Think of the Little Ones

After years of teaching teenagers, doing youth work with teenagers, and volunteering with teenagers who had been raised in Romania's orphanages, I chose to foster babies and toddlers. The trainer on my Skills to Foster course was incredulous. "Why, with all your experience, are you not fostering teens?" she asked.

The answer was simple and, to me at least, obvious. I had seen too much of that end of the spectrum, too much of the results of things that had gone wrong for children long before I met them. I had read a little about the impact of early childhood trauma, the effects of neglect on the developing brain, the importance of secure attachments, and I hoped to do what I could for children at the very beginning of the process. Perhaps what little I could do might begin to ameliorate some of the effects of their experiences, and help to secure an easier future than so many of the abandoned teens I had met were experiencing.

I was probably, no, definitely, naive. But I still think that fostering infants and toddlers is a serious job, requiring a unique skill set. A growing body of research indicates the importance of getting it right in the earliest months and years. Some of the children who have come to me have already displayed obvious signs of difficulties arising from their early experiences - anxiety, lack of stranger danger, problems around food, destructive behaviours, meltdowns, night terrors, excessive clinginess, violent outbursts - I could go on. But even for those little ones who present as 'normal', there is no guarantee that there will not be difficulties later in childhood.

It seems obvious to me that early intervention is better than waiting until crisis point and then trying to unpick years of difficulties, behaviours and thought patterns that are thoroughly entrenched.

It seems obvious to me. But not, as it turns out, to everyone. Two comments were made to me in the past two weeks that showed that an understanding of the effects of early neglect and abuse and broken attachments is not as widespread among professionals as I imagined.

Firstly I was at a meeting for foster carers where the allowances structure was being discussed. Here, carers receive a basic allowance for each child, varying according to age, and then a skills payment based on what the carer themselves brings to the table in terms of experience, qualifications, etc. The highest skills level is level 4. This level is not available to carers with children under 5. The explanation was simply that, "obviously", these very young children don't have the level of needs that an older child would have. Level 4 is reserved for those caring for children who have been assessed as having significant additional needs.

Now, I understand that a tiny baby may not display signs of significant additional needs (unless they are withdrawing of course - not uncommon!), but surprisingly young children (yes, even toddlers!) can show very clear signs of attachment disorder and other difficulties arising from their early life experiences. In her book "Why Can't My Child Behave?", Dr Amber Elliot suggests that neurological changes in a child's brain caused by early neglect can be evident from as young as six months. Certainly, three and four-year-olds can display extremely challenging behaviours! If a child is self-harming or throwing furniture, their age is only relevant to the amount of damage they can do, not the amount of need they have.

The second comment was made by a Health Visitor, lamenting with me that more couldn't be done for these traumatised little ones. She told me that CAMHS in our area does not accept referrals for children under 5. A light bulb went on in my head. It's so easy to imagine that pre-school children do not have significant additional needs if they are never assessed in the first place.

I take preparing children for permanence extremely seriously. Many of my foster children will go on to adoptive placements. Adopters should know that any child under 5 coming from my LA (and I'm sure it's not the only one) will not have been seen by a children's mental health professional. Any assessment of their attachment or their emotional needs will be coming from the social worker with input from the foster carer. Now, I have done some research, and social workers are not ignorant, but in my opinion, the input of a qualified psychologist or similar would be appropriate in some cases.

Adopters taking children from my LA should also know that therapeutic work will not have been carried out with the children. Their foster carers will not have been trained in any such techniques, beyond the most basic courses on attachment. We will all have relied on love, security, routine, boundaries and 'good enough' parenting - all good things in themselves, but are they enough? Some adoptive parents will later find that the answer is "no".

I'm sure money, as always, is a factor. But, not only does this collective blind eye do the children a disservice, it seems to me that it is also inefficient. If the foundations are faulty, a building will fall. Surely it is easier and more cost-effective to attend to the foundations before the building has gone too far, than to wait until later and have to unpick layers and layers of unstable brickwork?

However naive, I still hold on to the hope that foster carers doing the 'easy' job of caring for the little ones are, in fact, sowing something good into a child's life that will one day bear fruit. Nearly five years in, I'm not sorry I made the choice I did, but I wish I could do more.