Children’s emotional development is stunted, says child trauma expert Bruce Perry

(Photo: Murdo Macleod)

Derren Hayes talks to psychiatrist Bruce Perry who says many children’s problems stem from the absence of positive engagement with adults

A storyline in the TV drama Desperate Housewives had one of the women create an online pseudonym on a social networking site in an attempt to talk to her introverted teenage son.

The fact that the character had to resort to subterfuge illustrates the difficulty some young people have engaging with adults. This growing problem is linked to a stunting of children’s emotional development, says US child psychiatrist Bruce Perry.

The senior fellow at the Child Trauma Academy, a Texas-based not-for-profit organisation that promotes innovations in services, research and education in child maltreatment and trauma, is in Scotland this month to speak at a series of conferences examining the long-term consequences that experiencing trauma at a young age can have on a child’s development.

The academy’s research has shown that changes in the way children’s brains are developing are making it harder for them to form relationships.

Relationship impoverished

“Our culture is becoming relationship impoverished,” he says. “We are spending less time with people and more time watching TV or interacting electronically.

“The number of relationships children now have [with adults] is about one tenth of those three generations ago. It means children are not getting sufficient stimulation to develop properly – we are raising them in a different sensory world.”

Children’s relationships with positive adult role models can be a significant factor in their ability to deal with trauma in their lives, says Perry. Child trauma across much of the western world is on the increase, with the consequences seen in rises in exclusions from school, youth custody, mental health problems and growing numbers on the child protection register.

Much of Perry’s work examines the effects on children of living in chaotic circumstan­ces. For example, where a parent is addicted to alcohol or drugs, in households where domestic violence is common, and where sexual or emotional abuse takes place. He says the trauma this causes changes the biology of the child’s brain, damaging its development and making it more likely they will experience emotional problems.

This trauma tends to be in predominantly impoverished areas, but Perry says economics is not the defining factor. “If we find a poor family living in a community where there is stability – if they are part of a church group and have good friends – the outcomes for these children are not bad at all. Outcomes are not bad because of a lack of material goods, but because they don’t have adults in their lives.”

Child survivors

These findings are backed up by his experiences of working with child survivors of US disasters such as Hurricane Katrina, 9/11 and the Colombine shootings.

“We have learned a lot from children who in many ways have had normal lives and then experienced a catastrophic event. If they have had a normal development, these kids have a tendency to get better quicker than those who haven’t because their more stable social networks act as a therapeutic web.”

This work has helped develop the treatment programme at the academy that has pioneered the use of yoga, therapeutic massage and movement. The approach assesses the stage children are at in terms of motor, cognitive and emotional development.

“We use non-conventional methods to estimate what parts of the brain appear to be affected by trauma: we can then suggest the kinds of sequences of activities that can help the child,” says Perry.

Quick fix

This approach doesn’t sit comfortably with traditional methods of dealing with childhood behavioural problems. “We’re inclined to want a quick fix and medication fits that. Drugs can be helpful but they are poorly used. Cognitive behavioural therapy is excellent for some children, but many we work with aren’t responsive to that.”

In fact, he says “good old-fashioned social work” can play a role in a child’s recovery. “Some of the most important stuff we do is nothing to do with understanding the brain: it is making sure these kids have enough healthy adults in their life. It could be simple things like convincing a child to go to a neighbourhood party or spending time with their grandparents.”

But while he is confident that the professionals are in place to meet vulnerable children’s needs, he says the systems they work within – medical, child protection and youth justice – are “broken”.

“Our systems don’t understand these children. We can have a kid that has a good experience at a residential centre but then has to go back to this real world where the local mental health service doesn’t recognise trauma and just puts the kid on drugs.”

This article is published in the 6 November 2008 edition of Community Care under the headline “Lack of adult interaction?”

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