Child Development The Vulnerable Child

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Child DevelopmentThe Vulnerable Child

• Is this just a phase?

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Vulnerable Children
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What are Vulnerable Children?

• Your Text Covers
• Child Abuse Neglect
• Children of Alcoholics
• Children of Divorce
• Children of AIDS
• Children in Mourning
• All this equals to TRAUMA

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Maltreatment Defined

• Behavior towards another person, which
• Is outside the norms of conduct
• Entails a substantial risk of causing physical or
  emotional harm
• According to the National Research Council (NRC),
  1993 p. 59.

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Child Abuse Defined

• Physical or Emotional harm caused to a child
  (lt18) by a recognized caregiver.
• Neglect by a recognized caregiver.

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Care Givers

• Parents
• Guardians
• Adult siblings
• Teachers
• Day Care Workers
• Grandparents
• Baby Sitters/Nannies
• Etc.

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Physical Abuse

• According to the National Research Council
  (1993)
• Demonstrable harm (physical abuse) is when a
  child incurs injuries such as bruises,
  lacerations, burns, fractures as a result of
  parental action.
• Endangerment involves physical assault by the
  parent or temporary caregiver that may or may not
  cause injury to the child.

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Physical Abuse

• Physical abuse can be mild or severe
• Mild slapping, shoving, spanking with the
  hand
• Severe hitting with a hard object, scalding,
  burning, poisoning, stabbing, suffocating,
  drowning.

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Emotional Abuse

• Some Types of Emotional Abuse
• Punishing with Fear
• Ridiculing, Demeaning, Denigrating
• Threatening with Abandonment

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Sexual Abuse

• Approximately 1 in 6 American children have been
  sexually abused (Kohn, 1987).

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Types of Sexual Abuse

• Non-Touching Sexual Abuse
• Removing bathroom bedroom doors to look
• Having the child sleep with adults
• Bathing child well past appropriate age
• Contact Abuse
• Oral / Genital contact
• Attempting / Actual intercourse or Rape
• Sodomy

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Types of Sexual Abuse

• Sexual Humiliation
• Clothespins on the penis
• Humiliating role plays
• Sexual Torture
• Raped by Entire Family
• Violation by foreign objects
• Subjected to extreme pain / terror

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5 Factors that May Precipitate Child Abuse (Kempe
Kempe, 1978, pp. 2-24)

• Lack of Support Family is socially isolated
  lacks support systems
• Crisis A crisis, even a minor one, will serve as
  a trigger for abuse THE PRECIPITATING EFFECT
• Perceptions A child is seen as unlovable or
  disappointing in some way is targeted for abuse
• Unrealistic Expectations Parents expect too much
  of themselves their children
• Poor Models Abusers were often poorly nurtured
  by their own parents

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VERY BASIC Counseling Strategies that are
Effective in Working with Abused Children

• Listen carefully to verbal / nonverbal clues
• Report suspected child abuse immediately
• Let children know that they are not to blame
• What do you say to a rape victim?
• Remember that child abuse neglect are symptoms
  of a breakdown in the familys interactions
• Make home visits
• Put the family in touch with support services

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Areas that Need Addressing in Counseling Children
of Alcoholics (Black, 1987)

• Children of alcoholics usually protect their
  parents
• Children blame themselves for their parents
  drinking
• Children love their parents but are ashamed of
  their parents behavior
• Children take on the role responsibilities of
  the parent
• Children are caught in the middle of family
  violence
• Children seek to avoid the arguing violence

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VERY BASIC Counseling Strategies that are
Effective in Working with Children of Alcoholics

• Form a relationship that will help the child
  trust
• Give the child important information about the
  alcoholism that will help diminish self-blame
• Offer help referrals to the family
• Promote after school activities for the children
• Encourage teachers to provide extra help after
  school
• Establish rapport with the family make home
  visits
• EMPATHY EMPATHY EMPATHY

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Childrens Common Emotional Reactions to Parental
Divorce (Wallerstein Blakeslee, 1989)

• Anger may be directed at parents.
• Blame one parent may be blamed for leaving
  also self blame
• Anxiety uncertainty about the future
• Fear loss results in fear of rejection
  abandonment feelings of powerlessness
• Depression common due to loss low self esteem

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VERY BASIC Counseling Strategies that are
Effective in Working with Children of Divorce

• Encourage parents to talk with children takes
  the mystery out of the situation
• Reassure children that they did not cause the
  divorce
• Help parents avoid burdening demanding too much
  responsibility
• You are the man of the house now!
• Help parents support their children
• Help parents children adapt to change

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Special Fears of Children with AIDS (Weiner,
Best, Pizzo, 1994)

• Fear that friends will reject them
• Fear of getting sick
• Fear of dying
• Fear that parents will get sick from them
• Fear that they will get too tired to fight anymore

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Death What is this like?

• How did you view death as a child?
• How do you view death now?

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Treating Traumatized Children by Dr. Greg Janson

• Child needs to acknowledge and explore pain in
  therapy to integrate experience
• Serialized treatment preferred to one
  uninterrupted sequence treatment over time
• can be more responsive to developmental
  vulnerabilities
• Need support of more than just single therapist
• caregivers must be active participants in
  treatment

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Treating Traumatized Children by Dr. Greg Janson

• Clinician must decide whether treatment must be
  active, directive
• to elicit material unlikely to emerge
  spontaneously and to demonstrate that these
  issues need not be shameful and can be dealt with
  directly
• Or if treatment should be non-directive, allowing
  the child to lead
• Treatment must combine hard work and fun

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Treating Traumatized Children by Dr. Greg Janson

• Clinical course must attend to
• Physical Needs Cognitive Needs
• Emotional Needs Spiritual Needs
• Other considerations
• Behavioral consequences of trauma
• secret and dysfunctional
• dissociative/deviant sexual behaviors

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Treating Traumatized Children by Dr. Greg Janson

• Working with traumatized children means dealing
  with gross, sometimes horrible, situations which
  may have a strong personal impact on the
  therapist this impact may interfere with
  treatment. (James, Beverly. (1989). Treating
  traumatized children. The Free Press New York.
• Typical approach is to remove child from home
• inner dynamics of abuse still exist plus loss of
  family
• must be matched by an equally dynamic therapeutic
  process

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Treating Traumatized Children by Dr. Greg Janson

• Verbal/cognitive approaches useless
• abused kids come from inconsistent environments
• therapist must create absolutely consistent
  environment the play room does this
• Safety is essential
• Child must feel safe to explore, express,
  resolve
• Abuse and neglect cause serious inner conflicts
  and relationship problems for children, and play
  therapy provides the modality necessary for
  children to develop adaptive and coping
  mechanisms on their own terms and at their own
  emotional pace. (Landreth, G. (1996). Play
  therapy interventions with childrens problems.
  Aronson Northvale.

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Understanding the Developmental Significance of
Trauma by Dr. Greg Janson

• Critical distinction acute trauma / chronic
  trauma
• Acute trauma can be dealt with using
  psychological first aid and a therapy of
  reassurance
• Chronic trauma requires a more systematic
  reconstruction of the childs social map of the
  world
• Socioeconomic and demographic correlates of
  violent trauma predict an accumulation of risk
  factors in the childs life (domestic violence,
  poverty, minority group status)

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Factors that Help Effectively Deal with Trauma by
Dr. Greg Janson

• Actively trying to cope with stress (rather than
  just reacting)
• Cognitive competence (at least an average level
  of intelligence)
• Experiences of self-efficacy and a corresponding
  self-confidence and positive self-esteem
• Social support from persons outside the family

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Factors that Help Effectively Deal with Trauma by
Dr. Greg Janson

• Temperamental characteristics that favor active
  coping attempts and positive relationships with
  others (activity, goal orientation, sociability)
  rather than passive withdrawal
• A stable emotional relationship with at least one
  parent or other person
• An open, supportive educational climate and
  parental model of behavior that encourages
  constructive coping with problems

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Guidelines for Referral to a Mental Health
Professional

• These questions follow established assessment
  criteria related to appropriateness, frequency,
  duration, course, intensity impairment.
• Is the childs behavior appropriate for his or
  her age developmental level?
• Allowing for individual differences for
  developmental lags, consider whether the child is
  able to manage the appropriate developmental
  tasks for his or her particular age range.
• Is the childs behavior appropriate considering
  the circumstances?
• Is the childs behavior an expected reaction to
  the situation? For example, what if a child,
  embarrassed by the peer group, blushes? What if a
  provoked child fights back? Are these normal
  responses? What about the unexpected reactions?
  Sometimes a child overreacts, underreacts, or
  doesnt react at all. These unexpected reactions
  give clues to the childs stability.

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Guidelines for Referral to a Mental Health
Professional

• How frequently does the child display the problem
  behavior?
• Because development is not a smooth progression
  children often regress or slip back to behaviors
  that were characteristic of a previous level,
  counselors, parents, teachers need to be aware
  of how often the child has this problem.
• Has there been a sudden change in the childs
  behavior?
• It is important to determine whether the behavior
  that concerns the parent, teacher, or counselor
  is a sudden departure from the pattern of
  behavior that the child has been exhibiting
  previously. If so, the counselor or therapist
  must look to the childs immediate environment to
  see what might be causing this sudden change.
  Sometimes sudden changes of behavior are
  indicative of abuse or family disruptions caused
  by death, divorce, or domestic violence.

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Guidelines for Referral to a Mental Health
Professional

• What is the duration of the problem?
• Determine how long the problem has lasted will
  help the parent, teacher, or counselor decide
  whether a referral is necessary. Many
  developmental problems seem to disappear as
  quickly as they come. Specific fears are a good
  example of a normal developmental problem.
• Is the behavior interfering with the childs
  overall functioning?
• Is the child suffering somehow as a result of the
  problem? If so, to what degree is the childs
  functioning affected? Is the behavior causing the
  child to be rejected by agemates preventing the
  child from benefiting from school instruction
  blocking the healthy expression of emotion, or
  interfering with the childs happiness? Perhaps
  the behavior is affecting only one area of the
  childs development perhaps it is affecting all
  areas.