This is an adapted extract from Chapter 2 titled ‘Working with Children’ of Messy Social Work by Richard Devine.
Working with Children
The police attended a home after a neighbour contacted them and reported that they had heard shouting and screaming late at night. In the police report, it said, Arrived at property at 00:12, victim 21-year-old female, Lianne Watson, answered the door, holding Jacob, her two-year-old son. Victim upset and distressed. Said she argued with male suspect and partner, Gary Oldham. Suspect was angry, left while swearing denying he had done anything. After suspect left, we spoke to victim who didn’t want to prosecute. By the time I visited them two days later, Lianne and Gary presented as a unified couple, committed to their relationship with one another. They described the stress of looking after Jacob and his three-month old sister Ella with little family support, and recalled difficult experiences growing up. They told me they had hated school, often being bullied and having few friends. Lianne said she fell for Gary when he stood up for her as a group of girls were making fun of her at the bus stop after school. After that, Gary said they were inseparable. They didn’t care what others thought of them. Sometimes they would ‘bunk’ off school together and wander around, smoking cigarettes by the river and listening to music on shared headphones. They both got jobs in a local supermarket, and, with money in their pockets, they said this was the best time of their lives. When Lianne got pregnant at 17, they were excited, dreaming of having a happy family together. When I asked about the police report, they said they had argued about the night feed, and there was confusion about whose turn it was. Jacob was awake and didn’t seem affected, and Ella was asleep the whole time. I left the visit feeling sorry for the parents. Lianne had a sense of futility born out of a life where others had mistreated her, leaving her feeling powerless to change it, whereas Gary presented as deeply insecure about whether others would be there for him. This, coupled with Gary’s inability to handle strong feelings, meant he was defensive and inclined to misread situations, and he acted angrily and aggressively. Both parents, however, were desperate to try and afford their children the upbringing neither had had themselves.
I wrote up the assessment a few days later. I believed that because Jacob was young and Ella had been asleep, that the effects of witnessing or hearing their parents shout and argue would be negligible. I said their age was a protective factor because neither would remember this incident or have the language to describe what had happened.
My manager read the report. While I sat at my desk, she walked over with the report in her hand and pulled a chair around to sit beside me. Receiving feedback on my assessments always invoked anxiety.
I put a lot of effort into writing an assessment, so it was always uncomfortable and difficult for me to learn about the many errors in terms of format, grammar or content. When we reached the section in the report about Jacob and Ella where I had written that their young age protected them from the effects of domestic abuse, my manager asked me, ‘What did you mean by this?’ ‘Wasn’t it obvious?’ I thought to myself, trying to conceal my confusion by the question. ‘Oh, um, I guess that Jacob and Ella are so young they probably aren’t aware of what happened, so this kind of protected them.’
If they were older, I could understand the query because they would know what had happened and then be able to talk about it and remember it when they were older. Now it was my manager’s turn to look confused; unlike me, however, she didn’t hide it. She said, with encouragement, ‘I would suggest taking a look at some of the research on how domestic abuse can impact on infants, then we can re-think it.’ This feedback from my manager was a formative moment for me. I assumed that children were not affected by domestic abuse because they were too young. When my manager questioned me on this, I went on a journey to learn about the impact of early experiences on brain development. This chapter is about that journey and how my understanding of children’s development evolved. I also explore the limitations of what I learned and how this led me to look elsewhere into attachment theory and the implications this had for my practice.
Brain development
Initially, I learned about brain development in childhood. In their engrossing book, The Boy Who Was Raised as a Dog, psychiatrist Dr Bruce Perry and journalist Maria Szalavitz (2017) weave together insights from neuroscience with captivating case studies to describe how the brain undergoes significant development during infancy. Perry and Szalavitz describe how the brain develops sequentially and from the bottom up. The brainstem, responsible for essential regulatory functions, develops in utero and early infancy. The midbrain and limbic systems develop next, rapidly developing in the first few years. The cortex, the most evolutionary recent and sophisticated part of the brain responsible for abstract thought, emotional regulation and planning, develops in adolescence and doesn’t finish developing until well into adulthood.
Perry and Szalavitz point out that a baby’s responsiveness to its environment during this stage allows the baby to grow quickly, but also makes the baby vulnerable to negative experiences. This means that adversity or a traumatic experience can impact a child differently, depending on their age. Chronic and severe exposure to trauma early in infancy can alter the systems that regulate essential functions, and this can create lasting problems with physiological arousal (e.g., eating, toileting, sleeping, attachment, etc.) and emotional regulation. In turn, developmental capabilities that follow on from this as the child gets older, such as socialization, turn-taking and reading, can be harder to achieve or undermined by disruptions in essential arousal. A house built on shaky foundations is an overused yet helpful analogy here.
Alternatively, if a child has a stable start, with loving, attentive caregivers, and is then exposed to difficulties in middle childhood or adolescence, this will have a different impact because the brain is at a different stage of development. The effect of these disruptions will depend on the type of harm, duration, severity and availability of attentive, caring adults in the child’s life.
This perspective had significant implications for my practice, especially later in my career, when I was involved in care proceedings and I had to support children in transitioning and adjusting to foster care.
For example, a few years after I read Perry and Szalavitz’s book, I was the social worker for Jack. Jack was an adorable six-year-old well-built boy with curly brown hair and big, round, brown eyes. He could be mischievous and energetic, and at times, showed very challenging behaviours that wreaked havoc for his foster carers, Marie and Andy. They were besotted with him but were exhausted because he had so much energy and would have ‘massive meltdowns’ over tiny things. Marie and Andy were frustrated about Jack’s difficulty in doing what other six-year-old children could do, such as getting along with other children, listening to instructions, engaging in joint play, concentrating for short periods and learning some basic self-care skills. These behaviours also affected him in school. Although Marie and Andy understood – theoretically – that the serious and frightening incidents of violence between his parents, frequent police callouts and the emotional abuse from his mum had affected Jack’s development and ability to trust others, they struggled to know what to do differently. I was also at a loss. My job involved assessing harm to a child, a parent’s capacity to change and making difficult recommendations. I felt ill equipped and out of my depth offering therapeutic parenting advice.
In the midst of this, I remembered Perry’s idea of the neurosequential model of therapeutics, which he observed in one of the foster carers he worked with, called ‘Mama P.’ When Mama P. had rocked and held the traumatized children she cared for, she’d intuitively discovered what would become the foundation of our neuro-sequential approach: these children need patterned, repetitive experiences appropriate to their developmental needs that reflect the age which they’d missed important stimuli or had been traumatized, not their chronological age. (Perry and Szalavitz 2017, p.152) In reflecting on this idea with Marie and Andy, we discussed how they could care for Jack in a way that compensated for the lack of soothing, repetitive, rhythmic and connected experiences during his infancy. Marie started taking him to baby massage, sing and sign and baby swimming classes; chronologically, he was the oldest in these classes by a large margin, but developmentally, he fitted in. Marie and Andy also changed his evening routine, treating him like a much younger child, having a bath every night, rocking and singing nursery rhymes to him.
Did this solve all of Jack’s emotional and behavioural problems? Unfortunately not. There are no solutions that provide perfect outcomes in social work, a painful lesson that I learned over and over again. But it did reduce the intensity of Jack’s ‘meltdowns’, helped Marie and Andy feel more confident, and improved their relationship enough to prevent it from breaking down.
Richard Devine is a qualified social worker with over 10 years’ experience, with an MSc in Attachment Studies, and is Visiting Researcher at Cambridge University.
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