Children’s problems

When a child is behaving differently from what is regarded as the ‘norm’ a parent, teacher or social worker, which feels it is beyond their control, will seek professional help. These judgements can be subjective and ambiguous. The judgements that we make are placed against social strands and will vary depending on individual characteristics e.g. morals and expectations, families and different cultures. What one person may regard as deviating from the ‘norm’ another may not. This essay is going to illustrate the problems of understanding child’s behaviour by looking at how different psychological perspectives perceive social influence on children’s behaviour, the controversy surrounding how people perceive children’s behaviour and therefore why it is hard to develop a clinical formulation.

As a society whether it be parents, teachers or friends, we generally pick up on when children have problems due to their behaviour deviating from the norm. Understanding what is not the ‘norm’ in children’s behaviour is hard to categorise and define. It can be seen as behaviour, which violates social norms. Scheff (1966) introduced the idea of residual rules, unwritten rules in a society of which people are somehow aware and to which they generally conform. One problem with this definition is that we can only judge normality according to the situation.

When considering this definition there are a few questions, which arise. ‘Is children’s behaviour abnormal when they do not behave to the expectations of the people surrounding them and how is this measured?, ‘ Do children behave out of the ‘norm’ due to social influences? And ‘How do different psychological perspectives perceive children’s problems?

According to Developmental psychology a child’s ‘social context is fundamental for emotional, cognitive and social development. A significant part is the child’s family.’ (Oates, Hoghughi, Dallos, 1995, p281) There are many different family situations, which can cause great anxiety. For example ‘ a young child who acts out of control, breaks things and will not do what they are told, maybe seen as acting in this way because of inappropriate modelling in the family, lack of discipline and unclear rules.’ (Oates, Hoghughi, Dallos, 1995,p282)

Bowlby’s attachment theory incorporated a critical period in the formation of attachments between 6 months and three years. ‘During that time, he argued, the child needs continuous love and care.’ (Cowie, 1994, page 6) He believed that children who experience maternal deprivation below the age of three would suffer permanent damage, emotionally, socially and become emotionally withdrawn. In this situation the child is seen as passive and a ‘victim’ of the family. This view underlies learning theory and psychodynamic models of child development.

Social learning theorists take the view that the child’s personality or behaviour develops as a result of social interaction – through rewards and punishments, imitation, identifying with particular role models, and conforming to expectations. In regards to classical conditioning behaviours are learned by forming an association between an environmental event and a physiological reaction. It also believes in operant conditioning in which we associate certain types of behaviour with reinforcement. According to the social learning theory socialisation is where the child learns to conform to the norms of its society and to act in ways in which that are considered acceptable.

Although this process may involve different expectations from one society to the next, it seems that the highly sociable nature of children means that they are very prepared to learn and to respond to social influences. According to Freud, early experiences are crucial to our development and that a child’s behaviourism is due to psychic conflicts. Whereas, Erikson (1959) believes that psychological problems occur when the individual is insufficiently prepared to scope with society’s changing demands.

The realisation that children are actively involved in their own social development and that they can use social knowledge for their own ends, is one which challenges many of the earlier ideas about child development. What Piaget and Humanistic psychology suggests is that childhood isn’t just a matter of passive unfolding of development, or a gradual understanding of the outside world. Instead, it is an active process in which the child is busy constructing its understanding of the world and using its knowledge as it does so and potentially autonomous. Dunn (1988) believes that children understand people’s feelings, their intentions or goals and social rules.

The problem with seeing children from the perspective that they have their own beliefs, understandings and explanations is understanding how a child can appear to act in ways, which can be damaging to themselves and others. With these different perspectives in mind, behaviour which is not regarded as the ‘norm’ can suggest a compassionate view, that the child is a victim whose behaviour is the product of external forces, perhaps inadequate or abusive parenting or producing an image of the child as the cause of the problem, someone whose difficult behaviour needs to be contained and modified. Each view reflects a different aspect of the relationship between children and their social world.

There are several respects in which problems can be seen as context -embedded and normatively defined.

a) Different contexts offer different opportunities and place different demands on children, in terms of physical setting, social groupings, activities and routines. Children may behave differently at school than at home.

b) Standards of behaviour expected of children vary. There are different rules, rituals and regulations.

c) Those making judgements may vary in their expectations of children’s behaviour, there tolerance of difficulties and the effectiveness of their approach to maintaining discipline.

Each of the above is actors, which will modify the expression and identification of what is regarded as problems within the child. ‘Difficulties arise when the behaviour and goals of the child lack ‘goodness of fit’ with the social environment to which the child is expected to adapt (Chess and Thomas, 1984)

Apart from the issue of determining why the child is behaving out of the ‘norm’, psychologists also have the problems of arriving at a clinical formulation. These problems include developing a good therapeutic relationship, standardising assessment and diagnosis. Whether a child’s behaviour is identified, as a problem becomes a judgement about where to draw the line between normality and abnormality, health and pathology, integration and disturbance. A clinical psychologist will attempt to see things from the child’s point of view, which is difficult, as the child has usually attained characteristic behaviours of being distrustful, morose and uncommunicative. They must also be sympathetic to the child’s needs as well as empathetic in order to develop a good therapeutic relationship but must not allow themselves to be bias.

Clinical psychologists originally attempted to eradicate children’s problems, which often failed. Due to this they found by inviting parents to the sessions to gain more information on the family life that the parents were themselves experiencing severe conflict or difficulties and ‘in fact the child’s problems often seemed to be adaptations to their parents problems.’ (Hayley 1976 p 283) Further observations showed that children got caught up in conflicts due to:

* Conflict detouring – when the parents are in conflict and are too emotionally drained, a child can be used as a scapegoat and good develop behaviourisms such as truanting from school.

* Enmeshment – when families become immersed in each other’s feelings and thoughts and causes the child to lack privacy and emotional space.

* Distortions of reality – when children are placed in a position of falseness or denial, the truth of certain events is kept from them. This could cause problems with the child understanding what is real and what is not. (Laing, 1969)

With this type of analysis of the child’s life in the family it helped psychologists to see how children do, or do not, develop a sense of autonomy and ability to make decisions and solve their own problems. This provides a vital question for therapy with children. The main emphasis of the assignment is not simply to eliminate problems ‘but to try to ensure that children are able to use their intellectual and emotional resources to solve problems and make effective decisions later in life.'(Oates, Hoghughi, Dallos, 1995) With this information the psychologist will develop a set of recommendations for treatment on an informed basis. This though is a very complex process and standardisation can often be a problem.

Clinicians and researchers are standardising the assessment of emotional and behavioural problems. But while criteria may become dictated by convention, in the final analysis there is no universal standard for behaviour and social integration, no narrow set of rules that define children with behavioural problems Children are deemed to present problems when their behaviour falls outside the range of tolerance and age appropriateness. Their range maybe more or less wide depending on the context and the attitudes of those making such judgements.

With respect to diagnosis, the best tool is considered to be the face – to – face interviews. Open ended interviews in which the interviewer shows empathy towards the patient is considered the best way to encourage the patient to discuss their problems. Empathy is the ability to see things in a sympathetic way from the point of view of the patient without making judgements about the patient. However, structured interviews are considered better for obtaining information about traumatic events or abuse.

Interview techniques are not without their problems. Many practical and ethical considerations need to be made. For example a parent or another adult must accompany children and they may need someone to help with communication. One difficulty relating to diagnosis is that similar symptoms presented by patients may have different causes. Usually a diagnosis is possible but the cause of the problem remains unknown.

There are a number of styles and types of therapies practiced. Therapies usually consider two main dimensions along which therapies can be differentiated. Psychologists can either look at the problem that is located in the child compared to problems that may occur in the child’s environment, or consider current behaviour of the child and compare it to earlier experiences, which the child may have faced, and the child’s understanding of this behaviour.

The first dimension, which can be classified at one end of the continuum, focuses on problems, which may exist within the child itself. At the other end of the continuum a psychologists will look at issues such as social, physical and economic areas, which may cause problems. Due to this the psychologist may look at the extent to which a ‘problematic environment outside the child impacts on the development of the child and brings about changes inside the child with long term or permanent consequences. The two aspects location of causes and direction of therapy is by no means straightforward.’ (Oates, Hoghughi, Dallos, 1995)

There are many different therapies which range from looking at a child’s personal history and concentrating on how the child understands their difficulties, which is classified and based on a talking relationship between the child and the therapist, to a more environmental therapy which focuses on concentrating on the environment surrounding the child such as parents, siblings etc. With the more environmental therapy the psychologists would include working with the surrounding people as well as the immediate child. Another issue is looking at not only identifying the problems that the child is experiencing but also ways in which this behaviour can be modified. The therapist may arrange schedules of rewards, withholding of rewards and punishment to achieve this modification. ‘Given these two major dimensions along with different types of therapy vary, it can be seen that therapy with children is not a unified area, with universal approaches and frames of reference. It is one of the areas within applied psychology where the disagreements between practioners of different theoretical persuasions are at least as great as any commonality in method.’ (Oates, Hoghughi, Dallos, 1995)

As it can be seen by the evidence illustrated looking at children’s problems, identifying the issues and providing the most suitable form of therapy is a difficult and complicated process. To obtain a clinical formulation, characteristics such as the child’s surrounding environment, comparison of behaviourisms, expectations of the family and individual characteristics need to be taken into consideration. My perspective is that children’s behaviour is influenced by a social context and is troublesome as well as troubled, disorderly as well as disordered.