working with preschool-aged child abuse victims in group settings

Working with Preschool-Aged Child Abuse Victims in Group Settings

Peggy Pearl Southwest Missouri State University, Springfield

ABSTRACT" This paper will describe characteristics of child abuse victims and how the adult can best meet the victim's special needs in a group setting. Appropriate techniques to use to facilitate communication, to define appropriate behavior, to stimulate language, and to encourage skill development will be discussed. The appropriate staff training, support, and child-staff ratio will be included.

Child abuse victims behave as any child under stress. However, gener- ally these children have spent more time under stress than typical children. They will be slower to respond and appear withdrawn and indifferent to warm, caring adults (Martin, Beezley, Conway, & Kempe, 1980; Bradley, Caldwell, Fitzgerald, Morgan, & Rock, 1980). Maltreated children will respond with less predictability than other children because they have been living in an unstable and confusing environment. The usual techniques to encourage a child to participate and respond frequently get no response or indiscriminate superficial response (Mar- tin, Beezley, Conway & Kempe, 1980; George & Main, 1979). This paper will discuss how the adult can best meet the special needs of child abuse victims in a group setting through communication, definition of appropriate behavior, stimulation of language, and encouragement of skill development. In addition, this paper will def'me the specialized training and support needed by staffworking with child abuse victims in order to maintain effectiveness.

In their a t tempts to unders tand their worlds and avoid unpleasant experiences, abused children "stare continually," never making eye con-

Address requests for reprints to the author at Box 104, Home Economics, Southwest Missouri State University, 901 South National Ave., Springfield, MO 65804-0094.

Child & Youth Care Quarterly, 17(3), Fall 1988 ©1988 Human Sciences Press 185

186 Child & Youth Care Quarterly

tact with anyone. "It is as if they think by not looking someone in the eye, they make themselves invisible and therefore safe from attack" (Kempe & Kempe, 1978). This is the at tempt of the young child to not be seen and therefore, not hurt. To teachers and observers this child may appear dull, unresponsive, perhaps or to have hearing or sight deficits. In fact he/she is carefully analyzing the environment learning to "read" adult behavior. The child is trying to avoid danger carefully scanning the environment making very detailed and accurate mental pictures of the environment. As these children become secure enough to talk (or later as adults) they often reveal an exceptional memory of their environment and the behaviors of those around them. Observers of child victims need to be aware of this characteristic scanning behavior and not "misread" the behaviors nor too quickly a t tempt to evaluate this child (Kempe & Kempe, 1978).

In learning to survive in their environment, child abuse victims have adapted in one of two ways: either with internalized and overcontrolled behaviors or externalized and undercontrolled behaviors. The child who has internalized and overcontrolled his own behaviors is inhibited, shy, anxious, fearful, withdrawn, depressed, and/or frightened. He/she may be very anxious to please adults and meet adult needs. He/she may be easy to have around. In fact, this child may be easy to ignore and overlook. Some have a "fixed and unchanging smile." They may be passive and compliant accepting whatever happens to them. On the other hand, the child who has adapted by externalizing with undercontrolled behaviors tha t are aggressive, angry, and hostile is not easily overlooked and difficult to be around (Kempe & Kempe, 1978; McQuiston & Kempe, 1980).

Most adults stereotypically see the child abuse victim as the aggressive, negative child who is incapable of playing acceptably with other children and very difficult for adults to work with. This is, in fact, the accurate description for only about one-fourth of the victims in any group. Since aggressive and hyperactive children demand attention, they are the children that adults must deal with and cannot overlook. Both their language and behavior are aggressive toward adults and children. They are difficult to work with, not listening to directions, impervious to disapproval and forever hitting children. The impulsivity and distractibility prevent any relief from their demands on staff attention. They see themselves as bad, unlovable and stupid. They expect punishment and will call attention to their own misbehavior. They gain no pleasure from activities or people. Without t reatment they grow more aggressive. They respond well to a very calm, highly-structured environment (Kempe & Kempe, 1978).

The remaining three-fourths of all victims are overly compliant and accept whatever happens to them. They are passive and obedient, stoic

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and unresponsive, withdrawn and shy, easy to overlook. These are the survival techniques they have adopted. They feel guilty for misbehaving, responsible for getting parents upset or in trouble, and preoccupied with their desire to please adults (Kempe & Kempe, 1978). They are very sensitive to criticism by adults and need only mild suggestions to redirect their behavior. They need an environment tha t is accepting, full of hugs and encouraging. These children need a calm, predictable place to learn social skills and to release their feelings. They feel little joy or pleasure and have low serf-image. They are often compulsively neat and overly desirous of meeting adult goals. They show indiscriminate affec- tion for adults (McQuiston & Kempe, 1980; Steele, 1986).

To assist the teachers of young child abuse victims the following is a discussion of techniques that are effective with both internalized overcontrolled and externalized undercontrolled victims when they are mainstreamed into a preschool program with normal children. The topics and techniques discussed are divided into separate sections only for the purpose of this paper. In the developmental preschool they must be integrated simultaneously.

Communicate Clearly and Simply

In giving instructions, adults should make sure the directions are clear and simple. Since children during the preschool years feel tha t which is nearer is more important, adults should be physically near the child when giving directions. Teachers should use a clear, quiet voice while they are looking directly at the child. Children who have lived with many commands and general uneasiness will not respond well to general directions given from across the room. As with all children, teachers should give some latitude when giving instructions to allow the child to make simple decisions. It is important that the adult's words and body language are conveying the same message. These children are not easily fooled by people who say one thing and do another. Calm body language will placate and relax the child more than words. Voice tone is more important than what is said. The teacher should be careful to make sure tha t the voice says what is intended. 'Time to come in now?" spoken with a questioning voice leads the child to disobey the spoken words. "It is time to come in now" spoken in a clear, calm manner will tell the child what to do but spoken in a questioning voice will not.

The adult should tell the child what behavior or actions are appropriate and expected you want, ra ther than what not to do. "Clean up your toys and get ready for snacks" is too vague. "Place the blocks back on the shelves, matching the shape of the block to the label on the shelf, wash and dry your hands, and then come to the snack table" will provide the child with directions for appropriate action. The more concise and


specific the directions, the better they define appropriate actions. After each appropriate action teachers need to provide lots of praise and hugs to the child. All s taffshould model calm behavior. Additionally, the staff should exhibit a sense of humor (Honig, 1985. Honig, 1986).

Define Appropriate Behavior

Children should be told specifically what the adults expectations are and what will happen if expectation or limits are not met. It is important to be consistent in defining and maintaining limits. Saying, "Mary, the blocks are for building on the floor. If you want something to throw you may put the blocks back on the shelf and go outside and throw the balls" specifically defines expected behaviors and uses of equipment.

Methods used to correct and redirect should be those that do not frighten the child or make h im/her feel guilty or bad about himself/herself (Salter, Richardson, & Kairys, 1985). Abused children are highly punitive toward themselves. They are overly sensitive to criticism or rejection; early in a relationship they will usually need only the slightest of suggestions to t ry to please. Harshness will cause a quick return to frozen watchfulness and withdrawal (Kempe & Kempe, 1978). When the child begins to test limits it is usually a sign of progress tha t the child is feeling at ease. Teachers need to hold to limits. Children need the security of knowing what will be done if their behavior is not appropriate. Consistent and predictable limits give the child security. The preschool staff need to give order and predictability to compensate for the void the child may have previously experienced. As the child has these experiences with consistency and predictability he/she begins to develop trust.

Staff should also use logical consequences when setting limits. If the child misuses a piece of equipment or is disturbing other children, remove him/her from the activity. Teachers may verbalize to the child, "I'm sorry. You are not able to continue this activity at this time, but you will have to choose another a c t i v i t y . . . "The child needs guidance as to what is appropriate and an environment where limits are consistently set, logical consequences followed and the rights of each child are protected.

However, teachers should remember tha t these children have often been reared in very controlled em4ronments with many limits, and they need to learn about freedom. Children who have been victimized frequently have parents with many unmet emotional needs tha t the child is seeking to meet. Therefore, some children will be overly anxious to please adults to make the adult "have a good day." High parental expectations and disapproval of play and frivolousness or messiness restrict the child's ability to explore, express, and experience. The adults will

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need to model the joy and pleasure of play for these children. "Seeing teachers playing on a childlike level, and enjoying it, may be a revelation tha t opens new opportunities for such children," according to Kempe and Kempe (1978). In the preschool the goal is to encourage the child to meet his own needs and learn age-appropriate behaviors and increase verbal communication.

Stimulate Language

Child victims need encouragement to stimulate use of language (Steele, 1986). With nonverbal children, it is preferable for the teachers to concentrate first on usage, then work on the quality of usage. A correct language model and social responses to all language from the child are the best ways to build language skills. Initially adults should speak directly to the child but demand little from the child. For example, teachers may label everything around the child, such as objects, actions, and feelings.

It is important tha t children hear both simple and complex vocabu- lary. Children learn when they hear adults use complex words and then repeat the same thought using simpler words. Children will talk more and learn more words when adults accept all language from the child in an open nonjudgmental manner. The environment must be one in which the child's efforts to produce language and communicate are always accepted before any remediation can begin (Allen & Oliver, 1982; Salter, Richardson & Kairys, 1985).

Encourage Skill Development

To build skills in all areas of development children need many opportunities to engage in a wide variety of nonthreatening play activities. Initially children need a limited number of choices at any one time or the victimized child will again experience chaos and confusion. The child may easily become overstimulated with too many pieces of equipment and too many choices. The preschool needs familiar equipment and routine to give the child security while new activities and /or equipment are introduced slowly.

Adults must accept the child's level of performance of a new task with praise and reassurance, rather than criticism to avoid withdrawal. The child will need opportunities to practice sldlls without competition or evaluation by adults (Salter, Richardson, & Kairys, 1985). Frequently, the abused child has had excessive evaluation of everything he/she has done. Abusive parents commonly have inappropriately high standards that the child has internalized causing feelings of inferiority and lack of ability (Ney, Moore, McPhee & Trought, 1986), The child needs opportun-


ities to do those things that he/she does well and then guidance into other areas.

Abused children have commonly been praised for cleaning up, doing household chores, etc.; therefore, this maybe the place to begin. Washing table tops, or sinks may combine a familiar activity with relaxing water play. Then, the teacher may help the child move into new areas such as other water play, play in the housekeeping area or cooking activities. The child may need help with tasks tha t he cannot do on his own but allow him to do as much as possible to achieve the feeling of success, keeping in mind these do not come easily for the abused child. Verbal praise, smiles, and hugs are necessary to give positive reinforcement and encouragement (Mirandy, 1979).

A. Social Skills

Abused children will have unmet emotional needs and few social skills, They need assistance with changing their behaviors. Abused children must be encouraged by adults to stand up to each other (e.g. "Fell him you do not want him to draw on your paper"). Initiallythe aggressor may only listen because you are literally standing behind the victim, but the notion that people have rights and can assert them appropriately and effectively is important. These are youngsters whose personal rights have been violated; they need to have a place where this does not happen and a role model for preventing it from happening in a nonviolent manner. Efforts need to be made toward helping the child develop assertiveness and resistance.

The child should be provided opportunities to interact with a small group of age-mates. Often it is beneficial to pair the child who has few social skills with a child who has good social skills. The adult working with this small group needs to defend: and support each individual's rights while directly teaching skills that will assist each group member in successful group interaction. Mainstreaming the victimized child into a group of normal children will allow the victimized child to model appropriate behavior. The child's ability to learn social skills is directly related to his emotional development (Mirandy, 1979; McQuiston & Kempe, 1980; Steele, 1986).

B. Emotional Skills

The emotional development of victimized children will be delayed. As previously discussed, the victimized child will usually have adapted by

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undercontrolling or overcontrolling emotions with inappropriate, over- generalized means of release. Abused children commonly have excessive guilt and shame, little joy or pleasure, minimal empathy (Straker & Jacobson, 1981), and intense anger, frustration, and anxiety. All victimized children--both the overly controlled shy, withdrawn and the undercontrolled aggressive, acting out- -need opportunities for identify- ing and venting emotions (Kempe & Kempt, 1978; McQuiston & Kempe, 1980; Steele, 1986).

The environment needs to provide a calm, accepting atmosphere that accepts all feelings but not all behaviors. The program needs to convey order and routine, security and predictability so children can learn to t rust and feel secure. All feelings need to be accepted, discussed and labeled by the adult and the child. Materials and acth~ties tha t allow positive and acceptable venting of all feelings need to be made available to the child. The curricular offerings should be designed to remediate for developmental lag, stimulate language, as well as expression and venting of feelings.

Water play is one of the best activities for encouraging preschool-aged children to vent feelings. A variety of water play activities indoors and out are needed. Water play provides an experience in which the child is in control. It should be available in at least one form everyday when the child arrives. It is clean, neat, and nonthreatening with minimal rules or directions that the adult must impose. Water play also gives safety and security. Water play is an activity at which the child cannot fail or make a mess with and no product remains for adults to evaluate.

Indoors many children find natura l relaxation in washing sinks, table tops, dolls, and play dishes. Then they may progress to the use of boats, lids, dishes, pumps, water-wheels, and small buckets in a water table or large tub or pan. Water play outside may take the form of painting with water on fences, walks, patios, and walls. The child combines the large muscle activity of walking, stooping, and brushing with the ever soothing water. As the water freely goes onto the surface it quickly dries to provide a neverending opportuni ty for the child to paint and re-paint while growing calm and relaxed.

The water may be combined with sand for another relaxing medium tha t the child can control, shape, and manipulate freely. The sand and water, however, are messy and, therefore, not acceptable to many victimized children. Sand alone may be more acceptable to some children and can easily be cleaned off by dusting the sandy feet and hands with baby powder. Since these children have a strong need to please adults and adults have consistently equated their worth and value with their ability to keep clean, they may shy away from messy activities.

Another medium that readily allows for release of emotions is fmger painting, especially with shaving cream (white or food colored) or pud-


ding. The traditional use of finger paint may not appeal to many children because of the "mess." Liquid soap or shaving cream may be more acceptable because of their clean nature. The goal is to give the child a material tha t he/she is in control of and can freely manipulate.

Building blocks, either table top, wooden blocks for the floor or large hollow blocks (cardboard, wooden, or foam) can also allow the child a release for tension. The child should be in charge and adult intervention should be minimal. Blocks allow the child to gain control and mastery over the environment which is especially important for the child abuse victim. Blocks allow the child to gain a sense of achievement with pride of mastery (Cherry, 1976).

C. Motor Skills

Large muscle activities such as jumping and running allow the child physical releases of anxiety and frustration while acquiring motor skills. Children need space in which they can use large muscles with adequate, nonjudgmental supervision. Climbers, slides, and swings supplement other large muscle equipment commonly found on playgrounds. Small trampolines may give the child the same physical opportunities. Pound- ing and punching also allow the child to release anxiety and energy in an acceptable manner. Play dough is a medium tha t allows the child to manipulate, control, hit with pounders or fists, and shape and reshape. Play dough is also an activity that is not messy. Driving nails or pounding on boards has similar release values for the child. The atmosphere needs to be safe and remain free of competition, comparison, and adult evaluation.

D. Cognitive Skills

Abused children commonly suffer from intellectual delays due to their environment. Even when the home provides materials and opportunities for intellectual development, the stress and anxiety impede the normal acquisition and utilization of knowledge. However, most often the environment has lacked age-appropriate learning opportunities, guidance, and reinforcement of learning. The preschool needs to provide an environment where intellectual skills can be learned when the child is emotionally ready.

Abused children will initially lack the intrinsic motivation for learning and the joy from learning experienced by normal children. In an environment where they are accepted as they are, allowed to succeed and encouraged to meet their own needs rather than adult needs, these

Peggy Pearl 193

children will eventually experience the joy of learning and develop curiosity (Mirandy, 1979; Martin, Beezley, Conway & Kempe, 1974; Ney, Moore, McPhee, & Trought, 1986).

Training and Support for All Staff

Staff working with child abuse victims will need additional specific training in the special needs of abuse victims. In addition, staff need support and encouragement as they at tempt to meet the needs of child abuse victims. Staff not specifically trained to work with these special needs children will quickly become frustrated because the traditional methods of working with preschool-aged children do not produce the desired changes, the progress is slow, and the behaviors of these children are extreme. To prevent staff from becoming overly frustrated, staff needs to be prepared tha t abused children respond negatively to friendly overtures. Regardless of the initial responses from the child, staff need to continue to be warm, encouraging and accepting with lots of hugs and smiles. An adult model of sharing, helping and comforting is important in helping children develop trust and empathy (George & Main, 1979; Straker & Jacobson, 1981; Wolfgang, 1977).

All staff members need training specifically for their jobs with child victims. Anytime special needs children are mainstreamed into a preschool the staff-child ratios need to be lowered to allow staff to individu- alize and to prevent staff from being overwhelmed bythe demands being placed on them (McQuiston & Kempe, 1980; Mirandy, 1979).

Regular staff meetings will give support to staff, provide an avenue for evaluation of techniques being used, and allow all staff to have input into each child's developmental record and t rea tment plan. Further, it will allow an appropriate release for feelings of anxiety and frustration. The ability to verbalize frustrations and laugh together will aid the staff in relieving stress. Maintenance of short, daily logs on each child will provide the needed da ta for writing t rea tment reports as well as docu- ment for the staff the progress tha t each child is making. To be effective, staff members need to be provided a work environment in which each member is made to feel good about himself/herself and valued for his/her contributions to the program, an environment in which his/her have the opportuni ty for meaningful input, and an environment in which there is evidence of progress toward definable goals (Kempe & Kempe, 1978 & McQuiston & Kempe, 1980).

References

Allen, R. E. & Oliver, J. M. (1982). The effects of child maltreatment on language development. Child Abuse and Neglect, 6, 299-305.


Bradley, R. H., Catdwell B. M., Fitzgerald, J. A., Morgan, A. G., & Rock, S. L. (1980). Experience in day care and social competence among maltreated children. Child Abuse and Neglect, 10, 181-189.

Cherry, C. (1976). Creative play for the developing child. Belmont, CA: Fearon Pitman Publishers, Inc.

George, C. & Main, M. (1979). Social interactions of young abused children: Approach, avoidance, and aggression Child Development, 50, 306-318.

Honig. A. S. (1985). Compliance, control, and discipline. Young Children, 40, 47-52. Honig, A. S. (1986). Stress and coping in children. Young Children, 41, 47-59. Kempe, R. 8. & Kempe C. H. (1978). ChildAbuse. Cambridge, M/~ Harvard University Press. Martin, H. P., Beezley, P., Conway, E. F., & Kempe, C. H. (1974). The development of abused

children. Advanced Pediatrivs, 21, 25- 73. McQuiston, M. & Kempe, R. S. (1980). The t reatment of the child. In C. H. Kempe and R. E.

Heifer (Eds.), The battered child. (pp. 379-390). Mirandy, J. (1979). The preschool for abused children. In Martin, H. P. (Ed.), The abused

child: A multidisciplinary approavh to d~)elopmental issues and treatment (pp. 215-224). Cambridge, MA: Ballinger Press.

Morris-Vann, A. M. (1981). Group counseling for children who are abused. Southfield, MI: Aid-U Publishing Co.

Ney, P. G., Moore, C., McPhee, J., & Trought, P. (1986). Child abuse: A study of the child's perspective, Child Abuse and Neglect, 10, 511-518.

Salter, A. C., Richardson, C. M., & Kairys, S. W. (1985). Caring for abused preschoolers. Child Welfare League of America, 44, 4.

Straker, G. & Jacobson, R. S. (1981). Aggression, emotional maladjustment, and empathy in the abused child. Developmental Psychology, 17, 762-765.

Steele, B. F. (1986). Notes on the lasting effects of early child abuse throughout the life cycle. Child Abuse & Neglect, 10, 283-291.

Wolfgang, C. H. (1977). Helping aggressive and passive preschoolers thr(yugh play. Columbus, OH: Charles E. Merrill Publishing Co.

working with preschool-aged child abuse victims in group settings

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