Discuss the impact of abuse and neglect on childrens attachment and their neuropsychological, emotional, physical and behavioural development.
Review a treatment approach to working with abused children justifying you choice with regards to outcome research and also the ways in which the approach address the different impacts of child abuse and neglect.
We become the adults that we are today, throughout the experiences that we had as a child. If a person had a great, constructive and happy childhood, grew up in a functional family, surrounded by friends and nested in a safe neighbourhood, such a person will probably feel confident and strong, not fearing the future. On the other hand, one that had a chaotic childhood, living along with an unsupportive family surrounded by domestic violence and pain, and not having anybody to lend protection, this individual will probably grow up with insecure thoughts about the future, fearing to face relationships and will lack of the strengths to solve conflicts or simple problems from the normal daily routine.
An abused or neglected child might find him/herself in a solitary space; especially if he/she can’t find any kind of support; this child will have a high probability to become impulsive, aggressive and may have difficulties in the relationships.
The brain is formed in the early days of the foetus development, researches demonstrate that the brain starts to develop when the women are pregnant, and the first years of the life are fundamental for the brain development. Positive experiences and fulfilment of the basic needs, physical and psychological, will determinate a healthy development to the brain.
In according with Perry (Perry, 2004) “Brain growth and development is profoundly “front loaded” such that by age four, a child’s brain is 90% adult size.”
Maybe, the brain is the most important organ in the human morphology. It is responsible for the movement and balance of the body, behaviour, thoughts and feelings. The brain controls the heartbeat rate, the body temperature, supervises the functioning of the other organs; without the brain’s regulation we would not survive. The brain also has an important function to store memories, among them, those of anxiety, traumatic events or abuse. In short we can divide the brain in three main areas – the reptilian, the mammalian and the cortex (or neo-cortex). The reptilian brain is the primitive part of the brain and its basic task is survival; it controls the autonomous functions as respiration, heartbeat, balance and instinctive reactions; the mammalian brain, which also incorporates the limbic system as the emotional centre, is responsible for the emotions, short term memory and the body’s reaction to dangers; finally the cortex (or neo-cortex) is the newest part developed in the brain, whose functions are related to the highest mental processes – analysis, logics, intellectual quests. The cortex is always dominated by the reptilian and mammalian brains.
The brain functions are stimulated from the experiences, good or bad, in the individual’s life, and especially the experiences from the first years of life.
The abuse and neglect can have a large impact on the children’s attachment. “Early childhood experiences play a crucial role in long-term outcomes. In normative development, the attachment system provides the safe container that allows children to cope with and filter the vast amount of new experiences they are exposed to on a daily basis. Within the safety of that attachments system, including the ability to regulate their worlds, and develop an array of increasingly sophisticated developmental competencies” (Schore, 2001)
All the experiences which people have in life, cause the brain to change, this is due the brain’s plasticity, which means that its architecture and synapses can be rearranged overtime in response to an external stimulus. In essence some areas of the brain display more plasticity than others, specially the neo-cortex. Consequently traumatic experiences, like: physical and sexual abuse, neglect, substance use, mental Illness, incarceration, emotional abuse, divorce or separation, and prime carer abuse; are expected to cause changes in the brain, and those changes will carry the causal footprints, in this case bad outcomes are expected from bad experiences.
The leading function of the brain is to be conscious about what goes in the body and what goes on the environment, surrounding the body, this is the self-preservation instinct performed basically by the reptilian and mammalian brains. By doing so the body is always ready to defend itself and survive from any kind of harm. As individuals, we are oriented toward seeking our own well-being. Hence we tend to approach new resources, in hope of finding a reward in them for this behaviour. But in some situations, our past experiences may have taught us that such pleasure-seeking behaviour might be punished. Our other behavioural options then include fight or flight (two ways of eliminating dangers that threaten the body’s integrity) or inhibiting our behaviour so as to go unnoticed and thus avoid confrontation (frozen). The brain from a child who suffer a continue abuse can be in a fight-flight-frozen mode.
The children have a normal development of the brain if she has good and stables experiences in family, a reasonable neighbourhood, grandparents around, good opportunities to learn how to walk and talk in a safe environment, in this way the children learn how to regulate herself, of course this child will confront challenge situations and new experiences, however she will be able to deal with the normal life challenges, because she has a support and are able to self-regulate. This child will learn how to deal with the stress and she will create resilience in her life.
Children survived from bad experiences of abuse and neglect from her parents or caregivers, feels insecure and afraid. Those children might feel lonely, with no sense of protection or safety. Their lives become a chaos, especially if their parents are drug addicted. Many children have to look after her selves in the early years of life and sometimes they have to look after their brothers or sisters in extremes situations of neglect.
Researches showing the children brain who suffered abuse will be always in alert, waiting for the next bad experience to happen, always awaiting for the worse to happen with her. In different words is like this child is living in a war, waiting for the next bomb to be through it, however children responds in a different ways, some children respond in a fight-flight mode and other children respond in a frozen mode, they dissociate from the situation, it’s like they not there anymore, because the pain is to strong and the brain need to somehow to protect the children.
Usually the children that respond with a fight-flight mode display an aggressive behaviour, those kids are always in trouble at school, because they can’t not regulate their emotions and they explode, because the brain are in the fight-flight mode. They are usually anxious children and had insecure or disorganized attachments in the early days of life.
In according with Perry (Perry, 2004),” Compared to their peers, therefore, traumatized children may have less capacity to tolerate the normal demand and stresses of school, home and social life. When faced with challenge, for example, resilient children are likely to stay calm. Normal children in the same situation may become vigilant or perhaps slightly anxious. Vulnerable children will react with fear or terror.”
When the children are calm, they can use different part of the brain to process information, in different ways, however when they are afraid and anxious they use only primitives areas of the brain, they live in state of alert and are not able to absolve or process information properly in the moment.
The good news is the contemporary researches had discovered that the brain has a huge plasticity and the some way the brain can be destructed from bad experiences, It also can be regenerated from repetition of good experiences.
In according with (Perry, 2004), ” With the adequate repetition, this therapeutic healing process will influence those parts of the brain altered by developmental trauma”
The impact of abuse and neglect in the child in the infancy is enormous. The children can be affected neuropsychological, emotionally and physically, also impact in the children behavioural development might cause mental health illness in the future.
Fortunately, contemporary researches showing us how brilliant are the human brain. The basic needs and a good and safe care in the begging of life is a key to avoid so many pain and frustration. A large education and policies to avoid family violence is necessary to prevent more abuse and neglect in the society and repetition of strong models and good experiences are necessary to help the abused children to have a better life and feel safe.
(B) Review a treatment approach to working with abused children justifying you choice with regards to outcome research and also the ways in which the approach address the different impacts of child abuse and neglect.
It is essential for a complexly traumatized child to have a safe, predictable environment that will provide the foundation for their recovery and development of a positive identity.
It takes a carefully staged approach to help the child to develop the capacity to manage hi/her emotions and regain their equilibrium when distressed. The child also needs positive, structured repetition so that she/he can start to progress through the developmental stages that have been disrupted during the chaotic and traumatic early years.
The attachment, Self-Regulation and competency (ARC) provides a base framework for intervention.
The ARC model is grounded in theory and empirical knowledge about effects of trauma, recognizing the core effects of trauma exposure on attachment, self-regulation, and developmental competencies.
The ARC model can provide a safe, structured and predictable environment to contain and help to stabilise the child and family’s distress, gradually locating the child strengths, vulnerabilities, challenges and resources, steadily strengthening their capacity to identify and regulate their emotions, behaviours and attention, fostering the development of a range of survival skills and competencies that will provide a positive personal identity, a sense of control and self-efficacy, creating supportive links and sense of belonging.
Attachment- Is a stage when we create a safe and structured environment that is attuned to the child and helps to stabilise their distress, providing predictable routines and rituals, like weekly schedules with activities and appointments, setting consistent limits, children abuse usually needs to be in control because they don’t feel safe. Building a nurturing, therapeutic relationship that supports them as they learn to identify and express emotions in a safety way.
Regulation- Building skills in identifying and connecting to feelings and reading the others emotions as well. Help the children to gradually develop internal controls and the capacity to regulate emotions, behaviour and attention. The children will learn to express and communicate emotion safely, also recognising and adjusting to changes in emotional states.
Competency- Locating the child strengths and resources; tuning into successes and providing praise and recognition, building on the child’s strengths and talents to promote a positive self-concept, creating opportunities and coaching, so the child can gain mastery in relevant skills.
Encouraging the child evaluate outcomes to build their sense of control and self-confidence
The ARC model will help the child create resilience. The resilience is not a static condition and it will grow from:
Children feeling safe in their living environment and be able to manage emotions and regain their equilibrium when they get upset. Having a sense of efficacy based on their increasing of competencies, a capacity to sustain positive interpersonal relationship is really important for the child build a positive self-image and have a sense of belonging.
In according with (Perry, 2004) , “The brain altered in destructive ways by trauma and neglect can also be altered in reparative, healing ways. Exposing the child, over and over again, to developmentally appropriate experiences is the key.”
Childhood maturation is dynamic, the specific competencies and resources that will be target will be diverge from child to child, so is important have an individual assessment to identify an individual pre-existing conditions, family issues, systemic stresses and resources.
In according with (Kinniburgh , Blaustein, & Spinazzola, 2005) “Traumatized children need a flexible approach to intervention. ARC has been developed in response to this challenges as a intervention framework designed to address the array of developmental vulnerabilities experienced by the complexly traumatized child by building or restoring competencies, identifying and enhancing internal, familial, and systemic resources, and providing a foundation for continued growth.
Higgins, D. (1998). Mulri-type maltreatment: Relationship between familial characteristics, maltreatment and adjustment of children and adults. Unpublished doctoral dissertation. Burwood: Deakin University.
James, M. (1994). Child Abuse and neglect: Incidence and prevention. Family Matters(37), pp. 80-85.
Kinniburgh , K. J., Blaustein, M., & Spinazzola, J. (2005, May). Attachment, Self- Regulation and Competency- a comprehensive intervention frameqoek foer children with complex trauma. Psychiatric Annal, p. 35:5.
Miller- Perrin, C. L., & Perrin, R. D. (2007). Child maltreatment: An Introduction. Thousand Oaks, CA: Sage Publications.
Perry, B. D. (2004). Maltreated Children: Experience, Brain Development, and the Next Generation. New York: W.W. Norton.
Schore, A. (2001). Effects of a secure attachment on right brain development,affect regulation, and infant mental health. Infant Mental Health Journal(22), 7-66.
US National Research Council. (1993). Understanding child abuse and neglect. Washington, DC: National Academy Press.