Positive Relationships: Ask the expert ... Healing the hurt

In our school, we have an eight-year-old boy who was born in prison to a substance abuse addict and spent the first year of his life with an overbearing grandmother and obnoxious father. I believe he has attachment issues, which run through most of his behaviour - usually a violent reaction to any request. He has reacted badly to the school's Behaviour Support Team, and I seem to be the only one he responds to positively. His parents and grandparent, all of whom I've met, are aggressive and closed. What do I do to help this child?

This is a complex case and I wonder how it is that the child has reached the age of eight without, apparently, any interventions. First, his mother's addiction has given the child a difficult start in life. Unfortunately, the substance involved is not stated, as different drugs produce different effects in the child - or rather, their effects can be ameliorated by consistent, nurturing post-natal care.

For example, Karr-Morse & Wiley (1997) note that some babies born to crack cocaine-addicted mothers appeared to develop normally when they were placed in 'nurturing and stimulating' adoptive families. However, if not so fortunate, these children appear to have high levels of learning difficulties and attention deficits.

Alcohol misuse can have a devastating effect on the foetus, affecting the development of both bodily structures and the brain. The damage leads to a range of problems, including learning difficulties, behaviour problems, attention deficits and hyperactivity. Smoking (tobacco) can exacerbate the effects of alcohol misuse for the child.

Whatever the drug involved, it is often the impoverished emotional environment post-natally that really contributes to the child's later problems. A parent who is preoccupied with their need for a drug and the money required to acquire it, and then subject to the mood changes that accompany drug use, will fail to meet a child's most basic needs (Howe, 2005).

The fact that this child was born in prison suggests that the ante-natal period was also fraught with stress. The mother's own attitude to her pregnancy and stress levels will have affected the unborn child.

It is likely, too, that the child was born 'addicted', probably making his whole temperament more agitated and making him harder to care for.

BEHAVIOURAL DISORDERS

A longitudinal study by Sydsjo, Wadsby & Svedin (2001) of early mother-child interaction and behavioural disturbances in children at eight years of age (which seemed a particularly relevant paper) notes that mothers who 'experience psychosocial problems during pregnancy are at considerable risk of having children with behavioural disorders' (p143), which appear to persist well past infancy.

If the child's experiences are confounded by separations and less than optimal care, we have a scenario where an already vulnerable baby has his experiences compounded over time, probably giving him a very negative view of the world, adults and himself.

ATTACHMENT

We do not know what kind of attachment relationship this child made with his father and grandmother during this first year. But it will be the quality of that relationship that determines the type of attachment the child has.

I would imagine that the writer is correct that he does have 'attachment issues', which probably underpin his behaviour, but his anger, distress and violent reactions may stem from his pre-natal drug exposure.

We do not know how the changes in family dynamics were dealt with and how he was supported and understood - or not. There may also have been house moves, which can unsettle 'secure' children but will leave a child with emotional difficulties feeling unstable and lacking safety.

Nor do we know how long he has been at this particular school and the role of the writer, which would influence the type of intervention and support that she could give.

The child should be assessed for any learning difficulties that could be compounding his emotional problems and adding to his frustration and upset. What can be a danger with such a child is that basic aspects of his well-being are overlooked. For example, have his hearing and eyesight been checked? Have staff noticed any particular reactions or sensitivities to various smells or tastes? Does he respond to touch, and so on?

REACTIONS

Other areas of difficulty for him could be his capacity to make friends, and others' reactions to him. Do other children avoid him? Is he perceived sympathetically by staff? Children have powerful 'antennae' for how adults perceive them, and boys particularly appear to be very sensitive to whether they feel liked or disliked (Sax, 2005).

I also wonder what is meant by his 'bad' reaction to the Behaviour Support Team, as these are usually highly experienced individuals. Perhaps he is reacting to being given boundaries, and if he has not had these before or does not understand them, he may react poorly towards their imposition.

Also, is he taken from the classroom when a team member visits? Many children react 'badly' to such a situation, as they feel stigmatised, and highlighting their need for additional help may result in teasing/bullying.

His violent reaction to any request is mentioned. But does he fully recognise what adults want and expect?

I feel that although this child may be chronologically eight years old, in maturation he levels may be much younger. So his emotional needs, which may still be those of a very young child, need to be addressed before he can move on and partake in the everyday life of a busy school.

What seems to me to be vital, however, is to build on this child's apparent trust in the writer and to use this relationship to help the child regain some self-esteem.

The writer should think about what within her the child likes and responds to. Perhaps he senses that she accepts him for who he is and helps him to grow. But the writer cannot do this alone. She must work with the behaviour support team to build on the positive elements they identify in this child.

Finally, and this is hard, the writer must put aside her feelings about the boy's family and make every effort to value and welcome them, so everyone can work together to help this child.

They may refuse all help, but the writer must try to understand that their 'aggressive and closed' behaviour may stem from feeling judged and ostracised. The writer must also model a positive attitude herself so that the child can begin to feel safe.

There are no easy answers for this child, but I hope that something of what I have said is of some help.

REFERENCES

- Sydsjo, G, Wadsby, M, Goran Svedin: (2001) 'Pyschosocial Risk Mothers: early mother-child interaction and behavioural disturbances in children at eight years of age', Journal of Reproductive and Infant Psycholoogy, Vol 19, No2, pp135-145

- Karr-Morse, R, Wiley, MS, (1997) Ghosts from the Nursery: Tracing the Roots of Violence. New York, Atlantic Monthly Press

- Nadel, J, Muir, D, eds. (2005) Emotional Development. Oxford University Press

- Sax, L (2005) Why Gender Matters. New York, Broadway Books

- Howe, D (2005) Child Abuse and Neglect: Attachment, development and intervention. Basingstoke, Palgrave MacmIllan

Maria Robinson is an early years consultant and author of From Birth to One and Child Development from Birth to Eight: A journey through the early years (Open University Press). Her Nursery World series on child development can be bought online at: www.nurseryworld.co.uk/Books

If you have a behaviour query for Maria Robinson, please e-mail it to: ruth.thomson@haymarket.com, or write to the address on p15