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CHAPTER 1
The Challenge of Meeting Children's Needs in the Context of Difficult Family and Community Environments
Babies are born dependent on others to meet their physical, psychological/ emotional, and cognitive/intellectual needs. A committed caregiver and/ or an entire family typically devotes much time and energy to nurturing the baby and helping him or her grow and develop. Ideally, this caretaking process results in the formation of a two-way attachment relationship that serves as the template through which the growing infant experiences the world and learns to relate to others. In the best of all possible worlds, a family feels great happiness anticipating the birth of a child. When prepared emotionally, physically, and financially, most families can deal with the mixture of pleasure and stress associated with raising a child. However, unpredictable circumstances related to the home situation, the baby's health, the family's economic and psychological state, and the community and neighborhood in which the family lives can cause the birth experience and the child's early years to be shrouded with worry and concern. Unforeseen challenges may set in motion a chain of reactions when parents are not prepared to deal with the inevitable responsibilities associated with raising their new baby or when their personal situation changes, as following the death of a family member or a deployment into the military. When parents cannot care for their baby, relatives may do so, and when the extended family is unavailable, the child welfare system may step in. Society therefore maintains a vested interest in ensuring that families meet the needs of their children.
Social workers assist families and children, either through small-scale direct interventions or on a larger scale by helping communities establish and maintain essential services. This book presents different methods of helping children within their families, in schools, and in community settings. Whereas much of the focus here is on micro-level clinical practice with children and their families, the ecological perspective that guides such interventions always evaluates and considers the surrounding physical, economic, and political environments that may facilitate or hinder helping efforts.
THE SOCIAL CONTEXT OF CHILDREN'S LIVES
Children's basic needs include nurturance, responsiveness, predictability, support, and guidance from caretakers (Garbarino, Stott, & Associates, 1989; Garbarino, 1992). Fulfilling these needs requires at least one caring adult who will take the responsibility of being an active presence in the child's life. Over time an attachment relationship develops between the dependent baby and the nurturing caretaker, and this relationship has a crucial role in determining how the child will respond to others in the future. When the child's early relationships are neglectful, abusive, or traumatic, this can result in enduring emotional, behavioral, cognitive, social, and emotional problems later in the child's life (Perry, 2006; Osofsky, 1997).
Statistics from 2016 indicate that approximately 9.2 million poor children in the United States were living in single-parent families, with the majority in single-mother families (Children's Defense Fund, 2016). It is very challenging to balance the economic necessities of earning a living with finding the time to take care of home responsibilities and, in addition, to nurture and develop and maintain a loving relationship with a baby and young child. Although some mothers manage this very well, others do not, and the children may suffer neglect or abuse.
According to the Children's Defense Fund (2016), in 2014 nearly 1 in 11 children lived in extreme poverty (defined as an annual income of less than half the poverty level), and children in single-parent families were more likely to be poor. Black children have the highest poverty rate. Single mothers experience the combined effects of social isolation, economic pressure, and the burden of having sole responsibility for raising a child (Gustafsson, Larson, Nelson, & Gustafsson, 2009; American Psychological Association, 2007). These factors can seriously affect the mothers' ability to form a positive attachment with their babies.
What is the impact on children of living in impoverished environments, which may be characterized by unemployment, pervasive substance abuse, inadequate health care, poor quality child care, and high levels of child abuse and neglect? Numerous studies have found that these socioeconomic disadvantages can contribute to higher incidences of impairment in children's social, behavioral, and academic functioning (Achenbach, Howell, Quay, & Conners, 1991; Achenbach, McConaughy, & Howell, 1987; American Psychological Association, 2007; Brooks-Gunn & Duncan, 1997; Institute of Medicine, 1989; Perry, 2006; Perry & Szalavitz, 2006; Schteingart, Molnar, Klein, Lowe, & Hartmann, 1995; Siegel, 2012). Poverty is a serious social and personal crisis, and interventions to help poor children and families require broad-based efforts to find political and economic remedies, in addition to helping children with their emotional–behavioral difficulties.
However, all children raised in poverty do not develop psychological problems. The ratio of risk and resilience cannot be calculated with certainty, although practitioners should certainly try to reduce risk factors and do whatever possible to stack the deck in favor of the child and family. Sometimes an intervention to help the mother will have trickle-down positive effects on the child. The assessment of risk and resilience factors is discussed more fully as part of the tripartite assessment in Chapter 4.
The ecological–transactional focus of this book emphasizes the interacting multisystemic factors that contribute to children's mental, emotional, and behavioral difficulties, including both familial and environmental influences. Developmental factors also play a critical role in how children respond to favorable and stressful events in their lives. However, as previously mentioned, it is important to emphasize that any single element alone is seldom sufficient to lead to emotional problems. It is far more likely that multiple factors, both developmental and systemic, will interact to produce problematic behavior in a child (Cicchetti, 2008).
As depicted in Figure 1.1, the complex interplay between children and their social environments makes it essential to consider simultaneously a troubled child's biological, temperamental, and developmental status, the surrounding familial cultural context, and his or her physical and social environment. Although political advocacy may be essential for long-term improvement of the insidious effects of poverty, substance abuse/dependence, and violence, immediate supportive assistance must be offered to children and their families who are living in the midst of and trying to cope with these conditions. Children demonstrating troubled and troubling behaviors require prompt, direct services, even when these are provided in less than ideal social environments.
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THE CASE OF JACOB, AGE 10, AND DAMIEN, AGE 14
The following account is taken from a front-page article in The New York Times (Wilkerson, 1994). As when I prepared the second and third editions of this book, I wondered whether this case would seem out of date for this fourth edition over 20 years later. Sadly, it is not; the situation of urban children who live in high-crime, drug-infested neighborhoods is as bad as ever, and this case could just as easily appear in our local newspapers today.
Presenting Problem Situation
Damien, age 14, and Jacob, age 10, were arrested for armed robbery in the shooting death of a pregnant woman who refused to hand over money she had withdrawn from an automated teller machine. Jacob gave the go-ahead signal for the robbery, and Damien, a drug dealer who was trying to obtain money to pay drug debts, carried out the shooting. Damien pleaded guilty to second-degree murder, and both boys received the maximum sentence for juveniles — remaining in state custody until the age of 21.
Family Information
Both boys were born to mothers on welfare, each of whom had first given birth at age 14. Damien's father had abandoned his family, and Jacob's father was shot to death in a bar fight when the boy was 4 or 5 years old. Both boys grew up in an atmosphere of physical abuse; Jacob's father used to beat his mother, and Damien said that he ran away from home because his mother beat him. Both boys lived in crack houses, and Jacob's mother had a history of alcohol and crack dependence.
Jacob was the youngest of eight children, in a family in which he saw relatives and friends use guns to settle disputes. He saw his sister shot in the face when he was 4 or 5. Another sister introduced him to marijuana when he was 9. His mother did not appear for Jacob's first court hearing on the armed robbery charge, and when she subsequently came to testify, she was intoxicated and could not remember Jacob's birthday.
Damien dropped out of school after the seventh grade and went to live with a teenage older brother who was a drug dealer and who initiated him into the drug trade. Damien had earlier been a ward of the court after his mother was accused of beating one of his brothers. He apparently had no contact with his father. Damien took the gun used in the robbery/murder from his brother's house; in preparation for the attack, in Jacob's presence, Damien sharpened the bullets.
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Discussion
It is not difficult to identify the familial and social factors that coalesced in the behaviors resulting in this tragic murder. An overview of this case summary reveals the following negative influences and risk factors in the lives of these boys:
Family Disintegration
Female-headed single-parent households
Absent fathers (Jacob's was killed; Damien's abandoned the family)
Youthful runaway behavior (Damien)
Poverty
Both families were supported on welfare
Exposure to Violence and Abuse
Witness to spouse abuse (between parents — Jacob)
Witness to child abuse (parental abuse of sibling — Damien)
Personal experience of child abuse (Damien)
Witness to gunfights within family (Jacob)
Exposure to Substance Abuse
Residence in crack houses
Parental alcohol and crack dependence (Jacob)
Sibling drug dealing (Damien)
Drug abuse/dependence in the neighborhood
Encouragement to use drugs
Jacob's lawyer summarized his young client's situation by stating that "Jake is the product of his environment. He comes from a dysfunctional family. The older neighborhood boys were his heroes. They sold drugs. They had guns. They were his role models. He wanted to be like them" (quoted in Wilkerson, 1994, p. A-14).
Charles Patrick Ewing, a lawyer and forensic psychologist, comments in his book Kids Who Kill (1990): "Juvenile killers are not born but made. ... Virtually all juvenile killers have been significantly influenced in their homicidal behavior by one or more of a handful of known factors: child abuse, poverty, substance abuse, and access to guns" (p. 157). Certainly, these conditions do not always produce child killers; many youngsters manage to survive the ravages of noxious familial and social environments without succumbing to antisocial acts. Some even achieve great success, against all odds (Anthony & Cohler, 1987). Nonetheless, when the cards are stacked so heavily against healthy development, as they were for both Jacob and Damien, the outcome in terms of antisocial behavior is understandable. Furthermore, in addition to Ewing's list of factors contributing to homicidal behavior, we should consider the possibility that Jacob may have been born with fetal alcohol syndrome and/or the effects of his mother's crack addiction and that Damien may have suffered head injuries due to the serious and repeated beatings he received. Furthermore, mothers who are drug or alcohol dependent may be unable to respond appropriately to their babies' emotional needs for bonding. Both boys' seeming lack of empathy may be related to insecure or avoidant attachment due to the abuse and neglect they both suffered in the first 2 years of their lives (Karr-Morse & Wiley, 1997; Perry, 1997; Lieberman, 2004; Siegel, 2012). Heide (1999) points out that many abused youth have not experienced bonding with others and consequently they do not develop the values, empathy, and self-concept that fosters the self-control that might inhibit them from killing. The lack of an attachment figure in the first few years of life may cause an inablity to establish stable relationships later in life (Siegel, 2012).
We know nothing about either boy's academic record, such as possible learning or hyperactivity problems, or about any individual areas of strengths or achievement. However, both boys learned to survive in the face of situations that were, at times, life threatening, and they learned to adapt in circumstances that required great perseverance and strength. If only this resilience could have been focused on more positive interests and goals! This case illustrates how the cumulative influence of individual, familial, and social factors can culminate in juvenile criminal behaviors. Even when social and familial factors appear to predominate as causal, however, remediation necessitates intensive work with such youths on an individual basis. It is likely that after years of abuse and neglect, youngsters such as Damien and Jacob internalized and then replicated the dysfunctional behavior they witnessed and experienced during their formative years. Rehabilitation would require much more than environmental change to significantly alter such youngsters' sense of personal identity, their sense of self-respect and competence, and their views about future goals for their lives. Few if any prisons have programs that can provide the kind of in-depth treatment these boys would need. In fact, it is more likely that they would learn more antisocial behaviors from emulating other prisoners. Chapter 14 discusses in detail the treatment approaches for children who witness family and community violence.
EMOTIONAL AND BEHAVIORAL PROBLEMS
As stated by Hinshaw (2008), "emotional and behavioral problems in children and adolescents are distressingly prevalent and often lead to serious impairments in such crucial life domains as academic achievement, interpersonal competencies, and independent living skills" (p. 4). According to the U.S. Department of Health and Human Services (1999), about one in five children and adolescents in the United States suffer from some type of mental health problem during the course of a year. The overall precedence rates of childhood problems are estimated to be between 14 and 22% for all children, and "a significant proportion of children do not grow out of their childhood difficulties" (Mash & Dozois, 1996, p. 9).
Typical Problem Syndromes in Children
Professionals who work with children document that psychopathology in children is a relatively common occurrence, with overall estimates of developmental, emotional, and behavioral disorders ranging from 14 to 23% of all children, with more severe forms of mental disturbance occurring in an estimated 8–10% of all children (Brandenburg, Friedman, & Silver, 1990; Boyle et al., 1987; Mash & Dozois, 1996, 2003; Mash & Barkley, 2007, 2014).
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Excerpted from "Social Work Practice with Children"
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