What I learned immediately was that I was wrong to assume that Kiara’s hair pulling was a sign of continuing self-harm; in terms of something or nothing, perhaps it was a ‘nothing’ then. Because according to everything I was reading, it had nothing whatsoever to do with wanting to hurt oneself, or indeed give oneself a bald patch. It was a neurological condition, more like a compulsion than a habit – indeed a tic – and once started was extremely difficult to stop. It was more common in girls, apparently, and the usual age for onset was around 11, though it could apparently start earlier than that.
What did stand out, though, was that hair pulling wasn’t confined to any particular cultural or social group; even the happiest, most settled children could develop the compulsion, just as easily as an unhappy or abused child could. But as I’d suspected, it was a reaction to stress, and since that bald patch had clearly been there for a while, it was a stress that was ongoing.
So it was probably a case of finding out what form the stress took, and on that score I had little to go on. It might be something as straightforward as the start of puberty and anxiety about the changes that were going on inside Kiara; many girls developed issues with body-confidence around that time, and, physically, Kiara seemed quite a ‘young’ 12-year-old to me. It might be bullying – in which case, was it a response to the stress inherent in coming to school? Or was it home-based – something to do with her relationship with her mum? There could be so much going on that we didn’t know about, after all.
But it was pointless to speculate. All I could do was watch and wait and wonder – and try to tune into what it might be that gave her that look – as if she had the weight of the world on those narrow shoulders. That and the evident fatigue. What was that about?
‘Now that’s a very serious Casey face,’ came a voice from behind me. ‘I can see it in the screen. You want a coffee before the off?’
I swivelled around on the swivel chair to find Kelly in the doorway, brandishing my mug. There was an encouraging tendril of steam coming from it, too.
‘Just concentrating,’ I told her, accepting it gratefully. ‘Been trying to find out a bit about trichotillomania. Tricho – yes, I got that right. Trichotillomania. Did you hear about the hoo-hah in the year eight assembly?’
‘Sure did,’ Kelly said. ‘All poor Donald needed.’
‘Well, the girl, Kiara Bentley – I took her back to the Unit with me. Hence the search. She’s got quite some bald patch in her hair. And the whole business – I mean, just how tired d’you have to be to end up with your head in a boy’s lap?’
‘Assuming that was the case. He’ll probably say differently.’
I shook my head. ‘He might well, but I’m pretty sure I believe her.’
‘And you know what?’ Kelly said, pointing a finger towards the screen. ‘That does figure. Yes. It really does. One of the Maths teachers – whatshisface – was talking about Kiara the other day – yes, I’m sure he said the name Kiara – and saying that she kept falling asleep in lessons. Yes, I’m sure it was her. I’ll double check.’
‘Would you? And if you run into anyone else who might have dealings with her, ask them about her as well. I just have this sense that there’s more to this whole thing than meets the eye. Anyway, she’s coming back to me after lunch. Maybe I’ll get something more out of her then.’
‘And some cheap labour too,’ Kelly said, winking. ‘Nice work, Dr Watson!’
Kiara was already outside my door when I returned after the lunch break, having let her form teacher know she’d be with me for the rest of the day. Once again, I was struck by how doll-like she looked, from her petite, elfin face, to her nicely pressed school uniform, which looked as if it had only recently been bought. Now she was composed again, she positively gleamed with grooming, and I mused that if the school had to select a poster girl to reflect their sartorial benchmark, then this little girl would be she.
‘Ready to roll your sleeves up?’ I asked her, as I unlocked the door and opened it. ‘What are you getting out of this afternoon anyway?’
‘Double English,’ she said, without hesitation.
‘Well, we’ll be doing double decorating instead,’ I said. ‘That okay with you?’
‘That’s fine, miss,’ she said, taking the pink backpack from her shoulders and parking it on a nearby chair. ‘I’m good at decorating. I painted a whole bedroom wall last weekend, all by myself. Pink,’ she added, grinning.
I smiled at her. ‘How did I know you were going to say that? So, what would you like to do, sweetie? My walls all look bare, the glass in my door looks boring, and all my plants need a watering and a talking-to, so – take your pick. What are you best at?’
She chose to create some artwork for the door, which suited me fine. Doing something physical was often key to getting kids to open up. Rather than sit them down and start interrogating them, I’d learned over the years that a softly-softly, lateral approach was usually better – get them doing something alongside you that kept half their minds occupied, and a child would often relax enough to open up a little.
I was quite the expert at it, in fact. With my son Kieron, who had a mild form of autism called Asperger’s Syndrome (as it was known back then, anyway), I had become well practised in winkling out the nuts and bolts of anxiety in a child who preferred to bottle everything up. If he was struggling with something, I’d nag him to help me with something in the house or garden and then, once he was ‘in the zone’ of whatever he was doing, he’d be so much more receptive to sharing what was on his mind and we’d be able to find a solution together. It was never quite as simple as that with the kids in school, obviously, because we didn’t have that history and mother/son bond. But, eventually, after building up that all-important trust, they usually did start to talk.
And hopefully Kiara would, too. ‘Right then,’ I said as I clapped my hands together. ‘The door it is. I’ll leave the design ideas to you.’
Kiara threw herself into the work with gusto. Within ten minutes, she was carefully cutting out the giant cardboard Easter egg shapes she had decided would be perfect. She’d made four of them in total, having checked with me first, one for her to write her name on – ‘Kiara woz ’ere!’ she joked – and one for each of the three children who I told her would be joining me in the morning. She was using different coloured card for each and decorating them with contrasting borders. ‘You can explain to them that they have to write their names across this middle bit,’ she said. ‘And then they can stick them to the glass in the door. That should brighten the place up a bit, miss, shouldn’t it?’
A girl after my own heart, I thought, as I remembered the flowers that had previously adorned the door, all decorated by my last brood of children. I also noted that she seemed both alert and engaged and, with her hands fully occupied, was refraining from absent-mindedly fiddling with her hair.
‘That’s a great idea,’ I agreed, having a bit of a re-think, ‘and since you’re so good with the art stuff, you can put up some new borders round my display panels, while I get on with sorting out the books.’
‘I’ve always been good at practical things,’ she said. ‘I get it from my mum. That’s what she always says – that we’re both really good with our hands. But I’ll help you sort the books out as well, once I’m done. I’m good at that too.’
But it turned out there was something Kiara Bentley was even better at. The decorations made, she did indeed join me in the quiet corner and between us we pulled out every single book in there, dusted them off, categorised them and put them all back in their new positions, after which I left her to it, putting labels on the front of the shelves so everyone who borrowed a book would know where to put it back, while I had a quick