Under International law (Human Rights Treaty, International Treaty on Children’s Rights (art. 3:1), we have to provide a stable living situation for children. Tough we fail to do so also with refugee children and children who are exploited and maltreated, I want to draw your attention to those children who are placed out-of-home in our countries. Many of these children end up in foster care and orphanages or even (secure) youthcare institutions but these placements are often far from stable. Repeated involuntary placements (and schools!), which the child usually blames himself for, should be regarded as Adverse Childhood Experiences. These ACES exert a lasting effect on child development and should be avoided at all costs.
Recently Leiden University of Applied Sciences in Holland asked caregivers of 350 children, age 2-18, in family-style foster care how many previous placements they already had experienced. We came to a disconcerting mean of 3,6 placements (with a maximum for a 14 year-old boy with 22 homes and institutions).
With each involuntary placement we add ACES and as a consequence the child’s basic trust in himself and in others diminishes. Children come to feel they ‘are not wanted’. Behavior deteriorates and soon these children get labels like ‘Attachment Disorder’, ‘Oppositional Disorder’ or ‘Callous and Unemotional’. I cannot exclude the hypothesis this is up to a part iatrogenic. But in psychiatry there is no such thing as a ‘displacement disorder’. Anglin (2004) aptly calls this ‘pain based behavior’.
An example of 3 weeks ago:
A 14-yearold high school girl was placed against her consent in foster care. There her situation deteriorated quickly and she started cutting herself and refused to eat (actually she tried fighting her way back home). After 3 weeks she was transferred to a secure psychiatric hospital where she tried to commit suicide several times and her condition deteriorated quickly. It was then decided she needed trauma therapy upon which she was transferred to an open institution. I think we were already too late then, because she tried to jump in front of a car, was rescued from the water and taken by police from a railroad track. She told the desperate staff she could not bear freedom anymore. She was then moved to another secure institution where she convinced two other girls to attack staff with knives upon which she was transferred to another secure institution, all within a time-frame of a few months. The documentary ‘Alicia’ is one of the first to depict experiences of vulnerable children over a three-year timespan.
‘Alicia’
Cineast Maasja Ooms made a documentary of the life of ‘Alicia’, a girl that was transferred from institution to institution the best part of her young life (for a trailer see below). You need not be an expert to see her chances in life are now very slim. I recommend this documentary to everyone that works with vulnerable children and ask yourself what we could have done to prevent this happening. But do not think too long, before you are aware of it, she is already in yet another institution.
From the IDFA site:
"It’s not easy to find a foster family for you," an orphanage supervisor explains to nine-year-old Alicia. "After all, you are a very special girl." Alicia is crying. "I’m not special. I’m just a girl." This disturbing scene sets the tone for this film about Alicia, who was taken away from her teenage mother by the Child Welfare Bureau when she was 12 months old. She’s been living in an orphanage since the age of five, and they have never managed to find a foster family for her. In Alicia, we watch as she becomes a teenager, still craving safety and love. Over the course of three years, filmmaker Maasja Ooms follows her daily life up close. Alicia's yearning and powerlessness are palpable in these observations, which painfully reveal the effects of having no prospects.
Link to IDFA trailer:
https://www.idfa.nl/en/film/1b...-d636eb439c9a/alicia
Peer van der Helm is professor of residential youthcare at Leiden University of Applied Sciences, The Netherlands, helm.vd.p@hsleiden.nl.
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