A. Psychological Effects
It is important to make the connection between lack of resolution of developmental crises and emotional disturbance. Also review with trainees, through large or small group discussion, the difference between lack of opportunity to resolve developmental crises, development of pathological behavior to respond to an unhealthy home situation and healthy responses to an unhealthy home situation.
1.The child is likely to suffer severe damage to his self esteem, due to many denigrating and punitive messages he receives from the abusive parent. Poor self esteem can negatively influence the child's school performance, ability to form meaningful relationships with peers and adults, and derail his drive towards developmental mastery.
2.The child is at risk of suffering from depression, which may include self destructive behavior (inflicting injury, drug/alcohol abuse, running away from home, truancy from school). The seriousness of this condition should not be underestimated; suicidal ideation and/or gestures should be treated seriously.
3.The child is at risk for emotional problems such as overanxious disorder, unsocialized disorders. Discuss with trainees the variables that may be involved in the development of such a disorder i.e. child's temperament, the nature (severity, chronicity or acuteness) of the abuse, the availability of healthy and nurturing significant others in the child's life, the emotional health or illness of the parents, the family dynamics surrounding the abuse, the child's coping mechanisms, the child's level of ego development, the child's level of cognitive development, etc.
B. Behavior Patterns of Abused Children
When appropriate (depending on how inclusive the previous discussion was), review how and why these behaviors are developed.
1. Expressiveness and apparent sense of self:
a. The child may have few opinions, with no strong likes or dislikes
b. The child may be impulsive or, at the other extreme, unable to be spontaneous
c. These children may show extremes of behavior, such as acting in over aggressive or withdrawn ways.
d. The child's behavior may seem to reflect an earlier stage of emotional development (i.e.: he may continue to use physical aggression at an age when most children have started using verbal aggression instead)
e. The child may comfort himself through rocking and sucking
f. The child's behavior may show feelings of low self esteem: he may believe himself to be worthless, bad unlovable
2. The child may have very low tolerance to frustration or adversity, and may require immediate gratification
3. Language and learning problems:
a. Learning disabilities
b. Speech impediments
c. Poor memory
d. Declining academic ability
e. The child may appear to be driven to excel academically or show steady decline in schoolwork and I.Q
4. Relationships with peers
a. The child may feel different from peers and may not know how to make friends.
b. The child may be apprehensive when others cry
c. The child may attempt to control, exploit, manipulate peers to get things, services
d. The child may blame others when things go wrong
e. The child may have great difficulty making friends
f. The child may lack empathy for others' feelings
g. The child may become a scapegoat
h. The child may be self-destructive, exhibit antisocial behavior or withdrawn, passive behavior
5. Relationships with parents
a. The child may exhibit suspicious, mistrustful behavior which mirrors that of his/her parents
b. The child may talk glowingly (if unrealistically) about home and parents
c. The child may be solicitous of parent's needs
d. The child may not turn to parent for comfort
e. The child may exhibit inappropriately adult like behavior
f. The child may seek approval, attention
6. Relationships with other adults
a. The child may be solicitous and agreeable or suspicious and mistrustful towards adults
b. The child may try to control and manipulate to obtain food and favors
c. The child may not respond to praise and positive attention
d. The child may not respond to limits
e. The child may avoid being touched
C. The long term effects on a child's interpersonal skills
1. The child's senses may become muted, to avoid a painful environment. This often occurs in infancy.
2. Since the child's basic needs may not be met, he may not develop a basic sense of trust in adults in his life, and in his ability to impact on his environment
3. The child may engage in role reversal with the parent, or psuedo - mature behavior, since the parent expects the child to meet the parent's needs.
4. The child may have impaired decision making and problem solving.
5. Since the child cannot trust others, he may have difficulty forming true, lasting friendships
6. The child may equate feelings with actions, that is, he has not learned that a cognitive process occurs between the thinking of a thought and an action.
7. There are factors within the provision of child welfare services that may have deleterious results:
a. The child's with natural parents may be too infrequent to ensure attachment, or to solve relationship problems.
b. Feelings of worthlessness, and guilt may increase as a result of the placement process.
D. Treatment Implications
1. Most abused or neglected children probably need mental health counseling to resolve the behavioral and emotional problems discussed above.
2. Remediation for academic difficulty or learning problems should be assessed and provided when necessary
3. Speech therapy, and occupational therapy for gross of fine motor delays should be assessed and provided when necessary
4. Since the child's sense of self confidence and master is seriously impaired, remediation of learning problems alone is not enough. The child may need special therapeutic activities.