Assessment and intervention in Clara's child abuse case

Child Abuse in England

Initial Information

The bruises on Clara's upper arms are indicative of something serious that the health visitor, if she, indeed, has been seeing her for two and a half years, should have noted or anticipated. The account given is so scanty that the general information can hardly be gleaned. The other family members should have been asked or given in the account, even if the health visitor does not know the family very well. The barest family statistics could still have been obtained.

Besides Christine, who are the other adults in the family? And how many more children are in it? What is the socioeconomic status of this family? Its culture mix? Christine's educational achievement, her family and work background, her current aspirations and view of her present condition must be obtained. So too the views of the other members be secured.

The bruises on Clara's shoulders would not be visible if the pressure were not hard enough to imprint and create the bruises. It may or may not be the first time to be impressed, the likelihood is greater that this is not the first. The health worker should not have advised Christine to just walk away from Clara if the girl frustrated her or Christine would lose her temper. At Clara's age, leaving her alone can be dangerous and children her age are really difficult to manage. They need much guidance at this age and should not be left alone. What the health worker should have told Christine was to confine her disapproval to Clara's wrong acts out of discipline and not out of revenge or desire to inflict pain.

The head or breadwinner of the family should be sketched out. What does he do? What is his behavior towards his wife and each of the children? What is his family background? Is he aware of the bruises found on Clara's shoulders? It is unlikely that he is completely unaware of the tensions occurring in his own household. He should be asked for his reaction towards his own household. Check out if he is married to Christine or just living with her and the children.

More information should be obtained on Christine's family and work background, her accomplishments in school or work, where she has worked and the things she does at home on a routine basis. If she is responsible for the bruises on Clara's shoulders, she should explain thoroughly why she did the bruising.

Assess the physical environment of the home. That environment is a clear witness of the family's conditions. There need not be costly furniture, appliances and other items. The orderliness and cleanliness of the place will reflect the state of the occupants. It will also reflect the kind of nurturing Christine gives it.

Find out what Christine's personal aspirations are, her chronic frustrations, her joys, her wraths. What does she feel for her husband? What does she feel for each of the kids? Find out how extensive or deep her awareness is of the condition of each member of her family and how much they contribute to one another's fulfillment or frustrate it. Elicit the basis of her impatience. Explore the ground for her insecurity and displacement.

Ask Clara about the bruises. Ask her what she feels about them. Ask her who are kind to her and who are not kind to her. She may or may not supply the information asked, but observe what her non-verbal responses say, because they contain more truthful answers than those she can manage to verbalize. When she is unable to answer, offer guesses. Read between her lines. Ask her to talk about her older siblings, if any. Induce her by asking what her favorite toys are and what she enjoys most doing. With whom does she do these? Discover the other sibling or siblings. Ask the same questions asked of Clara.

Ask the neighbors, too. What do they notice about the family? Surely, they know the other members. What do these neighbors observe? How long have they been living nest or near the family of Christine? What do they perceive from Clara's case? Are they friendly to Christine and her husband? Why or why not?

Child Protection Plans

1. teachers - in the case of Anthony. His behavior with classmates should be observed and measures taken in order to curtain or curb their worsening criminality. If he has been absent or unable to participate in class actively, his teachers should be advised so they can extend him support. His classmates involved in the rowdy or illegal activities should be checked, too.

2. social and health workers - should talk more intensely and searchingly with all the members, incline them to open up to those offering support and to other members of the family. Conduct the intensive educational and guidance/motivational measures already suggested. Inform Christine and Dennis about what the law provides or prohibits, but without challenging or threatening them. Work along their common goals of family peace and happiness and personal openness to one another.

The two children should be regularly checked by a dietitian as to the surging nutritional needs and work for their sustenance, if there is any problem in this area. Although there are no other lesions seen on Clara, there can be other unseen symptoms of deprivation or neglect by Christine through the years.

3. medical and legal personnel - The two children should be routinely checked up by doctors and treated for any infections or deficiencies, which they are likely to have. Anthony should be examined for smoking, alcohol and drugs, although he may be too young for these. He should be counseled against stealing or taking part in such activities by citing the law.

Christine and Dennis should receive the rudiments of information on responsible parenthood: how Dennis can be a father to Anthony and a balanced real father to Clara and how Christine can be a true woman and mother to both children. They should also be taught how to develop a lasting relationship by being aware of each other's needs and knowing how to fill these.

4. NGOs - should hold regular meetings and community affairs, putting problem families together and having successful families talk to them. There should be an open house and free-wheeling guidance sessions where cases like Christine's occur.

These NGOs should also make available educational, medical, nutritional, physical and social resources that can help fill in gaps.

5. psychologists, dentists and other professionals - They are parents themselves and know what each member of Christine's family may feel. Psychologists can offer free and ready help to read what lies behind the behavior each member of Christine's family and incline each of them to understand the rest. Dentists can help track down which patient (young and old) sustains dental injuries likely caused by domestic abuse. Journalists can write more about anonymous cases and call for greater awareness and public support as well as support from the government and the private sectors.

6. personal support - Much can be gathered from this sector. Beryl and her husband can be encouraged to make it up with Christine. They were able to show their importance when Christine had the original break with her parents and her first boyfriend. They provided Anthony with the much-needed emotional support, which he needed at an early age. They can make up with Christine, rather than perpetuate the hostility or apathy.

Christine's parents can be tapped, as far as possible. They should be made aware of, and their sympathy elicited for, the consequences of Christine's having left home, and the wrong options she was compelled to take because she was too young to have any other. Now is the time for them to be of assistance and cooperation. The same urge call should be made to Dennis' family.

Both Christine and Dennis must have friends they call on or see. They too must be gathered or sounded off to help buoy up the spirits of the family and be part of a concerted action to prevent this family from breaking up as well as help make it survive and last.