Child development and parenting capacity
Although parents have needs in their own right, here we are concerned with the impact of parental substance use on the child.
Cleaver et al. (1999) reviewed the factors that place children at more or less vulnerable to the behaviours that result from their parents' problems. Their review was confined to the findings from research. This means that factors identified from clinical and professional practice were omitted.
In the following extract from Cleaver et al. (1999), only the effects of parental drug and alcohol use on the child are included. They point out that it can be difficult at times to distinguish the effects of substance use from the effects of mental health (e.g. where there is co-morbidity or a dual diagnosis) and domestic violence (e.g. where violent behaviour stems from excessive alcohol use).
It is recommended that those directly concerned with addressing children in need and child protection, should obtain Cleaver et al. (1999):
Cleaver, H., Unell, I. and Aldgate, J. (2000). Children's Needs - Parenting Capacity: The impact of parental mental illness, problem alcohol and drug use, and domestic violence on children's development. London: The Stationary Office.
The edited extract below is included for educational urposes, and as a 'taster' to go out and buy the book.
The age ranges have been divided in the effects upon:
Pre-birth - 2 years old
Key problems/risks
Health
- Foetal damage brought about by intake of harmful substances. The impact will depend on which substances are taken, the stage of the pregnancy when substances are ingested, and the route, amount and duration of substance use. Moderate regular alcohol or drug use may be less harmful than binge alcohol or drug use, which can place the foetus at risk from sudden withdrawal.
- Spontaneous abortion, premature birth and low birth weight, and still birth.
- Babies suffering withdrawal symptoms from foetal dependency may be difficult to manage.
- Drugs and alcohol use may have caused neurological and physical damage to the baby.
- Babies may be neglected physically and emotionally to the detriment of their health.
- Living in an impoverished physical environment may exacerbate the child's health problems.
Emotional and Behavioural Development
- A lack of commitment and increased unhappiness, tension and irritability in parents may result in inappropriate responses which lead to faulty attachment.
- Different strangers caring for children at different times can lead to insecure attachments.
Identity
- Children may fail to develop a positive identity because they are rejected and are uncertain of who they are.
Protective factors
- Good regular antenatal care.
- Adequate nutrition, financial support and housing for the expectant mother.
- The avoidance of viruses, unnecessary medication, smoking and severe stress.
- The presence of an alternative or supplementary caring adult who can respond to the developmental needs of the baby and support the mother.
- Sufficient financial support and good physical standards in the home.
- Regular supportive help from primary health care team and social services, including consistent day care.
- Appropriate mentoring for new mothers to show them how to look after children.
- Appropriate parent and toddler groups.
3 - 4 year olds
Key problems/risks
Health
- Children are placed in physical danger by parents whose physical capacity to care is limited by excessive drinking or drug use.
- Children may be subjected to direct physical violence by parents.
Emotional and Behavioural Development
- Children's cognitive development may be delayed through lack of stimulation and/or interaction with the parent, disorganisation and failure to attend pre-school facilities.
- Inconsistent parenting may damage children's attachment.
- When parent's behaviour is unpredictable and frightening children may display emotional symptoms similar to those of post-traumatic stress disorder
Self Care Skills
- Children may be at risk because they feel unable to tell anybody of their distress.
Other
- Children may have their physical needs neglected, e.g. they may be unfed or unwashed.
- Children may take on responsibilities beyond their years because of parental incapacity.
Protective factors
- The presence of an alternative, consistent caring adult who can respond to the cognitive and emotional needs of the child.
- Sufficient financial support and good physical standards in the home.
- Regular supportive help to the family from primary health care team and social services, including consistent day care and family assistance.
- Regular attendance at pre-school facilities.
- Good routine in the household around mealtimes, bedtimes etc.
5 - 9 years old
Key problems/risks
Health
- Children may be at increased risk of physical injury and show symptoms of extreme anxiety and fear.
Education
- Unplanned separation can cause distress and disrupt education and friendship patterns.
- Academic attainment may be negatively affected and children's behaviour in a school may become problematic.
Emotional and Behavioural Development
- Identity, age and gender may affect outcomes. Boys more quickly exhibit problematic behaviour but girls are also affected if parental problems endure.
- Inconsistent parenting may cause anxiety and faulty attachments.
Identity
- Children may develop poor self-esteem, and may blame themselves for their parents' problems.
Family and Social Relationships
- Children feel embarrassment and shame over parents' behaviour. As a consequence they curtail friendships and social interactions.
Other
- Children may take on too much responsibility for themselves, their parents and younger siblings.
Protective factors
- Children have the cognitive ability to rationalise drug and alcohol problems in terms of illness. This enables them to accept and cope with parents' behaviour more easily.
- The presence of an alternative, consistent, caring adult who can respond to the cognitive and emotional needs of children.
- Sufficient income and good physical standards in the home.
- Regular supportive help from a primary health care team and social services.
- Regular attendance at school.
- Sympathetic, empathic and vigilant teachers.
- Attendance at school medicals.
- A supportive older sibling - older siblings can offer significant support to children particularly when parents are overwhelmed by their own problems.
- A friend - Children who have at least one mutual friend have been shown to have higher self worth and lower scores on loneliness than those with out.
- Social networks outside the family, especially with a sympathetic adult of the same sex.
- Belonging to organised out-of-school activities, including homework clubs.
- Being taught different ways of coping and being sufficiently confident to know what to do when parents are incapacitated.
- An ability to separate either psychologically or physically from a stressful situation.
10 - 14 years old
Key problems/risks
Health
- Children have to deal with puberty without support.
- Children may be at increased risk of actual injury.
Education
- Children's education may suffer because they find it difficult to concentrate.
- Children may miss school because of looking after parents or siblings.
Emotional and Behavioural Development
- Children may be at increased risk of psychological problems.
- Children may be anxious about how to compensate for physical neglect.
- Children are at increased risk of emotional disturbance and conduct disorders including bullying.
- Children may be in denial of own needs and feelings.
Identity
- Children may reject their family and have low self-esteem.
Family and Social Relationships
- Children are cautious of exposing family life to outside scrutiny.
- Friendships are restricted.
- Children may fear the family will be broken up.
- Children may feel isolated and have no one to turn to.
- The problems of being a young carer increase.
Protective factors
- Sufficient financial support and good physical standards in the home.
- Practical and domestic help.
- Regular attendance at school.
- Sympathetic, empathic and vigilant teachers.
- Regular medical and dental checks including attendance at school medicals.
- Factual information about puberty, sex and contraception.
- Belonging to organised out-of-school activities, including homework clubs.
- A mentor or trusted adult with whom the child is able to discuss sensitive issues.
- An adult who assumes the role of champion, is committed to the child and 'acts vigorously, persistently and painstakingly on their behalf'.
- The acquisition of a range coping strategies and being sufficiently confident to know what to do when parents are incapacitated.
- An ability to separate either psychologically or physically from the stressful situation.
- Information on how to contact relevant professionals and a contact person in the event of a crisis regarding the parent.
- Unstigmatised support from relevant professionals. Some children derive satisfaction from their caring role and their responsibility for and influence within the family.
15+ year olds
Key problems/risks
Health
- Teenagers may have problems related to sexual relationships.
Education
- Teenagers are at increased risk of school exclusion.
Emotional and Behavioural Development
- Teenagers have inappropriate role models.
- Emotional problems may result from self blame and guilt, and lead to increased risk of suicidal behaviour, and vulnerability to crime.
Identity
- Low self-esteem as a consequence of inconsistent parenting.
Family and Social Relationships
- Increased isolation from both friends and adults outside the family.
- Teenagers' own needs may be sacrificed to meet the needs of their parents.
Other
- Poor life chances due to exclusion and poor school exclusion.
Protective factors
- Sufficient financial support and good physical standards in the home.
- Practical and domestic help.
- Regular attendance at school.
- Factual information about sex and contraception.
- Regular attendance at school or a form of further education.
- Sympathetic, empathic and vigilant teachers.
- For those no longer in full time education, a job.
- A trusted adult with whom the young person is able to discuss sensitive issues.
- An adult who assumes the role of champion, is committed to the child and 'acts vigorously, persistently and painstakingly on their behalf'.
- A mutual friend; research suggests that positive features in one relationship can compensate for negative qualities in another.
- The acquisition of a range coping strategies and being sufficiently confident to know what to do when parents are incapacitated .
- An ability to separate, either psychologically or physically from the stressful situation.
- Information on how to contact relevant professionals and a contact person in the event of a crisis regarding the parent.
- When young people act as carers, and experience a degree of satisfaction and control this may act as a protective factor
- Unstigmatised support from relevant professionals who recognise their role as a young carer.