On the eve of Government moves to increase the number of children who find permanent adoptive families, psychologist Hessel Willemsen describes the trauma facing those forced to live in temporary care settings
There has been concern for some time about the plight of children in local authority care. Separated from their families because of neglect or emotional, physical or sexual abuse, only a tiny few have been lucky enough to find the security of an adopted family. The rest - and there are nearly 60,000 children in the care of local authorities at any one time in England, with more than 10,000 under four years old - are placed in temporary foster homes or residential homes and schools.
Even those lucky enough to be adopted eventually can be subject to many changes in their young lives. While the child is in temporary foster care, it will take, on average, 21 months to find an adoptive family and, in the meantime, a child may experience several foster homes. Placements can break down for various reasons, but often because of the child's disturbed behaviour caused by his or her previous trauma. All these changes only lead to greater insecurity for the child.
The older the child, the greater the chance they will not be adopted. This can lead to even more temporary placements - only 51 per cent of children who have been fostered for four years have been in one placement for more than two years.
The Government is trying to rectify this situation with a raft of measures stemming from a review of the adoption process at the end of last year. The Adoption White Paper, published in December 2000, led to a draft bill in May this year, but that fell because of the general election. A new bill - the Adoption and Children Bill - is likely to be put before Parliament this month.
National Standards on Adoption were also published in July this year, to achieve a consistent way of working by the host of local authority and voluntary adoption agencies. A National Adoption Register is also being set up to maximise the chances of matching children and adoptive parents. How children react
Children in foster care miss their parents and siblings and feel frustrated with their new living situation. They often do not understand why they have been removed from their families and ask if they can go back. They may become violent to other children, aggressive when they are playing, and destroy their own or other children's toys. Some children become verbally rude, spit in people's faces or kick others. They may become depressed, withdrawn, isolated and sad. Others have severe tamper tantrums without an end, and are inconsolable, or start rocking and hurt themselves by banging their head on the wall.
It may help these children to verbalise their loss; to say how much they miss their family, friends, school or nursery. Some of them may not want to talk about their feelings of loss, but some will find it comforting. Some children are very explicit like John, aged four.
When John entered my room for our first meeting he found two small toy trains. He took paper and glue from the toy box and created a rail track with them. The track consisted of one long straight section to the house where he used to live with his mother and father. Just before the end of the track there was a siding to the foster carer's house. He asked me to take a train and join in a game. We had to give each of the trains a push, one at a time, so that they would each by-pass the foster carer's house and end up outside his parents' house. The trains should not overrun the track. John became frustrated because it was a difficult task and started to play a ball game.
Not all children can be as direct as John was. His game showed that he wanted nothing more than to be with his mother and father; he felt he would have gone past his home if the train came off the edge of the paper: he had precise needs to be met. John came from a family where there were concerns about alcohol abuse by the parents, and he was possibly physically abused. His family lived in poverty and neglected the children, who were taken into care. Drug addiction
A pre-birth conference can sometimes be convened by social services to plan for an unborn child when the child is deemed at significant risk of harm.
These children may be carried by drug-addicted women, women with learning difficulties or women who have suffered a deprived early life, which has resulted in mental health problems.
Tania, for example, was a child born with a drug addiction. She exhibited withdrawal symptoms after her birth. Tania came to our attention when she was two years old. She had severe temper tantrums, three to four times a day, after she and her older half-sister and half-brother were removed from her mother, who took drugs.
During the day she would eat as if there was no tomorrow and at a children's party, she was seen to switch plates after she had finished hers. Tania's behavioural problems may relate to neglect and deprivation, but also to brain damage, which may lead to neuro-developmental problems later on in her life. Such damage may also occur in children born from alcohol-abusing parents.
Cultural issues
Cultural differences can also cause problems for children in the adoption and fostering process. To feel most at home, children require placements with families of the same culture as their biological parents, although this is not always possible.
However, this is not the only issue at stake. Some immigrant families may not be aware of the role of social services, and may feel angry at what they see as interference in their way of life.
Different cultural views on how children should be brought up may be relevant when a child is taken into care; for example, a point of dispute in court may be the use of physical punishment. In addition, children in care can feel lost between two cultures.
The following case illustrates how a change in culture can exacerbate the trauma of a child being taken into care. Sonya, aged three, came to the attention of social services when she, her mother and her siblings were admitted to a long-stay hospital. Her father had recently died and her mother had mental health problems, so that she was unable to care for her children and herself.
This Muslim family had only recently emigrated from Eritrea because of the father's political involvement there. The children were removed from the mother and placed with an Eritrean foster family.
After a year the children were split up and placed with other families; Sonya was sent to English carers. She kicked and bit others, becoming particularly violent when she changed foster carers. Not only had she lost her mother and father and been in different foster homes, but she was living in a different cultural setting.
Fortunately, some children do return to their biological parents after being fostered. Input from social services and the courts can lead to changes in a family necessary to the child's well being. But sadly, this is not so in most cases.
Hessel Willemsen is a child and adult clinical psychologist at the Tavistock Clinic, London.
Facts and figures on children in care
- At any one time local authorities in England look after 58,000 children.
- About 20 per cent of children in local authority care - over 10,000 - are four years old or younger.
- Research suggests that 70 to 80 per cent need some form of mental health input.
- A staggering 70 per cent leave school without any qualifications.
- Children are, on average, looked after in temporary foster families for as long as 14 months before the search for a new adoptive family starts. Finding the right adoptive family takes on average another seven months.
- The older the child, the less chance of adoption.
- At December 2000, only 4.7 per cent of children in care were adopted.
- The Government is proposing a national target of 40 per cent adoption by 2004/5, an increase of more than 800 per cent. It also aims to provide children in care with better educational support and reduce the time of court proceedings and adoption.
