Child Abuse and Neglect, Vol. 3, pp. 959 - 965. 0 i 45-2134/79/0901-0959 $02.00/0. © Pergamon Press Ltd., 1979. Printed in Great Britain.

THE ABUSED CHILD: THE SCHOOL'S RESPONSE

DORO~RY DAY, FIELD OFFICER

CENTRE FOR Ih~DRMATIC~ AND ADVICE ON EDUCATIONAL DISADVANtaGE ii Anson Road, Manchester MI4 5BY

Child abuse is a world wide problem. It is neither Peculiar to any one soclo economic group, although more common in depressed areas. Nor is it limited to any age group. These facts mean that schools at any stage of education have to face and cope with the problem of abused children in their midst.

The initial feeling in many schools when cases of physical abuse become obvious to both teaching end ancillary staff is one of extreme anger. To most school personnel child abuse has not previously been within their experience, neither have they been trained to expect it or understand any of the causes. Therefore their quite forglveable first reaction is to suggest retribution and the immediate removal of the child from his family. The possible wider problems for the child if he is removed from his family are not, in the first instance, clear to the adults in the school.

Although this initial anger ks natural, it is not a satisfactory permament reaction. Whilst coping with distressing cases, school personnel need to be aware of, and try to understand, the stresses and strains suffered by the parents and the overall complexity of child abuse. We cannot completely exonerate parents but it is im~ortent that we realiss that in most families where children are abused, the parents need help desperately. There is strong evidence that there is a cycle of abuse and that parents abused, or rejected by their parents, are likely to abuse their children; most cases are co~lex and parents of whatever class, race or creed probably suffer a multiplicity of adverse material, medical and emotional circ~m~-tances.

The school cannot and should not be the sole agent in dealing with the complexities of child abuse but neither can it avoid being involved in the overall situation of individual cases. All children spemd a considerable amount of their waking hours on the school premises end it

is frequently the case that thole from families in most need of help arrive early and leave late and very few of them will not stay for school dinmer. It is therefore crucial that all school staff, not just the teaching staff, are helped to understand some causes and identifiable signs of child abuse.

All School personnel, therefore, need to be aware that child abuse is more frequent amongst parents who are:

isolated, poorly housed, living on the bread line, very young or emotionally immature, overburdened with children close in age, battered, alcoholic or dependent on drugs, end are single or have absent or temporarily absent spouses.

It is also useful to know that research identifies certain "trigger" situations which seem to accentuate or cause the problem. For example child abuse is common where there has been pre- marital pregnancy, an abnormal pregnancy, a difficult birth, or a premature birth and child- ren who are already at a disadvantage through some handicap, hospitalisation, of frequent mild illnesses are likely to suffer. Children's behaviour and quite natural stages of development during the first year can cause parents to reject their children and subsequently to be vlolent towards them.

Research shows that there are some identifiable signs of child abuse, for example:

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960 D. Day

a) Not ne=essarily abuse but sc~itlme8 going with it.

Children who are illkempt, dirty, tired, listless, overweight and retarded physically

I have k~n children with them signs who are in no way abused° Paul, for exile was a ~tt~r. He was smelly, dirty, slovenly dressed and had no friends becaume he "stank" He had an IQ of 146. ~he family was or~ of the most united I have k.,~n. Paul went to Gra~uuc school es did hle brothers and sisters. They had a tough rise but all won through. Paul is teaching in an inner city school. However, these signs should be watched for.

b) Warning signals

Excessive undersize.

Any unusual turks on the body.

"The Frozen watchfulness" of a child.

clinginq child.

The attention seeking child.

The mother who always says her child is Ill (a cry for help)

c) Other cerumen Incldbmcm:

The scapegoat in a family. In my ex~erier~e this can be the oldest, ~Iddle or youngest c h i l d .

The unwanted c h i l d .

~he child who ~a not and will never fulfil his parantJ' expectations.

The d~e. (Frequtntly the oldest glrl)

Oa big problem is that child1~n will often hide their d i s t r e s s , or indeed forget At for several hours in school. Like Denise who had saved her mother from suicide h~ gas three times and yet behaved totally normally and happily An school even ~he morning af~ez, or Ronnle with s i x Qbviotm cane m a r k s . He swore be ha d " f a l l e n o v e r a t t ~ e ~hnp" . Abused c h i l d ~ n a r e f r o q u ~ . t y l o y a l t o and p r o t e c t i v e o f t h e i r p a z ~ n t e . D e n i s e a t 8 s a i d "X c a n ' t go on t h e s c h o o l J o u r n ~ / . 1~ n o n ~ r n ~ d e :me'.

None of these signs on their on should be taken as a cua~e for labelling. Each case must be sensitively looked into hut, whenever there is roo~ for ~o~bt, any ancillary helper, school more~, nursery nurse, or ~eaobez ~ust eapZses her fears to the head t~acgmr. The head teacher must, taking into account his knowledg~ of ~he family, infom, warn and dlscnss any case with the school doctor, the educational welfare officer and the social services. All personnel in a school have the right to 'nag' the head teacher as the head teacher hm the right to '~ag' other agencies. There was perha~ not enough 'nagging' in the Norla Colwell case. A school is fort~u~tte if it has good professional links with other s~a~utory bodies, The School staff will be busy and over-worked but must re~ber that 8o are all profmsiooals. Having seld this a school must never go it alone. We as teacher8 should be involved and can do much to help our children and parents but it is pure arrogance to pretend t/~at we are trained or qualified to cope on our own, even if we had tim. So our first duty is to inform other bodies of our worries.

Although I stress the need to argue for action there is also a need for extreme care in avoiding the unfair labelling of a family, gossip within the neighbourhood, and J~dgmental attitudes within the s~affroom. In the forefront of our thinking as teachers will be and should be the child, hut I would make a strong plea for a deepening understanding of the parents.

Discussion, and the informing of others is i~or~ant but we must: consider what action ~he school should, or c a n take, as far as the child is concerned. I would suggest that the following points are important:

(i) Two main principles for the school ~o hold are:

It ks never the child's fault

The parents in all probability need help

The Abused C h i l d : t h e S c h o o l ' s Response 961

(2)We must try not to force a child to be disloyal to his parents. Individual confrontation and forceful qusstioni~ is not really appropriate. C~£1dren, as they grown older, know what we know. The buckle mark is a b u c k l e merk ew if they lie to us, but there is Do need to add insult to inJur~. ~ the child develop| he finds hlsoelf in a pawdic~-1ont of mixed loyalty and motives. On the one hand he may be being physically abused and would like sympathy on the other hand he is pzotactlve of his parents and may even ~eel guilty because he i~aglnee his Perent~ are Just to pun.tab h im so severely.

(3)Senttann~Ltty and over-protactlvo~ess is not really appropriate. Ca~o, OonomEn and a roali~atlon of the child's special case is i~orta~to ~T~Ls n~ay In~It~ a little e~s attention, keeping the child busy, protecting him from other ohllgLren but it will also ir~lu~e flL'm~ee8 and. an e n o o u r a g e m e n t t~::~,~ard cogn :L t ive a ~ t i v i t e 8 .

Tox, for example; was 4% when he entered the nursery g~hool and had been referred to the school by so~£al sez,vicee, From the age of 2 be had spent an h o u r ~ more e a c h day t i e d to a table leg, while hle child mlnder ~ho~l~. He also was suspected of b e i n g severely physically punished for any mled~anour. He b e g a n ~t days with a violent tant_~um and frequently did repeat perforna~ooe du~ing the dsy. ~ the violence died down it was practice to provide intereSt/he activities which involved action and T~Inklng, in o rde r to lead Tox into a sore balanced frame of nlnd. Gradu£11y the ~antrmm were less fEoqt~ent and now at ]4) y e a r s old Tox is a relat~Lvely balanced Junior. (Of course certain entlon~ were taken to resolve the situation Outsi~e school)

(4)Violence often leads to violence and we can expect the sort of bohaviotur ~orlbed ~Do~ from abused children, with very young chil~n, tan~ are e~cted but it Is when this s o r t o f behav iour ~ m ~ t i n u s s w e l l bey(:~d ml(~] le i n f a n t S t a g e a l ~ beoomoe e x a e s e i v o l y violent that it is extremely worrying and also dlffloult for t h e t a e o h o r t o cope with. The difficulty i8 that if we reject the child because o f h i s violent and dis~tivo behaviour we are placing him at an even greater emotional risk. On the other hand the teacher and other pupils h a v e ~ t a . Ideally e c h o o l a ~hould be staffed so that It is possible "to ~ve children from the classroom and then ~ve thin • "one to one" relationship duzlng a calming down period. In ~ pri~a~y sohools the heed tae~-~her or the deputy head are able to car~.'y o u t thle rol~, bu t i n schools where the presses are very greet ~ situation can bec~e i~elble. Violent and ~lez~t£~ boheviour is usually associated with three year old tantrue~ or asoon~ry children. For those who have never nlt it, a nine year old almost lifting a teacher off the floor i8 unbollev- able. When children are in l~his s t a t e they r ~ e d DO further rejection by anyone, but, on t h e other hand, the primary school must co,sider all its pupils and It~ staff and there- fore should be given help and support. ~he sad case is thst all too frequently no help is available until a school has been forced to suspend • child.

(5)It is fairly common to find that many abused childrlm have parents who ere ignorant of the basic norms of child develop-~nt and therefore are irritated by normal stages of develop- ment such an clunsiness, toilet training, messy eating, learning to acquire tastes in eating etc. Also some parents expect a sore rapid rate of learning and edul~ t~ of parental expectations, some parents are SO frustrated, or eve~ fearful O~ e ~ abnormality, that they physically abuse or mentally preseuriae their child. If the school ..as • policy of discussing their classroom activities with parents and welcoming parents' questlonJ, some of these unreasonable expec ta t . /~m aan be modified.

(6)Children whose mothers produce another child should be given special attention. Not only because of the poaslble sibling Jealousy but also because of the puselbility of mothez suffering from post-natal d~reaslon. Mothers of young babies need ~cial help and although this may Dot be the school'8 role, it can do Do harm for her tD feel that the school is anothe~ place where she can go freely. Good - ~rental relatl~hipe can omly help the mother who is under stress.

(7)Tee c h i l d i s c r u c i a l t o the s c h o o l ' s r o l e and i n severe oases, i t i s J~po r tan t to g ive h i " s e v e r a l h o u r s o f n o r m a l i t ~ a day i n a p l a c e where he f e e l s s e c u r e , s a f e and c a r e d f o r , as well as intellectually st-retched, as far as, and no further than, his ~tlonal state will allow.

962 D. Day

It is fortlmate that we find so -~ cases of child abuse which although severe are relatively short te~la, caused by severs stress, depression or some other trier point. Cases like Darron's mother, who during her third pregnancy fomld him quite impossible and got to more than screamlng point. Darren was referred to nursery school by the social services and a series of home helps were organlsed for mother. Darren also had some exciting weekend holidays with the school staff. When the new baby was 6 months old Darrsn's mother was over her bed patch but she still knew that she had several Porte of call if ever she felt under such stress again. This case once analysed was relatively simple, although it took time and goodwill from a number of professionals. The really long term cases are much more complex and indeed somltimes seem hopeless. Some of the most distressing and difficult are the ones I call the "movers". They vary in their pattern of behaviour but some of their character- istics are :-

I) Their children have been treated at a variety of Outpatient Departments

2) One spouse protects the other from investigation

3) Their children have attended several schools in an incredibly short time

4) The family has moved areas froquently These f~lies are fleeing from investigation and yet they demand attention in the school. This always rode me consider that they were begging for help or an immediate curs, but because of their mobility they ere almost impossible to support.

Another type of long term case is one where the child seems tr~ped in one sort of cycle or another. In these c u e s one feels t~hat the child is al~not doomod to follow the pattern. Tracey, six years old, is the grand-daughter and daughter of sx-prostitutes. Mother is an alcoholic and grandfather has twlca been imprisoned for incest with two of his daughters. Tracey's aunt at 14 haa Just produced her first ill~itimate ba~f. Cases like Tracey always -rode "~ foe]. that it would be right to whisk the child away before she followed the pattern. Yet Tracey's mother loved her and the bond between mother and child was extromly strong. C~e could cite many examples of such cases.

~e common and obvious course in dealing with long term cases, is the case conference, Llthough it has sometimes been my experience that these are not called until desperation point. Greater co-operation between professionals and earlier action is in everyone's mind but we must be aware that, Judging from a very recent Keele University study, there are still severe problems of case conferences being:-

Too large "Too many chiefs and not enough indians" eg no class teachers Not fully representative of all services involved Too late to be of use in a preventative way

This research also found evidence of professional parochlalness, lack of understanding, knowledge and trust of each others' roles, an excess of professional "in-Jargon" and an unwillingness to share information and expertise. It would seem that professlonal co- operation, without which we will never help to reduce child abuse, has a long way to go.

Co-operation at the grass roots level does happen and when it does one can at times see obvious results. The Jones family numbered eight with six children ranging in age from 1 year to ii years, and father could be described as feckless but fun. M~thar was tired, worn out, over burdened and was still only 27 years old. Karen, the eldest was frequently off school in order to help at home, could nevtr go on outings or school Journey and was exploited, and physically abused by Num and Dad. Fortunately, inapite of her pressures and absences, Karen's attainment was well above average. (She had a reading age of 13+ by 9 years old and her other ~rk matched this) . All six children were at risk. The family had had a social worker for 5 years, father was unemployed and was also on probation. After a case conference, it was decided that the school doctor should be the key worker because of the family's sudden rejection of all social workers generally and an apparent trust in the school and the doctor. Between all the professionals concerned, and over a period of a year, we devised a mot/1od of relieving mother's pressures without the children feeling rejected. Three of the children were "found to be delicate" and happily and importantly went to a boarding school for delicate children. This left mother with the then 2 year old, 4 year old and 8 year old during term time, the 6 year old, 10 year ~ld and 12 year old being in boarding school. This did not cure father, but it did relieve mother's pressures and

The Abused Child: the School's Response 963

physical abuse stopped. ~is is an exceptional case, but is a good example of professional co-operation. ~he professionals involved were--

the school doctor social services the educational welfare officer the head teacher the deputy head teacher the class teacher a probation officer

In the last two years we have been urged to co-operate by a variety of sources, the DES/DBSS

Joint Sunningdele Conference 1976, the Court report 1977, the Select Committee report on violence in the family 1977 the Joint ACC and AI~ report 1977, to mention but a few. Encouragement towards co-operation includes voluntary organisatio~s and I feel strongly that overall co-operation is crucial to the needs of present day society. This is so simple to say but not so simple to carry out. In the first place, this co-operatlon can and should include such a range of personnel from various parts of our bureaucracy that it becomes unmanageable° For example we. Immediately think of social services health and education as being concerned but we do not always consldsr housing, town planning, the probationary service, the policy and a large number of voluntary agencies. Secondly, professlonals and voluntary workers have a tendency to be bigoted about their own expertise, parochial about their "patch" and insecure when asked to move away from "the known". Thirdly, because so much of our soclet~ has grown like 'Topsy' rather than being plarmed there are incredible differences between local authority organisati~ and any generallsed pattern of co-operation between agencies is impossible.

I would suggest that at grass roots level co-operatlon to some extent is always possible if personnel have the right attitudes and goo~will, and let me hasten to say that many ~zkers in the field have. I would never want to do away with goodwill but I do think that time is at a pEemi~ with all those working with children or familieso For example the 8oclal worker on the Maria Colwell case ha~ 70 cases to deal with and in one primary school Z kno~ they average between 15 and 20 known cases of physical abuse in any one year. I would suggest then that consultation time Is built into Job descriptions and appropriate extra staff appointed. No amount of urging from the top can cause co-operation to happen unless

a) there is t he will and b) there is sufficient personal

Some suggestions for future priorities might be-

A For all professlonals involved with familSes

1) Some Joint irmervlce training

2) Adequate exchange of information

B o For schools

1) Head teachers should relieve teachers in the classroom for Joint professional oonsultetlo~

2) Head teachers in extreme circumstances should be able to request a medical examination without parents' co~sent

D. ~or pa~n~

i) There should be better preparation for parenthood

2) Parents should be helped to realiae that their feelings ere not uncommon and there is no shame attached to asking for help

3) There should be more help for single parents

4) A life llne 24 hours service "parents anonymous" should be available to parents

964 D. Day

D. For --d~cal and s o c i a l se rv i ces

i) Logical, efficient and yet sensitive "at risk" reglstere should be kept

2) Close attention should be Paid to pre-natal and ix~t-natal care and appropriate extra staff prov ided

3) Post-natal care should not stop at 3 months

4) Health visitors and social workers should watch closely for signs of parental reJecti~

5) General Practitioners should be cautious in the prescribing of tranquillisers

6) There should be regular medicals for under fives

7) The concept of a key worker or a natured person should be common practlce

E. Under five ~rovislon

Special attent~ion should be paid to under fives and all parents should have access to either play groups, mother and toddler groups, s~od childWlnding, day nurseries or nursery schools

TWO last points are crucial. First it is estimated that 20% of all young mothers have severe difficulty in mothering and ~ others find c/~ildren'e early years difficult. T~ese mothers used, perhal~, to have the extended family to lean on. Except in a few cases this is no lon~z so. We should have learnt by now that:

a) High rime flats are not for young mothers and children

b) ~hat housing without resource, playspace, shops, launderette etc is not enough

c) That we should not isolate a young mother away from her ne£~Iboure

Lastly, there is a need for a much greater awareness of the needs of parents

BZBLZOGRAPHY

Camerca~ J.Mo

Demborough C. a Stevenson O.

Gibson J.

Joblinq M.

Kemp C. H.

Kemp C.H. & Helfer R.E.

dl Lissovov V.

"The Battered Baby Syndrc~m", The Practitioner London Vol 209 1972

Case confe rences : A s tudy o f i n t e r ~rofemslonal c o m m n i c a t J ~ coverin~i chAld~n ac r i s k (Keels, E~land: Unlveraity of Keele, 1977)

"Parental abuse of children", in Social Work Today, vol 5 1974

Tne Abused Child: An aDa~oTatsd blbllogra~hy (London- Natlo~al Children's Bureau, 1976)

"Pediatric implications of the battered baby syndrome" Archives of disease in chil~hood (Lca~don: 1971), Vol 96

Helping the battered child and his famil~ (Philadelphia,: Lipp£cot, 1972 U.S.A.

"Child Care by adolescent parents" Children Today, (London: 1973) vol 2

National Society for the Prevention At ~Jk: N.S.P°C°C. Re~ort of Cr~elt~ to Children (Londk~n~ Routle~ge a Keqan Paul, 1976)

The Abused Chi ld: tbe S c h o o l ' s Response 965

Ollver J.E. Cox J. Taylor A. & Baldwin J.

Oliver J.E. & Taylor A.

Ounsted C. Oppenheimer R & Lin~s ay J.

Scott P.D.

Select Committee First Report

Silver H.K. Finklestein M.

Smith S.M. Hanson R. & Nobles

Smith S.M. & Noble S.

Renvoi ze J

Severely ili treated ¥oun~ children in North East Wiltshire, (Oxford: Oxford Regional Health Authority, 1974)

"Fiv~ generations of ill-treated children in one family pedigree" British Journal of Ps~chiatr x, Vol 119, 1971

"Aspects of bonding failure." Developmental Medicine and Child Neurolo~ (London: 1974) Vol 16, No. 4

"Fatal battered baby cases" Y~dicine Science and the Law, (Londcm: 1973) vol 13

Violence to Children, (L~don: Her Majes ty ' s stationery Office

"Deprivation" Journal of Pediatrics (London: 1967), Vol 70

"Parents of battered babies" British Medical Journal (1973 No 5889)

"Battered children and their parents" New Socle~ (London: 1973) Vol 26

Children An danger (London: RDutlege Kegan & Paul, 1974)

DOROTHY DAY FIELD 0FFICER CENTRE FOR INF(]RR~TION AND ADVICZ ON EDUCATIONAL DISAD~GE

July 1978