ERIC ED367481: Caring for Infants and Toddlers in Violent Environments: Hurt, Healing, and Hope.

53 Pages·1.2 MB·English

by  ERIC

DOCUMENT RESUME
PS 022 126
ED 367 481
Osofsky, Joy D., Ed.; Fenichel, Emily, Ed.
AUTHOR
Caring for Infants and Toddlers in Violent
TITLE
Environments: Hurt, Healing, and Hope.
Zero to Three/National Center for Clinical Infant
INSTITUTION
Programs, Arlington, VA.
Ford Foundation, New York, N.Y.
SPONS AGENCY
ISBN-0-943657-30-X; ISSN-0736-8083
REPORT NO
Jan 94
PUB DATE
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Caregiver Role; Child Rearing; Child Welfare;
DESCRIPTORS
Community Programs; *Coping; Early Childhood
Education; Government Role; *Intervention; Police
Community Relationship; *Prevention; Public Policy;
*Victims of Crime; *Violence; *Young Children
Victim Assistance
IDENTIFIERS
ABSTRACT
This journal issue is a contribution to the
development of caretaking strategies to help young victims of
violence, and is intended to provide support for those who are
(1) "Parenting in
helping the victims. Four main articles are:
Violent Environments" (Joy Osofsky and Beverly Roberson Jackson);
(2)
"Infants, Toddlers, and Violence: Developing a Community Response"
(3) "The Assessment and
(J. Ronald Lally nnd Marilyn M. Segal);
Treatment of Infants and Toddlers Exposed to Violence" (Charles H.
Zeanah); and (4) "Call for Violence Prevention and Intervention on
Behalf of Very Young Children" (The Zero to Three Study Group). These
major articles are supplemented by shorter pieces on helping children
channel aggression, early intervention, and community policing, as
well as brief case studies and vignettes. The report calls for a
family-centered approach to addressing trauma and prevention, a
realignment of values, and informed comprehensive public policy
strategies for reducing violence. A list of 38 organizational
of the
resources, along with a list of contributors and the members
Violence Study Group, are included. Contains 152 references. (MDM)
***********************************************************************
Reproductions supplied by EDRS are the best that can be made
from the priginal document.
***********************************************************************
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Toddlers in
Caring for Infants and
Violent Environments
PERMISSION TO REPRODUCE THIS
MATERIAL HAS BEEN GRANTED BY
E. Fenic
TO THE EDUCATIONAL RESOURCES
INFORMATION CENTER (ERIC)"
Clinical Infant Programs
tZERO TO THREE/National Center for
ZEST COPY AWE
2
To the readers of Zero to Three:
This issue of Zero to Three is a special one. It contains the complete text of a new publication,
Caring for Infants and Toddlers in Violent Environments: Hurt Healing, and Hope, developed by
the ZERO TO THREE Study Group on Violence, with support from the Ford Foundation.
This publication presents what is known about the impact of early experiences of violence on
development. It suggests ways to help children and adults cope successfully with their experi-
havens for
ence of violence. It describes ways in which community institutions can become safe
very young children and their caregivers.
We hope that you will find Caring for Infants and Toddlers in Violent Environments useful in
advo-
your own work. We encourage you to share and discuss it with colleagues, neighbors,
cates, public officals, and your local media. Please use the form on the inside back cover to
order additional copies; contact Emily Fenichel if you are interested in community-wide or con-
ference dissemination.
With best wishes for a safe and peaceful new year
Emily Fenichel and Joy D. Osofsky
ZERO TO THREE/National Center for Clinical Infant Programs
Tel. [phone] Fax [phone] TDD [phone]
2000 14th Street North, Suite 380, Arlington, VA 22201-2500
3
Caring for Infants and Toddlers in
Violent Environments:
Hurt, Healing, and Hope
editors
JOY D. OSOFSKY and EMILY FENICHEL,
Study Group on Violence
ZERO TO THREE
The
ZERO TO THREE/National Center for Clinical Infant Programs
Arlington, Virginia
Osofsky,
Introduction.
Joy
Ph.D.
D.
3
Beverly Roberson Jackson, Ed.D.
The Hiding Game
7
1. PARENTING IN VIOLENT ENVIRONMENTS
8
Joy Osofsky, Ph.D. and Beverly Roberson Jackson, Ed.D.
Alicia Lieberman. Ph.D.
The Story of Paul
9
James Garbarino, Ph.D.
Barbara and John
11
Three coping strategies for parents living in violent environments
12
Beverly Roberson Jackson, Ed.D.
Sally Provence, M.D.
Helping Young Children Channel Their Aggressive Energies
13
Dolores G. Norton,Ph.D.
My mommy didn't kill my daddy
16
INFANTS, TODDLERS AND VIOLENCE: DEVELOPING A COMMUNITY RESPONSE
20
2.
J. Ronald Lally. Ed.D. and Marilyn M. Segal, Ph.D.
Interventions with parents and caregivers in the community
22
Betsy McAlister Groves. LICSW
Steven Marans. Ph.D.
Child Development and Community Policing
25
Alicia F. Lieberman, Ph.D.
28
Antonia
EXPOSED TO VIOLENCE
3. THE ASSESSMENT AND TREATMENT OF INFANTS AND TODDLERS
29
Charles H. Zeanah, M.D.
Betsy McAlister GrovesXICSW
The W Family
33
Alicia F. Lieberman, Ph.D.
Cindy and Ramey
36
VERY YOUNG
CALL FOR VIOLENCE PREVENTION AND INTERVENTION ON BEHALF OF
38
4.
CHILDREN
The ZERO TO THREE Violence Study Group
Organizational Resources
42
Bibliography
44
Contributors
48
Violence Study Group
48
4
Acknowledgments
Copyright CD 1994
ZERO TO THREE/Nationai Center for Clinical
We gratefully acknowledge support from the Ford
Infant Programs
2000 14th Street North. Suite 380
Foundation, from the Violence Study Group of
Arlington, VA 22201-2500
ZERO TO THREE/National Center for Clinical
[phone]. fax [phone]
infant Programs, and from the children, parents,
ISBN 0-943657-30-X
and community workers who must live with vio-
Library of Congress Catalog Card Number 93-061752
lence every day and have been willing to share
Lehmann
Design: Susan
their experiences of hurt, healing, and hope.
ZERO TO THREE/National Center for Clinical
non profit
Infant Programs is the only
organi-
national
zation dedicated solely to improving the chances for
healthy physical. cognitive and social development of
infants, toddlers, and their hmilies.
1977. ZERO TO THREE is committed
Established in
to:
exercising leadership in developing and communicat-
ing a national vision of the importance of the first three
years of life and of the importance of early intervention
and prevention to healthy growth and development;
focusing attention on thc quality of infants' and tod-
dlers' major relationships and on children's day-to-day
experiences within these relationships;
developing a broader understanding of how services
for infants, toddlers, and their families are best provid-
ed: and
promoting traininu in keepinu with that understand-
ing.
5
2
INTRODUCTION
Joy D. Osofsky, Ph.D
who are helping the victims. It has been created by
Violence has saturated our nation. It has
ZERO TO THREE's Study Group on Violence,
reached down to our very youngest children and
which began examining the impact of violence on
has even shaken the cradle. Parents are concerned
very young children, their families, and practition-
about the physical safety of their children. They
ers in 1991. We have written Caring for Infants
are equally concerned with their psychological
and Toddlers in Violent Environments with a three-
safety. Tragically, the fears of parents are well-
fold purpose in mind:
grounded. Today's infants are in double jeopardy.
On the one hand, they are in danger of becoming
1. We will look at what it means to be a parent in
the concerns and prob-
the victims of violence. On the other hand, they can
a violent environment
become accustomed to violence, losing the ability
lems that parents face, the strategies they use to
to empathize with its victims, and taking on the
protect their children from physical and emotional
harm, and the ways in which living in a violent
role of the aggressor.
No one likes to think about violence and very
environment affects parents' ability to nurture and
young children. We are sickened by descriptions of
guide their children.
babies who are victims of violence. We even have
We will address the expanded concerns of care-
2.
difficulty thinking about infants and toddlers as
givers, teachers and other community helpers of
witnesses to violence. We would like to persuade
young children who must continually deal with
ourselves that children under three don't under-
violence and infants and toddlers exposed to vio-
stand or won't remember what they see, hear, and
lence.
feel.
We will discuss possible interventions and
3.
But because infants and toddlers do experience
treatment strategies for working with young chil-
violence (and do try to understand it, and do
dren and families exposed to violence.
remember it), we must pay attention to their expe-
Caring for Infants and Toddlers in Violent Envi-
rience. We must learn to comprehend the meaning
ronments is designed to help the reader understand
of violence for infants and toddlers, especially
the specific meanings of violence for the very
since they don't yet have language to help them
young child, for parents, and for individuals who
organize their experience and express their feel-
work in violent environments. This publication
ings. Unfortunately, there is no way to immunize
presents what is known about the impact of early
infants and toddlers against the plague of violence
experiences of violence on development. It sug-
that is devastating our nation. But there are ways to
gests ways to help children and adults cope suc-
protect children, to heal them, to nourish the
cessfully with their experiences of violence. It
resilience of childhood, to keep hope alive.
describes ways in which community institutions
This publication is a contribution to the devel-
can become safe havens for very young children
opment of caretaking strategies to help young vic-
and their caregivers.
tims of violence, and to provide support for those
3
shooting or stabbing. Half of these incidents
How infants and toddlers experience vio-
occurred in the home and half in the street (Groves,
lence
et al., 1993).
Violence is a complex phenomenon. To under-
In a 1992 survey of 6th, 7th, 8th, and 10th grade
stand how exposure to violence might affect the
school children, at least 30 percent reported wit-
development of a very young child, we need to
nessing at least one crime daily. Very few elemen-
know about:
tary school age children avoid some exposure to
the age of the child;
violence (Marans and Cohen, 1993).
the neighborhood in which the child lives;
What are some of the outcomes for children and
the amount of consistency in the child's life;
families who experience or are exposed to violence
in their communities? Let us list a few:
the kind and amount of support available from
Mothers teach their young children to watch TV
caregivers;
lying flat on the floor and put them to sleep in the
the child's experience of previous abuse;
bathtub to avoid random bullets that might fly
how close the child was to a violent event; and
through the windows.
the child's familiarity with the victim or the per-
Young children are fearful for their safety in the
petrator of the violence.
playgrounds and in their neighborhoods.
Researchers tend to categorize violence in terms
In both cities and suburbs, children carry guns
of: 1) community violence; 2) domestic violence;
and knives to school in order to feel safe.
and 3) physical and sexual abuse.
Almost all elementary school children who live
Community violence has reached epidemic pro-
in inner-city neighborhoods have witnessed or
portions in the urban United States. The United
been victimized by violence.
States is the most violent country in the industrial-
ized world. Children are exposed to this violence.
Many children living in the inner cities report
Infants' relatively immature cognitive and motor
that they do not expect to live beyond their teen
abilities may "protect" them for awhile from direct
years.
awareness of some aspects of community violence.
Parents report feeling helpless and hopeless
But infants and toddlers are exquisitely sensitive to
about the constant violence in their neighborhoods.
their caregivers fears and anxiety about exposure
Violence in the home is likely to be even more
to violence in the neighborhood, and young chil-
problematic for infants because of its literal and
dren's daily experience will be shaped by adults'
psychological proximity. Infants who live in vio-
coping strategies.
to witness
lent neighborhoods are also likely
Violence among youth, ages 11-17 has increased
domestic violence (Osofsky et al.. 1993). But it is
25% in the last decade (Uniform Crime Statistics,
important to remember that violence in the home is
1992).
an "equal opportunity phenomenon," occurring in
Homicide is the second leading cause of death
all economic, class, and ethnic groups. Domestic
among all 15 to 24 year olds in the United States
violence is associated with the maltreatment of
(National Center for Health Statistics, 1993).
infants. Strauss (1983) reported that mothers who
were abused by their male partners had higher rates
In 1991, the homicide rate for black males 15 to
of child abuse than non-battered women.
24 years old was 158.9/100,000 a rate 15 times
greater than that for the population as a whole, and
Although there are no reliable data describing the
nearly 10 times the rate for 15 to 24 year old white
extent to which very young children are witnesses
males. (National Center for Health Statistics,
to domestic violence, available statistics indicate
that 20 percent of adult women (as many as 15 mil-
1993)
lion) have experienced physical abuse at least once
National data document a greater than three-fold
by a male partner (Stark & Flitcraft, 1991).
increase in homicide rates among 15 to 24 year
1990
(6.3/100,000)
to
At least 3.3 million children witness parental
1950
olds
from
(19.9/100.000). (National Center for Health Statis-
abuse each year, including fatal assaults with guns
tics, 1992)
and/or knives as well as hitting or slapping (Jaffe,
Wilson &Wolfe, 1988).
A recent survey at Boston City Hospital found
Many parents have observed that infants and
that one of every 10 children under the age of six
toddlers become distressed in the presence of an
attending the Pediatric Clinic had witnessed a
7
4
argument. More serious forms of domestic vio-
cumstances symptoms are likely to occur.
lence are even more ominous in
Recent research studies describe behavior or
their conse-
symptoms among groups of very young children
quences for infant development. There have been
who have been exposed to specific forms of vio-
several case reports of two- to four-year-old chil-
lence. These findings remind us that infants and
dren (Bergen, 1958; Pruett, 1979; Schetky, 1978;
toddlers have fewer ways of expressing their feel-
Zeanah & Burk, 1984) who witnessed parent-par-
ings than even slightly older children, who use
ent homicide. All of these case studies, although
words, or play, or drawings to tell us about thcir
careful to note possible problems in the children
specific experience. Many kinds of stress could
prior to witnessing the murder, converge to suggest
cause a baby's difficulty sleeping or a little girl's
that witnessing such an event itself constitutes a
her child
withdrawal
catastrophic psychological trauma for the young
setting.
As
in
care
child. The involved children developed an array of
researchers z,iN ocates, and policymakers, we need
to understand patterns of response that are seen
new symptoms, including reenactments of the trau-
ma, nightmares, multiple fears, and, often, aggres- among many children. As parents, caregivers, and
clinicians, we must be careful to pay attention to
sive behavior.
the unique experience and the meaning of that
Physical abuse is the leading cause of death
among children less than one ycar of age in this
experience for every child in our care.
country. Homicide accounts for 10 percent of all
Some very young children who have been mal-
deaths of children between one and four years
treated demonstrate an increase
in aggressive
(Mrazek, 1993. citing Waller, Baker & Szocka,
behavior. Others withdraw or become depressed.
1989).
(Cicchetti & Lynch. 1993).
One-third of all victims of physical abuse are
Symptoms of post-traumatic stress disorder in
under one year of age. In 1990, more children
childrer under the age of three years may include
under the age of one year were maltreated than in
disrupted patterns of eating, sleeping difficulties,
any other year to date (DHHS, 1992).
difficulties attending and relating, anxious reac-
tions, fearfulness, and re-experiencing the trauma
In 1990, almost 90 percent of those children who
(shown by behaviors if children have not yet
died as a result of abuse or neglect were under age
acquired the ability to use language) (Drell, et al,
5; 53 percent were under age 1 (Daro and McCur-
dy. 1990).
1993).
As with other young children raised in high psy-
One-third of all sexual abuse cases involve chil-
chosocial risk environments, very young children
dren under six years of age (Schmitt and Krugman,
who experience urban violence may withdraw,
1992).
appear depressed, have difficulty paying attention,
or become aggressive (Osofsky, 1993).
Effects on development
Exposure to parental fighting leads to more
The very rapid and complex changes that are part
aggressive behaviors in boys and more withdrawal
of normal development during the first three years
in girls. Further, children who have been exposed
of life influence the infant or toddler's perception
to more anger (and a history of abuse) show
and experience of violence.
increased negative and aggressive reactions (Cum-
Exposure to violence affects the development of
mings et al, 1991; 1992 1993).
young children's thinking about themselves and
The role of caregivers
the world around them, including whether relation-
ships are trustworthy and dependable.
Knowing that very young children who have been
Since exposure to violence affecis children dif-
exposed to violence arc likely to respond with
ferently at different ages, repeated exposure to vio-
behavior that is both troubled and troubling, we
lence may lead to more significant (or severe)
must think carefully about the role of the adults
effects as children grow older.
who are caring for these children: parents, rela-
tives, friends, child care providers, ministers, nurs-
Very young children's capacities fm- perceiving
es, social workers, family advocates, and health
and remembering the experience affect the appear-
like, day after day, to
care workers. What is
it
ance (or non-appearance) of symptoms related to
address the needs of such children and their fami-
the child's exposure to violence, the pattern of
lies? Who will care for the caregivers?
symptoms, and at what age and under what cir-
5
In the next three sections of this publication, we
Psychiatry, SO, 96-118.
('ummings. EN.. Ballard, M.. EI-Sheikh, M. & Lake. M.
v,ill consider:
(1991). Resolution and children\ responses to interadult
The experiences and roles of parents living in
anger. Developmental Psychology, 27,
462-470.
violent environments;
Cummings. EM., Ilennessy. K.. Rabideau. G. & ('icehetti, I).
(1993). Responsees of physically abused children to different
2. Community issues, from the perspective of
Child Development,
forms of interadult anger.
in press.
front-line service providers and of community sys-
Cumming,. E. II., and Zahn-Waxler, C'. (1992). Emotions and
the socialization of aggression: Adults' angry behavior and
tems that might work together to meet the needs of
children's arousal and aggression in A. Fraczek and H. /mink-
chikken and families; and
New York: Springer-
and Aggrescion,
ley (Eds.)Socializaikm
3. Intervention and treatment issuo.s - What proi -
Verlag.
Trends in Child
Dam, D. and MeCurcy, K. (199(1). Current
!ems and/or disorders can be expected to result
Abuse Reporting and Fatalities: 77w Results of the 1990
from infants' and toddlers' exposure to violence,
Annual Fifiy-State Survi,y.
Chicago. IL: National Committee
what types of interventions work, and what treat-
for the Prevention of C'hild Abuse.
ment strategies will he most effective in working
Department of Health and Human Services, Child Abuse Sta-
tistics, 1992.
with the youngest of victims?
Drell, M., Siegel, C. & (iaensbauer, T. (1993). Post-traumatic
Each of these three sections includes the stories
Handbook of Infant
In: C.H. Zeanah (Ed.),
stress disorder.
of individual families whose infants and young
Mental Health.
New York: Guildford Press, pp. 291-304.
children have been affected by violence in the
Groves, 13., Zuckerman, B., Martins, S., & Cohen. D. (1993).
Journal of the
Silent victims: Children who witness violence.
home and/or community, or by physical abuse.
American Medical Association,
269, 262-264.
These examples come from researchers, and froin
Jaffe. P., Wilson, S., & Wolfe. D.(1988). Specific assessment
violence prevention and treatment programs across
and intervention strategies for children exposed to wife batter-
the country. Although names and identifying
Canadian Journal
ing: Preliminary empirical investigations,
of Conununity Mental Health, 7,
157-163.
details have been changed, the stories, and the
Vio-
Marans, S. & ('ohen, D. (1993). Children and Inner-cit
actual words, of individual parents, community
In L. Leavitt and N. Fox
lence: Strategies for Interventit.a.
caregivers, mental health workers, and children are
Eds). Psychological Effects of War aml Violence on Children,
(
in press.
real. They command our attention.
Mra/ek. P. (1993). Maltreatment and infant development. In
The final section of Caring for Infants and Tod-
Handbook of Infant Mental
Hea/th. New
C.II. Zeanah (Ed.),
dlers in Violent Envirotunents includes the Call for
York: Guilford Press. pp. 159-170.
Violence Prevention and Intervention on Behalf of
Health, United
National Center for I lealth Statistics (1992).
States, 1992.1lyatIsville,
MD: Public I lealth Service.
Very Young Children. issued in the spring of 1993
National Center for Health Statistics (1993). Advance Report
by the ZERO TO THREE Violence Study Group.
Statistics
of Final Mortality Statistics, 1992. Monthty Vita/
We call for:
Report.
Vol. 41, No. 2 (Supplement). August 31, 1993.
VioWnce It dw Liver of Kiang Chil-
Osofsky, JD. (1993).
a family-centered approach to addressing the
dren.
Position paper for the Carnegie Corporation Task Force
trauma of violence and working towards a future
on Meeting the Needs of Young Children. New York City.
without violence:
Osofsky, J.D.. Wewers, S.. Ilann. D.M. & Fick. A. (1993).
Chronic community violence: What is happening to our chil-
a campaign to change our national attitudes
dren? psychiatry, 56, .36-45.
toward violence and our tolerance of violent
Pruett. K. (1979). Home-based treatment fOr two infants who
behavior; and
Journal of the Anwrwan
witnessed their mother's murder.
/8. 647459.
Academy of (hild Prychiatry,
informed, comprehensive public policy at all
Schetky. D. (1978). Preschoolers' responses to murder of their
levels of government designed to reduce and pre-
Bulletin of the
motherx by their fathers: A study of four eases.
vent violence.
American Academy of Psychiatry aml Law 6,
45-53.
Our work is just beginning. We invite every
& Krugman. RD. (1902). Abuse and neglect of
Schmitt, B.
children. In R.F. Behrman (Ed.). Ne/son Textbook of Pedi-
reader of Caring for Infants and Thddlers in Vio-
(I4th
atrics edition). Philadelphia: W.I3. Saunders, pp. 78-83.
lent Enviromtwnts to join with us - to address the
In M.I..
Stark, E. & Flitcraft. A.11. (1991). Spouse abuse.
hurt that violence inflicts on our youngest children,
Violence in
Rosenberg & M.A. Fenley, (Eds.),
America.(pp.
123-157). New York: Oxford.
and to move, for their sake and ours, toward heal-
Strauss, M.A. (1903). Ordinary violence, child abuse and
ing, and toward hope.
wife-beating -- waht do they have in common'? In D. Finkel-
hor. R.J. Genes, G.T. Hotelling & H. Strauss (Eds.) The Dark
References
of Families.
Stile New York: Sage Publications.
Bergen, M.E. (1958). The effect of severe trauma on a four
Uniform Crime Statistics Report (1992). Federal Bureau of
Prychoanalytic Study of the
year-old child.
Chibi. 13, 408-429.
Investigation. Washington, D.C.
Cicehetti, D. & Lynch, NI. (1993). Toward an Zeanah, C'.11. & Burk. G.S. (1984). A young child who wit-
nessed her mother's murder: Therapeutic and legal considera-
ecological/transactional model of community violence and
American Journal of Ps.ychotherapy,
tions.
38, 132-145.
child maltreatment: C'onsequences for children's development.
6
the victim of a stray bullet than a car accident.)
The hiding game
Timothy is too young to understand "games"
and "rules," but he always puts his head down
It is night, and I hate to find myself in this
on the shelf of the car seat to keep an eye on
neighborhood, even in the car. But there is no
David when he is on the floor.
reasonable other route to my house. Driving
The hiding game probably helps me more
along the main thoroughfare of this area, I need
It makes me feel that
than it helps my children.
to be aware of any threatening or unusual
they are safer, and with their heads down, they
movements among the groups of people who
cannot see the fear and wariness in my face.
line the sidewalks. Violence may break out
It's a good game, because it does not seem to
the result of a
between them at any moment
scare the baby or make him cry. But the game
minor disagreement or an insult. As I drive, I
isn't working so well any more for the three-
need to scan the street and sidewalks. This
year-old. As I turn onto the main thoroughfare
frightens me
and announce that it is time to play the hiding
David, three years old,
I have two sons
game, David immediately begins asking ques-
and Timothy, 10 months. Driving in this neigh-
tions. The pervasiveness of violence in our
borhood is especially frightening when they are
community is not lost on him. When I told him
in the car with me.
not long ago that an elderly friend of our family
Here are the rules of the hiding game: When
had died, he responded, 'Who shot her?"
I say, "It's time to play the hiding game," David
It is a struggle to bring up calm, secure, fear-
unfastens his seat belt and curls up on the floor
less children in a violent community.
of the car, between the front and back seats.
(In this neighborhood, David is more likely to be
Beverly Roberson Jackson, Ed.D.
1_ 0
7