There are many physical indicators for emotional abuse that is seen in the children these can be seen in their body language having blank expressions and lack of attention in the nursery. The children are also suffering from intellectual neglect as they are not receiving any intellectual stimulation so they are not able to develop their own ideas and thinking. Erickson et al, 1989 (in Corby 2000, p.161) quotes;
“ The sharp decline in the intellectual functioning of these children, in their attachment disturbances and subsequent lack of social/emotional competence in a variety of situations is cause for great concern. The consequences of this form of maltreatment are particularly disturbing when considered in the light of the fact that it is probably the least likely pattern of maltreatment to be detected.”
So children do not generally enjoy good peer relationships this could add to the distress that they may already be enduring.
Later the twins especially Zoë are showing signs and symptoms of physical abuse:
Calam and Franchi 1987 (in Corby 2000, p.160) studied a small number of abused/neglected children who attended a NSPCC day centre with their mothers and they came to the conclusion that ‘the severity of injury was not the major determinant of the degree of disturbances that they showed; it was the family environment that they were continuing to experience was more significant part, it was not so much the actual physical abuse it was the way the parents related emotionally to their children. Steele (1986) argues along similar lines the main features of being an abused child is irregular care, which then leads to an aura of uncertainty, the ability to take pleasure in things and to make lasting attachments. Steele 1986 Calam and Franchi 1987 (in Corby 2000, p.160) it is the emotional quality of parenting that is the key Steele adds:
“Physical abuse does not necessarily cause trouble. Most people have had physical injuries, fractures or bumps during childhood due to purely accidental causes and they have not been harmed by it because they have been comforted and cared for by good caregivers at the time of the incident. Damage comes when the injuries are inflicted by those to whom one looks for love and protection and there is no relief from the trauma.”
For Steele, the emotionally ineffectiveness of this type of mistreatment can be alleviated only by positive interpersonal experiences.
The nursery has noticed that the twins and especially Zoë are becoming more withdrawn and having unexplained bruising and red marks, when the nursery have asked Angie about these she can always provide an explanation, but this does not always match up with the injuries that the twins have sustained.
The nursery must follow the correct procedures of safeguarding the children and their family. There are assessment, planning, intervention and reviewing (Department of Health, 2002a) this is what is known as the core assessment. The nursery need to keep a log and record any concerns they have for the twins any correspondences with the twins parents as this is very important for any subsequent police investigation or court action, they should be looking at contacting a social worker as the family may be known to them. Any correspondences that are made to social services must be followed up in writing within forty-eight hours. Section 47 of the Children’s Act 1989 states that those children who are in need are those who vulnerability is such that they are unlikely to reach or maintain a satisfactory level of health of development or significantly impaired, without these services outlined in the 1989 Children’s Act what will happen to the child health standards and development.
As both Wayne and Zoë are under school age and signs of unexplained physical abuse as been notice by the nursery the greater the likelihood that they would be placed on the official registration as they are vulnerable also they are unlikely to be seen by social services. If there has to be a case conference on the twins you should make sure that all relevant professional are invited and are able to attend, also those who would be involved in future work with the twins and family. You must ensure that the parents are invited and they must be given the child protection conference reports in advance of the conference, it may be necessary to exclude certain family members from part or all of the conference, the safety of staff either in the conference or after should be discussed, and most importantly ensure that all decisions are recorded in the outcome of the s47 enquiries record (Department of Health, 2000c).
Case two
Adam
Adam is a four year old child who attends nursery he as being there for a year.
The staff at the nursery are aware that Adam was abused by his father and is on the child protection register. The last six months Adams father as left and Adam and his mom live with his grandparents. Adam as become a lot happier child joined in activities and appears enthusiastic.
Day Care Standards setting are expected to use a key worker system, which allocates a member of staff to become the child’s key person and link between the care setting and the family unit. The nursery and Adams family have in common and which is very important, is that they all want the best for the Adam. Christine, Adams mom as a good relationship with the nursery she is supportive and pleased with Adams progress. The self-esteem and well being of the people in the partnership – nursery, family and Adam – is important when you have to work together. It can be an anxious time for Christine knowing that her child is on the child protection register and she is required to take Adam to nursery, so the staff have to be sensitive to the feelings of the family in this situation.
It as being noticed over the last two weeks Adam is becoming more aggressive towards several children. This could be due to a male student who has being at the nursery for the last two weeks of a six-week placement. Emery et al, 1998 (in Bee 2000, p.114) suggests that children who have being abused are far more likely to become aggressive than non-abused children. It seems that Adam is not able to take discipline by the male student perhaps he reminds Adam of his dad and when he was naughty he would be beaten and locked in the cupboard, this could be triggering bad memories we know from the case study that Adam is not afraid of men as he interacts well with his grandfather and is always pleased to see him.
Adam seems to be a child who is suffering from emotional problems due to his abuse, he needs to overcome these problems and one of the ways could be that Adam and his family use what is known as play therapy. Play therapy is a technique whereby the child's natural means of expression, is play, and is used as a therapeutic method to assist him/her in coping with emotional stress or trauma. It has been used effectively with children who have an understanding level of a normal three to eight year old, who are; distraught due to family problems aggressive or cruel, social underdeveloped, or victims of child abuse.
Practitioners of play therapy believe that this method allows the child to manipulate the world on a smaller scale, something that cannot be done in the child's everyday environment. By playing with specially selected materials, and with the direction of a person who reacts in a designated manner, the child can plays out his/her feelings, bringing these hidden emotions to the surface where they can face them and cope with them. In it's most psychotherapeutic form, the teacher is unconditionally accepting of anything the child might say or do. The teacher never expresses shock, argues, teases, moralizes, or tells the child that his/her perceptions are incorrect. An atmosphere should be developed in which the child knows that they can express themselves in a non-punitive environment. Yet, even though the atmosphere is easy-going, certain limits may have to be imposed such as restrictions on destroying materials, attacking the teacher, or going beyond a set time limit. Play therapy is based upon the fact that play is the child’s natural medium of self-expression. It is an opportunity for the child to ‘play out’ his feelings, which is based on the natural patterns of healthy interaction between parent and child, and is personal, physical and fun! It can result in a changed view of the self as worthy and lovable and of relationships as positive and rewarding (Anon, 2003).
There are different forms of play therapy in which could be used for Adam such as Expressive Arts (Art and Music in Therapy). Children often feel more comfortable working on abuse issues in nondirective ways such as creating artwork, which symbolizes their feelings and issues. Artwork allows children to express their feelings in a nonverbal way and allows for children to become empowered. Art therapy can be used in individual, family, and group settings. In music therapy, children are able to use a variety of musical instruments including drums, keyboards, maracas, etc. and these help to release feelings and for the therapist to work on the issues. Music sessions can be used for relaxation, anger work, self-esteem work or fun time.
Family counselling sessions would be a good thing for Adams family to attend as, Family sessions are valuable to families as children and parents can attend the sessions together. Family members are able to learn how others in their family have been affected by the abuse and can then work together to rebuild the family unit.
Play therapy is recommended for children who have suffered abuse in one form or another, some children suffer negative effects of abuse these can include depression, anger, low self esteem, not being able to trust and feel confused and to use play therapy can help reduce or remove these problems. It allows the therapists and parents to work together to help the child heal. The government white paper (Every Child Matters p39. 3.1) “the bond between the child and their parents is the most critical influence on a child’s life. Parenting has a strong impact on a child’s educational development, behaviour and mental health.” If the child has being abused they will be able to go on and live a happy and productive life. Therapy is a worthwhile investment in a child’s future.
To conclude child abuse is a serious and growing social problem abusive parents are often themselves being abused as children. In case study one it shows that the parents lack social skills have no adequate social support and living with high levels of stress also in the equation is depression. In case study two it does not give us any information about Adams father and any reasons why he abused Adam. Now that Adam is at nursery and around a male student could this student remind Adam of his father, is it triggering bad memories of his father or could he be displaying behaviour problems because he is missing his father? With the help of play therapy perhaps these questions can be answered.
Reference
Anon, (2003) www.hhcac.org
Bee, H, Boyd, D. (2003) The Developing Child. 10th edition, Needham Heights, USA; Allyn & Bacon Publishers.
Bruce, T, Meggitt, C, (2002) Child Care and Education. 2nd edition, London, Hodder and Stoughton.
Corby, B. (2000) Child Abuse. Buckingham; Open University Press.
www.doh.gov.uk/safeguarding
www.doh.gov.uk/everychildmatters
www.4therapy.com
