Assessing the child: providing opportunities for children to express their views within the context of S133 psychological assessments

Children communicate in different ways. Our task is to be open to what children have to tell

us.NZ Psychological Society Conference, July 2010

Paul’s drawing Paul ‘s story of his picture demonstrated (metaphorically) his awareness of his history and his ‘view’ of his current circumstances and future. This experience, early in my training, convinced me that children can tell you what you need to know about them, if you provide them with the opportunity.

This presentation will include:

• The Care of Children Act - Views vs Wishes• Methods of Communication• Observation of child in different contexts• Verbal – direct, indirect• Child’s Play – spontaneous and structured• Drawings and Stories• Consistency of information across contexts• Conclusions

The Care of Children Act 2004 requires the child’s “views” to be elicited

• A child must be given reasonable opportunity to express his or her views.

• Any views the child expresses must be taken into account, and not filtered through child’s age and maturity

• The Act does not provide a mechanism for how the child’s views are to be obtained

• The child’s views can be included in a S133 assessment and report, although it would not be the sole purpose of that report

Child’s views - Childs WishesWhat is the difference?

• Views involve a wider range of concerns than wishes• Views refers to how the child ‘sees’ the situation

from his/her perspective• Issues of the child’s age and maturity are therefore

incorporated within the child’s views• Wishes are future oriented, limited to what the

child longs for or wants e.g. Parents re-uniting• Suggests a child has a choice - which can impose an

intolerable burden on the child

Children Communicate in Different Ways

• It is necessary to provide the opportunity for the child to tell you in her own way, her views of her family and their relationships, her parents and their separation, and of her beliefs of her own needs in the future.

“Listening” to children

• “Listening to very young children does not necessarily mean taking all their utterances at face value, but it does mean observing the nuances of how they exhibit stress, or curiosity or anxiety or pleasure, in a manner which is congruent to their maturity... Although most infants do not learn to talk until their second year, their “voices” are there to hear from birth.” (Push & Selkirk in Davey, Upton & Varna, eds. 1996 in Henaghan, 2005 p 8)

Observation of the child in different contexts

Observation of the child’s behaviour provides fundamental information

• The Crowell Procedure (Zeanah, 1997): Parent as -– Caregiver– Interactant– Playmate– Attachment figureAnd child’s response to each parent in these different roles. Is there a difference in his

behaviour? What are the nuances that you observe?

• Sam’s behaviour – his pleasure, his anger, loss of control• Aiden’s behaviour – his relaxed demeanour and focused play, his anxiety and

change in persona • Amy was very clear in differentiation of her feelings

Verbal (direct)

• Is the child wanting to talk about how it is for him/her?• Offers information unsolicited? • Answers questions readily?• How the child says something is important, e.g. Sam• Some children find it more difficult to use verbal

communication to tell you the issues that are important to them– particularly younger children

• Some children take longer to develop trust in the assessor and the process – some opportunity to play/draw can facilitate this

Accessing the child’s views

• A range of “diagnostic equipment” allows the child to choose whatever communication media are best for him/her, whilst observation and appropriate verbal interaction is maintained.

As Violet Oaklander (1978) suggests:We need to “take off our adult glasses and look

and listen with the eyes and ears of a child”.

The assessment roomA space large enough for the child to express her views in her play, but not so big as to feel lost. A range of diagnostic equipment, that is respectful to the child (organised, clean not broken) and age appropriate

Assessment roomAnother view

Teddy bear family attachment gameSimple family day to day activities are played out with the bear family with the child, the mother and father bear then separate, and the child is asked questions about what happens then - playing out the little bear’s reaction to the separation and contact arrangements

Which media is right for this child?Play, Drawings & Stories

• Children’s play, drawings and the stories they tell of their pictures demonstrate the child’s ability to communicate their emotional and psychological issues metaphorically, illustrating the profound understanding they can have of the issues that are important to them.

Play (Spontaneous)Aiden

• Age 5.5 years• Aiden showing signs of serious psychological

distress

Aiden’s play - he protects the baby animalsAiden builds a block tower, but it collapses and he uses blocks to form a corral, strengthened with the fences. He places all the baby animals inside, with some trees for shelter.

The babies are the target of the large wild adult male animalsAiden added a row of adult male wild animals outside corral. When asked what is happening, he said “We must look after the babies. We must make sure they are safe”.

The corral, wild animals and discarded female animalsAiden places the female animals some distance away in a heap, as he is placing the wild animals. Their role comes up again in his drawing.

The baby animals are taken some distance for safetyAiden placed all the baby animals in the tip truck. When asked what was happening he said “They are going to a place a long way away, too far to walk, where they will be safe”. This theme was repeated in his drawing. Aiden’s father lives within walking distance of where he lives with his mother.

DrawingAiden

• Aiden was asked to draw a person. • When asked if the person lived in a family he

added five stick figures and described the family of the person in his drawing.

Aiden’s drawing of a person, with family addedNote the use of the page – figures are very tiny with the person more developed than the family. Family were added when A asked if person lived in a family. Genders were mixed up, there is a big sister called Jeremy, a father called by the name of his grandmother with whom he is very close, 2 other sisters with female names, and a mother called by his mother’s real name. All females which is significant. When he grows up he wants to be a girl – or a fairy.

Aiden’s drawing of a person Note: small size but more developed than drawing of family, encircled boundary suggesting protection, has trousers on & genital area covered with cross . The person is called “animal saver” and named Kaden. What will happen?“The baddies will try to follow, but they’ll get too tired and go to sleep, so all the baby animals will come back alive”. Q? ”He saved them by moving babies to a new home so far away that no baddies in the world will get them”.

”.

Play (Structured)Sam

• Age 6 years• Living primarily with mother

Teddy Bear attachment gameSam demonstrated with great assurance that the baby bear preferred to be with his father. This was consistent with all the other information he provided.

• Child is engaged in choosing from a list (appropriate to age and this child) of parental behaviours and allocating one parent as best, or both parents equal - examples:

- who’s the best at cooking dinner- Who’s the best at helping you get ready for school- Who’s the best at listening to you- Who’s the best at telling you off- Who’s the best at helping you with a problem- Who’s the best at being funny- Who’s the best at giving cuddles- Who’s the best at being angry- Who’s the best at fixing sore knees- Who’s the best at being kind- Who’s the best at comforting you when you wake at night with a bad dream Etc.

• This can lead to discussion of direct experiences

• Various other options – use of chart, different colours for different degrees of preference – explored with all contexts of child.

Verbal (indirect information) – a parenting ‘game’

Sam’s answers

• 18 categories in total• 9 - both parents (including some nurturance,

limits/boundaries & negative emotions)• 0 - mother only• 9 - father only (fun, nurturance, emotional

availability. He elaborated (unsolicited) on some later, like father listens to him more and helps him with worries)

DrawingAmy

• Aged 7.5years• Living with father and his parents and adult

brother• Lived with mother until a year ago – a very

close relationship (pseudo-adult)• Mother in new relationship and has moved

away (about 3 hours drive)• Amy is sad and father is trying to arrange

regular and frequent contact with mother

Amy’s drawing of a family doing something The family is at a swimming pool. Father is asleep in deck chair. Mother (see right hand side -hair, arm & foot disappearing through door,) is going to get some sun cream. The girl’s 2 sisters are in the pool, and the littlest one in the paddling pool. Her father has told her to jump in but she says “it is too cold”. Is the metaphor of the cold pool being used to demonstrate Amy’s feelings about living with her father. – the parents behaviour in the drawing reflecting her own parents positions.

Amy’s drawing of a mother and daughter doing something togetherThe girl is at the park with her mother and they are having fun.

Amy’s drawing of a father and daughter doing something togetherThe girl is helping her father in the shed. They get on well together sometimes but they also argue and she feels sad. These drawings appear to illustrate Amy’s feelings, by both visual and verbal means.

Congruency with other informationA “Jigsaw”

• Is this information consistent across the different media? – observed behaviour– verbal information given by child– Indirect information, – information from parents & other sources , i.e. school,

nanny, or significant others• Do all the pieces fit together?– Sam and Amy – were very verbal, all information

consistent across media.

Inconsistencies

• How can differences/inconsistencies be understood?

• Hypotheses? • Is further assessment required?

What Aiden said at times was inconsistent with what he said at other times, and with his play, drawings, observations, and reports of others

Conclusions

• “Listening” to children, observing their different moods, energy levels, degree of relaxation and interaction in different contexts, providing opportunities for them to “say” the hard things through indirect methods, such as drawing, stories and play, give a “picture” of a child in his family, and his view of his world which provides important information for the Court.

REFERENCES

• Henaghan, Mark (2005) “Care of Children” Lexis Nexis NZ Ltd. Wellington

• Oaklander, Violet (1978) “Windows to ouor Children” Real Peoples Press, Utah USA

• Zeanah C.H. (1997) “Relationship Assessment in Infant Mental Health” Journal of Infant Mental Health Vol 18 (2) p 182-197