The "Wounded" Child
Early childhood abuse is the most significant cause of dysfunctional behaviour in schools and society. It is important that teachers and all sectors of the education community understand what constitutes abuse and its prevalence in society. This Newsletter addresses this issue.
In 1962 there was a ground-breaking publication that identified the damage and impact of early childhood abuse and neglect on their subsequent behaviour. This initiated the understanding of the link between the treatment of children in their early years and their later sense of self and ability to relate to others. Led by the psychiatrist C. Henry Kempe the paper “The Battered Child-Syndrome” identified the trauma associated with abuse and subsequent cognitive alteration. This opened a flood of research into this topic and today most developmental psychiatric illnesses have their foundations in early childhood experiences. These disorders do not include those abnormal behaviours that are the result of a physical defect, things like psychosis, autism and development delay.
This is the first in a series of Newsletters that deal with abuse and neglect and the impact these, often comorbid actions have on the child. This article will deal with a description of abuse and neglect and their prevalence in the western world.
We describe abuse as any action that invalidates a person’s worth. It is an assault on a person’s physical or psychological self. These attacks can range in intensity from mild irritation up to being perceived as life-threatening. It is at the intense level the damage is done to the developing brain. In the general literature there are three categories on abuse as mentioned. These are:
This is the use of intentional force against a child’s body or an unwanted invasion of their physical space. It can be:
- Holding Down
- Exaggerated Tickling
- Pulling Hair
- Twisting Ear
This is a form of abuse where the child’s psychological boundaries are violated. This can take the form of non-accidental verbal or symbolic actions that are likely to result in significant psychological or emotional harm. Forms of emotional abuse are:
- Attacking the worth of the child by rejecting them, terrorising or isolating them.
- Telling the child that they are stupid, un-loveable or unwanted.
- Being overly harsh in criticising the child.
- Punishing the child when they become emotional – don’t be a baby, etc. or when they show no emotion when it would be appropriate to do so.
- When the love of a parent is conditional on their behaviour (I will love you if …)
This abuse is when an adult or older adolescent uses the child for their sexual gratification or for financial profit of the person committing the act. This can include:
- Unwanted touching or penetration of the sexual organs.
- Adults exposing their own genitals to a child.
- Exposure to inappropriate sexual experiences or information (i.e. Pornography).
Sexual abuse is a silent destroyer of too many young children in our society especially with the easy availability of pornography on the Internet.
There are other forms of abuse that do not get the coverage in most literature but are equally likely to expose the child to toxic levels of stress. These are:
- Intellectual Abuse – this occurs when a child is placed in a situation where they are asked to perform a task they are developmentally incapable of successfully achieving. An example is when a child is given a glass of milk to drink before they have developed the motor skills required for this task. When they fail they are either labelled as useless by the parent or confirm to themselves the belief that they are at fault because they failed.
Intellectual abuse also occurs when a significant other compares one child’s performance against another child implying one is better than the other.
- Spiritual Abuse – One type of spiritual abuse that occurs is when the parents put themselves above the child. The child must ‘worship’ the parent. A contrary form of spiritual abuse occurs when the parents put the child above themselves. The child becomes the focus of their devotion, they can do no wrong. These children never learn to take responsibility. In the first instance the parent knows best and you just do as you’re told. In the latter form the parent will not see any faults in the child’s behaviour and so they never get the natural consequences when they make a wrong choice.
The second form of spiritual abuse occurs when ‘religions’ teach that God will punish sinners and all are condemned unless they conform to some dogma. People who work with children brought up in some cults attest to the damage done through this form of abuse but it would be a brave politician who would underline the damage done when adherence to the word of any god is criticized.
This is a complex type of abuse. It occurs not when the individual is the target of the assault but is a witness. It is an issue for all those who work in highly stressful vocations such as police, reporters and even teachers who work in very difficult communities. However, for the purposes of linking abuse with subsequent behavioural difficulties I will limit the description to incidents that occur to children. This happens predominantly on families that experience domestic violence. This is particularly challenging for children who watch their mother being beaten by a partner. In a subsequent Newsletter I will describe the acquisition of trauma but for now it is enough that the child is forced to watch what is in reality their source of life be threatened. The fear is overwhelming and equal, if not more damaging than a direct attack on their person.
Neglect, if not an overt form of abuse it is a close cousin, it is a passive form of abuse. It is the lack of stimulation that is required to meet the child’s physical, social and intellectual needs. As mentioned earlier, this neglect in a developing child will fail to construct the neural pathways that have been developmentally expected. When these genetic windows for development stages like attachment are activated, and there is no stimulation then the neurons will be pruned and the opportunity to meet the developmental threshold is lost. Forms of neglect are:
- Physical – failure to provide for physical needs such as food.
- Medical – not providing medical care when the child is sick or needs dental work.
- Emotional – lack of nurture, encouragement, love and support.
- Educational – lack of providing educational resources and ensuring regular participation in schooling.
- Abandonment – leaving the child alone for long periods of time without any support.
There are countless studies into the frequency of child abuse and these are frightening and are most likely under reported. The general view is that from 1% to 9% of the population suffer from PTSD. This means that in a school of 1000 students you could expect 10 – 90 students to suffer this syndrome. Although PTSD occurs in every socioeconomic level of society it is not equally distributed across the landscape and resource poor suburbs are reported to have levels of up to 23%. So, in the school mentioned above you would have 230 students with PTSD.
Magnitude of Childhood PTSD
When first described Dr. Kempe estimated the occurrence at 6 per 1,000 children or 0.6% of the population experienced early childhood abuse. However modern studies estimate between 15% to 43% of children will experience a traumatic event and up to 15% will develop PTSD.
These numbers vary across each countries’ economic landscape and across nations. One can only imagine the level of PTSD amongst the children in the war-torn nations in the world. The financial cost to conduct a war fails to comprehend the potential future intellectual benefits we could enjoy if these children were allowed to develop their minds to their true potential. War is societal abuse on children and is sanctioned by political leaders.
In the US the Child Protection agencies get around three million reports each year. This involves 5.5 million children. Of the reported cases, there is proof of abuse in about 30%. From these cases, we have an idea how often different types of abuse occur:
- 65% neglect
- 18% physical abuse
- 10% sexual abuse
- 7% psychological (mental) abuse
However, girls are more likely to be abused then boys because girls are more likely to internalize their feelings while the boys that attract the most attention because they act out their pain therefore being recognised as being damaged.
Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD.
The next Newsletter will describe the impact abuse and neglect have on the structure of the brain.
Mtoto "Aliyejeruhiwa" Uonevu wa utotoni ni kisababishi muhimu zaidi cha tabia isiyofaa katika shule na jamii. Ni muhimu kwamba walimu na sekta zote za jamii ya elimu kuelewa nini huunda unyanyasaji na kuenea kwake katika jamii. Barua hii ya Habari inazungumzia suala hili. Mwaka 1962 gazeti la The Guardian lilitoa ripoti ya kwanza kuhusu jinsi unyanyasaji na kutelekezwa kwa watoto katika utoto wao ulivyoathiri tabia zao. Hii ilianzisha uelewa wa uhusiano kati ya matibabu ya watoto katika miaka yao ya mapema na hisia yao ya baadaye ya nafsi na uwezo wa kuwasiliana na wengine. Chini ya uongozi wa daktari wa magonjwa ya akili C. Henry Kempe karatasi <unk>The Battered Child-Syndrome<unk> ilitambua majeraha yanayohusiana na unyanyasaji na mabadiliko ya baadaye ya utambuzi. Hii ilifungua mafuriko ya utafiti juu ya mada hii na leo magonjwa mengi ya kisaikolojia ya maendeleo yana misingi yao katika uzoefu wa utotoni. Matatizo haya hayajumuishi tabia zisizo za kawaida ambazo ni matokeo ya kasoro ya kimwili, vitu kama vile psychotic, autism na kuchelewesha maendeleo. Hii ni ya kwanza katika mfululizo wa Newsletters kwamba kushughulika na unyanyasaji na uzembe na athari hizi, mara nyingi comorbid vitendo kuwa juu ya mtoto. Makala hii itazungumzia jinsi unyanyasaji na kupuuzwa na kuenea kwao katika ulimwengu wa magharibi. Tunataja unyanyasaji kama hatua yoyote ambayo hupunguza thamani ya mtu. Ni shambulio dhidi ya nafsi ya mtu kimwili au kisaikolojia. Mashambulizi hayo yanaweza kuwa na nguvu mbalimbali kuanzia kuchochea kidogo hadi kuonwa kuwa yanatisha uhai. Ni katika kiwango cha nguvu uharibifu unafanywa kwa ubongo unaokua. Katika fasihi ya jumla kuna makundi matatu juu ya unyanyasaji kama ilivyoelezwa. Hii ni: Hii ni matumizi ya makusudi ya nguvu dhidi ya mwili wa mtoto au uvamizi usio wa kutamaniwa wa nafasi yao ya kimwili. Inaweza kuwa: - Kudhibiti - Kutocheka kupita kiasi - Kuvuta nywele - Kutocheka sikio Hii ni aina ya unyanyasaji ambapo mipaka ya kisaikolojia ya mtoto inakiuka. Hii inaweza kuchukua fomu ya vitendo vya maneno au ishara zisizo za bahati ambazo zinaweza kusababisha madhara makubwa ya kisaikolojia au kihisia. Aina za unyanyasaji wa kihisia ni: - Kushambulia thamani ya mtoto kwa kumkataa, kumtisha au kumtenganisha. - Kumwambia mtoto kwamba yeye ni mpumbavu, asiyependwa au asiyetakiwa. - Kumkosoa mtoto kwa ukali kupita kiasi. - Kukumwa adhabu ya mtoto wakati wao kuwa hisia <unk> si kuwa mtoto, nk. au hawaonyeshi hisia wakati inapofaa kufanya hivyo. - Wakati upendo wa mzazi unategemea tabia yao (Nitakupenda ikiwa...) Uonevu huu ni wakati mtu mzima au kijana mkubwa anatumia mtoto kwa kuridhika kwake kingono au kwa faida ya kifedha ya mtu anayefanya kitendo hicho. Hii inaweza kujumuisha: - Kugusa au kupenya isiyotakiwa ya viungo vya ngono. - Watu wazima kufunua viungo vyao vya uzazi kwa mtoto. - Kuambukizwa kwa uzoefu au habari zisizofaa za kingono (yaani Pornografia). Uonevu wa kingono ni uharibifu wa kimya wa watoto wengi wadogo katika jamii yetu, haswa na upatikanaji rahisi wa ponografia kwenye mtandao. Kuna aina nyingine za unyanyasaji ambao haujatajwa katika fasihi nyingi lakini ni uwezekano sawa wa kumweka mtoto katika viwango vya sumu vya mkazo. Hizi ni: - Matumizi mabaya ya akili <unk> hii hutokea wakati mtoto huwekwa katika hali ambapo anaulizwa kufanya kazi ambayo hawawezi kufikia kwa mafanikio. Mfano ni wakati mtoto anapewa glasi ya maziwa ya kunywa kabla ya kuendeleza ujuzi wa magari unaohitajika kwa kazi hii. Wakati wao kushindwa, wao ni ama labelled kama bure na wazazi au kuthibitisha wenyewe imani kwamba wao ni katika kosa kwa sababu wao kushindwa. Uonevu wa kiakili pia hutokea wakati mwingine muhimu anakilinganisha utendaji wa mtoto mmoja dhidi ya mtoto mwingine akimaanisha mmoja ni bora kuliko mwingine. - Ukatili wa Kiroho  Aina moja ya utumishi wa kimwili unaotokea ni wakati wazazi wanapojiona kuwa wa maana zaidi kuliko mtoto. Mtoto lazima 'amwabudu' mzazi. Aina nyingine ya unyanyasaji wa kiroho hutokea wakati wazazi wanapomweka mtoto juu ya wao wenyewe. Mtoto anakuwa kitovu cha ujitoaji wao, hawawezi kufanya kosa lolote. Watoto hawa hawajifunzi kamwe kuchukua daraka. Katika hali ya kwanza mzazi anajua bora na wewe tu kufanya kama wewe ni aliiambia. Katika fomu ya mwisho mzazi hataona makosa yoyote katika tabia ya mtoto na hivyo hawapati matokeo ya asili wakati wao kufanya uchaguzi mbaya. Aina ya pili ya unyanyasaji wa kiroho hutokea wakati "dini" zinapofundisha kwamba Mungu atawaadhibu watenda-dhambi na wote wanahukumiwa isipokuwa wakifuata fundisho fulani. Watu wanaofanya kazi na watoto waliolelewa katika madhehebu fulani wanathibitisha uharibifu unaosababishwa na aina hii ya unyanyasaji lakini itakuwa ni mwanasiasa mwenye ujasiri ambaye angekazia uharibifu unaosababishwa wakati kushikamana na neno la mungu yeyote kunapokosowa. Hii ni aina tata ya unyanyasaji. Inatokea si wakati mtu huyo anaposhambuliwa bali anapokuwa shahidi. Ni suala kwa wale wote wanaofanya kazi katika taaluma zenye mkazo mkubwa kama vile polisi, waandishi wa habari na hata walimu ambao hufanya kazi katika jamii ngumu sana. Hata hivyo, kwa madhumuni ya kuunganisha unyanyasaji na matatizo ya baadaye ya tabia nitaweka maelezo tu kwa matukio yanayotokea kwa watoto. Jambo hilo hutukia hasa katika familia zinazokabili jeuri ya nyumbani. Hii ni changamoto hasa kwa watoto ambao huona mama yao akipigwa na mwenzi wake. Katika jarida la baadaye nitaelezea upatikanaji wa majeraha, lakini kwa sasa ni vya kutosha kwamba mtoto analazimika kuona kile ambacho ni chanzo cha maisha yake kutishiwa. Hofu hiyo ni kubwa sana na ni yenye kuumiza kama vile kushambuliwa moja kwa moja. Uangalifu, ikiwa sio aina ya wazi ya unyanyasaji ni binamu wa karibu, ni aina ya unyanyasaji wa kimwili. Ni ukosefu wa kichocheo kinachohitajika ili kukidhi mahitaji ya mtoto ya kimwili, kijamii na kiakili. Kama ilivyotajwa hapo awali, kutojali kwa mtoto katika ukuaji kutoshindwa kujenga njia za neva ambazo zimetarajiwa kwa maendeleo. Wakati madirisha haya ya maumbile kwa hatua za maendeleo kama vile kiunganishi huanzishwa, na hakuna kichocheo, neuroni zitapunguzwa na fursa ya kukutana na kizingiti cha maendeleo itapotea. Aina za kupuuzwa ni: - Kimwili <unk> kushindwa kutoa kwa ajili ya mahitaji ya kimwili kama vile chakula. - Matibabu <unk> kutotoa huduma za matibabu wakati mtoto ni mgonjwa au anahitaji kazi ya meno. - Kihisimu <unk> ukosefu wa kulea, kutia moyo, upendo na msaada. - Elimu <unk> ukosefu wa kutoa rasilimali za elimu na kuhakikisha ushiriki wa kawaida katika shule. - Kuachwa <unk> kuacha mtoto peke yake kwa muda mrefu bila msaada wowote. Kuna utafiti mwingi kuhusu jinsi unyanyasaji wa watoto unavyotukia, na unaogopesha sana. Kulingana na takwimu za utafiti, asilimia 1 hadi 9 ya watu duniani wanaugua ugonjwa wa PTSD. Hii inamaanisha kwamba katika shule ya wanafunzi 1000 unaweza kutarajia wanafunzi 10 <90 kuteseka ugonjwa huu. Ingawa PTSD hutokea katika kila ngazi ya kijamii ya uchumi, haijagawanywa sawa katika mazingira na vitongoji vya utajiri wa rasilimali zinaripotiwa kuwa na viwango vya hadi 23%. Kwa mfano, katika shule ya shule ya juu, wanafunzi 230 wana ugonjwa wa PTSD. Ugonjwa wa PTSD wa utotoni: Kempe alitabiri kuwa asilimia 6 ya watoto 1,000 au 0.6% ya idadi ya watu walipatwa na unyanyasaji wa utotoni. Kulingana na utafiti wa hivi karibuni, asilimia 15 hadi 43% ya watoto watapata tukio la kuumiza na hadi asilimia 15 watapata PTSD. Idadi hizi hutofautiana katika kila nchi'maendeleo ya kiuchumi na katika mataifa. Ni vigumu kueleza kiwango cha PTSD katika nchi zilizoharibiwa na vita. Gharama za kifedha za vita hazijumuishi faida za kiakili ambazo tunaweza kufurahia ikiwa watoto hawa wataruhusiwa kuendeleza akili zao kwa uwezo wao halisi. Vita ni unyanyasaji wa kijamii kwa watoto na unakubaliwa na viongozi wa kisiasa. Katika Marekani, mashirika ya ulinzi wa watoto hupokea ripoti milioni tatu kila mwaka. Hii inahusisha watoto milioni 5.5. Katika kesi zilizoripotiwa, kuna uthibitisho wa unyanyasaji katika asilimia 30 hivi. "Kutokana na visa hivi, tuna wazo la mara nyingi aina tofauti za unyanyasaji hutokea: ""kuachwa kwa 65%,"" ""unyanyasaji wa kimwili 18%,"" ""unyanyasaji wa kingono 10%,"" ""unyanyasaji wa kisaikolojia 7%"" Hata hivyo, wasichana ni uwezekano mkubwa wa kutendewa vibaya kuliko wavulana kwa sababu wasichana ni uwezekano mkubwa wa internalize hisia zao wakati wavulana ambao kuvutia zaidi kwa sababu wao kutenda nje maumivu yao." Utafiti unaonyesha kwamba kati ya asilimia 15 na 43 ya wasichana na asilimia 14 na 43 ya wavulana hupitia angalau moja ya matukio ya kuumiza. Katika watoto na vijana ambao wamepatwa na majeraha, asilimia 3 hadi 15 ya wasichana na asilimia 1 hadi 6 ya wavulana hupata PTSD. Gazeti la habari linalofuata litaeleza jinsi unyanyasaji na kupuuzwa vinavyoathiri muundo wa ubongo.