“4
your child; physical and emotional needs

Children
in need of adoption or fostering will have experienced separation from their
birth families. These children, regardless of their age will be affected (to a
varying degrees) by that separation. In addition to the effects of separation
and loss, many of these children may also have experienced varying degrees of
trauma as a result of neglect and/or abuse.

Many
of us are generally familiar with the physical impact of neglect and abuse on
children. However, it is important to be aware that the emotional effects of
early trauma may be less obvious, but equally profound. The repercussions of
this trauma can deeply affect your child, No matter at what age you adopted him
or her.

Today
there are many resources and services to help children who have physical,
emotional and developmental difficulties as a result of early trauma. The
purpose of this section, therefore, is to give you a basic understanding of the
possible needs your adopted child/ren may have, so that you can find the
services and information to meet your child’s needs.

Possible
effects of neglect and/or abuse in children

ABUSE
AND NEGLECT OF CHILDREN can take several
forms. The word “abuse” commonly refers to a clear identifiable event or series
of events in a child’s life, whereas “neglect” refers to an ongoing experience
of deprivation. “Abuse”, however, can sometimes be used to cover both
situations, so it is important to be clear about what has actually happened to
a child. A common image of children in the care system is of children who have
been sexually or physically abused. Yet many of them are being looked after
solely as a result of neglect of their basic needs and such neglect can
sometimes damage a child more than individual episodes of abuse.

Regardless
of how it occurs, neglect and abuse are traumatic events for a child.
You may often hear health professionals refer to children experiencing trauma
or being traumatised – a word defined in medical circles as meaning ‘emotionally
painful and harmful event that sometimes leads to long-term mental difficulties’.
It is this trauma that creates the emotional wounds that may take many years
(or even a lifetime) to resolve.

What
information can I find from the child’s medical records?

Your
child’s social worker is required by law to give you full information in
writing about your child when the agency first approaches you about a child (the
Child’s Permanence Report). This will include a summary of the child’s health
information by the medical adviser. The initial health assessment of your child
will record physical and emotional development, and will also indicate any
issues that should be followed up. A copy of the health assessment report will
be sent to your child’s GP as well to you. It is sensible to discuss this with
either with your GP or with the agency’s medical adviser, who may have carried
out the assessment and who will in any case submit comments on it to the
adoption court. The making of an adoption order does not prevent you from
consulting your adoption agency and its medical adviser if you have any
concerns about your child’s health. You may also ask your GP to consult the
agency on your behalf.

Your
child’s health assessment may include information about his or her birth
parents. It is important to remember that this information, whether given or
implied, must be treated as strictly confidential, privy only to yourselves as
parents, to your child’s GP, to the adoption court and, when he or she is
older, to your child.

What
physical and/or developmental problems might we have to deal with?

Symptoms
of neglect or abuse can include, for example, severe nappy rash, inadequate and
unexplained weight gain or loss, withdrawn behaviour (or its opposite,
indiscriminate displays of affection), unexplained bruises and a history of
frequent visits to hospital accident and emergency departments. Health
visitors, doctors, social workers, teachers and others involved with the child
can initiate action on the child’s behalf to deal with the situation, Which for
some children may include being looked after by the local authority. A child’s
physical and emotional development will often improve with placement in a
secure and loving environment, although in many cases this will take months, or
years, and in some instances could take even longer, in fact its shown it could
take a lifetime.

There may be physical and developmental problems
which do not go away after the child is placed with you or which may take many
years to overcome. Some of these difficulties, such as small size, can result
from poor antenatal care, as well as neglect after the child is born. These are difficulties,
therefore, that you may have to deal with as adoptive parents.

Physical
problems
in addition to any diagnosed
conditions the child might have been born with (e.g. Down’s syndrome, asthma,
other physical disabilities), the child may have general problems, such as a small
size, (height and weight) for his or her age and a tendency to contact minor
illnesses (such as colds or other types of infections) more frequently than
other children. Some children may have problems with wetting and soiling (day
and/or night), due to displayed physical development. It will be important for
you to work closely with your health visitor and/or GP to help your child with
these problems. Although these problems will improve over time, your child may
never completely overcome some of them.

developmental
problems
Children who have been
neglected do not develop the same “skills” as other children of their age
Neglected children, for example, may not learn how to talk or how to speak
properly; they may be slow in learning how to walk or run, how to throw a ball,
how to use the toilet, or how to eat properly. These are only a few of the
skills a neglected child may not learn. The extent to which a child develops
skills will differ with each individual and will also depend on the extent and
the time scale of the neglect.

What
emotional and/or mental problems might we have to deal with?

Problems
the child may be born with
Neglected
or abused children may have different types of mental health difficulties which
are not a direct result of neglect or abuse; for example, congenital conditions
such as heart disease. If such illnesses are already diagnosed in the child (or
if there is an inherited problem that exists in members of the birth family but
currently not in the child), you should be fully informed and given advice by
social workers and medical advisers. In rare cases, adopted children can
develop congenital conditions some time after their adoption. In such
situations adoptive parents are advised to contact their adoption agency in the
interest of members of their child’s birth family.

The
developing foetus can also be damaged before birth if the mother was a heavy
smoker or drinker, took harmful drugs or neglected herself and her diet…..”

And Andrew Webb, Director of Children and Young People’s Services at Stockport serves as an adviser to several Government bodies. Heaven help us all!