Be consistent, predictable and repetitive. Maltreated children are sensitive to change and some will be overwhelmed by new social situations. School outings, sleep-overs, camps, a new classroom with a new teacher or their teacher’s absence may create anxiety. Traumatised children need predictable routines. Make sure the child knows what to expect. If change is to occur, explain in advance what will happen and why. Children only benefit from learning opportunities if they feel safe and secure.
Model and teach social behaviours. Maltreated children may not know how to interact appropriately. Model desired behaviours and explain what you are doing and why. Maltreated children, especially those with disabilities, often have problems with appropriate physical space and contact. They may have to be taught not to stand too close to people, not to stare, not to play with their genitals in public and not to wipe their noses on their sleeves. Children with learning disabilities and attachment problems often initiate inappropriate physical contact with strangers. This is usually misinterpreted as affection. Perry suggests that instead of chiding, we should gently guide them to interact differently, providing opportunities to practise creating personal space and making eye-to-eye contact without staring.
Build on the skiIls needed to succeed in a group. Observe traumatised children to discover if they do best in small groups or one-to-one situations. Provide structured and regulated group interactions. If children have trouble being in a group, try pairing with a reliable buddy to build self-confidence and trust. Once they experience success, they will be more inclined to accept other settings, especially if the supportive peer is still there. Let them choose a partner for paired-reading sessions, computer games, or a group project that provide opportunities to wait, share, take turns, cooperate, and communicate. Games and tasks can increase in complexity as children develop. This provides experiences that these children might otherwise avoid. If young children are severely distressed and unpopular, befriend and spend time working with them. Others will be curious as to why the unpopular child is your friend. They want to please you and, with that in mind, some will join in. Of course, you can’t force anyone to make friends with a reticent child and moves have to be tactfully undertaken because if they backfire, the child you want to help may suffer further. Prevent bullying, exclusionary behaviour, and unkindness. If you work to provide all members of the group with a safe environment, maltreated children will be more likely to thrive.
Give traumatised children appropriate roles: if they have good number skills, make them the shop-keepers in shop-play; if they have creative talent, display their work. If they are skilled in physical activities, draw attention to them. Praise effort as well as achievements. Their behaviour and demeanour will change when they experience approval. When others observe their strengths they are more likely to befriend them and as they join in, you can gradually withdraw.
Don’t be afraid to talk about the traumatic event. Adults often imagine that if they don’t mention it again, children will forget what happened. They don’t! Perry confirms that if they sense that we are upset by the situation, they will hide their feelings, making recovery more prolonged. When the child is looking sad or worried say, “I can see that you are sad/worried today. Let’s talk about it”. Affirm that what happened to the child was distressing whether it involved death, a car-accident, bush-fires or abuse. Never avoid discussion: listen without over-reacting, answer questions, empathise, support then comfort for a lasting positive effect43.
Stop, listen to and play with traumatised children. When quiet and interactive, they may feel able to reveal their anxieties. This is a good time to introduce feelings and how to express them. Teach children healthy ways to act when sad, angry, confused, happy etc. Use and make children’s own “Feeling” books.
Have realistic expectations. Abused and neglected children have a great deal to overcome. Assessment by a child psychologist is helpful. Be patient with progress.
Provide appropriate comfort. Physically and sexually abused children are often distressed by physical contact. Give hugs to those who seek them and ask children’s permission to hug. They need to be in control of who touches them.
Discuss your expectations of behaviour and the consequences of inappropriate behaviour. Children need clear rules and consequences for breaking them. Be consistent when applying them and explain the reasons when you deviate. Use positive reinforcement and rewards. Take care not to put these children down.
Give the child developmentaIly appropriate information. The more the child knows about how the adult world ticks, the easier it will be to make sense of it. If there is a prosecution pending, children need to know something about the legal system and that, if there is a not-guilty finding, it is not the child’s fault. Unpredictability increases anxiety and fear leading to aggression, sleep and mood problems. Without information, children speculate to complete the story and their fantasies are more frightening than the truth. When a child is the first to find a parent or sibling hanging or shot, family members may lie claiming that the person who suicided had a heart attack. The adults think they are protecting the child but the child knows they are lying and lies increase anxiety, insecurity and distrust. The child has no-one to turn to.
If you don’t have the answers, say so!
Watch out for re-enactment, day-dreaming, withdrawal, hyper-activity and behavioural impulsivity. Traumatised children exhibit a combination of symptoms in the acute post-traumatic period. They often reappear when they have reminders of what happened; for example when they see their abusers, meet the social worker or go to court. Keep a record and note patterns of behaviour.
Protect the child. Stop and avoid activities that seem to cause distress.
Give the child choices and some sense of control. Traumatised children feel safer when they have some sense of control over their activities and social interactions. When behaving inappropriately, say “You have a choice. You can (do what is required) … Or you can continue doing this and the consequence will be … Which do you choose to do?” This helps to defuse situations where the child feels out of control and anxious44.
Praise for effort and use positive child management techniques. We need to learn how to motivate traumatised children and tap into their interests. Unfortunately, when they don’t enjoy and play truant from school, they may find and align themselves with other marginalised individuals. The cement that holds these youngsters together is both destructive and self-destructive, leading to a life of crime. When a child exhibits angry and anti-social behaviours and is perceived as a “bad kid”, the teachers’ reactions are likely to confirm their negative self-image. The message should be, “I care very much about you but this behaviour is unacceptable. Let’s talk about what we can do to change it”.
Provide 1:1 support. Bear in mind that abused children are often unable to focus adequately because of everything else that is happening in their lives. They will probably benefit from ongoing 1:1 attention from a regular volunteer or aide to compensate for this. Many are better at performing visual activities than auditory sequential ones and learn best through activities. Teachers can help by using strategies that appeal to visual special learners (and at the same time ASD, ADHD, FASD types of behaviours).
Play therapy is a valuable tool for abused traumatised children. When children don’t have the language to express feelings, they may draw pictures of what happened and talk about what they have drawn. Art therapy can impact significantly on Post-Traumatic-Stress Disorder, enabling children to integrate memories into consciousness thereby reducing the capacity of sensory stimuli to trigger traumatic responses. Play therapy is very useful for these situations. Perry reports that it took more than a year for children of 5-7 years to externalise their feelings of fear and loss after the terrorist attack on the World Trade Center and Washington DC. They had to come to terms with the finality of death and the effect it had on their lives. Play therapy has also been widely used with Australian children who lost their homes, family and friends in bush-fires.
Play