A new study shows how verbal abuse affects children – and sows the seeds for long-term issues such as self-harm and anxiety
Prof Peter Fonagy is head of the division of psychology and language sciences at University College London and CEO of the Anna Freud Centre
This online forum is suitable for anyone interested in creating a positive and nurturing learning environment.
Wednesday 8 November 2023
4.30pm – 6pm
(online event – zoom link will be shared with ticket holders)
Speakers
Dr Jon Reid
Senior Lecturer, Special Educational Needs, Oxford Brookes University & IRCT Trustee
Josh Tyers
Headteacher, Biscovery Academy, Cornwall
Tickets £10
Non-members welcome
The Centre for Child Mental Health (CCMH) are hosting a 1-day event presented by world-leading neuroscientists, Dr Martin Teicher and Professor Eamon McCrory.
This conference is a very rare opportunity to hear two world leading neuroscientists whose research over decades, has involved the brain scanning of young people who’ve suffered abuse and/or neglect.
Remarkably, Dr Martin Teicher (Harvard University USA) has researched the impact on the child/young-person’s brain of being shouted at, criticised, bullied, smacked, having suffered physical abuse, sexual abuse, watched domestic violence, parent to sibling violence.
Professor Eamon McCrory’s research includes the brain imagining of young people who’ve experienced maltreatment. He found adverse impact on the brain’s executive functions, reward systems, threat processing and emotional regulation systems. All this leads to fall out in terms of behaviours that challenge, and problems socially and with mental health. When people are ignorant of the needs of these children and young people, all too many suffer the gross social injustice of get permanently excluded.
Both neuroscientists will also address how to interrupt the trajectory from painful life experiences to long-term social, behavioural and mental health problems. We owe it to all children and young people who’ve suffered aversity to be neurochemically and neuroanatomically literate, and this conference will support you in this vital task.
Vital CPD for all mental health child professionals.
Date: Saturday 17th June 2023
(*Lunch included)
Times: 10am – 5pm
Venue: CCMH, London (Map)
We are pleased to share this event hosted by The Mulberry Bush, tctc and University of Essex. An Active Education Event is a new approach to training tailored to the needs of front-line practitioners working in residential childcare and foster care, mental health, education, HMPs, social care, therapeutic communities and the British Army.
For more information and to book visit https://www.eventbrite.co.uk/e/trauma-informed-practice-in-residential-settings-tickets-201525637607.
Most of you will all be aware of the ongoing Independent Review of Children’s Social Care currently taking place under the chairmanship of Josh MacAlister. (https://childrenssocialcare.independent-review.uk/) In the March Newsletter I reported that IRCT had joined with others from the Children’s Alliance Group through a letter to the Minister for Education regarding the way in which the review had been set up and the limited timescale being allowed to undertake what is supposed to be “the opportunity of a generation” to make significant changes to the system and improve social care for the most vulnerable children and young people in our society. Despite our reservations about the structure, remit, independence and timescale of the review, IRCT decided to make representations to the Review Panel in as constructive a manner as possible.
The IRCT believes it can use its knowledge base and broad experience to make a valuable contribution to the government review of children’s social care and welcomes the opportunity to put forward constructive proposals for improving the current system.
We know that children who come into the care system have generally had a poor start in life and are amongst the most vulnerable individuals in our communities. Most will have suffered multiple Adverse Childhood Experiences (ACE). The research base for the longterm effects of Adverse Childhood Experiences is striking and strong. The published research evidence, notably Felitti et al (1998) in the USA and Bellis et al (2014) in the UK, reminds us of the range of experiences which can have an adverse effect on the health and wellbeing of our children, young people, families and adults for a lifetime. Single experiences can have an adverse impact on the child’s health and wellbeing but multiple experiences can have a cumulative damaging impact which can compromise the child’s prospects of happiness and success for the entirety of their life unless something is done to address this prospect. We know that children in the care system often have poor educational outcomes, difficulties in making solid trusting relationships with others and disproportionate involvement with the criminal justice system.
Although some children overcome early disadvantages and go on to live successful and happy lives many do not and IRCT believes that one important reason looked after children have poorer outcomes is that they have unaddressed trauma. IRCT believes that the proper recognition of the role of trauma in the lives of children in care is essential to provide better outcomes for them. We have argued that a formal objective of the care system should be to assist children to recover from the trauma they have experienced historically and which will have been compounded further by their removal from their familiar home into the care system.
Children and young people can recover from trauma through relationships with trusted adults who are trained, supported and willing and able to hold the child in mind. All services should be “trauma informed”. It is the view of the IRCT that a central aim of the care system should be to organize services in such a way so as to ensure that all children have the best chance to recover from trauma. Furthermore we argue that this aim should be set out in primary legislation in line with Article 39 of the United Nations Rights of the Child.
You can read both the submissions we have made to the Review Panel by clicking on the dated links below:
April 2021 – Evidence for the Independent Review of Childrens Social Care
August 2021 – Response to the Case for Change
We have had one discussion with members of the Review Panel to further expand on our ideas and to make suggestions for change and have joined in some of the online discussions that have been taking place. There is still considerable disquiet from many about the review and you can read about these concerns by going to the following link Home – Care Review Watch Alliance
Together with The Mulberry Bush and International Centre for Therapeutic Care (ICTC), IRCT are presenting their annual conference this November.
To view the full day itinerary click here
Environments to Promote Recovery
Friday 12 November 2021
9.30am – 4.30pm
Oxford Quaker Meeting House
£10 discount for Early Bird bookings finishes this Friday.
1ST to 7TH FEBRUARY 2021
We welcome the opportunity to spread awareness about Children’s Mental Health Week and the resources that are available to help parents and professionals support the well-being of children.
IRCT is a charity which has at its heart the idea of trying to improve the understanding the general public and government has about the mental health needs of vulnerable and traumatized children and a desire to improve the availability and access to appropriate services to provide help.
Place2Be, which is sponsoring Children’s Mental Health Week, also has a mission to improve the mental health of children and young people. They do this by providing mental health services in schools as well as training for teachers and other educational staff and parents. They also try to raise awareness about the mental health needs of children and young people and promoting Children’s Mental Health Week provides an opportunity to put a spotlight on the importance of being able to talk about emotional issues as well as to raise vital funds to support their work.
Place2Be promoted the first Children’s Mental Health Week in 2015 and its impact has grown every year. This year the theme is “Express Yourself” with an emphasis on helping children and young people to find ways to share their feelings, thoughts or ideas through creative activities such as art, music, dance, poetry, photography, film, drama etc.
Details about planned activities and resources for children, teachers and parents to use can be found on the Place2Be website and are available free. There is also an online conference on Friday 5th February entitled ‘Creativity as a Healing Tool: Connecting Mind Body & Imagination’
Find out more about activities, events, resources and training opportunities and take inspiration from the poem by the American Youth Poet Laureate, Amanda Gorman, which she read at the inauguration of President Joe Biden
www.mentallyhealthyschools.org.uk
https://edition.cnn.com/2021/01/20/politics/amanda-gorman-inaugural-poem-transcript/index.html
Talking about one’s mental health and expressing one’s feelings can be difficult no matter what your age. Children will not always know what they are feeling and they often struggle to put things into words. It is important for the adults around them to be able to look for non-verbal cues about what a child might be feeling by paying attention to changes in their behaviour or demeanour or the way they speak about things. Direct questions such as “How are you feeling?” tend to be responded to with a shrug or an “Alright!” Spending time with a child playing and engaging in creative activities is likely to be more revealing and the adult can begin to recognize themes in what the child is doing as they express themselves at a more unconscious level. It is important to leave the child to create what they want in the way that they want rather than trying to push them to create something ‘better’ or ‘more realistic’. The idea is not to strive for excellence but rather for free expression and fun! What is important is to encourage and notice with all one’s senses what is going on. Often the way something develops is more important than the final product. It is best to avoid too much probing or speculation about the meaning of creations but to be open to any suggestions. To avoid the risk of projecting their own feelings onto the child it is best to avoid the temptation to make interpretations! The expression of a feeling even if not named can be therapeutic in its own right. If a child is aware of how they are feeling but does not know how to cope it can be helpful to give them the opportunity to express the emotion in a safe way through a creative activity when suggestions can be welcome as to how they might achieve it.
It is important to take into account that a child’s emotional response to a situation depends to a large extent on their capacity to understand. The cognitive capacity of pre-schoolers to make sense of things is more limited and as a result, the primary emotional response to stress is likely to be anxiety shown through hyper-arousal, regression, fear, aggression etc. As they move into a more egocentric phase of development around 4 or 5 years old they tend towards becoming the centre of their own world and begin to explore their own strengths and feel more powerful in terms of being able to make things happen instead of looking to adults to do things. This potential sense of omnipotence is curbed by adults reminding them that there are consequences to actions and with this comes responsibility and guilt. Children at this age tend to feel responsible for everything that happens and if, for example, their parents are cross or unhappy they will be sure that it has something to do with them. Guilt is silent and rarely expressed but it is deeply felt and only really recognized through the child’s behaviour and demeanour. Guilt gets added to anxiety. Once the child has the capacity to evaluate rights and justice they have the capacity to express unfairness in a meaningful way and one which can lead to real anger about the injustice of what is happening to them. This usually happens around the age of 9 or 10 years old. It is not until much later that young people develop the capacity to be able to compare the actual with the hypothetical and make a comparison along the lines of “if this had not happened to me my life would have been different”. The awareness that they have been subjected to a significant loss as a result of the trauma they have suffered can lead to depression in addition to the ongoing anxiety, the feeling that they may be to blame and the anger about the injustice of everything. That is a lot for any young person to have to bear and they should not have to face it alone.
Never has there been a more important time to give children a chance to express how they are feeling. Life as we knew it seems like a distant dream after nearly a year of living through a pandemic with long periods of lockdown conditions imposed on us. We are all constantly bombarded with frightening messages about the dire situation we are in. Families are confined to their own homes with parents trying to work from home and retain their jobs while homeschooling their children. There is financial hardship and insecurity for many. For the children and young people, the inability to be able to go to school consistently has led to worry and anxiety about the impact on their education and for the older ones fear of lost opportunities and career prospects. An inability to see their friends and socialize leads to further anxiety, loneliness, boredom and frustration. The loss of supportive adults at school means that there is less help available and nobody to independently monitor their well-being.
Research confirms that there has been an increase in child mental health problems during the COVID-19 pandemic. In the Summer of 2020 after the first period of lockdown was ending Young Minds (1) did a survey of children and young people and 80% of respondents reported that their mental health was “worse” than before the pandemic and of this 41% said that it was “much worse”. This was a 32% increase compared to March 2020. It is also the case that 11% said that their mental health was better than before and this seemed to be associated with having had a break from the pressures of their normal life including such things as bullying and academic pressure. One worrying feature of the survey was that 31% reported being unable to find any ongoing mental health support even though they had looked for it and needed it. Another 40% said that they needed help but had not actively looked for it. Another survey was conducted in the Autumn of 2020 when there was a short-lived uplift after schools were open and friendships were re-established but this was followed by a dip and a further 10% increase in those reporting mental health problems. Once again there were complaints about the lack of support services being available. Young Minds are calling for the government to provide funding to enable educational establishments to provide mental health support and additional funding for the NHS to provide help through the Child and Adolescent mental health Services. They are also promoting a well-being campaign targeted at helping children and young people to learn how to support themselves and ask for help when they need it.
A research study in the Lancet in January 2021 (2) compares the incidence of reported mental health problems before and during the pandemic and found a 5% increase in the 5 to 16 year age group with the highest incidence (27%) reported for teenage girls. It was found that children who had a parent in psychological distress were more likely to suffer mental health problems and those living in a household falling behind with the payment of bills and rent/mortgage were twice as likely to be suffering mental health problems. This is not surprising and perhaps the biggest factor in how children and young people weather stresses in their lives is how readily their parents/carers can provide an emotionally containing life experience for them and shield them from stress. When parents are experiencing increased stress themselves this is even more difficult than usual. Supporting parents is essential in order to achieve and maintain the well-being of children and young people
Sylvia Duncan
Clinical Child Psychologist
Chair IRCT
According to a study published by the University of Bristol in November 2018
Up to 17 per cent of children could have symptoms consistent with foetal alcohol spectrum disorder (FASD) according to new research published in Preventive Medicine.
The UK has the fourth-highest level of prenatal alcohol use in the world, but no estimates existed from a population-based study on how many people may have FASD. FASD is a group of lifelong conditions caused by exposure to alcohol in pregnancy that affect learning, behaviour and can cause physical abnormalities.
Researchers from the University of Bristol and Cardiff University worked with clinicians to assess a wide range of information on mothers drinking in pregnancy and studied the development of 13,495 children from Bristol’s Children of the 90s study.
They applied a screening tool and found that up to 79 per cent of children in the sample were exposed to alcohol in pregnancy and that up to 17 per cent screened positive for symptoms of FASD
Dr Cheryl McQuire, a researcher in epidemiology and alcohol-related outcomes at the University of Bristol, led the research and said:
“Our results showed that a significant number of children screened positive for features consistent with FASD. The results are based on a screening tool, which is not the same as a formal diagnosis. Nevertheless, the high rates of prenatal alcohol use and FASD-relevant symptoms that we found in our study suggest that FASD is likely to be a significant public health concern in the UK.
“These results are important because without UK estimates of FASD prevalence, awareness will remain low and children, teenagers and adults will continue to find it difficult to seek diagnosis and to access the support they may need.
Dr Raja Mukherjee runs a diagnostic clinic for FASD at Surrey and Borders Partnership NHS Foundation Trust and contributed towards the research. He said:
“It shows that it is a disorder that is seemingly hidden in plain sight that we need to pay attention to. Unless we start looking for it we will continue to miss it. If we fail to diagnose it then those affected individuals will continue to be affected by a lack of support and have a subsequent impact on them and wider service. These results can be the first step in helping us in the UK to realise it is no longer a condition we can ignore.”
However, there is some dispute about the conclusions drawn from the study, for example, Prof Kevin McConway, Emeritus Professor of Applied Statistics, The Open University, said:
“To summarise my views: yes, this study does provide some useful information, but I don’t think we can rely on it to estimate how common FASD is in the UK. There are good reasons why the researchers’ estimates of up to 17% of children having FASD symptoms are very likely to be an overestimate of the percentage of children who actually have FASD in the UK, and quite possibly it overestimates a lot. Does that mean that FASD is not really a problem in the UK? That’s absolutely not the case – the relatively high rates of drinking alcohol during pregnancy mean that FASD could well be more of a problem here than elsewhere. I agree with the researchers that research using more reliable methods of finding out the extent of FASD should be done. Is the Chief Medical Officer’s advice to avoid alcohol in pregnancy changed by any of this? Absolutely not.”
IRCT would welcome further research into this problematic area. A child with FAS may have the same presentational difficulties as children who have experienced postnatal developmental trauma (abuse and/or neglect) and two points arise:
In December 2014 the BBC reported:
A child born with foetal alcohol syndrome is not legally entitled to compensation after her mother drank excessively while pregnant, the Court of Appeal has ruled.
The seven-year-old girl was born with severe brain damage and is now in care.
Lawyers argued her mother had poisoned her foetus but appeal judges ruled she had not committed a criminal offence.
The case was brought by a council in the North West of England, which cannot be named for legal reasons.
It had been argued the woman ignored warnings and drank a “grossly excessive” amount of alcohol while pregnant.
She consumed eight cans of strong lager and half a bottle of vodka a day, the court heard.
Three appeal judges at the Court of Appeal had to rule on whether or not the girl was entitled to a payout from the government-funded Criminal Injuries Compensation Scheme as a victim of crime.
But Lord Justice Treacy said an “essential ingredient” for a crime to be committed “is the infliction of grievous bodily harm on a person – grievous bodily harm on a foetus will not suffice”.
This raises significant ethical, moral and legal questions which need addressing as a matter of urgency. While victims of developmental trauma can claim compensation when they have suffered physical and/or sexual abuse and but those suffering the effects of FAS aren’t able to. If the law were changed and criminal compensation could be successfully gained, would the mother necessarily be regarded as a criminal and should, instead support be offered to the mother as well as more support to the child?
Image courtesy of freepik.com