Saturday, September 1, 2007

Effect of Child abuse on infant/toddler Development

By Sudipa Sarkar
Introduction

Child abuse is characterized by the physical or psychological ill-treatment of a child by an adult. It is often termed as child maltreatment or child abuse and neglect. The child abuse may include various forms such as humiliation, conveying shameful feelings, or making the child frightened. The child sexual abuse is defined as an act of sexual assault of a child or sexual activity between a child and an adult only with the intention to pressurize or exploit the child in question. The Child Abuse Prevention and Treatment Act describes child abuse and neglect as: “at a minimum, any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm.” According to psycho-historical study of childhood and society the history of humanity is instituted upon child abuse. Infanticide has been a regular practice of ancient times and persists till in the present among some countries quite prevalently. In prehistoric and historic times infants were sacrificed for religious and spiritual purposes in support of conducting various inhuman rituals such as throwing into rivers, flinging onto manure heaps, exposing on hills and roadsides. There is a significant pervasiveness of child abuse considering the gender. The girls, of course, have a greater prevalence of being murdered and abandoned than that of boys. In 1741, the first orphan hospital was established by Thomas Coram just to avoid the unbearable pain of roadside children which is still quite a common issue in even most of the developed countries around the world.

Developmental Tasks for infants / toddlers from a traditional or alternative paradigm

The American Academy of Paediatrics (2000) reported that more than 2.5 million children are being abused and neglected each year. Among them, 35 % involves physical abuse, 15 % involves sexual abuse and 50 % involves negligence or psychological abuse. According to the report established by The U.S. National Adoption Centre, 52% of adoptable children (meaning those children in U.S. foster care freed for adoption) had symptoms of attachment disorder. A study conducted by Dante Cicchetti et al (1990, 1995) reported that 80% of abused and maltreat infants show evidence of attachment disorder symptoms (disorganized subtype). Lloyd deMause (1998) argued that the main psychological mechanism operating in case of almost all child abuses includes the adult’s projection of their own disowned parts of their psyche in order to feel them not to be threatened about their own self-image. The ideal maternal style involves a calming action responding to the cry or agony of the child as their part to ventilate and hence console the baby to detoxify its harmful emotions. On the other hand, a potentially precarious maternal style may involve striking to her child against their scream or crying as a result of her own dysfunctional development as a child and adolescent. As reported in the Bimin-Kuskusmin of New Guinea, an ideal example of a typical infanticide, incestuous culture, the mothers having long-established post-partum taboo against sex with their husbands and usually sleep naked with their children till they become at least four years old. The mothers practice orgasms while nourishing them in bed and continuously and actively involve in masturbating them. It is quite prevalent that the children with an experience of maltreatment such as physical and psychological negligence, physical and sexual abuse, are at jeopardy of developing critical psychiatric problems (Malinosky-Rummell & Hansen, 1993 and Gauthier et al, 1996) including reactive attachment disorder (Lyons-Ruth, 1999). The reactive attachment disorder is characterized by distorted perception of attachment provided by primary caregiver as a result of experiencing trauma developed from abuse or neglect, disrupting the normal development as an infant or toddler and hence risk for developing distorted attachment disorder (Solomon, 1999 and Hesse, 1990). Important to recognize the fact that this disruption in attachment style and hence perception may be associated with several developmental problems like anxiety, depression, mood-disorder affecting throughout the life span of an individual (Lyons-Ruth, 1996).

Biological Aspects of Developmental Task

Childbirth is defined as the process in which a baby is born. This phase is considered as the initiation of a person's life and an individual’s biological age is identified in relation to this event in most of the culture around the world. The life history theory, a comparatively newly coined term in the area of human developmental study, describes that how the understandable phenomenon of physiological traits and behavioural factors may influence the maturational and reproductive characteristics defining the life course involving several factors such as weaning age, puberty age, adult body size, first time sexual activity or mating. The changes in these factors perceived by an individual in his or her life span may significantly affect the entire biological development as a normal being. Recent studies in this area argued that the dysfunctional foetal programming may cause an inappropriate adjustment or impairment in foetal development involving a greater risk for a permanent cause for health and developmental dysfunction.

Psychological Aspects of Developmental Task

The psychological aspects of developmental tasks primarily involve development of cognitive as well as emotional aspects precisely influenced by parental and primary caregiver’s interaction to the child. One of the most important concepts in the developmental task is perceived competence which influences to a great extent in the development of anxiety, motivation, sense of worthiness and sense of self-ability in a child that practically influence an individual throughout his or her life span. The childhood is a crucial phase when a child continuously needs support and positive interaction with the adult member of the family, especially from parental figure and primary caregiver in order to build his or her effort to develop problem solving ability, judging ability, comparison of self to the world and vis-à-vis and an eventual enhancement of the cognitive and emotional development as an individual. Another important factor is perspective taking in which a child learns to take other’s perspective into consideration by the virtue of predictable sequence and effective interface between action and consequence relating to an event. For a developing child the parental figures may always attributed in their development of perspective taking in either positive and effective fashion or negative and destructive fashion, hence influencing the development spectrum of a child in either with positive motivation and emotion or with a traumatic depressive feelings along with a negative view about the world around.

Psychosocial Aspects of Developmental Task

The development of a child is a complex phenomenon influenced by various psychological and sociological factors. According to Erik Erickson the developmental process is basically a conjugation and interaction between eight distinct stages among which the first three vastly influencing the childhood phase. During 1-2years of age (stage described by Erickson as basic trust vs. basic mistrust: hope) a child needs to be well-handled, properly nurtured and loved by the responsible caregiver in order to build trust, security and a basic level of optimism. Otherwise, if the child treated badly, he or she must develop a feeling of insecurity and become mistrustful. Another psychological crisis triggers when the child is between 2-3½ years (phase known as autonomy vs. shame: will), when children having a good parenting style learn about his or her newly found abilities and become proud about controlling those abilities instead of being ashamed. On the other hand, if a child does not receive a good parenting treatment, he or she may develop a sense of negativism, stormy self-will, lack of confidence as well as destructive stubbornness affecting throughout the life. The next psychological stage spanning from 3½ years to the entry into formal school, known as initiative vs. guilt: purpose, is equally important, especially implementing the social interaction and broadening the social boundaries of a child. In this phase, a healthy developing child becomes able to participate in both imaginary and social play, becomes able to cooperate with others in various activities, whereas, a child immobilized with the influence of guilt becomes fearful, overtly dependent on adult figure, not being able either to participate or to participate in a distorted fashion in both the imaginative and social play.

Spiritual Aspects of Developmental Task

Spirituality, in its simplest form, may be defined love for every living being around the universe. Spirituality can also be characterized as everything related to one could mean to self and life. It is absolutely a very personal and unique phenomenon which has received a great interest in the history of humankind across different culture and geographical locations. A developing child learns numbers of important essential qualities by the virtue of proper implementation and enhancement of spiritual integration among family. These qualities primarily include faith, virtue, knowledge, self-control, perseverance, godliness, kindness and love. All of the essential qualities are intricately related to the psychosocial development of a child in question such as when a child initially learns to trust about the fulfilment of his or her needs met by the primary caregiver or parental figure, this, in turn, helps him or her to develop faith towards the authority figure in question with a feelings of security with an eventual manifestation of faith as a result of growing responsive parent-child bond. Virtue is an essentially innate quality that even to be believed an important inherited factor that carried over through generation. Knowledge is developed through the positive influence and application of the faith development process. Self-control is a crucial factor in such a sense that it receives a great attention of modelling while it develops within a child. A child must see his or her parental figure to be consistent over their self-control practices, which ultimately leads the child to adopt discipline not in a superficial mode rather to develop an inner foundation of moral knowledge enhancing the gradual realization of true self and the world around as well as the interactive function between the two. Perseverance teaches a child to be patient and helps a child to learn about delayed gratification and a belief and trust in self and spiritual power in presence to help us forever. The feeling of godliness and kindness allow a child to gain knowledge over the justice, commitment, compassion, forgiveness enabling the child to pursue the higher thought and feelings of secure attachment and uniqueness to the world around immediately beyond of family bonds. Love is the ultimate phenomenon of spiritual development by which a child must learn how to hinder hatred and convey the message of unconditional love for God and for others.

Child Abuse and the Alteration of Developmental Tasks of Infants / Toddlers

According to Brian Mattmiller (1999), child abuse can indifferently and inadvertently affect brain and hence its mechanism relating to the development. Study argued that several survival skills associated with the basic developmental process, may become so intrinsically powerful that may cause a biological alteration. Asst. Prof. Seth Pollak supported the idea of biological alteration as a result of child abuse by emphasising on the relation among traumatic early life experiences and later life disorders in adolescence and adults. In his experiment with the maltreated children Seth Pollak stressed on the changing chemical reaction and activity pattern in the suffering child noticed during the onset and prevalence of various stress-related stimuli primarily associated with the event of abuse and maltreatment of a child and known as event related potential (ERP) leading to the probale acute and permanent damage in cell areas responsible to develop various disorders in later days.
C.Kelvey Richards (2003) argued that there must be a strong structural relationship between the brain and behaviour of the abused children. Abused children articulate a spectrum of behaviours arraying from post-traumatic stress, depression, anxiety and suicidal ideations to impulsivity, aggression, felony, hyperactivity and substance abuse. The changing pattern of the brain and behaviour as a result of child abuse propose that environmental stressors can greatly influence the development of the brain mechanism which in turn influences the behaviour. Therefore, we may conclude that the self and environment act each other on a bi-directional mode. Hence the understanding of the effect of child abuse on the electrical potential in the nervous system incorporating the concept of the "I-function" eventually question the permanency of the characterization of ‘self’ and its function.

However, the effects in the brain as a consequence of child abuse have a direct link to the survivors' behaviour, attitude, perception and interaction with their environment. It is quite prevalent that abused children have most predominantly altered their sense of consciousness leading to an alternation to their sense of self. On the other hand, the sense of self is a result of the interaction of one's own sense of identity in combination with an understanding of others’ response to the individual’s attitude and behaviour. Those children being the victim of child abuse may develop multiple personality disorder characterizing the overt inclusion of imaginary companions in their environment in order to relief from immediate stress gathered as a consequence of abuse in question. In the internal part, the stimuli received from the environment to the nervous system may result conflicting and opposing external forces by virtue of defining oneself through specific actions resulting on the environment. These actions apparently conflicting in nature may result in fragmentation of one’s consciousness through the distorted operation of different messages originating from the subconscious. As a result the I-function which enables the transformation of subconscious thoughts into behavioural manifestation may produce a reaction in particular that may not be understandable in conscious experience, hence beyond the definition of conscious thought. At this point of time, the signals received by the I-function may not be able to produce proper response appropriate to the environment and eventually leads to the transmission of lucid narration of dual reality in association with a seemingly logical response. The dual reality involves either the materialization of internal and intrinsic fight and flight response or acting in accordance with the external abuse forcing a surrendering response to the abuse itself. The inborn intrinsic system by default always expect the comfort and security as a result of interaction with self and environment, hence the reality of stress and rejection leading pain and distress may result a conflict influencing the nervous system to either result in decline in functionality or become accustomed its operating structure leading to a successive maladaptive pattern of behaviour.
Dr Martin Teicher, one of the senior consultants at McLean's Hospital, a psychiatric centre affiliated to Harvard Medical School, argued that a child received emotional strain as a result of unsafe interaction in childhood may have derived malformations in various critical zones of the brain leading to depression, anxiety and other maladaptive conditions throughout the life span. Teicher also stressed on the devastating impact of verbal abuse and its permanency in life affecting at a deep-rooted level in various parts of life. In support of his statement, he conducted an experiment with the children suffering from negligence or abusive problem and found that the size of the corpus callosum of those victims of abuse is at least 40% smaller than that of the average. Corpus callosum plays the role of transferring messages between two hemispheres. Teicher and his colleagues hypothesized that the children suffering from childhood abuse may predominantly reside in one hemisphere and move rapidly into the other as a result of traumatic triggers. Consequently the over-burdening of one hemisphere may lead to serious maladaptive disorders. Several researches conducted on this theme claimed that individuals suffering from childhood trauma, in general, reside in their left hemisphere, whereas, as soon as their traumatic thoughts become prevalent, their residence shifts into the right hemisphere which leads to the onset of uncontrollable emotion without any logical guidance derived from their left brain. The contemporary neuroscience arena focuses on the relation of physiological changes in response to external stimuli. Mr. Peter Wilson, the director of the children's mental health charity Young Minds, claimed that the development of brain and its mechanism is basically dynamic in nature as a result of continuous interaction with the environmental stimuli acting on it. Hence, this affirms that the negative experiences influence greatly in children’s emotional lives and their successive development.

Personal Experience

While accomplishing my practical modules as a novice social worker, I interacted with a single mother with an addict son of age around 21-22 years old. The boy in question has shown a great extent of creativity with a special concern in music and painting especially in his childhood. The mother first noticed him while taking drugs with his peers around 2years back and took him to the social organization working for addicts and their family. The case study says that the mother left her son to the neighbour’s house in the day time when she went for her full-time job. There the child was sexually abused by one adult member of the neighbour’s family day-after-day throughout his onset of puberty and post-puberty phase as well and when he asked for help from her mother at the initial stage of the abuse, his mother simply refused to provide him any kind of support and showed a great deal of mistrust against his statement by naming and emphasizing it as his utmost imagination or over-reaction. It also seems that the mother probably due to her own personal and societal stress always maintained a distance in her interaction with her child. According to the data received from the mother, it is quite prevalent that the boy became very quite and numb and the boy showed a gradual decline in almost around him including studies. As per the report from her mother, he was unable to maintain a trustworthy relationship with anyone including the opposite sex relationship, whereas, his homo and hetero sexual relationships with different types of individuals are very ubiquitous.

If we analyse this case in relevance with the scientific studies conducted in this area, we may assume that the child being creative in nature may have a rich potentiality in his right brain implying that the child in question may have an enhanced right hemisphere incorporating his creative attitude. While being abused by the adult neighbour, when the child initially asked for help from his mother and received a mistrustful inconsistent attitude from his mother, it consequently results the development of self-identity distortion leading to learn to mistrust the environment (Erik Erickson). As we know that our left hemisphere is responsible for logical integration, whereas right hemisphere operates on the basis of intuition by prioritizing the emotional reason at the front. However, our left brain encompasses the cognitive manifestation operating in the logical level, and our right brain takes in the role of creative augmentation whatsoever (Malinosky-Rummell, 1993). The functional differences and ability for performing functions in both of the hemispheres reveal individual differences and the prevalence of determination of superiority of hemispheres is yet unknown.

Gender differences in child abuse

There is a significance gender difference prevalent in the case of child abuse among all cultures throughout the world. For example, in India, the child molestation, especially prevalent among little girl, is a common and crucial social issue manifested in socially accepted boundary in the name of ‘early marriage’, where an innocent baby girl was compelled to get married to an older person in order to maintain family status or sometimes for the uplifting of family rank within a community. There female children were used to be masturbated by their mother (primary caregiver) in order to maintain a peaceful sleep and male children used to get the same treatment to become more manly (Lloyd deMause, 1998). In china, the early marriages are quite prevalent among siblings of either in direct relation or cousin relations, especially the marriages are quite common with several numbers of brothers with a girl in question (Lloyd deMause, 1998). The prevalence of rape among the girls in China and India is so high that very few number of girls may actually enter into the pubertal stage with an intact hymen (Lloyd deMause, 1998). In Japan, the masturbation and co-sleeping with parents as well as mother-son incest are the most common issues established for child abuse.

Effects of Child Abuse

According to Jim Hopper, 2006 the child abuse primarily include three distinct factors such as potential damage developed as a result of maltreatment, negative affects including maladaptive pattern of behaviour to inability in relational adjustment and make people doom with a feelings of intense suffering of pain. These factors eventually affect the human condition in question by the virtue of affirming few factors including the childhood painful suffering experiences, caregivers’ inability to convey support and message of love and compassion, and our lack of experiencing support to deal with pain and cope up with traumatic experiences. The child abuse may depend on various factors including the developmental age of occurrence, the responsible person who committed the abuse, the response the child received as a result of his or her sharing about the abuse or negligence he or she experienced, severity of violence, length of abuse.
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