Child Maltreatment on Brain Development : Implications for Practice and Policy

by Child Welfare Information Gateway

(Page 4 of 5)

The knowledge we have gained from research examining the effects of maltreatment on brain development can be helpful in many ways. With this information, we are better able to understand what is happening within the brains of children who have been abused and neglected. In fact, much of this research is providing further, solid evidence for what professionals and caregivers have been describing in behavioral, emotional, and psychological terms. We can use this information to improve our systems of care, and to strengthen our prevention efforts.

There has been some encouraging progress in States' recognition of early brain development research and how this information can be used to improve services. In a survey conducted by the Child Welfare League of America in 2000, 31 States reported that they had reviewed relevant research findings. Many also reported that they had engaged in efforts to increase awareness about early brain development, and that both legislative and policy changes had occurred to enhance prevention, early intervention, and healthy child development programs.

The Child Welfare System

While the goal of the child welfare system is to protect children, many child welfare interventions-such as investigation, appearance in court, removal from home, placement in a foster home, etc.-may actually reinforce the child's view that the world is unknown, uncontrollable, and frightening. These experiences can actually contribute to the traumatized child's "catalog" of fearful situations. In addition, many child welfare systems in the United States do not provide comprehensive assessments to all children in their care, and therefore the treatments provided may not be the most effective-they may not accurately target each child's unique experience.

As much as possible, the child welfare system needs to address these deficits and reform practice to provide consistency, repetition, nurturance, predictability, and control (returned to the child) to diminish the fearful nature of the interventions. In addition, child welfare systems should provide comprehensive assessments for all children as soon as possible to examine their physical, cognitive, emotional, and social development. Accomplishing these objectives will require the participation of all stakeholders including policymakers; family court judges; managers; child welfare workers; medical, mental health, and education professionals; kinship, foster, and adoptive parents; and the parents and children themselves. Every group must examine its contribution to the development of the children served by the child welfare system, and strive to provide that contribution in a manner that will promote healthy development for each child.

The Role of Professionals

One of the first tasks for professionals who work with children who have been maltreated is to educate themselves about the effects of maltreatment on early brain development, as well as interventions likely to be effective. For example, "talk" therapy must do more than talk if the child is in a persistent hyper-arousal state; the child's brain may well be unresponsive to verbal interactions. According to Dr. Schore, "What will get through is tone of voice, demeanor, facial expressions and a sense of empathy that is rooted in the early psychobiological attunement between mother and infant".

Professionals who are knowledgeable about this issue need to educate others who work with and care for the children. Information can be provided to foster parents and other caregivers to help them understand the effects of maltreatment on children's brain development, how those early experiences may influence current behavior and functioning, and what can be done to help the children recover their lost potential. CPS workers, judges, and teachers also may not be knowledgeable about these issues; they can benefit from opportunities to understand the importance of their contributions to the child's environment. By working in a coordinated manner, professionals and caregivers can help to minimize unpredictable, unknown, and frightening experiences and assist the child's movement along a path of healthy development.

Human service professionals are increasingly receptive to new knowledge about human brain development. Professionals across disciplines are engaged in exciting new efforts to rethink the brain and apply the knowledge and ideas to support the healthy development and well-being of children. As these efforts begin to offer meaningful information, it must be translated into policies and practices for the front-line workers and caregivers in order to have the most impact on improving child well-being in child welfare systems.

The Role of Caregivers

Many children who have suffered abuse and neglect are removed from their homes by the child welfare system for their safety. These children may be temporarily cared for by extended family, foster parents, or group home staff, and some will be adopted. While many caregivers have an innate sense about how to raise children, familiarity with the effects of maltreatment on brain development and the possible manifestations of those effects are not likely to be "common knowledge."

It is important for caregivers to have realistic expectations for the children in their care. Children who have been abused or neglected may not be functioning at their chronological age in terms of their physical, social, emotional, and cognitive skills. They may also be displaying unusual and/or difficult coping behaviors. For example, abused or neglected children may:

• Be unable to control their emotions and have frequent outbursts
• Be quiet and submissive
• Have difficulties learning in school
• Have difficulties getting along with siblings or classmates
• Have unusual eating or sleeping behaviors
• Attempt to provoke fights or solicit sexual experiences
• Be socially or emotionally inappropriate for their age
• Be unresponsive to affection.

"It is easy for foster parents to become confused, frustrated, and sometimes devastated from the lack of response and reciprocity to the love, affection, attention, and care they offer". Even caregivers with the best of intentions can misunderstand a child's behavior, fashion their response based on that misunderstanding, and then wonder why their response was not effective.

About the Author

www.childwelfare.gov
Formerly the National Clearinghouse on Child Abuse and Neglect Information and the National Adoption Information Clearinghouse, Child Welfare Information Gateway provides access to information and resources to help protect children and strengthen families. A service of the Children's Bureau, Administration for Children and Families, U.S. Department of Health and Human Services.