A couple of weeks ago, I wrote a blog about Sylvia Duncan’s presentation at the Trauma Informed Practice Conference in Birmingham in September, which you can find HERE. I mentioned how she pointed out the importance of not making false promises, in order to gain a child’s trust. I have realised that there is something else she mentioned that is important to share.
She spoke about how children who have not been able to form attachments when they were very young, and those whose trust has been broken to the point where they have lost any willingness to form new attachments, may be 7 or 8 years old, but in a lot of ways, emotionally, they function like babies. Because they have not had the opportunity to go through those early development stages yet, or they have regressed to before the stage where they went through that development.
The fact that these children in certain ways are at the developmental stage of a baby, does not mean that they need to be carried around or put in nappies. They are still school-age children and need to be allowed their dignity. However, on certain levels, they do need to be given the kind of security and reassurance that is usually given to a baby and not to a school-age child.
Generally speaking, school-age children have already developed a certain sense of independence. They will go out and play by themselves and do not need to be watched and supported every moment of the day. Babies do need this, because they are unable to self-regulate – they need co-regulation to calm down again every time they become afraid, anxious or upset – and also because it is through the constant interaction with, and reassurance by, a trustworthy adult that the baby learns to form attachments (and forms the neural pathways in the brain to be able to do so).
In this sense, children who have been neglected or who have gone through very traumatic experiences are very much like babies in their needs. In the partnership that Ms Duncan talked about, where they succeeded in preparing ‘impossible to place’ children in long-term family care in 83% of cases, giving the children two years and lots of support to help them go through the development of the ability to form attachments was at the core of their programme.
In order to give these children the sense of security they needed to start trusting the foster families caring for them and to gradually learn to form attachments to them, a very stable and secure environment had to be created.
To provide a sense of security, Ms Duncan mentioned the importance of providing stability of 1) Place; 2) Person; and 3) Routine.
Stability of place means that to start out with, certainly the first year or so, the child was not taken along to all kinds of places. The child first needed to become completely familiar and at home in their own home and in their classroom. The foster parents were instructed not to take the child out to visit friends, to go on outings, or to go to shops, etc. Only when the child was starting to feel secure and starting to bond with the foster parents, could they slowly start to introduce occasional outings such as going to the shop or visiting someone the child was already very familiar with, and slowly building on that.
Stability of person means the foster parents were also instructed not to have lots of people coming to their home to visit them. The child needs to be given the opportunity to become familiar with the foster parents and start to build up trust and a bond with them. Having a lot of other people come in and out, would introduce stress into the house and make it harder for the child to feel secure there, at the start. It also meant that the foster parents who signed up for this, had to agree to be there for the child for the whole two year period, no respite care and no sending the child out for a sleep-over during that time.
Stability of routine, means giving the child a sense of security by making every day very predictable. With things like mealtimes, bedtime, school time, bath time and play time at set moments of the day, the routine can provide the child with a sense of comfort. It is something to hold on to, to help the child self-regulate, by knowing this will end at that time and then that will happen. No surprises to produce stress.
As much as possible these three things need to be kept stable, to provide the child with a sense of security and to help bring down their stress levels. If it is unavoidable to interrupt things, only one out of three should be changed. So out of place/person/routine, when the stability of all has been estabilished for the child, you can start to change something about either the place, or the person or the routine.
In other words, if you go out of the home (the place of security) it needs to be with the person who is normally always around and still adhering to the normal routine of the sequence of events in the day. If the foster parents are unable to be around for the child – the person is changed – the child should still be able to be in the home, and the person taking care of the child should be someone the child already knowns (has met on a number of occasions) and who is very familiar with the child’s routine, so that no changes will be made to it. This was a service provided by the programme, for emergencies, instead of the respite care usually available to foster parent. And if the routine is going to be disturbed, the child should at least be allowed to be in a very familiar place and with a trusted (by the child) person, to help reassure the child and help them deal with the changes.
This approach proved very effective. And it is heartening to hear that even children who are extremely troubled by their background can still be given the opportunity to catch up on this important development. It is not easy to do, however, and it requires very thorough training and a lot of support for the foster family. Also, to be able to handle all of these children’s needs, they had to be placed as the only child (or the youngest by a large gap) in the family.
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Indeed effective techniques, as already mentioned above maintaining trust with the Child is of utmost importance and maintaining this trust consistent is another. One of the challenge as i see through my practice with children is to maintain that pace in between love, care and discipline especially with the children of age group 8-10 years with a fair understanding in institutional care.
VERY NICE BLOG, FAIRLY UNDERSTOOD AND PRETTY MUCH EVIDENCE BASED.