Inclusion: Working with parents with alcohol problems - Stepping in

An estimated 472,000 children in England live with an alcohol- or drug-dependent parent or carer, according to figures collected by the Children’s Commissioner for England in 2019/20. The National Association for Children of Alcoholics (Nacoa) sets this estimate higher, at around 3 million across the UK. According to the charity’s research, these children are twice as likely to experience difficulties at school, to develop their own alcoholism or addiction, or get into trouble with the police.

But early years professionals can protect children and prevent intergenerational cycles of behaviour by identifying problems early and providing appropriate help.

INCREASING NUMBERS

According to the NSPCC, the number of children affected by parental substance misuse has increased since the Covid-19 pandemic began. It reported a 66 per cent increase in calls to its helpline in February this year from people concerned about parents’ use of drugs and alcohol. Calls rose from an average of 709 per month before the first national lockdown, in January to March 2020, to 1,178 a month in April 2020 to January 2021.

‘We’ve not only seen a rise in contacts and referrals but we’re also seeing families who weren’t previously known to children’s services requiring help and support for substance misuse,’ says Kam Thandi, head of NSPCC Helpline.

Living in a household where a parent or carer misuses substances does not necessarily mean a child will experience abuse, according to the NSPCC. However, it can make it more difficult for parents to provide safe and consistent care, putting children at risk of:

• physical and emotional abuse or neglect
• behavioural or emotional problems
• having to care for parents or siblings
• poor school attendance or low grades
• experiencing poverty
• being exposed to drugs or criminal activity
• being separated from parents.
  
  

GIVING SUPPORT

Early years professionals will use skills learned through safeguarding training to spot signs that something is wrong in a child’s life, says Early Years Alliance quality and standards manager Melanie Pilcher. These include behavioural changes such as regression or challenging behaviour, erratic attendance, and signs of neglect. ‘The parent’s need for alcohol might be put before what the child might need, such as new clothes, shoes or equipment,’ Pilcher says. She also recommends observing what children do and say in role-play situations.

If a practitioner has any cause for concern, Pilcher recommends practitioners begin a supportive, non-judgemental conversation with parents. ‘Find out what’s going on and how you can encourage them to seek support – perhaps talk to their GP or health visitor – and just flag up sometimes that what’s happening isn’t acceptable,’ she recommends.

Families may be reluctant to admit a problem with addictions, or become defensive, because they might fear losing their children if social services become involved. Practitioners may also be nervous about raising the topic in case it threatens a trusted relationship. But Pilcher emphasises that practitioners should not ignore any safeguarding concern, and if necessary, follow procedures for sharing information about the child with children’s services.

‘Living in a family where there’s alcohol abuse is categorised as an Adverse Childhood Experience, and they have long-term implications for a child,’ she says (see Case study).

Nacoa provides guides about how to speak to adults and children affected by addictions (see Further information). Helpline supervisor Abbie Laidlow says practitioners should speak to the child as well as the parent or carer. The approach for under-fives, who may not be able to sit down and have a conversation, is different than for older children. She recommends practitioners let the child take the lead on raising the subject, perhaps during playtime.

‘If they do talk to you about their parents’ drinking, let them know there are other children who are going through this,’ she says. ‘Say they probably need some help, but there’s nothing [the child] can do. That’s a really important message, because often children will feel either responsible for the problem or responsible to try and change it, which obviously is impossible.’

Laidlow also suggests using specific books or videos to encourage a child to speak. Jasper’s Wish, written by a former Nacoa volunteer counsellor, tells the story of how Jasper copes when placed into the care of his grandmothers. ‘Reading a book like this is really good because it can prompt them to ask questions,’ Laidlow says.

CASE STUDY: Tommy’s story

Now in his 40s, life could have been very different for Tommy* if someone had noticed how alcohol, and other problems, were damaging his childhood.

His father, a controlling man, was ‘barely there’. His mother complained about him constantly, telling Tommy things he was too young to hear.

Tommy had two siblings but felt no connection to them. Their father’s job moved them around the UK, making it hard for Tommy to make friends. ‘I was totally isolated,’ he says.

Tommy was born with a physical problem that affected his walking. Children in primary school bullied him about this. ‘They started calling me deformed,’ he says. ‘I got beaten up at school fairly often. I’d cry every morning.’

Teachers nor Tommy’s parents gave him the attention and love he needed. By the age of 12, he would spend time at home in a cupboard listening to rap music. He suffered from bulimia and incontinence.

Tommy can’t remember when his mother began drinking. Looking back, he sees she behaved strangely. ‘She used to pretend to have fits [when she was drunk],’ he says. ‘She developed this real angry face. There was always a scowl there. She looked at you like you’re just nothing.’

When Tommy started secondary school, he began to drink himself. ‘My mum started to buy us alcohol,’ he says. ‘I’d have friends around and she’d buy us cider. Once I tried drinking, it felt like a breath of fresh air. I felt I could be something I’d been wanting to be for such a long time. I’d hassle her to buy me alcohol. I think she was just so fed up with me crying and being upset in the past that she bought me it.’

Tommy describes his teenage years as ‘chaos’ – drink, drugs, violence and infrequent school attendance. By 16, his mother was buying two bottles of vodka a week, which she would try to hide. ‘The house was always a mess. There was dog crap everywhere and she never really looked after herself or us,’ he recalls. ‘She used to go to the pub four or five nights a week. I got my brother from a very young age to steal me food from the shops.’

Tommy’s mother never sought help for her alcohol problems. It wasn’t until his 30s, after a failed marriage, that Tommy’s brother convinced him to go to rehab. His body was so dependent on alcohol that he would down a pint of vodka in the morning just to ‘feel alright’. ‘I was scared to sleep,’ says Tommy. ‘I would wake up with tremors and hallucinations.’

Tommy has been sober for two years and nine months. He understands that much of what happened was not his fault. ‘Behaviours are passed down from family to family,’ he says. ‘Half of the time, we don’t recognise these behaviours and the damage that we can do to children. A connection – it’s what every human being needs.’

*Not his real name.

Caring for children taken into care

Early years settings may need to support children taken into care as a result of parental or carer substance misuse. One Oxfordshire nursery manager, who wishes to remain anonymous, cared for three children on child protection plans.

She advises settings begin such placements with open and honest conversations with the agencies involved and family members about any traumas the children have experienced.

‘We made sure they had something that was theirs – their comforter – and that their key person was always there,’ she adds. ‘There was constant feedback with families, and six weekly multi-agency reviews on how everybody was doing.’

Her main focus was to help the children build trust with staff and feel settled in their new homes. ‘With the three-year-old, we wrote a wish list of what she’d like to have in her new bedroom, then worked with the family to make that happen,’ she says.

She recommends settings investigate two services available from local authorities for looked after children: Virtual Schools, and Personal Education Plans (PEPs). ‘The PEPs are really effective – they really help you identify any emotional or social areas that the children may begin to struggle in,’ she adds.

FURTHER INFORMATION

• Public Health England guidance for professionals
• Nacoa
• Jasper’s Wish
• NSPCC Helpline: 0808 800 5000
• NSPCC, Parental substance misuse: https://bit.ly/2XoLqK0
• We are with you
• Talk to Frank
• Adfam
• Drugfam
• Alcoholics Anonymous UK