Neglect

1. The Impact of Trauma and Abuse on Children’s Attachment and Development.Laverne Antrobus10.2.16

2. Neglect • Neglect is the ongoing failure to meet a child’s basic needs and is the most common form of abuse. • A child may be left hungry or dirty, without adequate clothing, shelter, supervision, medical or health care. • A child may be put in danger or not protected from physical or emotional harm • They may not get the love, care and attention they need from their parents

3. A child who is neglected will often suffer from other abuse as well. Neglect is dangerous and can cause , long-term damage – even death.

4. Neglect is difficult to spot…usually because it is often the absence of something rather than the presence and relies on an individuals judgement. • Lack of basic nurturing can lead to serious psychological problems • E.g. Romanian orphanages

5. These infants could spend up to 20 hours a day in their cots unattended. • Many showed serious cognitive impairment – much of which persisted in later years • Others engaged in stereotypical or self stimulatory/soothing behaviours. • Early neglect has been shown to lead to considerable deficits in IQ, affect brain development and general emotional development

6. Parents • Neglectful/problematic parenting – where parents do not see/are not able to interpret the signals from their children • Or see the signs and assume nothing is needed from them or are simply unable to find/provide a response

7. Attachment types – how experience shapes behaviour and belief • Secure: distressed by separation; accepts comfort; recovers equilibrium • Insecure – avoidant / anxious: little distress on separation; ignores parent on return; watchful and inhibited in play • Insecure- ambivalent / resistant: high levels of distress on separation; not comforted by reunion; alternates between anger and clinging; inhibited in play • Disorganised – confused / disturbed behaviour including ‘freezing’ Models of attachment are subject to change over time

8. The purpose of attachment • The experience of security (emotional and physical) is the goal of the attachment system • Attachment can be viewed as an evolutionary survival strategy • The child who is secure in their dependence on their carer can take steps to independence , safe in the knowledge they can retreat to the ‘secure base’ of their carer • This has parallels in the processes of learning and exploring. What risks can be taken? What errors can be tolerated?

9. Effect of Abuse/Trauma High stress levels Difficulty focusing and concentrating Problems regulating emotions A hyper alertness/vigilance making it difficult to relax Victims of abuse with no safe adult to rely can be seen responding in number of different ways -identifying with the abuser -becoming violent

10. Others may retreat or take up a dissociative state • Numb like state • Inability to use their emotions and bodily reactions to guide them to know about dangerous situations

11. Case Study • 5 year old • Early life spent in an orphanage • Very little care and stimulation • Lack of control of psychological and emotional state • Insecure Attachments • Assessment over 3 months

12. Your thoughts… • Did the experience of being cared for/thought about help • Our hope was that if she continued to receive care in this way some new ways of relating/attaching might be possible • Healthier brain structure as a result of better experiences? • Thoughts/Questions?

13. References • NSPCC website • ‘Nurturing Natures’ by Graham Music