By John Fallowfield
Date Posted: December 18th, 2013
John Fallowfield is a qualified social worker. He has worked with children and families in statutory settings for six years; as a Social Worker in a Looked After Children Team as well as a Social Worker and Senior Practitioner in a Referral and Assessment Team. Currently he is working within an Adoption and Permanency Team. This basis for this paper was written in 2012 as part of his post qualifying education.
Understanding child development and child observation in social work practice
Drawing on practice, observation, research and theory this paper seeks to critically reflect on key aspects of child development. Analysis and understanding of child development is grounded through reference to a case example of a child and family. Appendix A contains a summary regarding the child, whom is named Jamie. The names and case details have been amended to ensure confidentiality.
It is intended that the reader begin by reading Appendix A to gain insight into the details of the case under discussion. This paper views the relationship between knowledge and practice as complex and inter-related. Flaskas (2007) provides a useful image of a “spiral” to illustrate this relationship. This perspective is based on the suggestion of practice generating theory, that theory then informs and shapes practice, research and practice then tests the boundaries of the theory, theory is broadened and developed, which in turn informs practice, and that in turn then challenges theory. By utilising a case example, this paper seeks to demonstrate how theory and knowledge are inter-related with practice.
The need for social workers to have an in depth understanding of child development is reflected in research and literature. Knowledge and practical application of child development is fundamental to safeguarding children and promoting positive outcomes for children and families (Davies and Ward, 2011; Brandon et al, 2011). The importance of social workers directly ‘experiencing’ children through observation and interaction in order to inform their assessment of child development is also reflected in current literature (Munro, 2011; Ferguson, 2011). The importance of reflecting on and acting on issues of anti oppressive practice and how this relates to social work with children and families is integrated into this paper.
As part of this paper I undertook two observations of Jamie. I was in the role of an observer and not a participant. The first observation was of Jamie in reception class at school, interacting with peers, receiving instructions from his teacher and engaging in structured play and learning. The second observation was of Jamie with his foster carer in a public playground, interacting with and being cared for. These observations formed part of a larger pool of evidence upon which I analysed and understood Jamie’s development.
What are the theoretical ideas and research-based information that informed my understanding of Jamie’s development?
My overall theoretical viewpoint was that Jamie’s early development had taken place within the context of a series of complex interactions between him and the environment that constituted his world. I analysed Jamie’s development and needs in the context of his attachments, caregivers capacity and skills, the environment and wider family relationships. This is representative of a transactional model utilising an attachment perspective that enabled me to recognise the complex interaction of both parental and child vulnerability and protective factors (Howe, 2006). I will now outline the key theoretical ideas and concepts that will later be used to analyse and understand Jamie’s developmental journey and needs.
An ecological approach emphasises thinking about the social and personal elements in a child’s social situation and seeing how those elements interact with each other to make up the whole (Payne, 2005). Uri Bronfenbrenner (1979) developed the ‘ecological system of human development’ that recognises each individual’s micro, meso, exo and macro systems. The settings in which the child is directly involved, including home, school or neighbourhood, are labelled the micro-systems and the relationships between them form the meso-system. Settings such as the child’s parent’s network of friends or work colleagues are referred to as the exo-system, and wider society the macro-system (Bronfenbrenner, 1979).
Resilience is a strengths based concept that reflects the positives and ‘a capacity to deal with severe adversity’ (Hill et al, 2007. P2). An ecological approach to the formation of resilience is useful for assessing the contributing factors by examining individual, family and community factors that come together to constitute the development of resilience (Benzies and Mychasiuk, 2009).
Attachment theory offers an understanding of personality development and behaviour in close relationships and provides an account of how people develop emotional and relationship styles. Child psychiatrist John Bowlby theorised how children need to feel a sense of belonging to committed and caring adults, whether they be parents or carers. Bowlby explored how this leads to a feeling of security in the child, which in turn promotes growth and exploration. Bowlby theorised that children can then explore the world, have new experiences and develop safe in knowledge that they have a secure base, where they will be comforted and protected in times of uncertainty or distress (Bowlby, 1988).
Inner World of the Child
Exploration of the concept of attachment promotes thinking about what has gone before for a child in their early experiences. This involves exploring what can be termed the ‘inner world’ of the child. English psychoanalyst Donald Winnicott (1965) understood the child’s inner world to be a mix of basic sensations, fears and instincts. Winnicott theorised that the parent or carer of the child must ‘hold’ them, not just physically but emotionally to help them learn to manage their emotions. The parent or carer therefore enables the child to hold ‘himself’ together and according to Winnicott this is the development of a healthy and ‘integrated’ inner world.
Concepts of attachment and the child’s inner world demonstrate just how early our sense of self and sense of identity begins to form. Identity concerns our growing sense of self as separate and valued being (Bergen, 2008). For children to make successful progress they have to become confident about themselves and their abilities. Fundamental to this development are experiences of relationships and attachment because if children feel accepted and valued by family and by wider society they can develop a strong sense of their own individuality and a positive view of their own abilities (Ward, 2001).
If a child is safely attached to their parent or carer, it follows that separation and loss of a parent will have a major impact for that child. There are a wide range of factors that will influence a child’s reaction including age, attachment to the caregiver, past experience of separation, the perceived reasons for the separation, how prepared they are and the responses of adults around them (Fahlberg, 2008).
Critique of Theoretical Ideas and Research
Attachment developmental theory is a well researched and evidence based area of study that can be effectively used in working with children and families. However, a critical approach is essential as a simplistic application of this theory cannot be used to understand a child’s development and as a basis for intervention and planning. On the contrary, it should be used to integrate an understanding of attachment as part of a holistic approach to psychosocial development by utilising an ecological framework (Howe, 2005). This stresses the complex and interweaving aspects of a child’s life that come together to form an individuals world. This includes the child’s development needs, the provision of care and wider environmental and structural factors.
Jamie’s early experiences and his world in the care of his parents
In this section, I will illustrate how the key theoretical ideas and concepts can be used to analyse and understand Jamie’s journey, development and needs. Case records detailed Jamie’s early experiences of a home environment that was often frightening and neglectful. Sue and David had been more pre-occupied with their own emotional needs, to the extent that they could not notice or respond to Jamie’s needs. There was little chance of Jamie feeling ‘held’ as Winnicot described. He was more likely to feel ignored and abandoned during a time when he is unable to comprehend what it all means.
Sue reported that David was very jealous and rejecting of Jamie and that their relationship in the home was characterised by domestic disputes and abuse. An influential text by Hester et al (2000) highlights the research relating to the damaging effects of domestic violence on children’s well being and as a result it is possible to hypothesise that Jamie had been frightened of his parents and not sufficiently “kept in mind” by them nor emotionally attuned to. As a result, it is unlikely that Jamie was able to develop a secure base from which to explore the world as described by Bowlby.
Knowledge and research regarding the impact of parental learning disability and mental health on children is relevant to understanding Jamie’s development. Messages from research indicate that both cognitive functioning and other psychological factors may impact on parenting ability (Stanley et al, 2009). With regard to cognitive functioning, Sue had experienced language delay herself as so it was not surprising to find that she struggled to provide appropriate stimulation for Jamie in this area. This was evident in the significant delay in Jamie’s speech and language.
With regard to psychological factors, by listening to Sue I was able to hear that she felt emotionally deprived and controlled by her parents as a child. During her adult life Sue had been exploited and abused by those close to her. Sue suffered from depression and anxiety and had been unable to evaluate the impact of these experiences on her own behaviour and parenting. This was evident in Sue’s disconnected and insensitive parenting.
Research suggests that up to 80% of children who are abused have a ‘disorganised attachment’ and when they become parents themselves, their interactions with their children is characterised by low levels of reciprocity and engagement as well as hostility and unpredictability (Barlow and Schrader-McMillan, 2010). The key factors of parents’ behaviour that contribute to disorganised attachment include unresolved loss and trauma, disconnected and extremely insensitive parenting and low parental mentalisation and reflective function (Shemmings & Shemmings, 2011). These parental behaviours were identifiable in Sue and David’s response to the parenting task.
Sue did not experience the support offered by family as positive, in fact she expressed that she felt her family sought to control her and so she was resistant to their support. By adopting an ecological framework, it is possible to see how Sue’s emotional well being and parenting capacity was severely compromised by the complex interaction of individual, wider family and environmental factors. This in turn impacted on Jamie’s early experiences, the quality of care he received and hence his development.
My awareness of Sue’s learning disability, experience of abusive relationships and isolation from her extended family made me reflect on the concept of powerlessness that was pervasive in her life. She had experienced exclusion, rejection and been treated as inferior that had led to feelings of dependency, helplessness and inadequacy. An anti-oppressive framework enabled me to recognise the divisions of age, gender and disability and how they interact with social structures to formulate Sue’s internal relations within the family as well as her external relations with professionals and the wider community (Dalrymple & Burke, 2006).
The practice issue for me as a social worker was to find ways of recognising and validating difference without discriminating unjustly. This provided a framework from within which I was able to recognise and support diversity, acknowledge difference and challenge oppression and division (Dalrymple & Burke, 2006). I put this into practice through ensuring Sue had an independent adult advocate, 1:1 adult learning support and by ensuring my practice was grounded with reference to best practice with parents with learning disabilities (DoH & DfES, 2007).
Jamie was a young child in care with global developmental delay and his ‘voice’ was not being heard in the process of deciding his future and this raised issues relating to anti-oppressive practice. It was important that I gained an understanding of his wishes and feelings through play and conveyed this to the court to ensure that Jamie’s ‘voice’ was heard and taken into account when deciding his future care. Being labeled a ‘child in care’ raises further issues of anti-oppressive practice and it was important that I reflected on how this impacted on his identity and sense of self.
Jamie’s grandparents were a significant feature of his world in the first two years of his life. I observed Jamie’s positive and affectionate relationship with his grandparents and Jamie was able to identify that they were part of his ‘family’. By reference to research (Benzies & Mychasiuk, 2009) I hypothesised the protective nature of this relationship and its contribution in promoting Jamie’s resilience and his development of identity. Jamie’s grandparents wanted to care for their grandson permanently but were deemed unsuitable due to their age and their deteriorating health. This raised further issues of human rights, including Jamie’s right to family life.
Jamie’s Journey into Foster Care
Jamie experienced a sudden and frightening separation from Sue and subsequently further separations from substitute carers. It is possible to theorise the impact that this had on Jamie’s development. In terms of his sense of stability, security and trust in the world, it is likely that these were significantly undermined and compounded his negative experiences whilst in the care of Sue and David. This was evident in his very traumatic way of relating to the world. His behaviour and presentation was characterised by confusion, control, violence, aggression and anxiety.
From my observations of Jamie over time, I was able to reflect on his development in the context of the change in his primary carer and environment. There can be ‘turning points’ in a child’s life that emphasises that a change in one part of the system has a ripple effect on the whole system (Gilligan, 2001). For Jamie, I would suggest that the turning point was moving into the home and care of his current foster carers, Martin and Grace, whom was carefully supported by a skilled and empathetic psychotherapist. Their care, combined with weekly play therapy sessions undoubtedly had a significant impact on his overall development and wellbeing.
In the same way that theory and research suggests that adversity is most debilitating when it comes it comes in multiple forms, it is important to take into account the strengthening countervailing protective factors. From the start of their relationship Grace enjoyed and fostered Jamie’s attempts at communication; her eyes lit up when he made contact with her and she used humour to great effect when attempting to understand his effort at communication. By keeping Jamie ‘in mind’, Grace encouraged him to think and communicate and ensured that Jamie did not feel hopeless when he was not understood but instead persisted in his attempts and his speech and language development has accelerated in response.
Perhaps the most striking feature of Grace’s care was her patient and emotionally containing approach. By being sensitively attuned to Jamie’s needs, Grace was able to develop a beautiful reciprocity in their relationship. During my observations of Jamie with Martin and Grace, I observed a child who played happily in the playground with his carers at his side. I observed him to laugh, play and seek affection appropriately. This was in stark contrast to my early observations of him, both with his previous foster carer and his mother. It is possible to hypothesis that because Martin and Grace emotionally ‘held’ Jamie and this enabled him to develop the ability to explore his inner world and by acknowledging Martin and Grace as safe objects he has been able to extend this notion to others.
Grace and Martin were able to manage and contain Jamie’s distress and his extremely difficult behaviour has mellowed a great deal. Over time Jamie was able to achieve a very important developmental emotional milestone in that when he was frustrated by not being able to do something, instead of getting angry and destroying his environment he was able to seek Grace’s comfort and cry. This was a major factor in his previous placement breakdowns because until he could rely and trust his carers he could not seek out containment or comfort from them.
Jamie’s developmental response to the care received from Martin and Grace was remarkable; all areas of development accelerated and he was enabled to lay down the foundations to reach on-going developmental milestones. During my observation of him at school I observed a child that fitted in with his peers, who engaged happily with play and learning and who responded positively to school staff. Both of these observations were in stark contrast to my first observations Jamie.
How did Jamie make me feel? What might it tell me about the Jamie’s inner world?
As Jamie’s social worker, it was important for me to reflect on Jamie’s inner world in order to understand his needs. By having insight into how I experienced Jamie and into my own inner world (and by acknowledging that this brings something to my relationship with Jamie) it was possible for me to have some empathy for his feelings and to hypothesise what the feelings in myself might tell me about his experiences. The work of Ruch (2007; 2008) regarding reflective practice has been influential in my development in this area.
When I first met Jamie I remember experiencing him as exhausting and even frightening due to his apparent anger and unregulated emotional state. I remember feeling anxious and avoidant of this ‘damaged’ child. His previous and current foster carers had experienced him the same way and this had led to placement breakdowns which had further compounded his sense of separation, loss and rejection.
The concepts of transference and counter-transference that are derived from psychoanalytic theory are useful here. Transference occurs when the child behaves towards another person as though they were the child’s mother, father or another significant adult in the child’s life (Bauer and Kobos, 1995). With reference to this theoretical viewpoint, Jamie’s challenging, aggressive and controlling behaviours could be understood in terms of him projecting his beliefs about his parents onto me and his foster carers, believing that we are like his parents. With reference to psychoanalytic theory I could hypothesise that due to Jamie’s early experience of his parents, Jamie viewed his foster carers as critical and neglectful parents and this can be understood as negative transference.
By reflecting on my own feelings and supporting his foster carers to do the same, I was able to hypothesise that Jamie was transferring feelings or fantasies that he would like to direct at his parents onto his foster carers and me. Jamie’s challenging and negative behaviour and presentation resulted in his foster carers unthinkingly responding as a rejecting parent. This can be understood as the concept of counter-transference.
Key Conclusions about Jamie’s Development
It was my assessment that many of Jamie’s developmental difficulties and delays stemmed from his early experiences of care. Jamie developed a traumatic way of relating due to the insensitive and neglectful parenting that he received during the first three years of life. There were also protective ecological factors during this time in the form of the care and relationship he experienced with his maternal grandparents as well as his positive experience at nursery. These islands of good care helped build his resilience and to some degree counter-balanced the negative experiences of his world.
By reflecting on the feelings provoked in those around Jamie and by undertaking an assessment based on a set of theoretical constructs it was possible to identify that Jamie’s primary need was the attachment to a primary carer who could facilitate his development of a secure base by providing reciprocal attunement and sensitive care. With this aim in mind, Jamie was carefully matched with carers that could meet these needs and work through the difficult times. Jamie was able to form a secure relationship with Martin and Grace.
There was a distinct change in developmental trajectory after Jamie moved to the care of Martin and Grace, whom with the support of a very experienced psychotherapist, has been able to retrospectively help Jamie revisit the early stages of development. Evidence of this secure relationship and base from which to explore the world was evident in the observation of him with Martin and Grace at the playground.
Over time, Jamie has been able to develop the necessary foundations of the previous stages of development; namely the development of attachment, self-regulation and the capacity to exhibit empathy and pro-social behaviour. This has enabled him to move into the next significant phase of child development that that is usually between the ages of 3-7 years (Bergen, 2008). During this stage, Jamie has begun to establish peer relationship and become integrated into peer groups as evidenced in the school observation.
What have I learnt about myself and the observer role and the use of observation as a tool for assessing children?
It is helpful to reflect on what I learnt about myself and on the use of observation in practice as a tool for assessment. When I consider observation as a tool in current context of working with children and families, I recognise that it is an opportunity to ‘stop and reflect’ on my work. I recognise that observations can never be objective since the subjective feelings of the observer are involved in the task. However, transferred feelings can be acknowledged and even if their origin is not understood they can be used a tool in thinking and exploring the feelings and what they may mean in terms of the child’s world (McMahon & Farnfield , 1994).
In conclusion, statutory children and families social work is characterised by regulatory and procedural approaches as the dominant framework and this has been to the exclusion of social work grounded in an understanding of child development and use of reflective practice that acknowledges the centrality of self and the impact of anxiety on professional practice (Munro, 2011).
This paper further developed my practice by reflecting on how the skills and understanding that child observation promotes can be used as an effective tool within a framework of reflective practice. Such an approach acknowledges both the intellectual and emotional dimensions of social work practice. Observation is now a key tool that I utilise in my practice and I integrate a theoretical and practical understanding of child development in my assessments and care planning.
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APPENDIX A: case summary
Sue and David (birth mother and father)
Grace and Martin (foster carers)
Family Background and Early Experiences:
Jamie and Sue were known to social services since birth. There were long term and on-going concerns regarding Sue’s ability to meet Jamie’s basic needs in the context of her learning disability and mental health difficulties.
David’s involvement was sporadic in the first three years of Jamie’s life and when he did interact with Jamie he was observed to be insensitive, rejecting and jealous of Jamie. David and Sue’s relationship was characterised by domestic abuse.
Despite the intervention of the local authority, Jamie was accommodated and subject to a Child Protection Plan under the category of neglect and emotional abuse. Two of his foster placements broke down because of his challenging behaviour.
I began working with Jamie and his family after the case was transferred from the Child Protection Team and into the Looked After Children Team where I was working at the time.
When I first met Jamie his behaviour was characterised by violence, aggression and destruction in his foster placement; struggling to settle at night, breaking toys, harming himself and hitting out at the carers and their children. It felt like his only easily accessible emotion was anger and hyper-vigilance.
I observed contact between Jamie and Sue to be characterised by Jamie’s traumatic ways of relating to his mother; including being avoidant, aggressive, controlling, hyperactive and anxious during contact. Sue was often non-responsive and pre-occupied with herself during contact. David refused to engage with social workers and moved away with no further contact.
I referred Jamie to the local Child and Adolescent Mental Health Team and Jamie attended weekly sessions with a psychotherapist. I requested that therapist also asked to work in partnership with me to support Martin and Grace (Jamie’s foster carers).
It was my role to undertake an assessment of Jamie’s needs and Sue’s parenting capacity and devise a package of support for Sue and Jamie and in order to ascertain whether Sue would be able to provide Jamie with good enough care. Despite intensive support, there was little change over a further period of six months. Following a legal planning meeting, the Local Authority initiated care proceedings and a full care order was sought.