Listen to thisThe effects of prolonged abuse and neglect often persist long after a child has been removed from the home, manifesting as a puzzling picture of delinquent behaviors and academic failures. This article reminds readers to look beyond the conduct to the child’s history and its context.
David had a long history of running away from home and being disruptive in school. Because of this, he had been declared incorrigible by the courts and placed in foster care for a short period of time. By high school, he was diagnosed with a severe emotional/behavioral disorder and placed in special education classes.
Philip had a long history of drug abuse, noncompliance, and running away. He had also been declared incorrigible and hospitalized in a residential treatment facility. He began abusing drugs and was placed on probation. He finally dropped out of high school when he turned 18.
I encountered both of these young men when they were on my caseload as the case manager for students with emotional and behavioral disorders at their high school. While their special education folders provided me with much pertinent information about their histories and school performance, one of the most significant factors in their lives was conspicuously absent: the fact that they had both suffered severe physical abuse as young children.
Phillip finally revealed this to me one day as he was describing his history of running away and of being hospitalized for incorrigible behavior. I asked him why he had done such things, and he said that his parents used to beat him with fly swatters, so he ran away. When I asked him why he had never told anyone, he said that no one had ever asked. This highlighted for me a significant weakness in our response to juvenile delinquency. We tend to see outward behaviors as totally separate from history or context, from either past or present. “Juvenile delinquent” becomes the sum total of all that is wrong with a youth, and also relieves us of any response but incarceration and the courts.
The Persistent Effects of Maltreatment
Research consistently shows a significant correlation between a history of abuse and subsequent delinquent behavior and involvement in the juvenile courts. In particular, this correlation was confirmed by the results of a recent study (Sexton, 1998) that examined the school histories of 123 young people currently living in foster care. All of these young people had been removed from their homes because of abuse and/or neglect, and a striking number demonstrated similar negative patterns in their behavior, academic achievement, and relationships. The four patterns revealed in this study have also been well documented through much additional research.
Drug involvement and aggression
In studies involving maltreated children, the behaviors that most frequently require intervention by the courts involve drug abuse and aggression. According to Groves, Zuckerman, Marans, and Cohen (1993), children who have been mistreated may fail to take adequate care of themselves, and “seek relief from the intolerable feelings of fear and anxiety through alcohol and other drug abuse; and/or they may become the perpetrators of violence” (p. 264). When seen in the context of a significant history of abuse, both of these behaviors can be understood as efforts to relieve unbearable pain, either by numbing it or turning it outward.
Negative academic outcomes
Maltreatment — both the commission of physical abuse and the omission of neglect — is also implicated in a broad array of negative academic and social outcomes. These ranged from below-average performance on intelligence tests to social and emotional problems ranging from hostility to apathy and withdrawal, to learning problems and low self-esteem (Cicchetti, 1989; Erickson, Egeland, & Pianta, 1989; Malinosky-Rummel & Hanson, 1993). The exceptional over-representation of older, maltreated children in populations of truants (as well as runaways, delinquents, prostitutes, and chemically dependent youth) also underlines this grave consequence of abuse and neglect (Kurtz, Gaudin, Wodarski, & Howing, 1993).
Disrupted relationships with peers
In addition to its effects on behavior and academic achievement, abuse can affect children’s social relationships in dramatic ways. In particular, maltreated children exhibit significant deficits in peer interaction and in emotional control (Hoffman-Plotkin & Twentyman, 1984; Cicchetti, 1989). They have difficulty not only in regulating their own emotions, but also in reading others’ emotions. This is often demonstrated by their failure to show empathy (Erickson, Egeland, & Pianta, 1989) and by their responding with fear, anger, and physical aggression to other children who are upset. Although both neglected and abused children show more aggression toward peers than children who have not been maltreated, neglected children interact less frequently with peers, while the aggression of physically abused children spills over into fantasy and free play.
Disrupted relationships with adults
Research also indicates that maltreated children have far greater difficulty developing good relationships with adult caregivers other than their parents than children who have not been maltreated have (Cicchetti et aI., 1993). In fact, these children may “manifest a striking difficulty with relationship formation, maintenance, and consolidation that persists over time and that extends to other adults as well as to peers" (Cicchetti, 1989, p. 399). Superficially innocuous overtures by an adult to build relationships with a child, or entirely appropriate discipline, may spark unexpected and disturbing responses in a chronically traumatized child, which in turn affect the way those adults interact with the child (James, 1994).
Looking beyond the Behavior
Often, the simplest way to view young people who are acting out in the four ways described above is to categorize them as “conduct disordered” or “oppositional defiant.” However, my early experience as a special education resource support person for students with emotional/behavioral disorders taught me the inherent danger of such thinking. At that time, I had 20 adolescents on my caseload, virtually all of whom had a behavioral history rife with aggressive, oppositional behaviors, and drug abuse. However, when I got to know them, only one actually met the criteria for a conduct disorder. The rest were living out the effects of experiences early in life that had set them on a trajectory of school failure and trouble with the juvenile justice system. So what, then, do we do with these troubled and troubling young people? Clearly, the answer is a complex one that involves primary prevention (e.g., wraparound services to meet the needs of at-risk families) and various types of social, emotional, and academic support. However, at the heart of maltreatment is a disruption in the primary relationship between the child and the one person who should have taken care of him or her.
Therefore, one of the greatest needs for these children is to come in contact with at least one person they can trust, rely on, and bond with. Above all else, maltreated children need such caring adults who are predictable and “there” for them long-term.
Unfortunately, many of our social service and educational policies are not designed to meet this need. For example, in the study cited earlier (Sexton, 1998), it was not uncommon for the participating foster children to have been moved five or more times from one foster home to another. In schools as well, such discontinuity is built into the very structure of the system. In junior high and high schools, students change classes up to six or seven times a day and have a different teacher each period.
Elementary school children often bond with one teacher for a year, but then must move on to a new teacher when they enter the next grade. While this can be difficult for typical children, it can be devastating for children who have been maltreated, because every change signifies another loss. Although enrollment in special education resource classes may allow for a slightly greater chance to forge and maintain relationships, overall, opportunities to provide nurturance can be limited.
However, schools and programs around the country are finding innovative ways to meet this need. For example, nurturing is an integral part of the structure of the successful Central Park East schools in New York City (Meier, 1995). While these schools exist in some of the most dangerous settings in America, they are characterized by great success for their children. Not surprisingly, their program includes a group component where every adult in the school meets for six hours a week with a small group of young people, providing counsel, guidance, and nurturance. Hopefully, such programs and their promising results will encourage all of us to look beyond young people’s troubling behavior to the history and context in which it occurred, and to find new ways to provide the nurturing and support that all children need to grow and thrive.
References
Cicchetti, D. (1989). How research on child maltreatment has informed the study of child development: Perspectives from developmental psychopathology. In Cicchetti, D . & Carlson, V. (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 377-431). New York: Cambridge University Press.
Cicchetti, D., & Carlson. V. (1989). Preface. In Cicchetti. D., & Carlson, V. (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. xiii-xx). New York: Cambridge University Press.
Cicchetti, D., Rogosch. F., Lynch, M., & Holt. K. (1993). Resilience in maltreated children: Processes leading to adaptive outcome. Development and Psychopathology, 5. 629-647.
Erickson, M., Egeland. B., & Pianta, B. (1989). The effects of maltreatment on the development of young children. In Cicchetti. D . & Carlson, V. (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 647-685). New York: Cambridge University Press.
Groves, B., Zuckerman, B., Marans, S., & Cohen, D. (1993). Silent victims: Children who witness violence. JAMA, 269, 262-264.
Hoffman-Plotkin, D., & Twentyman, C. (1984). A multimodal assessment of behavioral and cognitive deficits in abused and neglected preschoolers. Child Development. 55. 794-802.
James, B. (1994). Handbook for the treatment of attachment trauma problems in children. New York: The Free Press.
Kurtz, D ., Gaudin, J., Wodarski, J., & Howing, P. (1993). Maltreatment in the school-aged child: School performance consequences. Child Abuse and Neglect, 17, 581-589.
Malinosky-Rummel, R., & Hanson, D. (1993). Long-term consequences of childhood physical abuse. Psychological Bulletin, 114,668-79.
Meier. D. (1995). The power of their ideas. Boston: Beacon Press.
Sexton, E. (1998). A study of the impact of risk factors on the developmental trajectory of maltreated children. Unpublished doctoral dissertation, University of Nevada. Reno.
This feature from Reaching Today’s Youth, Vol.3,3, pp. 10-12
