rooted in their lived experiences with children and families in early childhood environments. Nonetheless, explicit reference to care practices or indeed approaches to caring were not obvious. This resonates with a school of thought within CDA which highlights the implicit or indeed the ‘unsaid’; discourses which are implied as opposed to explicit (Jalbert, 1994).
In a similar way, Löfdahl and Folke-Fichtelius (2015) discuss care in relation to preschool assessment documentation as invisible or taken for granted. However, the authors draw the conclusion that in the context of their Swedish study, one reason an ethic of care has become invisible is that it has been subsumed by educational practices: A comparison over time shows a shift in the use of the term care, from care related service towards care as an educational tool. (p. 265)
However, I believe data from this study are more optimistic. Participants held the well-being of children to be of paramount importance in the assessment process and appeared determined to reconcile the ‘choice’ of baseline technology with their deeply held pedagogical values. Despite a policy narrative predicated on discourses of accountability, the reality of participant teachers’ care ethics and practices were so embedded and such a formative element of a broader relational pedagogy, that they were neither perceived as distinct nor referred to discretely. It raises the question: Do care ethics in assessment become considered only when their absence is noted?
Participant teachers’ motivational displacement and responsivity demonstrated care-full attitudes and actions in an era marked by intensified external accountability. However, increased pressure on practitioners to evidence children’s learning through summative assessment for school accountability arguably diminishes the prominence of care ethics in work with young children. Such conclusions underscore the importance of identifying, discussing and attending to the presence of care ethics – thereby moving this discourse from the unsaid to the said. I contend that articulating how being care-full manifests in assessment relationships can act as a powerful corrective to the oppressive power of intensifying external accountability.
Conclusion
This research has questioned the extent of the presence or absence of an ethic of care in early childhood summative assessment policy and practice. Practitioner views reflected acute awareness of the accountability drivers of current assessment policy. The voices of the practitioners in the study reflect thinking that government policy can shape our frames of reference and arguably limit the language which we use to describe our experiences. The ethic of care I had expected to be prominent in their responses was not obvious. Rather, it was perceived as backgrounded, arguably embedded in their practice and assumed rather than explicit. This proposition warrants further study.
Through this research, I have attempted to encourage a shift from what appears to be a current focus on government policy and the providers of Baseline Assessment onto teachers and children. By considering writings on relational pedagogy (Papatheodorou and Moyles, 2008) and care ethics (Goldstein, 1998; Noddings, 1984, 2005, 2013), I have aspired to turn attention to those on whom the policy impacts and look anew at this assessment relationship. It is with these thoughts in mind that I advocate for a reorientation of policy and practice so that both attend to the relational aspect of assessment in ways which are respectful, attentive and care-full.
Footnotes
Funding
The author(s) received no financial support for the research, authorship and/or publication of this article.
