Preschool Child Defiant or Disruptive? Some Ideas You Might Want to Use

When preschool children are defiant, disobedient, and disruptive, there are a lot of difficulties created for everyone. Nothing goes smoothly at home, from getting dressed to bedtime. For today’s multitasking families, having a child who gets expelled from preschool or day care can be a disaster. Parents become concerned over the child’s future--  what happens when he (usually, but not always) gets bigger and it’s impossible to force compliance? And the child too suffers from a constant barrage of disapproval and punishment, gets kicked out of story hour at the library, and is not allowed to play at the houses of friends whose mothers have had enough of dealing with bad behavior.

What can be done to help these children and their families? It’s clear that more punishment, time-outs, even spankings are not the answer, but tend to make the situation even worse.

In response to the high number of expulsions and suspensions of preschool children, positive behavioral intervention and support (PBIS) has been developed. It seems to be an effective way for schools and teachers to deal with problem behavior in preschoolers, and it can be used by parents as well. This approach depends on figuring out why and under what circumstances young children misbehave—something they can’t explain to you no matter how much you ask them.

Very few children are actually defiant, disobedient, and disruptive all the time, even if it sometimes feels that way to adults. When they do misbehave, the problem may be as much or more about the circumstances, the time, and the place, as about the child’s own nature. Unfortunately, frequent child misbehavior makes adults mad, impatient, and in a hurry to punish even though nothing has happened yet. This makes matters worse, as both child and adult begin to anticipate trouble and to expect bad experiences with each other, and both may become less and less able to deal effectively even with small problems.

However, if we can pinpoint the situations where preschoolers have trouble  behaving well, we may be able to take special care with those situations and slow down or stop the development of serious social problems. Anticipating that a child may find some experience difficult to deal with can allow an adult to “buffer” the situation, reduce its impact on the child, and guide the child through the troubled time. How do you pinpoint and anticipate hard times? It’s difficult unless you have some systematic way to do it.

At www.pyramidmodel.org/wp-content/uploads/2016/10/fcc_behavior_incident_report.pdf

you can find a template for observing a child’s behavior and keeping a record of what you see. Doing this systematically for each behavior problem can let you see a pattern of behavior that will help explain why the child is having trouble and what you may be able to do to help improve things. Records like this should be made when children are physically aggressive to adults or other children, when they run off from where they should be and don’t answer adult calls, and when the child does things like head-banging or self-biting that could cause injury—really important problem behaviors that need to be stopped for the good of everyone concerned. (You may also want to keep records of tantrums, inappropriate language, hitting, destroying property, and disruptive behavior if children persist in these even as they get older or if your usual methods do not seem to handle them effectively.)

The form stresses the circumstances that accompanied the behavior problem, for example, large or small group activities, nap time, or meals. Young children often have difficulty in handling transitions of any kind, whether it’s getting dressed, leaving home in the morning, having Mom leave and Dad or a baby-sitter arrive, the beginning of mealtimes, and so on. If this is the case, the cure may be for adults to anticipate the transition and give a “distant early warning”—tell the child what will happen five or ten minutes early, or use a timer of some kind to help the child prepare (this gets easier when they can tell time). The child may have had exactly the same experiences the day before and we might think he will know what’s happening, but this may not be one of the skills of a 3- or 4-year-old, who needs to be reminded in order to accept changes that adults want without so much difficulty. Sometimes transitions are allowed to be too open-ended, as when an adults tells the child it’s time to leave but then gets caught up in a phone call or other adult event, which can create almost as much trouble as failing to give warning.

Positive behavior interventions and supports also involve giving praise when children are behaving as we would like them to, rather than just taking good social behavior for granted and getting angry at or punishing unwanted behavior.  Although people usually concentrate on what children do wrong, it may also be important to record the times and circumstances when a child does very well, and to be prepared to praise and thank the child for that desirable behavior.

The point of PBIS is to watch carefully to figure out preschoolers’ social strengths and weaknesses. When there are clear weaknesses under certain circumstances, we can often tweak the circumstances or use friendly guidance to make things a bit easier until a child masters a social or self-regulatory skill. We would do this for educational or athletic skills, for example by reminding an older child to “sound out” a word she can’t read, or by helping a child practice dribbling a ball. But we often forget that children have to learn how to behave as well as to read or play a game.  

Although PBIS methods were created for use in schools, they can work for parents too, and can help stop the vicious circle of child misbehavior and parent anger. And, if your child is expelled from preschool or day care, remind the school that PBIS is available--  and it works.

The Background of "Three Identical Strangers"

Probably most interested people saw the movie Three Identical Strangers before I did—I only got to it on an airplane recently. This semi-documentary story of triplets born in the early ‘60s and adopted by separate families through a well-known New York adoption agency is fascinating but does not really touch on all the historical details.

As you may already know, the Identical Strangers, reared separately and with no knowledge of each other, met by accident as young men, were fascinated by the immediate relationship they formed, started a restaurant together, and became media darlings to some extent. Looking into the circumstances of their separate adoptions, they were able to find out that their placements had been part of a study conducted by the child psychiatrist Peter Neubauer  in an effort to examine the effects of nature (heredity) and nurture (experiences of caregiving) on child development. Each of the triplets recalled childhood events in which psychologists or other observers came to their homes and tested their development in various ways. The adoptive parents did not know that they had only one triplet per family, and they accepted the testing as part of a study of normal child development. In fact, the boys had been placed in homes that were expected to present some contrast in childrearing methods—one affluent, one middle-class, and one working-class, with the idea that these different homes would provide different experiences for each of the three genetically identical children.

When the triplets and their adoptive parents found that they had not been informed about the circumstances or the study, they were deeply offended and angry, feeling they had been treated like lab rats or guinea pigs. They began to search for the still unpublished results of the study as well as attempting successfully to find the identity of their biological mother. Peter Neubauer has died, and the data collected in the study is sealed in the archives of the Yale Child Study Center, not to be opened until 2060, when all or most of those involved in the study will also be dead. The two surviving triplets are frustrated and distressed by this and feel that it was wrong to keep them from knowing their brothers. They have also found that a number of identical twin pairs were placed apart and included in the research; some of them have reunited, but there are probably some who still do not know they have a twin.

It’s very understandable that the triplets and some of the twins have strong negative feelings about these events in their lives. The fact that the adoptions took place through a Jewish agency, and many of the children were Jewish, calls up horrible reminiscences of Nazi experimentation on children. Today’s research ethics would not permit any such study to be done now.

But is it reasonable to blame Peter Neubauer, the cooperating adoption agency, or anyone else involved in the implementation of the study for the choices they made? Today, yes, they would be considered culpable, but if we look at historical background the conclusion is less clear.

First, let me point out that before reliable birth control and legalized abortion, there were large numbers of “illegitimate” or “unwanted” babies who needed care. Unmarried mothers were strongly discouraged from keeping their babies. Even healthy, married mothers who had multiple births might well be advised to give a baby for adoption because of practical and medical issues that could arise from trying to rear two or three infants together. (The famous Dionne quintuplets in Canada were actually taken to be raised in a government institution because of this kind of reasoning.) The idea of separating children at birth was very much a current one at that time, so it is very likely that triplets would have been separated for adoption under any circumstances; the Neubauer study was simply a matter of following up on the children’s development after placement was already made. The placement of the children in the three somewhat different homes was a little unusual, because ordinarily adoption agencies tried to place children with adoptive families whose socioeconomic status was about the same as the birth mother’s (birth fathers did not come into the equation at this point). However, the three families were all sufficiently well off to care for adopted children, and all had already adopted at least one child successfully, so although one of the boys may have had more luxuries than the others, no one suffered from poverty or deprivation, and in fact the families were more similar to each other than we would be likely to see in today’s increasing inequity.

How about the secrecy? Today, we encourage adoptive families to learn all they can about the adopted child’s biological background—even to enter into an open adoption where the birth mother stays in contact with the child. We stress the need to be clear with the child about his or her adoption from an early age. Adopted children today are much more likely to be of different ethnicities from their adoptive parents and siblings, so adoptive status is often easily visible to outsiders. These circumstances were not usually the case when the triplets were born. Secrecy in adoption was seen as essential for the birth mother, who could now go on with her life without having to fear that anyone--  including a future husband and children—would ever know about her distressing history. Adoptive parents themselves often preferred to keep the adoption a secret out of concern for the social stigma that known infertility might bring for them; men especially might not want the adoption to be known, out of feared confusion between infertility and impotence. If no one was to know about the adoption, certainly the children could not be told, because they would be bound to ask questions or tell people outside the family, and as a result many adopted individuals found out that they were adopted only after the deaths of their adoptive parents.

The Neubauer study also took place in the wake of revelations about an earlier study that purported to investigate effects of nature or of nurture in adopted children, especially in twins one of whom had been adopted. A British psychologist, Cyril Burt, had conducted what appeared to be extensive studies looking at the effects of heredity and environment on intelligence. He published conclusions showing a strong effect of heredity on intelligence, with twins reared in different families resembling each other closely on intelligence tests. But Burt’s work turned out to have many flaws. For example, one of a pair of twins might remain with the birth family while the other one was placed with a cousin or aunt in the same village, and the children might grow up going to school and playing together, so their environments were really not different. In addition, it became plain after a while that Burt had actually used fraudulent methods of analyzing and presenting his data, publishing statistics that simply were not possible calculations.

The Burt scandal meant that questions about heredity and environment were completely unanswered. Peter Neubauer thought to do work that would help to answer those questions with children who were already being separated at birth and whose adoptive status was already being kept secret. The one twist in placement of the triplets was the use of three families somewhat different in socioeconomic status, but all perfectly capable of adopting and rearing children. Neubauer’s work did not meet either the scientific or the ethical standards of the present day, and the sealing and archiving of the records does raise many questions, but the story of the triplets should not be interpreted as evidence of cruelty or indifference to the needs of children and of families. We can sympathize with the surprise and distress felt by the triplets as the story unwound (and thank for their willingness to tell us their experiences) without assuming that the study was conducted by “mad scientists”.

Parental Alienation Treatments: The Experiences from the Children's Perspectives

When children and adolescents are placed in psychological treatment outside their homes—even treatments that last only a few days—they are sometimes held incommunicado by their therapists and staff members. Not only are they kept without phones or money, but they are told that if they do not cooperate they will be sent to wilderness camps or residential treatment centers where they will not be able to reach anyone they know. This can happen in many forms of treatment, but it seems to be especially characteristic of programs that purport to treat “parental alienation”, in which a child of divorced parents rejects contact with one of the parents.

Under the heading “When threats substitute for therapy”, I wrote the following description of a parental alienation treatment on this blog in September 2016. I’m repeating this right now because “Polly” and two other young people have now told their stories on a television program. I’ll give the link to that program later in this post.

“I recently received a long email from a young woman I’ll call Polly. She is 17 years old, has finished high school, and recently went to court to become legally emancipated. But her emancipation petition was not Polly’s first experience with the courts. Her parents, who are divorced, have become locked into an accusation of “parental alienation”—the idea that Polly and her sister, who preferred to live with their father and avoid their mother’s household and her boyfriend, must have this preference because their father had “brainwashed” them into believing bad things about the mother. (Proof of this claim was that the girls insisted that it was their own decision!)

Polly’s mother contacted a California therapist whose psychology license had been revoked but who said he could practice a “psychoeducational” method called Family Bridges. As is the case for many proprietary treatments, it is not easy to find a description of Family Bridges. However, Polly has described what happened to her and to her younger sister when a judge ordered the girls to travel from their home state to California and to participate in Family Bridges. 

According to Polly’s report, when the girls tried to refuse, they were taken away from the courthouse by employees of a “youth transport service”. (These “services” and the little regulation they undergo were discussed by Ira Robbins at www.americancriminallawreview.com/files/7714/0539/9315/Robbins.pdf.) The transporters responded to Polly’s crying and lying down on the ground by telling her that her father would go to jail if she didn’t go, and hinting that she herself would be confined in a residential treatment center. The two girls were taken to a town in California, where they were met by their mother, the mother’s boyfriend, and several psychologists, who met them in a hotel room and apparently do not have an office. The plan was to provide the girls with treatment that would convince them that their father had made them think that their mother was abusive.

The treatment, or “psychoeducation”, consisted of watching and discussing a number of video presentations. These included material about visual illusions, about how people may express opinions that are not really their own because of social pressures, and about the well-known study by Milgram in which participants who believed they were giving other people serious electric shocks often continued to do so when ordered by an authoritative experimenter. The implications of these presentations were apparently that the girls should understand that opinions they thought were their own had actually been created in their minds by their father—a plan with its own logic, perhaps, but not one based on any evidence that deeply emotional beliefs can easily be changed, nor indeed on any evidence that they had been influenced in their opinions by the father.

At almost 18, Polly was almost four years past the age when adolescents are normally given the chance for informed consent to medical or other therapeutic procedures. Instead, threats were used to force her cooperation, and her concerns and opinions were ignored. The threats came into the picture when Polly continued to be resistant and to speak rejectingly to her mother in spite of this “treatment”. According to Polly, one of the psychologists told her, “If you continue that behavior, you will be sent somewhere else. You seem like you need more help than we can give you”—superficially an offer of help for a vulnerable person, but in essence a threat of further disruption to her life. Arrest was threatened if she did not mind her mother, and for several days both girls were told that if they did not cooperate they would go to a treatment facility for juvenile offenders or to wilderness therapy--  these both being situations where teenagers are held incommunicado, have no opportunity to report abuse, and live in austere, even dangerous conditions. Back at the mother’s house, too, incarceration in a residential treatment center was the threat used to obtain obedience.

If Polly had not succeeded in her emancipation petition, or if she had been much younger, no doubt her behavior would have continued to be manipulated by threats--  and perhaps some of the threats would even have been acted upon. What if her behavior had changed in response to those threats? Would that have indicated that the “treatment” was effective—or simply that people respond at least temporarily to sufficiently serious threats?

One other question: when people are trained to do interventions that in practice include threats, are they trained in effective threatening?”

Now, in November, 2018, “Polly”--  real name Arianna—has joined with two other young people who have experienced Family Bridges to describe their feelings in the aftermath of the program, in the following Bay Area television interview:

https://www.nbcbayarea.com/investigations/No-Oversight-for-Programs-Advertising-They-Reconnect-Children-with-Alienated-Parents-499412851.html?fbclid=IwAR0cptVAebcW0R3Z3uxd5OyklJzBsiVI2lczvgXWuesB99TF3b8L6Ki94Kg

Journal articles by Richard Warshak,  a major advocate for Family Bridges, fail to note the concerns raised by Arianna, Sam, and Leo, or to discuss how the use of youth transport service workers can alter the children’s experiences. Even a 2018 article by Warshak in the Journal of Divorce & Remarriage ignores these points, although many psychologists today are voicing serious concerns about adverse events associated with some psychological treatments and the need to report these as part of any research program.

Family courts need to be aware of the information provided by the reports of young adults about Family Bridges and other “parental alienation” treatments and to take these into account as seriously as they take the claims of program proponents. In addition, judges--  and the public in general—should be alert to the rhetorical device employed by Linda Gottlieb in her contribution to the television interview, when she abuses analogies to create the argument that parental alienation can be equated with child sexual abuse.

How Not to Get Any Help for Children That You Think Have Reactive Attachment Disorder

Have you, or has someone else, decided that your child has Reactive Attachment Disorder? Has this diagnosis been made because the child is aloof, aggressive, sneaky, and avoids being affectionate on your terms? I know there are a lot of you out there, and many of you feel pretty desperate—you don’t even like the child any more, and that disturbs you as much as the child’s behavior does. You and the child need the help of knowledgeable professionals, or it seems that the least awful thing that could happen is disrupting the adoption or putting the child in residential treatment until age 18.

I’m going to tell you how NOT to get any help for your family. Part of my instructions will be drawn from a book by Keri Willimas, “Reactive Attachment Disorder (RAD): The essential guide for parents”, a self-published book available on Amazon.

1.     1.  Get into an argument with any available professional about whether your child’s behavior problems and your emotional distress are caused by Reactive Attachment Disorder. Insist that no matter what the mental health professional shows you in DSM-5, the problems that concern you are indicative of an attachment disorder and nothing else. Stay focused on the name that’s used, not on a discussion of the mood and behavior problems of the child and others in the family. If the professional tells you the name is not important, leave and do not make another appointment. This will ensure that your family does not get any help in thinking about the many sources of behavior problems and various effective ways of treating them.

2.      2. Go immediately back to your on line support groups and have them reinforce your beliefs that attachment and attachment disorders in the child are at the root of all family problems. Ask them to recommend practitioners who will accept your diagnosis and start doing attachment therapy of some kind. This will guarantee that you will not risk encountering any professional psychologists or clinical social workers who are trained in work with children’s behavior problems.

3.    3.   If you lose faith and call a mental health professional with advanced training, or a clinic that employs such people, be sure you demand immediately to know whether they treat Reactive Attachment Disorder (or simply, attachment disorders). If they hesitate or ask you to be more specific about the problem, hang up--  they obviously are not RAD specialists. This way you won’t accidentally connect with anyone who might have the training to help your family.

4.    4.   If you locate some mental health professionals that you might use, be sure to choose the one with the lowest level of training and licensure; with any luck you could find someone who is operating under another person’s license. The less trained the people are, the nicer they are, and the more likely they are to listen to you unquestioningly. If you do this, you can be almost sure that you will not run up against a practitioner who knows more than you and your support groups do and might actually be of help.

5.     5.  Always assume that only other people who have lived with a child with behavior problems can understand or be of any help to you. This will assist you in avoiding mental health professionals who are trained in working with many kinds of families and many overlapping problems.

6.      6. Be sure not to use any evidence-based programs like Parent-Child Interaction Therapy that ask you to learn new things or to work with your child in new ways. Insist that the child be fixed and that no other family changes take place. Generally, this will avoid any beneficial changes.

7.    7.   It’s wise to choose only treatments that assume one single factor, like RAD, as the cause of any of the problems you are experiencing. Most problems have multiple causes, so focusing on a single one can help you avoid any benefits of treatment that you might otherwise get.

8.      If you choose a treatment program, make sure it’s trademarked. That will mean that nobody can get at evidence to test whether it is both safe and effective. The proprietors will be able to make all sorts of claims and have their statements protected as commercial speech. You won’t have to worry about understanding empirical research or asking any of the right questions, which will be much more comfortable for you although not very likely to be of any help to your family.

9.      Always follow the recommendations made by Keri Williams in her book (mentioned above). She certainly knows how to prevent even the best-qualified mental health professional from helping your family. For instance, she advises parents, “Be very cautious about sharing sensitive information about yourself with your child’s therapist. It’s easy to think of them as objective. They’re not. If it comes to taking sides, they’re on your child’s side. Don’t blurt out that you don’t feel affectionate towards your children, that you are frustrated, or that you are angry. If you do, that’s almost certainly the only thing they’ll focus on going forward. They’ll conclude that your feelings and actions, not RAD, are the cause of your child’s behaviors. If the therapist focuses on ‘fixing’ you, your child will not get the help they so desperately need.” This approach, akin to treating repeated illness with antibiotics rather than considering what environmental factors are causing it, will certainly make sure that your family avoids help but is instead encouraged to find residential placement for a child and “love her at a distance”--- and all your friends will say how brave you are and how sad it is that your child was so damaged that no one could help. (How about suing the adoption agency too?)

You see, it’s pretty easy when you know how. You can be sure your aggressive or behaviorally disturbed child never gets any help, while at the same time claiming the moral high ground as the victim and sufferer who has only been trying to do the best thing for everyone. Just don’t forget to talk about RAD a lot.

What Bowlby Really Said, or, More Fun with Parental Alienation

I don’t usually watch to see what Craig Childress says on Facebook, but a lawyer colleague has called my attention to his recent comments about attachment and its implications for children who avoid one of their divorced parents. He attributes his own ideas to John Bowlby, Mary D.S. Ainsworth, and Otto Kernberg, not to mention Sal Minuchin, and describes these people with a novel collective noun as a “pantheon of kahunas”.

The problem is that Childress either doesn’t know or doesn’t understand what Bowlby actually said about attachment, or that attachment theory has changed a good deal in the course of decades of research and discussion. (I published an article in 2010 in Theory & Psychology, titled “Attachment theory and its vicissitudes”—and there have been many vicissitudes.)

Bowlby’s work was focused on trying to find explanations for some common and obvious toddler behaviors. These were of course not newly discovered but had been described for centuries, even mentioned in the Iliad. The two basic kinds of behavior Bowlby was looking were, first, the tendency of toddlers to stay close to familiar people under some circumstances, to avoid strangers and strange events, and to show severe and lasting distress when separated from familiar people, and, second, the tendency of toddlers to be curious and explore the environment under some circumstances. They stay near and they go away, with apparently contradictory motives. Why does this happen? Attachment theory began as an attempt to answer this question and built from there.

However, Bowlby’s original concern was with the way toddlers try to stay near familiar people, especially if they (the toddlers) are sick, injured, frightened, or in a strange place. He saw children hospitalized in England in the ‘30s and ‘40s, when parents were not allowed to visit and surgeries like tonsillectomies were common. Those children were terribly distressed and for months after would cling to a parent as they had not done before. Bowlby also saw European children brought to England by the Kindertransports when their families were threatened by the Nazis—suddenly packed up and sent off with strange caregivers and large groups of other children and suffering from separation, fear, and often physical distress as well. In addition, Bowlby observed English children evacuated to the countryside when London was being bombed nightly.

In all these cases the young children were badly distressed both short-term and long-term in ways that were not the same for children of school age or older. Bowlby prepared two reports for the World Health Organization, entitled “Maternal Care and Mental Health” and “Deprivation of Maternal Care”. In other words—Bowlby attributed the children’s problems to loss of the mother. He believed that human beings in early childhood were able to form an attachment to only one person, and that one was the mother. Bowlby called this tenet of his early theory monotropy. As we can see in his film “Nine Days in a Residential Nursery”, about a toddler left at a residential child care facility while his mother has another baby, fathers were not considered by Bowlby at this point to be attachment figures, and the lonely, frightened little boy in the film does not respond much to his father’s occasional visits.

Nowadays, we assume that fathers, mothers, grandparents, sisters, brothers, and babysitters can all be attachment figures for young children. Bowlby clearly did not think so—and would not have supported Childress’s view that children’s attachment to their fathers is a critical issue. It was all about mothers at that early stage in attachment theory. Why? Well, two reasons. One is that parenting behaviors have changed, with fathers given (and taking) more responsibility for child care, at least in educated middle-class groups. Bowlby would have been astonished at the idea of fathers in the delivery room (remember, even Dr. Spock said that the best thing a father could do for the child is to love the mother). But in addition to that matter, Bowlby focused on mother-baby relationships because he was searching for an explanation of toddler behavior in the lives of animals. He attributed the child’s desire to stay close to mother to evolutionary processes such that children of our remote ancestors were more likely to survive and reproduce if they fled to mother when something strange happened. Genetically-controlled behaviors of that kind are easily observed in some animals and were being studied by ethologists like Nikolaas Tinbergen. Whether human beings also showed such “fixed action patterns” was a major question, and Bowlby argued that toddler behavior toward familiar people was an example of what is sometimes described as “instinct”. Because most animals that show the tendency to stay near an adult do this with their mothers, Bowlby looked to behavior toward the mother as the foundation of social and emotional development, or attachment.

By 1995, Michael Rutter, one of the most important figures in the modernization of attachment theory, had marked a number of changes in the way the theory was developing. He ruled out monotropy (the exclusive attachment to the mother), as all the evidence was that toddlers usually have multiple attachments. Writing in the journal Child Development in 2002, Rutter referred to the overuse of the attachment concept as “evangelism”, and said “[It] is clear that parental loss or separation carries quite mild risks unless the loss leads to impaired parenting or other forms of family adaptation.” Presumably Childress would claim that lack of contact with one parent, as desired by the child, would be “family maladaptation”, but this claim cannot be derived from Bowlby (unless it’s the mother who is missing!) or from the more recent version of attachment theory as discussed by Rutter.

There’s a lot more to be said here, with respect to Bowlby and attachment theory. As the years passed, Bowlby dropped his ethological view and began to think of early attachment behavior as the foundation of an internal working model of social relationships, like the mental models  earlier suggested by Kenneth Craik. These models helped to determine social expectations and social behaviors and were “goal-corrected”, altering with time and social interaction, so that the original “attachment system” did not last for very long. (By the way, almost nobody ever talks about the exploratory system, which acts in cooperation with the attachment system and in Bowlby’s original formulation keeps a balance with attachment.) The attachment system of any individual turns into  an internal working model in the course of development, so it cannot become “deactivated” any longer, or contribute to pathological mourning if the child experiences separation in the school years or adolescence, as is the case for most of the families Childress attempts to describe.

One last thing here: Kernberg and narcissism as associated with broken attachment. Sorry, this is not what people think today. Narcissism in adolescents is connected with “overparenting”, “helicopter parenting”, but especially with excessive psychological control of children by their parents. Psychological control involves strenuous efforts to change children’s beliefs, attitudes, and emotions to those that are preferred by one or both parents. How better could we describe some of the interventions offered for “parental alienation”!

Separating Migrant Children from Their Parents

I don't seem to be able to overcome the format of the material I copied and 
pasted here, so you may not be able to read everything-- but the journal links should work anyway.

I'm sure that some readers are very interested in the outcomes for migrant children of the practice of  separating them from their families.  Here are some things you might want to read about this, especially if you work directly  with children or with their families.  The first piece, from the NYT, is a description of the changed behavior of some children who have  gone through separation and then  been reunited with their families. It shows clearly that the problems are not  over when reunion has occurred.  https://www.nytimes.com/2018/07/31/migrant-children-separation-anxiety.html Here are a number of free articles from a professional journal, addressing a variety of problems related to early childhood trauma  resulting from violence and separation. As the leading publication for pediatric mental health, the Journal of the American Academy of Child and Adolescent Psychiatry has  published many articles demonstrating the damaging effects of early childhood trauma on later development, the role of parental stress in the  intergenerational transmission of both psychiatric and other medical outcomes, and the positive role of parents in promoting child and  adolescent mental health. We oppose the practice of separating immigrant children from their families. In collaboration with our publisher, Elsevier, we have created a free collection of articles published in JAACAP on the effects of separation,  early life trauma, and related topics, and will maintain and update it until this practice is no longer the norm. Select articles from this collection include: Mental health in Syrian refugee children resettling in the United States: war trauma, migration, and the role of parental stress Childhood trauma and illicit drug use in adolescence Traumatic stress interacts with bipolar disorder genetic risk to increase risk for suicide attempts Trauma exposure and externalizing disorders in adolescents Default-mode network abnormalities in pediatric posttraumatic stress disorder Intergenerational transmission of maternal childhood maltreatment exposure: implications for fetal brain development The network structure of posttraumatic stress symptoms in children and adolescents exposed to disasters Trauma exposure and posttraumatic stress disorder in a national sample of adolescents Preventing children's posttraumatic stress after disaster with teacher-based intervention Developmental timing of trauma exposure relative to puberty and the nature of psychopathology among adolescent girls What are the transgenerational consequences of maternal childhood adversity and maternal stress during pregnancy? Transforming trajectories for traumatized children View the full collection of articles on the JAACAP.org website under the collections tab in the menu. View articles

The Demand for Obedience: How Two Alternative Psychotherapies for Children Resemble Each Other

Discussions of non-evidence-based medical treatments often use the term CAM—complementary and alternative medicine. The idea is that such treatments can be used in two ways. They may be complementary to evidence-based medicine, as when yoga or nutritional components are added to conventional cancer treatment. Or, they may be used as alternatives and substituted for evidence-based treatments, as when substances made from apricot pits are used to treat cancer rather than radiation or chemotherapy.

Non-evidence-based treatments also exist in psychotherapy, but they are usually used as alternatives rather than as complementary additions to evidence-based treatments. Because of that, I usually call them alternative psychotherapies (APs) rather than using CAM or CAP to describe them. APs are not just treatments that lack a good evidentiary foundation; there are psychotherapies that are still in the process of data collection that are not APs in spite of their relatively small evidentiary support. APs are different in that they are not plausible, because they employ faulty logic or because they are not congruent with things we know about human beings. APs for children and adolescents are noticeably out of step with established information about child development, for instance. APs also have potentials for causing harm to clients, sometimes serious harm, sometimes harm in the form of opportunity costs as families expend resources on ineffective treatments.

APs for children and adolescents may resemble each other even though the theories behind them and the practices they employ are quite different. This is especially the case when the focus of the treatment is on compliance and obedience to adults. 

My original interest in APs involved Attachment Therapy, a treatment for children that stresses obedience and considers compliance to be the indicator that children have formed emotional attachments to adults. This is implausible for many reasons, but especially because it assumes a single factor at work to determine complex behaviors that are based on both maturation and experience. Advocates of Attachment Therapy have published descriptions of their practices and discussions of their rationales for limiting children’s diets, requiring tedious and difficult manual labor, and threatening children that they will never go home if they do not cooperate. Members of groups like the Facebook closed group Attachment Therapy Is Wrong have disclosed their experiences in this form of AP.

More recently, I have identified some treatments for “parental alienation” as APs. These treatments purport to correct children of divorced parents who strongly prefer one parent and resist visiting the non-preferred parent. The children are thus disobedient to the non-preferred parent, and if they have been ordered by a court to visit they may also be failing in compliance to the court and its officers. Parental alienation treatments have been described by their advocates as involving multiday workshops in which children may not contact the preferred parent, must spend time with the non-preferred parent, and must watch educational videos and engage in “fun” activities followed by a required vacation with the non-preferred parent. Some of the programs maintain separation from the preferred parent for 90 days or more and make communication with that parent contingent on complying with rules for desired behavior toward the non-preferred parent. The children have no money or phone allowed to them and are often a great distance from home.

 Although as far as I know there is no social media site where adolescents or young adults have described their past experiences with parental alienation treatments, over the last year I have seen a number of accounts of the proceedings as experienced and recalled by those who have been through them. These accounts have some details in common. One is that the children (I am going to include adolescents in this category) were taken from school or home to the place of treatment by youth transport services workers. The transporters in some cases applied handcuffs to the children before transporting them by car or plane. Money and phones were taken away, so although some children were told that they could leave the treatment rooms if they liked, and that they were not being forced to do anything, in reality they had little choice except to find themselves alone on the streets of a strange city. Cooperation was also obtained  by means of threats—for example, if a child would not eat when given food, he or she might be told that this was very unhealthy and it would be necessary to place the child in residential treatment for his or her own good. Wilderness therapy programs were often mentioned, with emphasis on the impossibility of escaping or communicating with anyone on the outside. Other threats involved manipulation of concerns about the preferred parent, for example that he or she would go to jail or be fined a large amount if the child did not cooperate, watch the videos, play the games, and talk to and make eye contact with the non-preferred parent.

The common themes of Attachment Therapy practices and those of parental alienation interventions are evident. The children are essentially held captive by practitioners. They have in many cases experienced physical restraint—handcuffs for the parental alienation cases, “take-downs” for the Attachment Therapy situations. Although in theory they may be able to leave the premises, in practice this would mean going into a frightening milieu that they are not prepared to handle. In both cases, descriptions by victims include constant intrusive supervision and demands for compliance with unnecessary assignments, whether cutting the grass with nail scissors in one case or watching videos and discussing them in the other. Victims of both methods have reported practitioners’ laughter at the children’s discomfiture. Threats of abandonment or of more intense seclusion and isolation are in both case used to manipulate children’s behavior. In both therapies, children learn to comply to whatever extent they are able  in order to escape from the pressure and constant demands they experience. Only children who for physical or mental reasons cannot comply will not show the temporary behavior changes required of them, and as a result advocates of both methods claim that their treatments are effective.

I don’t discount the importance of some degree of obedience and compliance in children and adolescents. Their own safety may well depend on established habits of attending to adult advice. However, when a psychotherapy focuses entirely on compliance as an indication of mental health, and especially on compliance to an adult’s demands for affection and gratitude, a mistake is being made. This is particularly true when an intrusive treatment is directed toward older school-age children and young adolescents, whose normal developmental trajectory is moving them away from their relationships with parents and toward relationships with peers, romantic connections for the future, and cooperation with friends, teachers, and employers.

Finally, I want to point out that treatments involving parent-child relationships need to involve changes in both child and adult, without which the relationship itself cannot really change. In infant mental health circles, one important principle is that treatment must be treatment of the dyad, and this is true in a more complicated way of relationships between parents and older children too. Yet the APs discussed in this post focus on making the child change. Why? Presumably this is because a) the child can’t get away, and b) the adult is paying the bill. It’s certainly not because there is evidence that this approach is effective, or even that it is consistent with the ideas of family systems that are so often and so nonchalantly invoked.

A New Book About Crime and Children

Children and crime can be connected in a lot of different ways. Children can commit crimes, sometimes starting when very young as “runners” for older criminals. If caught, they may receive various penalties considered as interventions, from placement in foster care to imprisonment (sometimes with life sentences!) as juveniles. They can be victims of crime, too, and some would even argue that in having been brought into criminal activity they have already been victimized. Arguments about children’s rights and the reasons children become criminals—or victims of crimes like child abuse and neglect—are intense, and reflect the ongoing culture wars of the United States and their associated differences on child-rearing and treatment of adult criminals.

Clearly it is a complicated task to discuss the many topics we can categorize as “children and crime”. There are plenty of books out there that focus on some single topic like child maltreatment or juvenile justice. But a new book by Dr. Connie Tang brings all these topics together in a coherent way. Children and crime (Rowman & Littlefield, 2019) is an unusual and valuable contribution that can be used with benefit by the general public as well as by undergraduate and graduate students in psychology, sociology, social work, and criminology. (And if you belong to the general public you don’t have to  worry about the learning objectives and thought questions in each chapter, but just dip in to what catches your attention!)

Children and crime emphasizes the need for critical thinking about complex problems by discussing the real problems of research design that must be addressed when it is impossible to do experimental work that separates possible causes and effects in a meaningful way. This is the part of the book that most psychologists and psychology students will find most useful. But in addition Dr. Tang expresses a deep compassion and sympathy for children caught in the toils of crime, a practical concern reflecting her early training as asocial worker. A third factor that makes this book unique is Dr. Tang’s awareness of cultural differences, born of her own upbringing in China and adult life and parenthood in the United States (which, full disclosure, she and I have discussed many times).

Like any other serious work on the events of childhood, Children and crime has to deal with the fact that although laws are written as if every person from birth to age 18 has the same needs and abilities, this is actually far from true. Dr. Tang shows three graphs early in the book that demonstrate this fact clearly with respect to children and their involvement with crime. The first graph shows that almost 50% of child victims of  homicide are under 6 years of age; 10% are between 6 and 11; perhaps 7% are 12-14; and more than 35% are 15-17. In other words, young children are most often killed, school-age children and young adolescents quite rarely, and older adolescents with increasing frequency. In a second graph, the child homicide victim’s relationship with the killer is shown. Almost 60% of victims under 6 are killed by family member, another 20% by acquaintances, very few by strangers, and almost 20% by unknown persons.  Child victims between 6 and 11 are killed with about the same frequency by family and unknown persons (about 40% each), and less than 10% of the time by both acquaintances and strangers. By ages 12-14, family killers are reduced to 10% and stranger killings to about 15%, while acquaintances are the killers 25% of the time and killers are unknown in about 50% of cases. These developmental changes proceed with victims aged 15-17, who are rarely killed by family, somewhat more often by strangers, but nearly 40% of the time by acquaintances and 55% of the time by unknown persons. A third graph shows victim age differences in weapons used in the killing: for the youngest children, knives or objects are rarely used, firearms in only about 15% of cases, and the most common method of killing (50%) is “personal”--  that is, the child is killed by beating, strangulation, or similar methods. By ages 6-11, firearms have become the method of killing 50% of the time and “personal” methods have shrunk to 5%. By ages 12-14, 65% of the child victims are killed by firearms, and by ages 15-17 this has increased to 85%.

These developmental differences in child homicide victims reflect a range of factors like physical vulnerability, contact with family and with outsiders, and active involvement in dangerous activities, all of which change with age. Children and crime offers information about psychological theories of development and about social and community factors like those discussed by Urie Bronfenbrenner, as Dr. Tang uses these concepts to discuss how maltreatment, delinquency, and children’s eyewitness testimonies can be understood.

This is a really valuable book. It is not a general discussion of children and the law , or even an extensive discussion of the laws of various countries concerning  a single topic (like the enormously-detailed tome of Hoyano and Kennan, Child Abuse: Law and Policy Across Boundaries, that covers most English-speaking countries). Much more usefully for most readers Children and crime brings together overviews of relevant topics in ways that introduce important ideas to beginning students or general readers and that prepare readers to go more deeply into the complex research literature.

PS: I do have a tiny criticism. If I had written this book (which I would be proud to have done) I would not have been so nice about repressed memory! This is a contentious topic, but I think the results are in, and do not support the idea of repression or the related “recovered memory”.

Separation of Migrant Children: Commenting on Proposed HHS Rule Change

Some readers may be aware that the Department of Health and Human Services proposes to make a change in the Flores amendment that (in theory) limits separation of  undocumented migrant children from their parents to 20 days.  The new rule is described as:

The Department of Health and Human Services (HHS) Proposed Rule: Apprehension, Processing, Care, and Custody of Alien Minors and Unaccompanied Alien Children

You can comment on what rules should apply in these cases by going to 

https://www.regulations.gov/comment?D=HHS_FRDOC_0001-0700&p=1.

Here is the comment I posted:

I am a developmental psychologist and the author of a book on infant development, one on emotional attachment in childhood, and textbooks on child development. I am concerned about the assumption that a HHS rule about separation of children from parents can be equally appropriate for children of all ages, birth to 18 years.  Clinical and observational studies of child development show that the impact of separation on children is most severe during the toddler period, roughly 10 months to 3 years of age. Preschool children are also negatively affected, but because of their better language development,  can tolerate separation somewhat better than toddlers can. Both toddlers and preschoolers show the impact of abrupt and long-term separations by crying, withdrawal, failure to play or explore, and problems with eating and sleeping. Notably, if separation  goes on for more than a few days, these effects will not disappear when the child is reunited with a parent, but will continue to be apparent for weeks or months, as the child has sleep problems or nightmares, is easily startled and frightened, and both clings to and behaves aggressively toward the parent. These reactions are difficult for any parent to cope with, but are especially so for a parent who is also frightened and distressed about an uncertain future.

School-age children are also distressed by separation, especially when they are confused by a new language, but their reactions and long-term responses are much less seriously negative than is the case for toddlers and preschoolers. In my opinion, decisions about rules on treatment of separated migrant children should focus on care of toddlers and preschoolers if triage needs to be done because of limited resources. Ideally, toddlers and preschoolers would remain with parents in whatever detention is used. A less ideal solution, but a better one than seems in place at this time, is that separation be limited to 20 days at the most, and that care for the separated young children follow guidelines for high-quality child care as provided by organizations like the National Association for Education of Young Children (NAEYC). These guidelines would set maximum numbers of children to be cared for by one caregiver , with a ratio of 1:3 for the youngest children in this group and 1:5 for older preschoolers; would provide that children have assigned caregivers rather  simply placing a number of caregivers to work with all of the children in a large group: would provide that these young children be cared for in small groups rather than large rooms full of children; and would emphasize individualized care for the children, with physical contact and talking prioritized.

Much concern has been expressed in recent years about the physical and mental health consequences of adverse childhood experiences (ACEs), and how these consequences continue into adult life. Most migrant children have already experienced a number of ACEs in their home countries-- these being the reason for the family's migration-- and have often experienced more on their journeys. For toddlers and preschoolers, separation from familiar caregivers is a seriously adverse childhood experience in and of itself. When this separation is abrupt and long-term, when the separation has occurred in frightening, even violent, circumstances, and when young children do not receive the care that could help them escape the worst effects of these events, we must consider the accumulation of traumas  that are being inflicted and their real consequences. Although we cannot undo the effects of earlier ACEs on migrant children, we can refrain from subjecting them  to further distress and further needs for social services that neither they nor their parents may have access to.

I do not mean by these statements to minimize the distress of 6- and 7-year-olds or of older children when confined to prison conditions following terrifying events before and on their journeys. However, my concern is that it is developmentally inappropriate and potentially harmful to assume that the youngest children can tolerate abrupt separation and the apparent loss of all they know in the same way that older children and adolescents can manage. It is time for the HHS rule to recognize the different needs of younger and older children and to assign resources accordingly.

*********** Readers, if you would like to comment on this issue, you should understand that you do not have to identify yourself or explain your credentials as I did. There is also a checklist that you can read before commenting that will give you an idea of how to approach this. I hope people will speak up while the chance exists. 

Autism Treatments, Science, Risks, & Benefits

The Association for Science in Autism Treatment (https://asatonline.org) is an interesting organization that includes some big names ( like Tristram Smith) and seems to have the admirable goal of providing information about autism treatments that can help parents make their own choices of treatment. The website has a considerable list of specific treatments and the empirical evidence that supports them, if there is any. It’s a good place to find definitions and descriptions of both well-known and obscure treatments that target autism spectrum disorders.

Looking at the evidence for various autism treatments as discussed at asatonline.org, we’re reminded of the great difficulty of outcome research in general and work on autism in particular. Because therapies have shared general factors (like individual attention) that can cause improved outcomes, it’s important always to compare the outcome of a type of treatment to the outcome seen when there is no treatment, or a treatment whose effectiveness is already known. It’s not enough to report that a group of people did better after a treatment than they did before—they might have done just the same (or even still better!) if they had no treatment at all. When a study focuses on children, this is a point of special importance, because children change quickly as a result of their natural development, even if they are on an unusual developmental trajectory like autism.

When a comparison group is used in studying treatment outcomes, it’s essential that every person being treated has an equal chance of getting into the treatment group or into the comparison group. They need to be randomly assigned to groups, not allowed to choose for themselves which group they prefer. If that’s not done, it may appear that a treatment is more effective than the comparison simply because the people who chose it are in better shape to begin with or are more sensitive to treatment.

You can see how difficult these things may be to do, especially with respect to autism. Permission for autistic children to be in outcome research has to be sought from their parents, who may be horrified at the thought that their children will be “guinea pigs” , may be frightened of what researchers might do, may be extremely protective of their vulnerable children, and may simply have so many demands in their lives that they cannot cope with the inconvenience of being responsible  for participation in research. They may resent the idea of having their children assigned at random to treatment conditions or to a comparison group, even if they are promised that each child will eventually get treatment. The children themselves may be reluctant, anxious, oppositional, or in other ways require a great deal of individual handling.

It’s far from surprising that no autism treatment has nearly enough empirical work supporting it, and it’s to the credit of ASAT that they do their best to make this plain. However, there are some points they fail to make as clear, and I am not sure whether this failure occurs because the website authors don’t want to offend anyone who proposes an autism treatment.

The first problem I see on this website is that quite a few proposed treatments are listed under the heading “doesn’t work or is untested”. Now, although I am quite aware that it is not possible to show that something does not exist (unless you can find some mutually exclusive thing that can be shown to exist), but I would argue that there is a big difference between treatments that have been thoroughly tested  and shown to be ineffective, like Facilitated Communication, and those that have never been tested in any systematic way, like Son Rise.  When a treatment has been systematically tested, there are some things we can know about it, for example that there are people who have been trained to apply the method in a predictable way. In addition, we have evidence that the treatment does not make a condition worse; not all therapies are really “therapeutic”, and some actually exacerbate problems. Systematic investigation of a therapy can also tell us whether other forms of harm were done, including whether autistic children (or others) found the treatment distressing or frightening. Choosing a treatment scientifically requires attention to both demonstrated benefits and demonstrated risks of the treatment.

The asatoline.org website is not very different from some similar sites with respect to this problem of grouping together untested and tested but ineffective treatments. The California Evidence Based Clearinghouse for Child Welfare (www.cebc4cw.org) similarly confuses issues  as it rates treatments both in terms of their evidence basis and of their importance for child welfare concerns; users may not notice the difference between these ratings. In addition, cebc4cw.org bases its rating on information provided by advocates of treatments. The California site also rates many of the listed treatments NR (not rated) because no evidence is provided—leading to a situation somewhat like that of asatonline.org, where the listing of a treatment does not necessarily indicate that its outcome has been tested systematically or that it has been shown to be effective.

A second problem of the asatonline.org site is that the material presented mentions almost nothing about potential harms associated with treatments. This topic has received increasing attention over the last twenty years or so, and that attention has been strongly focused on unwanted effects on vulnerable individuals like autistic children. The journal Clinical Psychology is preparing to do a special issue on potentially harmful psychotherapies. Potential harms from mental health interventions can range from physical injury and death to “opportunity costs”, the loss of opportunities to make use of effective treatments or of limited resources like time and money that might be better spent on other needs of an autistic child or of other family members.

The ASAT website lists “patterning” as an ineffective or untested treatment. Patterning is a physical movement therapy that involves having five adults move a child’s head and limbs through positions characteristic of infant reflex movements, on the assumption that the nervous system can be “rebuilt” by this reenactment of early life. Patterning for autism and nervous system injuries has been rejected twice by committees of the American Medical Association It  has not only never been shown to be ineffective, it also has the potential for physical injury as untrained people move the child’s head and limbs into different positions. Above all, patterning has opportunity costs, as it is to be done several times a day, exactly on schedule, by a number of adults greater than is found in most Western households. Patterning is privileged over adult work and the needs of other children in a household, so that family functioning is negatively affected, as are relationships with family members, friends, and neighbors who are repeatedly asked to help with the therapy.

Similarly, asatonline.org lists Faciitated Communication (FC) as an unsupported or untested therapy for autism. FC is a method by which an adult works with a child to use a keyboard with the intention of understanding thoughts the child cannot express in speech. FC has received systematic investigation and it has been demonstrated that what is “said” on the keyboard stems from the beliefs and thoughts of the facilitating adult, not the child. The website makes this clear, but does not note the harm done to a number of families when a facilitating adult used the keyboard to accuse a family member of sexual abuse of the child, causing a criminal investigation with all its associated stress and mutual distrust in the family.

The ASAT website lists under unsupported and untested treatments two associated therapies, one under the name “bonding (attachment ) therapies “ and the other under the name “holding therapy”. The first covers both holding therapy and “gentle teaching”, although holding therapy appears again under its own name. Egregiously, neither of the references to holding therapy gives a complete description of how it is done and the potential for physical and psychological harm inherent in this coercive restraint treatment, although the first description does use the word “forcibly” and warns parents against covering the child with blankets as part of this method. The first description also notes that autism is not a bonding or attachment issue, so a therapy that is posited to increase attachment is in any case irrelevant. Both descriptions end with the idea that well-designed and implemented research on holding therapy is needed. None of the risks, child injuries, or deaths associated with holding therapy are mentioned. The pain and fear experienced by children undergoing this treatment are well established and are frequently discussed by adults who went through holding therapy on a closed Facebook group called “Attachment Therapy Is Wrong”.

I find it quite disturbing that a website stressing a scientific approach should omit well-known information about the potential for harm shown by some treatments. The risks associated with holding therapy have been understood for over two decades. A scientific approach must examine both risks and benefits of a treatment, even one for competent adults--  when the patients are autistic children who cannot make their own choices, the information give to parents must be particularly concerned with the potential for harm. 

I'm going to add to this post a statement made by an English man with autism, Les C., now an adult, about his childhood experiences with holding therapy: 

My life experience as a undiagnosed autistic/ aspergers child.

My parents have always said that my problems started when I started school. At age 4 I went to playschool with my mam, so I was never left with other children, until my first day at primary when I was 5.

I was very upset, and I could not understand why my mam had gone home and left me, so during most of the day I sat crying and saying I wanted to go home and I didnt like being with other children who just got on with it. After break time when the whistle was blown, all the other children lined up ready to go back inside, while I ran the other way onto the field and rolled on the grass. I vaguely remember doing this and maybe because I thought it was funny to get the teacher to run after me.

The head teacher had said to my mam that my behaviours were not acceptable and that I could end up in borstal if something was not done. In a later year, I found out that I was the only one in the class that was adopted when someone in the class mentioned it, but I didnt know what it meant, and the other children seemed to treat it like a joke that I didnt have natural parents. My mam explained to me what it meant and at first I felt left out, but I didnt have a problem with it, but my parents started to think that I did.

Over the years I never mixed or made friends like others did, and had many problems at home and at school. My parents found my behaviour very alien and badly behaved. I was born in the 70s when in them days some parents punished with shouting and slapping. I was also taken to see numerous  child psychologists and councillors, where my parents would do the talking, while for me I could not communicate. My mam had read some information on autism which was very little at the time, and mentioned the possibility to a psychologist of me being autistic, but they said no and that I was just a very naughty attention seeking child. My autism has affected me differently to how it has other people. I see and feel things differently to others. I could not help the way I behaved, and my parents could not cope and were getting to their wits end. For me I had a high sensitivity of being physically touched in childhood. I was fine with my parents holding my hand to go out or being asked for a light hug, but anything more than that was uncomfortable and distressing if pushed over my limit.

If my mam came and touched me or to put her arms around me, I would resist and push her away. To a parent, that may seem perfectly natural and comforting, but to me it was not, but as a child I couldn't think of a way to explain it. The times when I was slapped for something wrong, and what is just a little tap to a parent, was like a big bash over the head for me, so I naturally went berserk, and retaliated and all hell breaks loose. I wondered when are they going to get the message that its painful for me to be touched.

Every so often I had to go to hospital appointments to see a orthopaedic doctor about my legs because they were not growing right along with my weight issue. Again I hated these appointments because of the touching, so I was probably being awkward. The doctor included in the medical notes that I was out of control and disturbed in some way. When the time came that they felt I needed to have surgery, which I didnt want and still wish I had not, because I wasnt unhappy with the way things were. My parents were concerned about my mobility in case I ended up disabled, so I didnt get listened to, and was taken to hospital, which I thought was a good way to get off school because I was bullied with no friends, and I was early years at the big school now. I was pressurised into having it done. The nurses were horrible to me, they treated me like I was some sort of a freak, and didnt care about my pain until I asked for painkillers. I hated them touching me to remove my stitches and dressings. My leg was stiff, they told me to bend it, or they would get the physiotherapist onto me. The physio came and she was great with the other children on the ward, but she was nasty and brutal with me while the others watched me scream, cry and shout in pain.

I assumed the nurses told my parents everything that happened, but they had not, and they would not have allowed this if they did. It sounded like the psychologist I was under at the time told my parents and the hospital staff not to listen to me. Time off school for another traumatic experience of pain and physical touch, I was no better off.

Sometime later after that, I decided I wanted to spend some time on my own away from home and school. I had bath, got into my favourite clothes and left with my savings book without saying anything. I was found by the police and brought home, and they all wanted to know why I did it.

I did this on 2 occasions, and the 2nd time, 2 nice policemen brought me back and said if I went missing again I would be taken into a home.

My parents thought that I did this because I was adopted, so again I was taken to see a doctor who introduced me to a lady that I could see and talk to and go out and do things with, and that she was adopted too. I did not want this because I didnt really have a problem with it.

Then later my mam read something in a magazine about holding therapy, or someone that had told her about a lady that did it. She did not know what it was or what it was all about, but she told me that we were going to see a lady that could help. A lady who learnt from Welch, unknown then.  As usual, I would just be sitting listening to my parents tell her about everything including our rows, being pushed away and that I was adopted. Surely with experience with others, she should know that I have a resistance to being touched. So what sounded very nice and loving to my parents was agony to me. The distress I have had with unwanted physical touch was bad enough. My parents were desperate for a solution, so they listened to whatever she said to do a hold no matter what I was to say or do to get away from this prolonged uncomfortable painful touch.  A week later, after it had happened 3 more times at home, including the lady coming to our home where another session took place, and seeing her doing this on a TV documentary with others, I was lucky that my dad put a stop to this because he couldnt see how it would solve anything, and he did not like the atmosphere, and for me this had greatly pushed my limits of touch over the top to torture.  My grandparents at the time were told about this, and they agreed that my dad did the right thing. After this last resort, my parents just had to accept the way I was.

END.

-