Blog Posts

Reflections on the DDP Conference

1/12/2016

Over on Twitter we’ve been connecting with @3beesandahoney, an adoptive mummy and blogger at 3beesandahoney.wordpress.com. She has kindly given us permission to reproduce this excerpt from her blog post on October 17th this year.

…That brings me nicely back to the DDP conference (yes, I know I have been waffling again!)

For 2 amazing days, I found myself surrounded by individuals who WANT to support vulnerable children/teens and their families – I should say professionals but from my experience the whole conference environment has an autonomous feel and people would struggle to be able to identify your adopters/carers from your psychologists/social workers/psychodrama therapists, etc., unless your name is in the programme as a speaker for the conference – oh and of course, if you are Dan Hughes!

In truth I cannot tell you if there were any other adopters/carers at the conference (chances are there would have been and quite possibly some of these were also there in a professional capacity), and really I am not sure it is important. That is not to say that I did not know a sole who was attending – Buzz’s therapist was there, as was Jemima (Waxy’s previous DDP therapist and angel in disguise).

We were all there with one goal on our minds. To develop and gain more insight into “The Power of DDP”.

The importance of companionship provided another strong theme throughout the 2-day conference, both in the formal content of Professor Colwyn Trevarthen and Dan Hughes’s presentation but also through the sense of fellowship and camaraderie amongst groups of delegates and the desire to create an environment of safety and understanding in their work with families and children who have/are experiencing the crippling effects of early developmental trauma, helping them move from ‘Mistrust to Trust’ and reducing the risks of ‘blocked care’ occurring (the damage this can cause, I know only too well from personal experience).

I could spend hours writing about the conference. No matter how many times I find myself being drawn into the affect of the content or case studies being presented, and how often it leaves me with an emotional lump in my throat (if I am lucky – usually the hankie has already been deployed by then), as it resonates with my own sons’ struggles and experiences. In the past this would be enough to have me running for the hills and maybe if I had been at a local authority conference or training day, it would have had this exact reaction.

However, at no point did I feel the need to excuse myself and there is one simple reason for this – I knew, if I wobbled, there would be support there if I wanted or needed it.

So while the exhausted, emotionally fragile and jaded side of being an adopter to two vulnerable and traumatised brothers, finds all the National Adoption Week recruitment campaigns difficult when there is a sense of glossing over the realities of adoption. This years’ theme gives myself and many other families the opportunity to try and highlight the need for better adoption support and the lessons that have been learnt and are still to be learnt in order to give our children and families the support they need… No deserve!

With this said, during this week with the help of Buzzbee, I am setting myself the challenge of creating a couple of posts which highlights ‘the good, the bad and the on another planet’ experiences of ‘Adoption Support’.

For more from this blog visit 3beesandahoney.wordpress.com

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Why Attachment Matters - an interview with Professor Helen Minnis.

23/11/2016

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🔊 Why Attachment Matters [click to listen to audio file of this interview]
In the following interview between Professor Helen Minnis from the University of Glasgow and David Woodier a teacher, adoptive parent and blogger for Scottish Attachment in Action, Helen speaks about 'Why Attachment Matters' to her. Themes emerging from the interview may well resonate with those living and working with children and young people who’ve had an adverse start in life.

How do we give children the gift of a safe haven?

… I can’t help feel I have been gifted,
Lifted out of darkness,
Carried by angels to a safe place,
A haven with four windows,
And a single door,
The most beautiful place in all the world,
With the most beautiful people to welcome me, … 1

How do we create a world that is safe for children who have suffered abuse and neglect? How do we help them thrive in relationships? The words above are from a poem of a child who was adopted. The question for those of us who live and work with children who have suffered maltreatment is, how to put what we know about attachment into action. In the following interview, Professor Helen Minnis talks about her passion for helping children and young people. She discusses a range of issues, from teenagers to new therapeutic approaches, and from brain development to helping children cope with separation and loss.

When did your interest in attachment begin?

I wanted to do psychiatry, but before I wanted to do psychiatry, I wanted to travel. I spoke to the head of Child and Adolescent Psychiatry at the Maudsley Hospital. I said, “I am going to Guatemala for a year to work in an orphanage. What would you suggest I think about?” He said, “You should think about attachment and attachment disorders,” and he gave me the draft of the psychiatric classification system for attachment disorders. That was where my interest was born. That draft talked about children who had been abused and neglected being indiscriminately friendly on the one hand, and on the other hand, some of them being withdrawn and failing to seek comfort. I arrived at the orphanage and saw that right in front of my face. I was literally covered in children under five. I couldn’t walk forward until I peeled their little hands off. I became passionately interested in attachment.

Is Scotland a nurturing place to grow up? Are children able to build healthy attachments here?

It is all relative. In terms of encouraging the public to think about attachment the Scottish Government is quite far ahead. I remember a few years ago there were billboards, paid for by the Scottish Government, of a big sponge and the words: This is Your Baby’s Brain. I also think we realize we have some really big problems, and one of the big problems is the way we treat our teenagers. I think we ignore them; we don't give them eye contact; and we don’t give them a role in society. There are some major things we could do to make Scotland a more nurturing place, but it is great to live and work in a country where that’s what we are aiming for.

When did you first become involved with the work of Scottish Attachment in Action and why does an organization like Scottish Attachment in Action need to exist?

I was involved from day one. We had the Attachment Reference Group in Glasgow for colleagues from different disciplines to come along and discuss attachment. Edwina Grant heard about what we were doing, and we organized a day when we brainstormed about what Scottish Attachment in Action should look like. It was an incredibly exciting day, because we discovered that although we were from such different disciplines, we were really talking the same language. We realized was there was a need for a common language about attachment particularly across front line services that work with children including police, teachers, and nursery nurses. There was a role for both training and advocacy. I think Scottish Attachment in Action tries to sit in that space. It is always going to be needed, because getting people to think about young children is tricky. It is very hard for adults to put themselves in the mind of a child, because it is a long time since we were children. I think it is something that needs to be a daily struggle.

A number of years ago, you looked at the mental health of a group of adopted children living in Scotland. What effect does nurturing care and a stable family life have on children who were maltreated early in life?

It makes all the difference. Adopted parents have known that. I remember being sharply told off many years ago because I used the term “natural parents” which was an old term people used to use for birth parents, and someone said, “Adopted parents are natural parents, because they have done the nurturing.” That is so true. A child comes into the world with their genetic hand of cards, and what happens to that genetic hand of cards depends so much on the nurturing they receive from their family. From the study of epigenetics, for example, we know that the environment that surrounds the child can modify the DNA. Nurturing from parents is so crucial.

If we were to look inside a child’s brain, that of a child who suffered maltreatment early in life. What are some of differences nurturing care can make?

We don’t know more than we do know. The brain is like an unexplored landscape. One of the reasons I am in child and adolescent mental health is because we know less about the brain than we know about the universe. We know that the frontal temporal lobe of the brain, the sticky-out bit at the forehead, is bigger in humans. That’s because we need more in terms of planning and social interaction. Children who suffered early neglect and maltreatment sometimes have problems with some of the functions particularly associated with that part of the brain. Nurturing care can help children inhibit some of their emotional responses. Learning to plug into other special people by being part of a family and having the world interpreted for you by your parents, older siblings, and gran etc. is really important.

There are some children who seem to resist connecting with that nurturing care. Is there anything to understand about how children build attachments that could help us reach out to these children?

One of the things we have become more interested in is faulty signaling. This is when neglected children, because of their early experience of neglect, have learned to manage their own world so they habitually don't reach out to parents and carers. They fundamentally don’t understand that parents and carers are there to help you, support you, and comfort you when you are stressed. John Bowlby, who developed attachment theory, described how right across species it is a profound instinct to reach out to your carers when you are, for example, stressed, frightened, or have a tummy ache. It is actually a really small minority of abused and neglected children who don’t reach out. These children are then missing out on huge swathes of normal development. One of the really fantastic things is that in about ninety-nine times out of a hundred if neglected children are placed in loving families early in life that lack of signaling disappears quite quickly. However, there is a tiny minority of children in which it doesn’t melt away. I don’t know if that has something to do with the constitution of the children themselves or whether it has to do with not having the opportunity to be placed in a loving family soon enough. There is a tiny minority of children who, even in teenage years and adulthood, just don’t get that they should be reaching out.

I have noticed that some children with difficult starts in life -- children who don’t seem to respond well to the nurturing care of a foster carer or adoptive parent -- appear to ‘sort things out’ during adolescence. Is there something going on developmentally, a kind of re-wiring of the brain, that allows a young person to see things in a different way?

We know there are two rapid periods of brain development in life, the first few months and years of life and then again in adolescence. In adolescence the axons of the brain -- the long connections between your brain cells -- are being ‘cladded’ with myelin sheaths. It is a bit like cavity wall insulation. This is not something I am an expert on, but I have heard it used to explain why a child who is quite articulate at nine years old seems to almost lose the power of speech when they reach twelve. There is a lot going on in the brain that they are concentrating on. It is recognized that it is a time of opportunity because there is so much plasticity, so much of an opportunity for change and new development in the brain. One of the things that always gives me hope is that we now know you can develop new brain cells even in old age. The brain is different than other organs in the body. When you are born, your heart looks like it looks when you are an adult; it is just a small version of what it will be when you grow up. That is not true of the brain. When you are born and then again in adolescence, the brain has a huge amount of sculpting to be done. It is also worth remembering that some people heal and recover even later than that. I have personal stories of adoptive children who have left home at the age of sixteen and said, “I am never going to darken your door again.” Then they turn up later. I have a family friend whose son came back at his adoptive mum’s seventieth birthday party. He had been in prison and was covered in tattoos from head to toe. Now he is a loved member of the family again. So, although you are right that there are opportunities in teenager years, there are later opportunities as well.

You have been piloting something called the New Orleans Intervention Model in Glasgow. Could you say something about what makes this model different to services-as-usual for children and families?

There are two big differences. One, it is an infant mental health model. The other difference is that it offers treatment to birth families so that it is not just an assessment model. It was developed by Professors Charles Zeanah and Julie Larrieu from Tulane University in New Orleans. For a long time in New Orleans, every child who came into foster care under the age of five was offered this model. It offers standardized, attachment-based assessments in each of their caregiving relationships. They also do interviews and questionnaires with the birth parents about their own experience of attachment and caregiving, and refer the birth parents for help. For example, if they have problems with substance misuse or domestic violence. That process takes about three months, and then there is a period of intensive treatment with the aim of changing the birth family’s relationships so they can get the child home. But if it doesn’t work within a time limit, then the child is recommended for adoption.

Has any aspect of the study surprised you?

We have learned a lot about the nature of our systems here in Glasgow and about the ways in which we inadvertently cause delays for children. I think it has a lot to do with our difficulties as adults in putting ourselves in the mind of a child. There are so many places through a child’s journey where adults from all sorts of professional backgrounds could have thought, ‘This is not right for this child, and we need to move this forward,’ but we don’t. It has been a surprise at what kind of a perennial, entrenched problem that is.

Would there be a benefit in Scotland if we follow the example of some parts of the US where foster carers are also recruited to become prospective adopters?

One of the things we have become interested in through this project is the nature of foster care. Mary Dozier from Delaware has talked about commitment in foster care and whether the commitment comes from the length of a foster placement or from the freedom foster carers are given by their manager to fall in love with the child. In the United States, foster carers usually join the register as adopters. The philosophy behind that is that foster carers are supposed to be totally child centered, to love and commit to the child and potentially be the child’s forever parent. But if the birth parents get their life back on track, then the foster carers will have to relinquish that child. Some people say to me that it must be awful for the foster carer, but can you imagine that is generally what we do to children. The system in the United States allows the adult to take the hit rather than the child, and it seems to work well. Certainly in New Orleans it reduces delays. It means you are also not building in a loss for the child.

It is still a reality in the UK and in Scotland that children who are looked after are often moved around. They experience new foster parents, new schools, and new social workers. How do we help children who form multiple attachments? For example, should a child who is adopted visit their previous foster carers? Should a young person who is unexpectedly moved to a new school over the summer holidays have an opportunity to say goodbye to his teacher at his old school?

Those are examples of attachment in action. They are examples of being child centered. In a family where there has not been disruption through abuse and neglect and placement moves, that is what you would do for your child. For various reasons at the age of four, my daughter had to move, and we made a goodbye cake and we visited everyone. That is what you do because you nurture your children’s attachments. It is about nurturing children’s attachments and recognizing that secure attachments can come from surprising places. A child who has had a difficult early start may have a secure attachment with someone like their teacher, and that has got to be recognized.

Some people are concerned that contact, for example, with a previous foster carer, will prolong a child’s sense of loss and that it might make it more difficult for a child to form an attachment to a new family.

Probably the most important thing is to try and tune into the child. Try and understand that a child is likely to be grieving. Children go through bereavement processes in the same way that adults do. Relationships shift for children, and that is not a reason to pretend they don’t exist. Once a child is placed with a forever family, and the child understands that they are in a family who are committing to them for the rest of their lives, contact with a previous foster family can be very positive. This is very different than the situation where you have, for example, quite a damaged birth parent. I am not suggesting all birth parents are damaged. But if, for example, you had a birth parent where the experience for the child visiting the birth parent is really traumatic, then that needs to be thought about in a child-centered way. Difficult decisions have to be made. Children should not be allowed to see people who may have a negative effect on the child’s development.

Children with attachment difficulties often struggle to get the right kind of support in their schools. Can you talk about some of the reasons for this? Is it because children with attachment issues often present a variety of difficulties, and that makes it harder to identify that there may be an underlying attachment issue?

I think there is a lot in that. Identification is a problem. Particularly if they have attachment disorders, children with attachment issues nearly always have other problems. That is confusing, not just for teachers, but also for parents and clinicians as well. We know something we didn’t know fifteen years ago, if children or adolescents have one mental health problem, they are more likely to have others. We used to say, for example, if you have ADHD, then it can’t be anxiety. We know now that wasn’t sensible at all. Children with ADHD are at higher risk, for example, of having problems with autism or vice versa. Children who experienced early neglect and abuse are at higher risk than the general population of having other neurodevelopmental problems. This is some data we have found, and other people have found this, too: children who have had early neglect and abuse and have mental health problems often have complex neurodevelopmental problems. How these problems can be identified in school is really difficult. On the plus side, educational psychologists in Scotland are on the ball with this. I think they have led the way in thinking about attachment in schools and helping teaching staff think about attachment.

We are in the process of trying to develop something called the School Attachment Monitor, SAM. In the last six months, I have been working with Stephen Brewster and Allessandro Vinciarelli from Glasgow University School of Computing Science. SAM will be like a computerized version of the Manchester Child Attachment Story Task. If it works it will be automatically rated which means that it can be used in schools and we can look at the profile of attachment in children in the classroom.

I have heard carers, adoptive parents, and social workers express frustration with the mental health services available for young people in Scotland. Is there a mismatch between the needs of our children and what is offered to families? Is there something we can do about that?

Sometimes it is a problem of not recognizing the complexity of problems children experience when they have been maltreated. I have a lot of sympathy for my colleagues. Many do recognize the complexity, but I think we have all been on a really steep learning curve. We have done some research recently that suggested the direction of travel may not be what we thought it was. We know that a lot of ADHD has genetic causes, but I had always thought another route into ADHD was maltreatment. From some of the data we got recently, it is starting to look as though it might be the other way round. Children with some of these neurodevelopmental problems, in families that are already struggling, might be more likely to be maltreated. Therefore, in a sense, many maltreated children have a double whammy. This is new information for child and adolescent mental health services. In the past, we used to see children who had been maltreated and think that it is no wonder they have conduct problems, problems with behaviour. In fact, we should be thinking we really need to assess these children carefully. They may have genetic loading towards some neurodevelopmental problems that are going to make them more difficult to look after in the first place, not that there is ever an excuse to maltreat a child. The understanding of the complexity of these children hasn’t been there in our profession, but we are getting there. The other big issue is there are not enough of us. There are far too few child and adolescent mental health clinicians. Something parents could do is lobby. My clinical colleagues are genuinely overwhelmed.

You have been looking at the feasibility of DDP -- dyadic developmental psychotherapy2-- as a treatment for maltreated children in the UK. What is it about DDP compared to other approaches that makes it worthwhile considering the relatively high financial cost?

I think it’s worth considering, because it is different to existing psychotherapeutic interventions for children who have experienced abuse and neglect in that it promotes what Mary Dozier calls ‘a gentle challenge.’ Old-fashioned psychotherapy is very much led by the child; the child leads what happens in the room and the psychotherapist follows. That is sensible for the great majority of children, but if you have children that don’t signal their needs, that kind of child-centred approach is maybe not going to be successful. What I like about DDP and what gives it potential is the idea of PACE: playfulness, acceptance, curiosity and empathy. The PACE stance is a bit more gently challenging; you are not letting the child get away with hiding under the table and not engaging in therapy. In a playful, accepting and curious way, you are going to be saying, “The things that happened to you in the past are probably what’s making you sit under the table, but you have these good parents here who are ready to give you a good snuggle, so come and experience the love that’s available for you.” It's more directive in a gentle way. We also know from our research that therapists who are using it are very enthusiastic. So I think it has a lot of potential and needs a trial.

What are the barriers to seeing a wider availability of DDP in the UK?

One of the things the NHS should be proud of is that we carefully review the evidence base for those interventions. We haven’t yet got a robust evidence base for DDP. We need randomized, controlled trials if it is going to be commissioned.

Over the last ten years, there has been a resurgence of interest in attachment. Training on attachment is popular; it has almost become a buzzword. But are we really putting attachment into action?

I think so. It is a bit of a double-edged sword. I was at a meeting in England a couple of years ago with lots of social workers and academics. I think I was the only child and adolescent psychiatrist. People were saying, “All this early years stuff and attachment stuff; it is kind of flavor of the month.” I was thinking “Sorry!” So there are, in some circles, people who don’t see the importance of it. But again, that is one of the reasons I am happy to be living and working in Scotland because we have developed a shared language. Scottish Attachment in Action has to be patted on the back for that. There are other groups working towards a much more nurturing place to live. For example, it is wonderful that in education we now have this idea of, ‘How Nurturing is Our School?’ This is not some kind of soft option or some wishy-washy place. If we are nurturing children, they can thrive, and they can do well emotionally, behaviourally, and in their attainment.

But isn’t there a problem that attachment can remain too theoretical and abstract? Our understanding of attachment still does not make enough of a difference in how we make decisions; for example, in the way we work with a child who is being disruptive in school and being threatened with exclusion. Are we underestimating the difficulty of how to put what we know about attachment into practice?

There is a problem: attachment has been very laboratory based. The measures recommended for use in clinics are too cumbersome. For example, the gold standard measure for attachment in young infants is the Strange Situation Procedure3. I think that is probably the most important scientific advance in the twentieth century. However, it takes two or three people about twenty minutes to actually do it, and that is not including the set-up time and the hour and half to rate it. It is not feasible in the NHS. That is one of the reasons we are trying to develop better tools like SAM. We want to develop things that are quick and easy. In terms of intervening with children in schools and families, it is about trying to translate the learning from research into practice. Things like ‘How Nurturing is Our School’ are phenomenally important because teachers who understand the roots of children’s behaviours are going to change the ethos of the classroom. I wouldn’t underestimate the importance of talking about attachment. We have to keep harping on about it. This is not flavour of the month. Attachment is a fundamental instinct that allows children and young people to plug into what they need for their development, and there is a reciprocal caregiving instinct in adults to respond to that. That is the glue that holds our society together.

We welcome responses to the kinds of issues Helen raises in the interview. We plan to edit these responses and put them on the Scottish Attachment in Action website to give us a bigger picture of how we are putting attachment into action.

Following on from this interview, the next recording will be David speaking with our Chair of Trustee's, Edwina Grant.

References

1. Ruairi, Life Story Collection: Poems after Adoption About Life Before Foster Care. Leicester UK: Ruairi; 2012. A link is available from http://drawingtheidealself.co.uk/drawingtheidealself/Downloads.html

2. DDP stands for Dyadic Developmental Psychotherapy. It is a therapy and parenting approach that uses what we know about attachment and trauma to help children and families with their relationships. Further information is available from http://ddpnetwork.org/uk/

3. The Strange Situation Procedure was developed by Mary Ainsworth and is used to assess the attachment relationships between young children and their caregivers. The child is observed while strangers and caregivers.

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Inclusion Makes Better Teachers

1/9/2016

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Back to the Floor

The three visitors looked friendly, but what I thought would be an opportunity to showcase our work left us feeling we had been caught short.

Someone in headquarters decided it would be good for morale if the heads of education, social work, and health met with some of us who work directly with young people. The initiative was called ‘Back to the Floor.’

One of the three, dressed in a grey suit, asked me, “Why should my child’s education suffer because the teacher has to deal with the behaviour of a young person who is in foster care?”

I have heard the same kind of argument in many schools, sometimes expressed in different ways: “We can’t meet Johnny’s needs here.” In other words, Johnny ruins everyone else’s chance at a good education.

I tried to answer the man in the grey suit, “If I could take you to some of my schools, you would see that schools that are the most inclusive are best for all young people.” My words sounded unconvincing. I wasn’t prepared for his question, and I couldn’t back up my view with any evidence.

The inclusion of children who are looked after in mainstream education is often a contentious issue. Sometimes it is characterized by simplistic thinking1. “We can’t meet Johnny’s needs here” may be true, but is there really some magical other place where Johnny can be ‘fixed’?

Inclusion can also define and strengthen important values. When faced with the challenging behaviour of a looked after child in her school, one head teacher said, “I don’t want him to go to a special school. He needs the relationships he has with children here who don’t have attachment difficulties. He won’t have those role models in a special school. I am not going to exclude him.”

Inclusion can also create ambiguity. It can force teachers into an uncomfortable position, one in which we feel we have to chose between contradictory imperatives2:

Is my job to teach my subject or is teaching about helping children develop as individuals?

I am here to make sure the young person who wouldn’t say boo to a goose can learn, but what do I do when that young person is threatened by the child who acts out the effects of the neglect they have suffered at home?

Inclusion requires substantive change3; it challenges us to look at ourselves and to question the commitment to our values.

Can You Give Me One More Chance?

Successfully including young people who are looked after and who may have attachment difficulties in any kind of mainstream setting can be difficult. Paul was fourteen years old and had been signed up by his foster carer to go to summer camp. It soon became apparent that his carer was under a lot of stress. She said, “I told Paul if he gets sent home, the moment he comes through the door, I will put him in respite care. He has been excluded from school, and people have come to the house to say he is causing trouble in the community. His mum doesn’t even want to see him.” Paul probably felt being sent to camp was just another rejection. This looked far from promising.

I met Paul as he stepped off the bus and introduced him to his group. He seemed to take an almost instant liking to his group leader, an easygoing and energetic young man. I noticed after a couple of days they were rarely apart. However, Paul also mercilessly bullied another boy.

The head of the camp wanted to send Paul back home. “It's not fair on others in the group. He is ruining their week,” she said to me.

I pleaded for one more chance.

I took Paul aside. “We are going to do everything we can not to send you home, but you have to stop bullying. You are going to spend the rest of the day with me and help me clean the kitchens.”

After that Paul’s behaviour wasn’t perfect, but he stopped bullying. A couple of days before the end of the camp, I asked him about his birthday. “I see you have a birthday when you get home. Will you do anything special?”

“No one has ever done anything for my birthday,” he replied.

The next day, I was sitting at lunch on the table next to Paul. Without warning, the other young people came into the dinning room and sang “Happy Birthday” to him.

Paul looked like a deer caught in the brightness of a spotlight. I think he wanted to run away, but he couldn’t. About fifty young people surrounded him.

A year later, we had a call from his foster carer. She told us Paul had looked through the camp brochure until he found the same group of leaders and asked her to sign him up. She told us it had been a much better year at home.

Why did it work? It wasn’t just one thing that made a difference. His group leader had worked hard to build a relationship with Paul, and the head of the camp was willing to take a risk and give me one more chance to reach out to him. I believe Paul got the message that he was wanted there.

Paul contacted us again this year. He apologized and said he plans to spend the summer with the Army and cannot come to camp. Two years ago, when I first met Paul, he was an outcast, unclaimed and unwanted. Being included in that camp had transformed his life.

Excellent and Inclusive

Camp and school are very different, but some of the issues around inclusion are similar. Will other children suffer because of the behaviour of a child who is looked after? It is relationships that make the difference. Teachers who include children prioritize the importance of relationships in learning, and this benefits all the children in their class. In order to test my hypothesis, I interviewed a group of young people, a teacher, and a teaching assistant.

It had been a steep leading curve for Lewis’ teacher. The impulsive and often angry twelve year old, who had also struggled in his foster care placement was in trouble almost every week.

At the end of the year, I interviewed a group of Lewis’ peers. They all acknowledged their learning had been held back to some extent by their classmate’s challenging behaviours. However, they all had something positive to say about their school: “The work we produce is good and the staff are really friendly.” They also had no difficulty identifying the things they had accomplished. They all rated the relationships in their class as a 4 or 5 out of 5. One of the group commented on how her teacher had handled pupils’ behaviour problems: “She is good at it because she will sit down and have a calm chat with them and calm them down.”

The kinds of skills teachers and teaching assistants learn in order to support a young person with attachment difficulties seem to transfer readily to other children. Another teacher at the end of school year commented:

“I have been teaching for fourteen years. Callum has helped me more than any other child to think about my teaching.

“I have learned to make fewer assumptions about the behaviour of other children in my class. I used to think some behaviours were because a child was spoiled at home. I have learned they may have real issues and need my help.”

“One of my pupils was playing up for another teacher. I used Wondering Aloud, and I gave him some different options for what might be upsetting him. If I hadn’t used this approach, he would never have told me what was wrong.”

“We are rolling out some of these things across the school. Callum has raised the profile of how we handle emotions.”

A teaching assistant from another school wrote:
“I have been able to transfer the skills I have learned to help other children. For example, I noticed a change in another child's behaviour. He was getting upset and walking out of class. I asked the teacher if I could have some time with him. I used Wondering Aloud. I said I had noticed that he was spending a lot of time on his own and that he was distracted easily. I tentatively asked him if the class was too loud or maybe he had a lot on his mind. He said there was too much noise and that it was hard to concentrate. I tried to empathize with him. Later, this child told me he was worried about something happening at home.”

In these classrooms, the behaviour of the children who are looked after had some negative impact on the other children. However, the teachers and teaching assistant were able to use the skills they had learned to identify and respond with sensitivity to children who were struggling. It also seems that the other children in their classes recognize that despite some difficulties, the relationships in their class were very good. They were generally positive about their school and what they had learned.

Inclusion matters because young people who are looked after find the acceptance they need in order to overcome their sense of rejection and shame. And to answer the question from the man in the grey suit, I would be happy to see my own children in a classroom with the kind of teacher who values relationships, who understands young people’s needs, and who finds a way to support the learning of all young people.

* Under the provisions of the Children (Scotland) Act 1995, 'Looked After Children' are defined as those in the care of their local authority.

Features of Inclusive Schools 4

They understand the children. They are able to be inside the children’s heads and understand what makes them tick.
Relationships are good. Staff and pupils know each other.
They value the learning of teachers as much as the learning of pupils.
Teachers are encouraged to take risks with their teaching, and they're not made to feel foolish when things go wrong.
They value a range of achievements, not just academic outcomes.
Children have a real sense of belonging; they have a stake in the school.
They are communities of belief, where there is common vision and teamwork.

“These are difficult things to achieve but there is hope because many schools are able to be both excellent and inclusive.” Martyn Rouse, Professor Emeritus, Aberdeen University 4

Keeping it Real: Where are you on the inclusion spectrum?

In order to support this young person, I need resources from outside my classroom; he needs to see an expert.

The most important resource for supporting this young person is the commitment and expertise of the teacher.

Education is the transmission of knowledge and skills.

Education is about the development of the whole person.

📄Download this article as a pdf

References:

1. Learning Teaching Scotland. Focusing on Inclusion and the Education (Additional Support for Learning Act) (Scotland) Act 2004. Dundee: Learning Teaching Scotland; 2006. Available from: http://www.educationscotland.gov.uk/Images/FocusingOnInclusion_tcm4-342924.pdf [Accessed 16 August 2016].
2. Clark C, Dyson A, Millward A, Robson S. Theories of inclusion, theories of schools: deconstructing and reconstructing the 'inclusive school'. British Educational Research Journal. 1999; 25 (2): 157-177.
3. McLeskey J, Waldron N. Inclusive Schools in Action: Making Differences Ordinary. Alexandria VA: Association for Supervision and Curriculum Development; 2000.
4. Martyn R. The journey to excellence. Available from: http://www.journeytoexcellence.org.uk/videos/martynrouseinclusiveexcellentschools.asp [Accessed 16 August 2016].

First published within ‘Inclusion Makes Better Teachers’ www.saia.org.uk/blog September 2016
© 2016 David Woodier, Support Teacher, Inclusion Base, North Lanarkshire. Permission granted to reproduce for personal and educational use only. Copyright notice must remain intact.

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Using the ‘L’ Word

1/8/2016

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“Many of the most intense emotions arise during the formation of attachment relationships. The formation of a bond is described as falling in love … ”
John Bowlby in The Making and Breaking of Affectional Bonds.

I had been standing in the kitchen nervously wiping down already clean counters, when my son shouted from the living room to tell me they had arrived. For me It was a huge occasion, I was about to meet the child I hoped would become my new daughter, but for her it was just a visit to another foster family who would be looking after her for a few days. Even as I anticipated her arrival, the roots of the love a mother has for a daughter were forming, but it wasn’t straightforward.

Social workers had been telling Katie since she was six that they were looking to find her a family. Five years later, after living with temporary foster carers, they were still looking. This visit would give us an opportunity to meet Katie and begin the process of becoming her permanent foster family.

As I reached the front door a small figure jumped out of the car looked up at me over the top of her glasses and with an expression I would come to know so well, shouted, ‘Hiya, I’m here!’ My heart melted and I just wanted to scoop her up and give her a huge hug but I restrained myself. With an overly formal handshake, I introduced myself.

‘I’m Katie,’ she said cheerfully, ‘and I saw a house with lions just before we got here.’ I couldn’t think where there was a house with lions nearby, but I didn’t get a chance to ask any more questions as Katie’s foster family was just behind her and there was a flurry of introductions.

The rest of the visit passed with our children, their children, and Katie running in and out the garden playing and the adults drinking coffee. I managed to prize Katie away from the fun to take her upstairs and show her the room she would be using. I was planning to give it a fresh coat of paint, and I wanted to find out her favourite colour. I couldn’t tell her but I wanted this room to be hers.

❝While we all know that simply loving a child is not enough, it is certainly the best place to begin. Without it a child simply cannot thrive.❞

Anyone who has ever given birth will tell you that one of the many worries that comes along with pregnancy is the fear, ‘Will I love my baby when I see him or her?’ Fortunately, most new parents fall in love instantly when they meet the wee one or at the very least over the first few hectic sleep deprived days and weeks of life. What is much less understood is the process of starting to love a child who is not part of your family by birth. Very little is written about falling in love with an adopted child and even less about loving a fostered child. It sometimes feels like that word is taboo and does not usually figure in the children’s reports given to the potential adopter or carer. Perhaps every report should have a section asking ‘Who loves this child and whom does the child love?’ While we all know that simply loving a child is not enough, it is certainly the best place to begin. Without it a child simply cannot thrive.

Looking back on my initial dealings with Katie, I am sure that the process of starting to love her began with that first ‘Hiya’ and grew stronger even while I was decorating her room. My husband could see what was happening and reminded me several times that this was early days and many things might still prevent her joining our family. Despite all his warnings, I couldn’t help myself. I was falling in love with her.

She has now lived with us for several months, she is very much part of the family and I love her wholeheartedly. I do not begin to understand all the biological and psychological processes that have made this happen but I am grateful for them. Over the last few months, this determined, stoical, and immensely practical child has taught me many things. Most importantly, she has taught me the value of allowing myself to love, and how to be aware of my surroundings. I now know that the house at the top of our road has large stone lions in the garden and I had never noticed them. She saw them on her first visit. I saw a little girl that needed the love of a family.

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Endings

1/7/2016

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Our thanks to foster carer Jane for her guest blog this month - 'Keeping it real' with the ending of an attachment.

I was sitting at the edge of the hall watching the toddlers playing when it happened. A small child ran up to my boy, grabbed the car he was playing with and gave him a hefty shove that left him sprawled on the floor. As he let out a long wail and his eyes searched for me among the ranks of adults at the edge of the room I had an overwhelming urge to retaliate and make the other child suffer and feel as badly as my wee one did at that point. However being a rational woman in my early forties with all my inhibitions intact I contented myself with giving the offending child a filthy look as I scooped up my wee one and sat him on my knee to comfort him and his wounded pride. Less than a minute passed before he wriggled off my knee and headed back into the fray while I was aware that my heart was still racing and I needed to calm the mother tiger that was raging inside. Anyone who has ever spent any amount of time with groups of toddlers will know they are a tough unforgiving bunch where survival of the fittest is the name of the game and the adults are merely there to act as referees and mop the tears but even so I was surprised by the strength of my reaction and the level of distress I had just experienced.

❝...by then the damage had been done and our family was completely smitten with him.❞

All of this is a very normal reaction for a securely attached mother and child but I was not Andrew’s mum and he was never going to be my son. Although I had first brought him home from the hospital as a tiny, scrawny week old baby, I had always known he was not my own and I was going to be sharing the parenting with his biological parents until they reached a point where they could have him home for good. However by the day of the toddler group incident he had lived with our family for nearly 18 months and despite having contact with his parents at least 3 times every week we weren’t anywhere closer to him going home. On the other hand, he had spent a busy 18 months making himself very much at home in our family, our lives and our hearts.

It would be a full year later before his future would be decided and he would move to live with his new adoptive family but by then the damage had been done and our family was, to the last gran, completely smitten with him.

I have four birth children and the youngest was just 4 years old and still at nursery when we were approved as foster carers and Andrew made his noisy appearance in our lives. My older children were used to having younger ones around and Robbie, my youngest was more than happy not to be the baby of the family any longer as he was now a big boy who would be going to school after the summer. The kids were happy that I was now working from home and could pick them and whatever friends were available to play after school. I loved looking after him and my own brood without the pressures of work and deadlines and the morning commute. It was a win win for all of us.

But two and a half years in I really wasn’t sure we were doing the right thing. By then Andrew had not seen his birth parents for nearly a year and it had been our family who had been there for the birthdays, the Christmases, and the holidays. We had been the ones who had cheered the first steps and it was us who had sat at his cot side through long, scary nights in hospital with a respiratory infection. He called me 'mum' and my husband 'dad', not because we used those terms with him, but because the others in the house did and he was one of the group. Given all this, you won't be surprised to know that we were all dreading the day when we would say goodbye and he would start his new life with his new family. The week of introduction went really well and everyone hit it off from the beginning. Andrew seemed to accept what was happening and all the preparatory talk about meeting mummy and daddy and the cat all seemed to be paying off and he coped really well with all the changes of that week. It is fair to say that he coped better than I did but I hid my tears until after the kids were in bed and tried to keep the tone positive. The adoptive couple were great and could see how much we loved him and how much we would miss him and there was plenty of talk about meeting up after the summer holidays and continuing to play a peripheral but significant part in his life. It was exactly what we needed to hear and we clung to those words in the days and weeks after he left.

❝we all experienced grief, but without any of the space or understanding that normally accompanies a significant loss.❞

Sadly, as often happens we did not meet up after the summer and when I met his new mum for a prearranged coffee she told me that he never talked about us and that she was sure that he had forgotten us. This was hard to hear and would have been more devastating if I had not spoken to a social worker who had visited Andrew in his new house the week before and been told that he had been using our names when playing with some of his new toys. That was a difficult summer for us as a family, we all experienced grief but without any of the space or understanding that normally accompanies a significant loss. For my children it was the first time they had experienced a loss on this scale and they all grieved in their own ways but suffice to say it took a huge toll on us. I've often wondered how both Andrew and his adoptive parents were feeling over this time, and how he was making sense of what had happened to him.

The most frustrating part of the business however was the lack of understanding from the new supervising social worker who had been assigned to us that summer. She couldn’t understand why we were still talking about Andrew weeks after he had left, she told us to move on it, was our role as foster carers to hand children on. This might be true but I have talked to many foster carers who have prepared children for adoption and all have struggled to say goodbye. I know one foster carer who has seen over 30 wee ones leave her care and she describes it as as painful now as it always has been. Foster carers are taught about the importance of attachment, they work hard to help children and young people form positive warmly attached relationships but sadly no one tells us how to turn off those feelings at the end of a placement.

The system spends a lot of time and effort keeping children in touch with family who have let them down. My question is why do we put so little energy into keeping them in touch with those who have picked them up and helped them back onto their feet? Children who been brought up in a loving and caring families are then told that they are no longer allowed contact with everyone they know as it is will upset them or destabilise the new placement. We no longer keep children in hospital with very limited visits from their parents and I cannot imagine that the government would arrange to evacuate children to the country to live with strangers in these more enlightened times as was done during World War II. Wouldn't it be more helpful if we acknowledged the grief and loss experienced by everyone when it comes to moving children to their new families?

Jane Wright

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Parenting Teenagers With Attachment Difficulties

1/6/2016

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As parents of teenagers with attachment difficulties, we may need an extraordinary sensitivity and resilience to stay connected and engaged with our children. It is something we can’t do on our own, and yet finding help for adopted teenagers and for those who are in foster care can be difficult. We see our children struggling, but we can’t get others to recognize they need help. Sometimes help comes in an unusual form, even from a couple of rabbits.

Have you ever had an experience like this? “Mr. Woodier, what you are describing about your daughter* sounds like any other fifteen-year old.”

I feel a wave of despair wash over me. Perhaps this teacher is just trying to reassure me, but it has the opposite effect. My daughter is struggling. Why can’t the teachers hear what I am trying to say? I have been trying to get them to understand for years.

In my experience, parenting an adopted teenager is different. I have four children, and my youngest is adopted. All four of them experienced the teen years differently. Although they all faced challenges growing up, my adopted daughter’s struggles are more intense. She gets knocked back harder by failure and rejection.

One of the most important things I learned as a youth worker, teacher, and parent is the importance of staying connected, of not letting my children become alienated during those turbulent years.

But that’s not so easy because good parenting is a two-way thing. Dan Hughes and Jonathan Baylin, authors of Brain Based Parenting, describe this as a kind of reciprocal relationship, “When a mother and her infant feel mutual joy in each other’s presence, the infant experiences herself as capable of eliciting Mom’s joy, and the mother experiences herself as capable of eliciting her infant’s joy1.” Feeling I have helped my son with a problem or shared a joke with my daughter helps me stay positive, open, and engaged with my children especially when they are struggling. But too often, with my daughter, I am drawn into a conflict, and I am made to feel that I have nothing to offer.

In addition, when I was going through a difficult time with my sons, I could go back and remember what they were like before they became teenagers, the cute and cuddly years. But that is not so easy with my adopted daughter. It has never been easy for her to show love. There isn’t so much of a good ‘before teenager’ time to refer back to.

I try to imagine what life is like from my daughter’s perspective. She wants her friends to accept her, but she doesn’t want to stand out at school. She wants her parents to respect her as an adult, but she still hugs a teddy bear. She worries what the future will look like and whether she will pass her exams. She can’t stop thinking about a boy at school, but she lives in dread that he will find out she likes him. No wonder she seems stressed when she gets home from school.

So as a parent I have to work even harder to stay connected to my daughter. I don’t want her to feel alienated or alone. In order to do this, my daughter and I recently became bunny rabbit foster parents. (Yes, there is a charity in Scotland for homeless rabbits). The rabbits also come with strange names. I remember one particularly difficult day, and we were both upset. I said, “Come on. You hold Hey Diddle and I will hold Nuts in May.” We sat there in silence for a few minutes. As our stress levels dropped, we began to talk about the rabbits. The angry words were quickly forgotten and life looked more hopeful again.

Parenting my daughter takes every ounce of creativity, patience, and hopefulness I have and then some more. I hold on to every good moment because I know that somewhere in there is a young person who may just need a bit longer to sort out her life. When I get little back that helps me feel like I am a doing a good job as a parent, I need affirmation from friends and family.

So, on behalf of all those parents of troubled teenagers, we know you can’t fix everything, but don’t minimize what we are going through. We need as much help as we can get during this really important time in our children’s lives. Finally, I love my garden but if it helps me stay connected to a very special daughter, I am willing to share it with a couple of rabbits.

*My daughter has given me permission to publish these details. “Dad, none of my friends read your blog anyway.”

Future Blogs

I am taking a break over the summer, but look for future blogs on why inclusion matters, how understanding attachment helps build resilience in young people, and an interview with Helen Minnis, Professor of Child and Adolescent Psychiatry at Glasgow University.

References

1. J. Baylin, and D. A. Hughes, Brain Based Parenting: The Neuroscience of Caregiving for Healthy Attachment (New York: W.W. Norton and Company, 2010).

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Wondering Aloud - Building Support for Young People who are in Crisis

1/5/2016

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Swearing at the head teacher is never a good idea. I was told that David needed anger management. How would I convince his head teacher that David’s problem was not his anger? In fact, anger was probably the appropriate response to all he was going through. There was something else that could help him, but it would take time and commitment. Louise Bomber in her book, Inside I’m Hurting, calls it Wondering Aloud. It is a powerful tool. However, it works better when we learn to use it first by noticing the emotions of children when they are more settled and well regulated.

Louise Bomber describes Wondering Aloud as the process by which a key adult uses observations of the child to think about what the child might be feeling and then comments on the meaning of those emotions (1). This can help children with attachment difficulties become more self-aware and learn to regulate their internal states. ‘The only way we can change the way we feel is by becoming aware of our inner experience and learning to befriend what is going on inside ourselves’ (2).

Wondering Aloud is a process:
1. Notice a change in the child’s behaviour.
2. Describe this change to the child.
3. Make a tentative remark as to what this behaviour means or how it might relate to the child’s internal state.

When I am using Wondering Aloud with a child who is distressed, I add a fourth step. I try to remind him or her of someone who can be a secure base for them. “I have seen your teacher help other children. I am sure she could help sort this out.”

David had been in and out of care all his life; he was now living in a temporary foster placement. Even as a newborn, his birth mother had never been able to offer him sensitive and predictable care. David struggled with feelings of rejection, but also longed for a relationship with a mother. These conflicting emotions made it even harder for him to grieve his loss and at the same time left him longing for someone who would claim him. The unpredictability of his life left him extremely anxious and constantly vigilant. Most of his energy in class was used trying to say and do the right thing so that others would like him. The more he tried to get other children to like him, the more they seemed to reject him.

David’s teacher told me, “He is not coping with playtimes. He is aggressive towards the other children. He has also become much more attention seeking and I can see he is extremely anxious. Sadly, he doesn't know how to express or even recognize all the emotions he is feeling, and he deals with them through being angry with others.“

We decided to try Wondering Aloud, but it wasn’t a straightforward experience.

One morning, David asked the classroom assistant, “Why are my eyes flicking?” (David had been crying.)

“I can see you have tears in your eyes. I wonder if you are feeling sad. Perhaps you are missing your mum. Have I got that right?”

David raised his voice, “No!”

Thinking about his sadness probably reminded him of how vulnerable he felt. He was unable to accept the empathy of the adult.

A year later, David was still waiting for a permanent foster family. Tentatively, I peered through the door of his classroom. The pupils were working in groups of three. David was lying on his tummy on the floor. Next to him were two other pupils. His body language was almost a mirror image of theirs. Here was a rare moment of stillness in David’s otherwise restless day.

Here, also, was an opportunity for David’s teacher to Wonder Aloud in a different way. This time she could notice a more regulated emotion and tentatively give it meaning for David. “I noticed when you were working you looked just like the other two children, the way you were lying on your tummy and listening carefully. I wonder if you had a good feeling being so close to other children who were calm?”

Later, David’s teacher remarked, “If I notice this emotion for him, then he can begin to notice it for himself. If he can notice his emotions, it might just give him enough time to pause before allowing his anger to burst out.”

Louise Bomber says, “Once a child has a sense of what their experience might mean, they are then more in a position to take control over their states, sensations and feelings” (1).

However, being able to recognize what David looked like when he was not anxious, sad, or upset was challenging. With children like David, those moments are quite rare. They are easily missed and yet they were vital if his teacher was to show David that she was tuned in to him without making him feel more vulnerable. In addition, if David could learn to accept her interest in his inner life when he was settled, then he might also accept her support more readily when really distressed.

David’s life didn’t improve. His temporary foster placement broke down. Overnight he was moved to another foster carer. He came into school the next day and lined up his classmates. “Put your hand up if you are going to miss me!” Again, David was desperately looking for someone to affirm that he belonged somewhere.

I was concerned that David’s behaviours would escalate. Would all the work David’s teacher had put in over the months pay off at this moment of crisis in his life?

David’s teacher met me a couple of days after his move. She commented, “He wouldn't settle to work and was in everyone's face, quite aggressive and argumentative. I took him into the cloakroom and asked him if he knew what was bothering him. He replied calmly, ‘I don't know,’ and it dawned on me that he didn't know what he was feeling and couldn't put the emotions he was feeling into words.”

“I said to him, ‘I wonder if going though so much change has been hard for you. If it was me, I would find it very hard.’ He then nodded. I asked him if he went back into class would he like me to come and sit beside him for a little while to help him settle back into his work and he replied, ‘Yes.’”

Had the teacher’s work to notice David’s inner life worked? His behaviour was still challenging and yet at a moment of crisis in his life he had been able to accept help. Learning to accept the help and reassurance of a key adult is a hugely important step for many children with attachment difficulties.

Wondering Aloud is not just a gimmick; it works because of a teacher’s commitment to understand and empathize with a child. It works also because the young person learns that even his strongest emotions can be identified and understood by a caring adult.

We ought to work hard at learning how to use the Wondering Aloud tool. Despite all that has happened to some young people, it can still make a significant difference at the time when a child needs us most.

Keeping it Real

1. Wondering Aloud only works if you have invested the time to really become attuned to a young person. You have to be able to understand their behaviour as communication, and they have to have had to learn to trust you.

2. Expect some resistance from a young person. Don’t overuse it. When I was practicing at home, my sons would say to me sometimes, “Dad, you doing that Wondering Aloud thing again!”

3. When you try it, observe very carefully how a young person responds. Sometimes, all I am looking for is a pause. The young person for a split second doesn’t know what to say after I have Wondered Aloud, and I know it has worked just because I have helped the child be curious about himself.

4. It is very important that we don’t do this to manipulate a young person. We are not trying to solve their difficulties; we first want to show that we are curious and accepting of their inner lives.

References

1. L. M. Bomber, Inside I’m Hurting, Practical Strategies for Supporting Children with Attachment Difficulties in Schools (London: Worth Publishing, 2007).

2. B.A. van der Kolk, The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma (New York: Penguin, 2014).

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An Unconventional Family

1/4/2016

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This month we are honoured to have our first guest blogger. She is 16 and passionate about wanting others to know what it is like growing up in foster care and the importance of belonging to a family.

An Unconventional Family

Imagine a life of turmoil. Imagine having lived in umpteen homes and with umpteen supposed ‘parents’ by the time you were just eight years old. Now think how happy you would be if that feeling of being tossed about like unwanted luggage had finally come to an end. You’d feel pretty good, right? You’d feel as though you had a chance to be normal?

Now imagine being told that, regardless of how happy you are, you are being moved again. The decision is not yours to make. Sounds pretty horrendous? Welcome to my life.

❝ You end up distancing yourself from your own feelings.❞

I have been in foster care for most of my life and my story is as far from simple as you can get.

Let me first give you a little insight into life as a foster child. You have a succession of social workers ruling your life, making all your decisions without even consulting you. You have no say on anything, big or small, like where you’re going to live, who with or for how long. You learn to have a suitcase packed at the ready and to move at a day’s notice. You’re forced to live with strangers on a daily basis, and you look around and are filled with dread at seeing unfamiliar faces and places. You end up distancing yourself from your own feelings.

I was put into my first foster care placement from birth, and I remained there until I was four years old. Then I was placed back with my biological mother and sister for two years before re-entering the system. My mum relapsed when I was six. The four years she spent in rehab suddenly went down the drain, and my mum once again succumbed to her dark way of living. At this time, all I could think to myself was, “Is this going to be my future? Is this the person I should look up to and become? Am I going to be like my mum?”

As humans, we are social beings, and we need the love and encouragement from others to grow and thrive. Without love, life would be a lonely and desolate existence. This is the life I used to live with my biological mother and sister. I felt like I wasn’t loved by the family I had been born into. I wanted an escape.

This escape came in the form of school. When living a life in care, nothing is permanent. However, school was an escape because no matter how many times I moved, school remained the same and that is what I needed to gain stability. Schools gave me structure and routines and this was extremely beneficial.

There are lots of things school has given me and I want to pause here in my story and mention a few so that you can look out for other pupils in your class who are in care and help support them better.

I have teachers in my secondary school who give me some one-to-one support at lunchtimes. This is good because I can a catch up if I have missed work or am falling behind.

I didn’t do as well in my 4th year exams as I had hoped. I felt anxious in the exam hall, surrounded by lots of people. But this year, I was given separate accommodation that reduced my stress.

I also have trouble being surrounded by a large group of people in the cafeteria at lunch. I can avoid the noise and crowds in the canteen by going to the Support for Learning Base.

When I was in my first secondary school, I was bullied and decided that it was best for me to change schools. My foster carers were very supportive and listened to me despite my social worker expressing concern at another move. I settled well in my new school and plan to stay there till sixth year. This shows the importance of listening to young people, one of pledges made by my local authority in their corporate parenting strategy, which I helped launch.

Doing my Duke of Edinburgh award was also good because it helped me see how many other skills I have, such as volunteering at my local after school club. I now regularly volunteer in my community centre as a youth worker. I’ve also recently got a weekend job as an entertainer at McDonalds where I face paint and will soon be attending a course to teach me how to make balloon animals!

Being moved from so many different foster homes left me with emptiness in my heart and a feeling that I didn’t truly belong anywhere or with anyone. Winning awards for my achievements has helped me gain confidence. For example, I won an important award for child-care. All my achievements can go into my memory box, which is huge!

So now, let me get back to my story. Being moved from place to place so often, I felt like I was a burden to my foster carers and that I wasn’t good enough for them and their standards. I felt so isolated, afraid and unloved. I didn’t have a clue about who I was. I had lost all hope in myself and in my dreams of having a family. I believed I was destined to live the life of my mother, alone and in need of help.

❝ Family makes me who I am today,
because without family I couldn’t have had the
encouragement to pursue my hopes and dreams. ❞

But then something unexpected happened! Aged eight, two of the most exceptional people walked into my life. They gave me the confidence to come out of the dark and into the light, and they made my life so much better when they made me permanent. Permanence is a big part of a foster child’s life, it showed me that I am wanted, that I do belong somewhere, that I’m not a burden and that those around me accept me.

I know my new and forever foster carers as mum and dad. They are a couple that focus on every need a child has and have offered me the best possible life. They have given me a home, the love of a parent and above all they have given me security. I am thankful that they have done everything in their power to help me.

My identity is family. Family makes me who I am today because without family I couldn’t have had the encouragement to pursue my hopes and dreams. Mine is not a conventional family.
In the end, no matter if I want to know my biological family or not, I know in my heart that I will always love my permanent family. They continue to play an important role in making me the person I am today and the person I want to become in the future.

A Long Journey for Looked After Children in Scotland

Research by the Scottish Children’s Reporter Administration has found that:
•   Twenty-six percent had five or more moves before finding a permanent home
•   Thirty-eight percent had waited for five or more years between the date when permanence was identified and the first Order was granted
•   Twelve percent of looked after children had a Permanence Order
•   Seven percent of those young people who cease to be looked after were adopted
SCRA, Permanence Planning and Decision Making for Looked After Children in Scotland, 2015, http://www.gov.scot/Resource/0049/00490291.pdf

Keeping it real

1. What are some of the barriers to helping children find permanent families? What can we do to overcome these barriers?
2. Did you realize that schools play such an important part in giving children stability? What kind of ethos do we need to help build in our schools?
3. Permanence allows young people to build stronger lives with:

Next month
Coming next month is a discussion around how to help children notice their inner lives.
This can be an effective way to help them learn to regulate their emotions.

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The Broken Toilet and the Importance of Attunement

1/3/2016

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David Woodier.
Support teacher, North Lanarkshire

Helping children build secure attachments in the classroom can be lot harder than it looks. Attachment theory draws from many disciplines, and it is not easy to know where to start. In addition, teachers may wonder if all of this relationship stuff is part of their job description. Attunement is probably the best place to begin, but it takes know-how, time, and effort.

One of the key bits of work that allowed the theory of attachment to take off was the research of Mary Ainsworth. From her detailed observations of mothers and infants, she showed that infants become securely attached when their caregivers are in sync with them both physically and emotionally. This gives the child the experience of being met and understood. [1]

❝As a new teacher, I didn’t know where to start.❞

I learned the importance of attunement almost by chance in my first teaching job in Scotland. I wasn’t that anxious about meeting my new pupils, but maybe I should have been. I quickly found out that one ten-year-old boy in my class, David*, was in the midst of an emotional crisis. He had been placed recently with a foster carer, having suffered years of neglect and abuse from his mum.

I remember walking David back to class one day when he suddenly collapsed to the ground. It was as if his legs had been taken out from under him; he lay there sobbing. He had been looking forward to seeing his mum, but she hadn’t shown up again.

David’s difficulties in class were extremely challenging, and the only strategy I was given to help him was a point system in which he could earn or lose Golden Time (the Scottish equivalent of free time) each Friday. By Monday afternoon, David had already lost all of his Golden Time. When presented with work, he would tear it up and swear at me. When challenged, he would sometimes bite deeply into his arm or tear everything off the walls of the classroom. As a new teacher, I didn’t know where to start.

I remembered something from one of my lectures at university. Over the next two weeks, I wrote down descriptions of all of David’s challenging behaviours. I described his behaviours as if I was giving it to someone who had never met him. I focused on the detail of what each behaviour looked liked. For example, rather than saying, “He was disrespectful to adults,” I wrote, “He pointed his bum at me and smacked it!”

Little by little, David’s behaviour in school began to change. The meltdowns still came, but they didn’t last as long. I noticed when he was really upset, he didn’t want me to leave. After a couple of months, the head teacher came to me, “I am changing David’s risk assessment so he can go out of the school and play football with the team, as long as you go with him.”

What caused the improvement? Upon reflection, I realized that the only thing that had changed was something in me. I noticed that I could tell what kind of day David would have just by watching him walk into school in the morning. This awareness allowed me to fine-tune the work I was giving him. I made sure there was no mental maths on a day when he was anticipating a visit with his mum. I could tell when he was anxious or frightened.

❝Simply making observations was not enough.
  I also had to learn to 'read' the behaviours
   as cues in order to respond appropriately.❞

One day he came to me and said that the sink was broken in the toilets. Previously I would have ignored this and got on with the lesson, but I could see that it was causing him distress. He was pacing restlessly. He was worried that someone might get hurt. After that, each morning, before we began class, I would take him to look out the window, and reassure him that the plumbers that worked for Glasgow City Council were very good and would come soon. I also found myself feeling empathy towards him instead of being afraid of his anger and violent behaviour.

What made the difference in my classroom? David experienced what it was like to have an adult attuned to him. Mary Ainsworth defined this kind of sensitivity in the mothers she observed as, “the ability to perceive and to interpret accurately the signals and communications implicit in her infant’s behaviour, and given this understanding, to respond to them appropriately.” [2]

Simply making observations was not enough. I also had to learn to “read” the behaviours as cues in order to respond appropriately. I developed an awareness of David’s inner state, his thoughts and feelings, a mind-mindedness.

Attunement builds secure attachments when the supporting adult:

•   Builds an extensive knowledge of a child through observation
•   Is capable of perceiving things from the child’s point of view
•   Responds in way that shows the adult is reading the behaviour as a “cue”
•   Monitors the child’s response to ensure that the adult is reading the cue correctly
•   Voices out loud what is going on in the child’s mind [3]

This isn’t something that only primary school teachers can learn to do. I remember when I was training to be a teacher, observing a teenager who looked like she was about to explode with anger. As the class approached the art room, the teacher was standing at the doorway. She was an older lady and small in stature. I remember thinking this could go badly. I held my breath.

As the rest of the class settled to work, the teacher, as if able to read some tell-tale signs, honed in on the one, angry teenager. She sat next to her and said in a quiet, chatty tone, “I was thinking about you and what you would need to finish your work. I have been saving these pens for you.” It was like watching a parent of a much younger child, arranging the materials on the desk and all the while chatting away. There was an almost palpable drop in the tension. I breathed again.

Becoming attuned is foundational in supporting a child with attachment difficulties. Many other kinds of support depend on at least one adult being able to “read” the young person. Attunement allows us to act quickly to help a child who is not coping, and to offer just the right kind of reassurance. Once we can read his or her cues, we can begin the work of helping a child become more self-aware and emotionally regulated. (This will be covered in more depth in a future blog.)

It is inevitable that there will be times when we get it wrong. We may miss a cue and leave the child feeling disconnected. However, having the sensitivity to repair the relationship is important; it is a vital part of the process of building secure attachments.

Over the years, I lost touch with David. However, seven years later, I was in a meeting with senior social workers and politicians from across Scotland. A group of young people presented a drama about the lives of looked after children. I couldn’t believe my eyes; there was David. Much taller and more confident, he performed flawlessly. Seeing David brought back some of my favourite memories of teaching: the look of surprise on his face and the sound of his laughter when I came into the classroom dressed up as a character from a story we were reading. I am grateful for David and all that he taught me.

* Names and identifying details have been changed to protect the privacy of individuals.

Better Practice by Building Attunement

1. Observe the young person and write detailed descriptions of their behaviours. Descriptions like, “He was disrespectful,” don't help us notice what the young person looks like. Our goal is to train ourselves to be able to recognize subtle differences in things like facial expression and tone of voice.

2. Don’t just observe behaviours that are challenging or distressed. Try to identify behaviours that show when he is settled, concentrating, happy, and relaxed. These are harder to notice because they may occur only infrequently.

3. Observe your own and others’ reactions to the young person. These can also be clues to how the child is feeling. As we become attuned to the young person, we will probably pick up on their feelings of rejection, shame, and hopelessness.

4. Prioritize those behaviours. Rather than which ones cause you most difficulty as a teacher, think about which behaviours make the young person more vulnerable. When I do this it helps me to have more empathy. I am not trying to change the young person because his behaviours make my life more difficult; rather, I need to think about how his behaviours are causing him to become isolated and cutting him off from the kinds of things that kids ought to be able to enjoy.

5. Use the questions in Louise Bomber’s book, Inside I’m Hurting. [4]
What makes his eyes sparkle?
What makes him fidget?
What makes him feel uncomfortable?
Which feelings does he try and avoid?
How does he cope with failure?
How does he respond to help?
What happens when there is tension of conflict in the room?

Other Resources

Edward Tronick’s ‘Still Face Experiment’ shows how sensitive children are to the loss of attunement: http://scienceblogs.com/thoughtfulanimal/2010/10/18/ed-tronick-and-the-still-face/

B.A. van der Kolk, The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma (New York: Penguin, 2014), p. 107-124. In chapter seven, he explains the importance of emotional attunement and the benefits of secure attachments.

References

[1] B.A. van der Kolk, The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma (New York: Penguin, 2014), p. 113.

[2] M. D. S. Ainsworth, S. M. Bell, and D. J. Stayton, “Infant–mother attachment and social development: Socialization as a product of reciprocal responsiveness to signals,” in The Introduction of the Child Into a Social World, ed. M. P. M. Richards. (London: Cambridge University Press,1974), 99-135.

[3] E. Meins, “Sensitive Attunement to Infants’ Internal States: Operationalizing the Construct of Mind-Mindedness,” Attachment & Human Development, 15:5-6, (2013): 524-544.

[4] L. M. Bomber, Inside I’m Hurting, Practical Strategies for Supporting Children with Attachment Difficulties in Schools. (London: Worth Publishing, 2007), p. 87.

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How not to begin a lesson: understanding the behaviours of children with attachment difficulties

1/2/2016

2 Comments

David Woodier.
Support teacher, North Lanarkshire

How not to begin a lesson: understanding the behaviours of children with attachment difficulties

Sean* had been excluded from school and was sitting around in the children’s house. Although a bright kid, I was his only link to any formal education. Each week when we met, he had shown himself to be resourceful at finding something to control. Once when I read to him, I missed a word. Sean insisted that I re-read it from the beginning.

Sean showed signs of being traumatized by the chaotic experiences of growing up in a family in which there was domestic violence and drug abuse. I found it hard to imagine what it must have been like.
From an early age, Sean’s only survival strategy was probably his ability to predict what others were about to do and to manipulate the adults around him.

This time I had come prepared with what I thought would be an engaging activity. We would build a model eyeball and conduct some simple experiments.

Sean was hyper-vigilant. As I walked into the room, I felt his gaze scanning me from head to toe.
Right away he saw I was carrying something in my bag. As I took out the pieces of the model eyeball, he brought out his phone. “Here listen to this. There aren’t that many swear words.”

I tried to reengage him in the activity. “Haven’t you ever wondered how your eye works? I’ll help you build a model eyeball.”

❝Recognising what we don’t understand allows us to
take a different stance, one in which curiosity about
what underlies their behaviour replaces frustration.❞

Sean, who was already squirming on his chair, without warning threw up his arms and roared.

Sean was telling me that he could not tolerate the uncertainty of not knowing and not being in control.
My approach to introducing this activity was to assume that Sean, like most kids, would be motivated by curiosity, the thrill of discovering what makes something work. What I forgot was that Sean had never experienced the presence of a parent, a secure base who could moderate his anxiety when he was learning to explore his world as an infant. Sean’s roar was an expression of a primal defensive mechanism in the face of what felt like an overwhelming threat.

This example underlines several important principles for those of us who teach young people with attachment difficulties. First, we can’t always trust our own intuition about how children view learning.
Being able to recognize that some children’s beliefs, attitudes, and feelings are hard to discern sounds too obvious, but it is often overlooked. Recognizing what we don’t understand allows us to take a different stance, one in which curiosity about what underlies their behaviour replaces frustration.

Deep down, I believe Sean could discover that kind of inquisitiveness that propels most children to learn, but I needed to approach him differently. If I had realized that the underlying issues were more about trust and the need for control, then I could have allowed him some measure of control in the activity. “Sean, you have a choice today. You decide which to do the first, the maths quiz or a science project.”

In addition, we need to become intentional about 'learning' the child. For example, we should learn what the tell-tale signs are that he or she is not coping. We need to learn what works for each child, what helps them connect to or tolerate the presence of another human being. Sean enjoyed completing mental maths quizzes. The fact that the questions had straightforward answers and the quiz was timed probably gave him a sense of something predictable and controlled, and therefore safe.

Is part of our problem as teachers that we make too many assumptions about young people?
We make assumptions about their behaviour based on our own experience of life. Children with attachment difficulties need teachers who are more open-minded, who accept that there may be unexpected explanations for their behaviour. It is not a quick fix, but the curiosity and acceptance we give may be a starting point for some young people.

❝When I maintain that kind of curious stance,
I am better able to think about alternative
explanations for a young person’s behaviour.❞

Why it works:
Researchers know relatively little about the characteristics of teachers who are able to maintain supportive relationships with young people who have very challenging behaviours [1]. However, we can learn some things from the research on parenting and attachment.

Parents who are able to raise kids who are securely attached tend to be better at mentalization.
This is the imaginative capacity to understand the kinds of beliefs, attitudes, and emotions that underlie one’s own and another person’s behaviour [2]. Such parents are deeply interested in the thoughts and feelings of their children; they also recognize that their ability to truly know what is in their child’s mind is limited. They are good at perspective taking, understanding that their child may perceive shared experiences differently. As a result of this such parents, and maybe some teachers, are able to maintain what is called a curious stance. They resist the temptation of making assumptions about a young person’s behaviours.

Why this works for young people who have attachment difficulties is still, I think, a mystery.
Do young people feel less anxious? Do they sense a deeper commitment from such teachers?
Are teachers able to ‘learn’ the child and offer support before a young person becomes more agitated?
I know that when I maintain that kind of curious stance, I am better able to think about alternative explanations for a young person’s behaviour. That allows me to maintain empathy towards a child and reassure them when they feel overwhelmed and vulnerable.

* names and identifying details have been changed to protect the privacy of individuals.

Building Better Practice by Understanding Attachment

1. What kinds of behaviours in the classroom might be due to attachment difficulties and/or a history of abuse and neglect?

2. If you are teaching a young person with challenging behaviours, what assumptions are you making about what motivates their behaviour?

3. If you think about behaviour as a form of communication, what is he or she actually telling you?

4. How would an understanding of attachment and trauma change your practice? How would it change your priorities in the classroom?

Resources

1. Centre for Excellence for Looked After Children in Scotland. “Unit 06c: Understanding attachment, Helen Minnis: Mental health.” wecanandmustdobetter.org
This short video gives a succinct explanation of attachment

2. Centre for Excellence for Looked After Children in Scotland. “Unit 07a: Understanding trauma and loss, Helen Minnis: Trauma and neglect.” wecanandmustdobetter.org
This short video gives a succinct explanation of the trauma of neglect and abuse.

3. Geddes, H. (2006). Attachment in the Classroom: the links between children’s early experience, emotional well-being and performance in school. London: Worth Publishing.
Chapter 3 gives an outline of attachment theory and pages 76, 96, 114 include a summary of the impact insecure attachments can have on learning.

4. Geddes, H. & Hanko G. (2006) Behaviour and the Learning of Looked-After and Other Vulnerable Children. www.familieslink.co.uk/download/july07/Behaviour,%20attachment%20and%20communication.pdf
This paper looks at behaviour as a communication, attachment history and implications for behaviour and learning.

5. Golding, K. (2013). Observing Children with Attachment Difficulties in School: a Tool for Identifying and Supporting Emotional and Social Difficulities in Children Aged 5-11. London: Jessica Kingsley
Appendix 2 describes attachment theory and how children with insecure attachments may present in school.

6. Hertfordshire County Council. (2007). Working with Looked after or Adopted Children in School. CSF Publication 0046, Issue 1. www.hertsdirect.org/infobase/docs/pdfstore/csf0046.pdf
Check out the two-page poster that can help staff think about what might underly behaviours.

References:

[1] Stacks, M. A., Wong, K., Dykehouse T. (2013). Teacher reflective functioning: a preliminary study of measurement and self-reported teaching behaviour. Reflective Practice: International and Multidisciplinary Perspectives, 14: 1-19.

[2] Ordway, M. R., Sadler, L. S., Dixon J., & Slade A. (2014). Parental reflective functioning: analysis and promotion of the concept for paediatric nursing. Journal of Clinical Nursing, 23: 3490-3500.

In my next article, I plan to share more about how understanding attachment helped me change my approach as a teacher...

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Reflections on the DDP Conference

Why Attachment Matters - an interview with Professor Helen Minnis.

Inclusion Makes Better Teachers

Using the ‘L’ Word

Endings

Parenting Teenagers With Attachment Difficulties

Wondering Aloud - Building Support for Young People who are in Crisis

An Unconventional Family

The Broken Toilet and the Importance of Attunement

How not to begin a lesson: understanding the behaviours of children with attachment difficulties

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