“Children who exhibit the most severe and persistent anti-social behaviour are being failed by the system”

There has been a mixed response to the item about children with “Callous Unemotional Traits” on the BBC Radio 4 Today programme this morning.

 

(Clip here)

An interview with both parents and the young person just after 7.30am, was followed by discussion from leading psychiatrist, Professor Stephen Scott, after 8.00 and then a final segment asking if children with severe behavioural problems are being failed by ‘the system’ just before the end of the programme. Justin Webb‘s sensitive interview highlighted the regular violence and abuse experienced by the family, which leads them now to seek residential school or accommodation under section 20 for their son ‘Max’, as there is no other prospect of change in sight. Max is adopted but his difficulties were explained not so much by early trauma as by a psychopathic trait: Callous Unemotional Trait, which leaves him unable to feel empathy for others, or understand the problems with his behaviour. The overall message was: With an estimation of 1 in 100 adults exhibiting psychopathic traits (and overwhelmingly represented amongst the prison population), should we not be paying more attention to these children who seem to be heading that way, to find ways of moderating their behaviour and teaching / modelling greater empathetic behaviour, if not feelings. Multi-systemic therapy was suggested as one possible route, but the need for significant improvement in the provision of mental health services for young people was emphasised, both from a humanitarian / medical point of view and in view of the costs incurred in ignoring the issue.

So why the mixed response?

It was great to have such prominence given to the difficulties experienced by families in accessing help when they are being abused by their children – and these parents left no doubt that they considered their experience the equivalent of intimate partner violence.  The figure of 1 in 100 children being affected in some way by this condition was alarming (in the context of the many other additional causes that we know about), and there was no suggestion that this was the only explanation for abuse from child to parent, but it lent some weight to the general statistical discussion. There was some suggestion that children could be helped towards more appropriate social behaviour through rewards systems and positive reinforcement, notwithstanding the unlikely improvement in genuine demonstrations of empathy.

BUT….

The overwhelming sense of hopelessness was very strong. Not only was this a condition that might not be treatable, but the very means of help and support is out of reach for many as mental health services, particularly for young people, remain so poorly resourced. I think some parents felt that this was yet another possible diagnosis amongst so many others; and with still no real sense of definition of the problem or official recognition.

Family Futures, an independent adoption support agency, have written a response which you can read here. They remind us of the need to consider the whole picture and not to be hasty in ruling out the effects of early trauma on the developing brain.

I will remain optimistic because that is in my nature. And because the more coverage the better from my point of view – though clearly if you are a parent experiencing abuse on a daily basis, this is small comfort. I would like to know more about the condition, and to see for myself how it fits into the existing understanding and models of child to parent violence and abuse that we already have.

The radio interviews will be available for the next four weeks.

 

4 Comments

Filed under Discussion, radio and video

4 responses to ““Children who exhibit the most severe and persistent anti-social behaviour are being failed by the system”

  1. Different perspectives are always interesting and we appreciate you bringing this BBC interview to the attention of your blog’s followers. From our parental perspectives the interviewer and the professionals seemed to lack the understanding that others in the field of trauma have been able to offer us as adoptive families. For example, Bruce Perry has spoken of difficulties in terms of social connection and intimacy for traumatised children – they can only only manage close connection with others in small doses. The label of CUT seems an extremely stigmatising one and one that seems unlikely to engender the connection that our children so badly need in ways that feel comfortable and safe for them, Behaviours like this need to be understood in context, and the adoption context, with all the losses this inevitably means for a child, seems quite important and was somewhat overlooked in this programme, which did not give much hope. Neuroplasticity issues also seemed to be overlooked. Adoption IS the intervention that can make a difference to a child, if families dealing with such difficulties can be appropriately supported – but this did not really come across in the radio programme.

    • Thank you for your experienced and thoughtful comments, which you express more clearly than I could. I admit that my rush to publish something meant that my post was not as nuanced as it might have been. The lack of context, or wider acknowledgement of issues around adoption, in the BBC piece was indeed a shame, and would have added so much more to the wider discussion.
      For me, the fact that the issue was being discussed at all was exciting, but it is indeed important that the public are brought the full facts if we are to raise awareness in a helpful manner.

      • Thank you for publishing. Listening again yesterday with another adopter we both felt very uncomfortable indeed when the parents were asked whether they loved their child. We cringed in unison. This question seemed potentially harmful given that the child might hear negative responses if parents were burned out and exhausted. What parent would not be taken aback by such a question? It was as if the interviewer imagined that Max had no feelings and would not be hurt, because he did not seem to care about his parents. This mistake can be made very easily with autistic children and adults and is very unfortunate when this happens. The BBC have just sent out a survey to adopters for a forthcoming programme, soon to be aired, and asked the question ‘Are you glad you adopted?’ Parents reported on online forums that they found this hard to answer and we felt it conflated parental love, which unless something has gone horribly wrong, is always there in an adoption, and ‘being let down by services’. It could potentially mislead instead of clarify.

  2. Thank you again for your comments. This is an important discussion and I hope that other people will feel able to join in.

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