University of Washington



The Effects of Abuse and Neglect on Child DevelopmentSection 4: From Five to 11 YearsWorksheet1. After watching this video, what do you think are the most important points and insights? Please write down your ideas. 2. Assess Jenwei’s development in all 4 domains. Do her behaviors reflect developmental delays, and if so, which ones? Does she appear to have unresolved or poorly resolved developmental issues and if so, which areas concern you? 3. How would you suggest that Jean deal with the following problems: hoarding food, bed wetting, and stealing. How would you explain why Jenwei has these behavior problems?4. How should the teacher deal with the issues of seeking attention from the teacher, performance below grade level, and lying to the teacher? Please write down your responses. 5. What additional community resource services would you include in your case plan for Jenwei? Identify possible resource agencies and the types of services you would recommend. What kind of support would you provide to the foster parents? Please write down your responses. The Effects of Abuse and Neglect on Child DevelopmentSection 4: From Five to 11 YearsAnswer KeyFor after you’ve answered the questions on your ownAfter watching this video, what do you think are the most important points and insights? Please write down your ideas.Sample AnswerChildren in the child welfare system have likely experienced more than one type of traumatic stressor. The cumulative impact of stressors over time (toxic stress) carry long-term repercussions to development because when faced with toxic stress, a child’s only focus is survival.Behavioral issues, depression/anxiety, high energy, inability to pay attention, etc. often result from exposure to trauma. Anxiety is also a common result of traumatic or toxic stress. These behavioral indicators are misinterpreted as symptoms of ADHD.When trauma occurs early in life, children do not develop the capacity to regulate their experiences – to calm themselves down, to sooth themselves, to interact in appropriate ways with other people, to learn from their behavior, etc.Anger, worry, and sadness are common in children who’ve experienced trauma. These sudden mood changes are not always obvious, and can be perplexing or frustrating for Caregivers. These behaviors can often be misunderstood and seen as something that is “wrong” with the child, as opposed to a normal response to stressful events which has built up over time.Assess Jenwei’s development in all 4 domains. Do her behaviors reflect developmental delays, and if so, which ones? Does she appear to have unresolved or poorly resolved developmental issues, and if so, which areas concern you?Sample AnswerPhysical – Jenwei’s difficulty with bed wetting could be contributing to the effects of abuse/neglect on her physical development.Social – Jenwei presents as though she feels inferior and incapable. She is likely aware of the opinions her peers have of her. Jenwei appears to compensate by attempting to control other children – by being bossy and domineering.Emotional – Jenwei presents as though she has low self-esteem. Her ability to regulate emotions appears to be hampered, and she is known to respond extremely to minor stressors. Impulsive lying and stealing, coupled with sneaking and hiding food, could be a result of inconsistent care in her early years.Cognitive – Jenwei’s lack of problem-solving skills with both peers and adults is likely a result of cognitive delay. Additionally, her poor academic performance is also an indicator of cognitive delay.How would you suggest that Jean deal with the following problems: hoarding food, bed wetting, and stealing? How would you explain why Jenwei has these behavior problems?Sample AnswerIt’s important for Jenwei’s Caregivers to understand that food hoarding, bed wetting, and stealing are all manifestations of the effects of maltreatment on Jenwei’s development. Despite being in an adoptive home for some time, Jenwei has experienced a great deal of transition and instability throughout her nine years. It is likely that she was never able to fully recover from the effects of neglect during infancy.The most effective support for Jean would likely be in-home mental health services, with a focus on childhood mental health and supporting the relationship between Jenwei and her Caregiver. In order for Jenwei to successfully transition to a permanent placement following her placement in Jean’s home, it is imperative that she learn how to develop a trusting, secure attachment with her primary Caregiver. Once this attachment is established, through a thoughtful transition and ongoing mental health support, Jenwei should be able to transfer this attachment to her permanent placement once that placement is identified.To meet the immediate needs of hoarding food, a behavioral intervention for which Jenwei is praised or earns a reward for safe food handling would be ideal. Since Jenwei enjoys helping in the kitchen so much, I’d build on this strength to help Jenwei learn to trust that there will always be food available to her, and she has control over learning how to feed herself by participating in meal preparation. Jenwei will likely feel empowered by the encouragement and rewards for not hoarding food and for her increased independence and contributions to the family through assistance with meal preparation.Although Jenwei should never be punished or shamed for bed wetting, checking and changing her sheets should become a part of her daily routine. Jenwei should be empowered and rewarded for cleaning up after herself. Jenwei probably feels shame already for bed wetting, so it is likely she will need the daily support of her Caregiver for some time before she is able to independently check and change her sheets. How should the teacher deal with the issues of seeking attention from the teacher, performance below grade level, and lying to the teacher? Please write down your responses. Sample AnswerIf it has not occurred already, a full academic assessment by the school counselor or school psychologist is needed to develop a plan to bring Jenwei’s academic performance up to grade level. The teacher and school counselor should work together with the Caregiver to implement a positive behavioral support program for Jenwei to be rewarded for honesty and patience when she is seeking attention from her teacher. Likewise, if the teacher is amenable, putting in place a structured 1:1 check-in between Jenwei and her teacher may help reduce the amount of time Jenwei is inappropriately seeking attention from her teacher.What additional community resource services would you include in your case plan for Jenwei? Identify possible resource agencies and the types of services you would recommend. What kind of support would you provide to the foster parents? Please write down your responses. Sample AnswerMental Health Services – either a Community Mental Health Agency, or a contracted Mental Health Provider (Professional Services Contract)In-Home Behavioral Intervention Services – Positive Parenting Program (Triple P), Family Preservation Services, Homebuilders, etc.Free training for Jean through the Alliance for Child Welfare Excellence:Attachment and the Impact of Trauma on Children within the Child Welfare System ()Child Development () Effects of Abuse and Neglect on Child Development – Caregivers () Introduction to Positive Discipline ()Mental Health: In-Depth Applications for Child Welfare ()Parenting the Positive Discipline Way ()Transforming the Difficult Child: The Nurtured Heart Approach () ................
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