The question of the criteria to assess the need for judicially separate a child from his parents is a question both relevant and surreal. Indeed, on one side we now have specific indicators that allow to have a margin of reduced uncertainty. On the other hand, we know that these indicators are and will still be long unnecessary for emotional reasons. We will briefly outline these two aspects.
Before entering the heart of the matter, remember three key principles.
1. The separation protects the child physically, but does not deal with the mental difficulties caused by the trauma.
2. The separation, even fully motivated, can be traumatic and harmful in itself if it is not a treatment accompanied, that is to say the establishment of a specific device to listen and support of the child before, during and after separation (Mr. David)(, 1998).
3. There are to many terms of separation, more or less complete and complex.
Add to these principles that we consider that family ties are not good for a child by "gasoline". There are terms and conditions of family ties that allow a child to develop his personality in a harmonious manner, and other modalities of links that cause damage early and extremely serious. A family that "works" well is the ideal environment for a child, and no other "devices" that can propose is able to hold together as well all scalable components of personality (feelings of identity, self-esteem building)(, the ability to control his impulses, to share the fun with others, etc.). Such a family provides the best shoring individuals for access to autonomy. A family that works very hard is even more disruptive or even frankly toxic that the child has with her parents early arm's length, he built should adapt to inadequate exchanges, participate actively without ever find security or appeasement. His identity is woven from the identification of violent parents, abandonnants, crazy.
Such family operation does not allow the child to be empowering for many reasons. In particular, children fear that any movement of empowerment on their part would be felt by their parents as an attack and did result in abandonment, or reprisals, or depressive collapse of a parent too vulnerable. They also fail to be empowering because they have no reassuring internal parental image enabling them to face the world. Many of them will therefore present affective disorders (including violent behaviour) and important intellectuals and will definitely be the responsibility of the company.
1 - The milestones of assessment in situations of parental failure
In some contexts such as serious abuse, proven sexual abuse or neglect which endanger the life of a baby, the need for a parent-child separation is required.
But in other situations where the child is subjected to violence or show of violent or sexual scenes, a parental delirium, of educational neglect important but involving not his life directly at risk, in unpredictable collage and rejection alternating, systematic deformations of his messages, various stakeholders hesitate to take a decision as hard for the parents and themselves. It should be noted that, in the vast majority of these situations, cannot be faulted for these parents intend to make their sick child: whatever their actual harm, it is the result of disastrous childhood they suffered when they were smallwhich prevented them to acquire the minimum parental capacity.
In these complex situations, the content of the various reports and decisions unfortunately often depend on emotional, personal factors to each stakeholder, and the greater heterogeneity prevails in practice throughout the national territory. They also depend on cultural factors regarding the more or less vital place attributed to the family in our society; policies, the parents being voters while children are not; and economic, it is always cheaper to not separate.
Our team, composed of the same caregivers for 23 years, in part specialized in the management of situations of parent-child separation, has resumed all judicial situations that have been entrusted for care in day hospital, or hospital full time, and/or family placement (110 situations) or for expertise (60 situations), and described, thanks to this decline, precise benchmarks for decision support.
Four routes at risk
We first spotted four routes to high risk, which may be the source of major psychological difficulties in children (intellectual disability, abuse, conduct disorder, disorder psychotic, etc.) rapidly irreversible and making impossible any social integration or autonomy.
A child was separated from his family from birth, and then he was placed for 6 months to 1 year in nursery, the time that the situation is assessed, and then placed in foster care. Considered too quickly as protected a child placed in nursery, which is incorrect. Indeed, despite commendable efforts of organization, a good number of nurseries in France do not enough time to individual relationship extended with an adult of stable reference offer. This deficiency is itself at the origin of important personality disorders, in particular of instability psychomotor crippling, disorders that appear in their magnitude, when the child is a little more about two, three years old, so out of the institution.
The child was removed semi-early family, between four and twelve months and then placed in foster care. It notes that these children, whose mothers had massive psychic disorders, often already very significant behavior problems suffer up to autistic traits. These personality problems will hinder the insertion in a potential host family.
The child was withdrawn early and then placed in foster care with attempts to return to the parents every weekend, or whenever the latter give an appearance of normality by delivering to live as a couple after to be separated, by moving to a more correct apartment, by enrolling in a job (which shall not be required), or by announcing that they will see a psychiatrist.
These returns prevent the child, who is permanent pending review his parents, of real emotional connections with her foster family. In addition, it is common, although non-constant, that his mind is "contaminated" significantly whenever he meets her parents without be protected, i.e. non-publicized visits without the presence of a third party, (Mr. Berger, c. Rigaud, 2001). We call contamination the fact that the child is a resurgence of his mental disorder or his learning difficulties after having been in contact with his parents (Mr. Berger, 2001). This can occur even if they had an adequate educational attitude at the meeting. What are images of the past ressurgies on this occasion that caused this aggravation.
The child was removed late, after the age of two to four years. Behavior disorders are then often massive, although consistently underestimated by a good number of social workers or educators providing family follow-up.
Three groups of indicators
We distinguish three groups of indicators (or milestones) to assess the need or not separation: those concerning the psychological structuring of parents (four milestones), those dealing with the manner in which parental pathology occurs in the parent-child interaction (eight milestones), and those relating to the manner in which the child reacts (seven milestones). This work was published in its entirety Mr. Berger (b 2001), and here we just give a few principles, while knowing that the particularity of each situation must be taken into account.
Some of these milestones have an absolute value: they sign that the situation requires a separation because it is very dangerous for the emotional and intellectual child development. Other milestones were a relative value: they constitute important alarm signals. We here give their enumeration, not detailing what an example in each group.
(A) milestones concerning the psychological structuring of parents
Example A1: the presence of maternal mental disorders important and chronic with elements delusional type persecution, influence, auditory hallucinations, melancholic type depression syndrome, especially as the child is involved in the delirious process and the object of massive projections. There is that what matters is not only the diagnosis of mental illness of the parent, but also the manner in which it affects parenting and speaks to the child. This operation requires a withdrawal of the child even if the mother accepts home visits and presents a certain degree of collaboration. We hear often from stakeholders that a baby is too small so a separation to be issued at this time, even when they find totally aberrant mother-child interactions. It is a mistake, because we know with certainty that when damage psychic will appear in children, they will be particularly serious.
Only the meeting of three conditions (child not involved in maternal delirium, presence of a father very good mental health and a specialized team of well trained and able to quickly locate the appearance of pathological mental processes set or a judgment of development in the baby) should suspend the immediate need for a placement. Nevertheless, this suspension application that is at the same time exerted a continuous vigilance.
(B) milestones concerning the parent-child relationship
Example B1: the parental couple cannot maintain that briefly identification to the physical needs of his child. It is here all the "clinic of the real" concerning the neglect and chronic deficiencies: failure to comply with the rhythms of sleep and feeding of the child, undernutrition, lack of cleanliness, clothes not changed, uninsured essential medical care, small child left only prolonged(, etc.). In this context, it is not a problem of poverty, but a failure of parent to decentre self-esteem to worry about the child and meet its signals.
These references must absolutely be evaluated objectively, not infiltrated by affectivity of the intervener.
In addition to a possible developmental disability, children subjected to this kind of parental behaviour will develop processes of defence deal with unpredictable, inconsistent environment, abandoning, sudden, or even painful: systematic attacks of any proposed link, refusal of any dependencewhich prevents proposed learning, "particularities" explosions, psychosomatic disruption fears massive abandonment, until, in the most serious cases, autism spectrum disorders.
Milestone B2: the parent presents an inaffectivité and an inability to have emotional exchanges with her child, by the look, speak, sometimes touch (absence of stimulation, of exchanges, given bottle stalled by a cushion, etc.).
Milestone B7: parent-child relationship harmonious érotisée involving the genitals.
Milestone B8: parents of extreme violence, even without blows.
(C) milestones concerning the reactions of the child
Example C1: the evaluation of the quotient of development (up to three years) and the quotient (after three years).
It is one of the most important milestones. Long disparaged because they might make the child prisoner of a diagnosis of intellectual disability (this is a "weak"), the level tests have yet irreplaceable value. Indeed, they show how the intellectual capacities of the child under the influence of its environment have evolved if one accepts that he is born with normal intellectual potentialities. They are an accurate indicator of a harmfulness of environment requiring separation.
Too easily forward the idea that, in such contexts, the intellectual disability is due to a family environment "frustrating" and insufficiently stimulating. The reality is another: our long experience of land leads to the hypothesis that these children stop to not suffer, because thinking is too scary for them.
Another interest of these tests is to show whether the forms of support proposed subsequently are effective: If this is the case, they must be accompanied by a gradual rebound in intellectual performance.
Do not measure the development quotient or quotient, i.e. not to give this simple way to evaluate the results they produce, causes legal, educational, social and health institutions to reproduce the same possible inadequate functioning permanently.
Milestone C2: onset of autistic and psychotic disorders.
Milestone C3: presence of contamination processes (recurrence of serious behavioural disorders in children in contact with his parents).
(D) related milestones mean that there is a very worrying situation.
Finally, include some related milestones which, as we have indicated, mean that there is a very worrying situation.
A2: Psychopathic behaviour of parents with a wandering in all its forms.
A3: parents do not controlling their impulses.
A4: parents unable to accept the lesser share of responsibility in the current situation.
A5: the tempted supported previously ended in failure.
A6: aid has been accepted, but after a reasonable time of intervention, no significant change has emerged in the educational and emotional parental attitude.
B3: the parent has massive projections that result in an inability to represent her as different child self-esteem.
C3: the presence of significant psychomotor instability.
It should be added that some situations are limits, and that it is impossible to decide. Then, there is no alternative to propose the most coherent possible support and to be sensitive to the potential signs of evolution to fixed childhood disease.
These indicators have been validated by our practice, but also by the fact that they cut those used by many specialized services in support of early parenting failures and parent-child separation situations: we refer here primarily to services anglophones (P. Steinhauer)(, 1996). Can be considered that the fact that no other French specialized centre did such work is significant in itself. It is as if it was impossible to establish a genuine knowledge and experience that could bring thousands of longitudinal follow-ups were thus wasted on behalf of the "culture of uncertainty" that reigns in the field of the protection of the child ("in any manner")", there is no certainty on what for a child, nor sufficiently precise criteria to evaluate whether to separate it from its parents").
2 - The uselessness of these indicators
Although we consider that there is currently a scientific knowledge concerning the identification of situations which require an investment, we see that terms of reflection that we propose are little exportable outside labour relations that we have woven over time with a few magistrates. Therefore, we present these milestones only as a testimony of how a team can reflect on the problem of the placement. Indeed, a second issue shows the true dimension of the problem: why is there not in France for evaluation of the results obtained by the different modalities of support in the field of the protection of the child (AEMO, placement with complete or partial separation), taken in various therapeutic support, with a comparison with the starting balance? Or, otherwise, said then that we entered a period of rigorous budget, why not-a-there no evaluation of the results obtained with the 30 billion francs (2001) spent on the protection of children in danger?
Some evaluations are bewildered:
In a study carried out in our service, 77.2% of the children separated judicially had an intellectual disability with an IQ between 75 and 54 at the time where they were addressed we care. In almost all cases, this assessment of intellectual development had not been completed previously and it is our team that it conducted on admission in our service.
A research on the fate of the children of social assistance to childhood adults shows that only 32 per cent have a certificate of professional competence or a higher diploma (f. Mouhot, 2001).
A departmental Directorate nursery welfare indicates that at least 95% of children who had to be separated from their parents in the first months of their lives and were then in their family must be again separated judicially in the following years, this time in a prolonged manner, and that they then present important psychic disorders. The interest of this study is to show that even when the need for investment is evaluated appropriately, this does not mean that the assessment of the possibility of return to family be conducted adequately (unpublished).
Another study in progress in our service shows that 90% of situations of pre-teens aged 10 to 14 years, with an individual "hyperviolence" (which is not the same as the gestures violence of the "sensitive suburbs"), one of the determining factors of this pejorative evolution was a too late decision of parent-child separation.
The causes of that need well accept call one day the failure of the protection of children are many, but one of them occupies a predominant place: the ideology of family ties. We thus call a theory and a position of principle that the maintenance of the physical link between the child and its parents has a value of absolute and untouchable. Any professional situations of significant parental educational mismatch feels a tension within him between the child identification and identification with the parent. The ideology of the family relationship is at work when occurs a mass identification to the suffering of parents over the identification of suffering and terror felt by the child in their presence. One is then considered violence is for parents separation, at the expense of violence experienced by children in these situations. But this fact to focus on parents is not even recognized as such: it is common that it houses behind the alleged need for the child to remain with his parents. For reasons that we don't know, this ideology is extremely common in France.
Yet, in other countries, judges of children themselves are positioned differently, which confronts us without escape to modes of thought which we do not have. Thus in Quebec, there is a significant case law indicating that "decisions relating to the placement of the child must meet the need for continuity of the relationship of the latter, reflect the notion of time of the child, not that of the adult", following the conclusions of the report Jasmin (a judge of the Quebec children). In a 1983 decision, the Supreme Court of the Canada indicates that the Act no longer considers that children are the property of those who gave them life but looking what suits them best, acknowledging that children have needs different and sometimes irreconcilable with desire or interest (root) of their parents C. Woods, 1983, 2RCS, 173-184). Yet another word, it is indicated that "the mere evidence that parents are capable of exercising parental authority does not necessarily an immediate return of the child with them". "It is true that the law gives preference to family ties but this must not go against the development and the development of the child" (J.F. Boulais, text annotated the child protection Act 1994). In 1997, in respect of a judgment concerning a child of three years and a half placed since the age of one month and a half in foster care, it is accepted in Canadian law that the judge has the possibility to decide on a stable life project in a foster home for a child until his majority"this security can be disturbed by a deadline of three or five or ten years for a judicial appointment" (case Samuel v., 11.07.1997, Court of Quebec, the Youth Division). Decisions are sometimes supported on orders of thirty pages, with a comparison precise between the jurisdiction of the various experts, the number of situations they have taken close to that for which they are invited as experts, supports their work (Mr. Berger)(, C. Rigaud, 2000). Thus, even when the notion of physical, educational, or moral danger, fades, that stability of the link persists because the rupture of a highly invested and safe emotional connection is in itself a significant danger to a child's development. It is sufficient to measure the benefit of this way of thinking, to remember the enormous emotional knocks and the magnitude of the sense of insecurity experienced by many placed children, before each hearing where the judge must decide whether or not they need to leave their homestay familyWhile their parents have not changed their educational attitudes.
North Italy, for example in six courts of Milan, seriously inadequate parents are:
be deprived for at the outset of their parental rights; and their child is placed in adoption if after careful the situation assessment they don't seem to be able to evolve into the acquisition of jurisdiction sufficient parental.
be separated from their children for six months; a device is then proposed to massive manner during this period; then a new assessment is then made, after which can be decided a move to the first alternative (forfeiture-adoption) If parents were unable to develop minimum parenting process. And yet, the Italy is the country of "mama".
Can discuss the disadvantages and the merits of each legislation. But the most interesting is how representations of the concrete material link biological-child parents, lived as unassailable certainty, in France are in fact of a total relativity. Also measure how the Act affects our way of thinking. These examples come from abroad leads us to believe that everything happens as if, in our country, the parent-child relationship was the subject of a respect for "religious". Sacred text that embodies this dogma is the Act of 1970 on "educational assistance", centred on the relationship of the child with its parents, it is intended to safeguard, while seeking to protect the child. But it does define a way very unclear what is an appropriate educational measure, and that evokes the notion of danger and severely compromised education (unlike Italian and Quebec legislation cited above that they really focus on the child). The 1970 Act is applied in a very common way with familialist ideology, the question that invades professionals being "how to ensure that the child remains in his family, was - this at a price of considerable psychological damage, or returns (for a longer or shorter duration)"? While the permanent and essential question should be: "of what capabilities (intellectual, emotional, relational) a child shall be provided to carry out an existence roughly normal, happier, or more unfortunate than the average." And from there, what is the relational system that will best to approach this goal?
We use the term of "religious" in the sense where it is a point of view that did not, discuss perhaps by implicit reference to respect for "sacred" should be "maternal instincts". This dogma must be applied, as various ministerial statements regardless of the Government of which they arise, there no need to be proven, it is located in a different register than science, , and therefore its results did not need to be evaluated. Is known created damage to individuals whenever a religion becomes State religion, and this is the case here. Any State religion fully assume a share of ignorance in this case, for all the work on early attachment and how children develop very quickly and often irreversible of affective disorders and intellectuals.
3 - The responsibility of stakeholders
A lucid and coherent Professional with himself will seek to offer the child an ability to think for himself, so that it can acquire the autonomy that will be indispensable in its existence... If this requires the establishment of an investment, it will seek judges, but by being aware that the placement is not in itself sufficient. It will also help the child cope with fears of abandonment, loneliness, and implement a "counterweight" to the idealization of any topic parents is obliged to implement when it depends on adults too agonizing and which do not support to be criticized. This "counterweight" is based on three major tools.
Offer the child a link stable, reliable, continuous (which lack most in the protection of the child device) with an adult.
Protect the child from the movements of uptake and aspiration (Mr. Berger, 1997, 2001) which he may be in contact with his parents, putting in place of the publicized visits if necessary (Mr. Berger, C. Rigaud)(, 2001).
Propose a device listens on an extended period, the child which requires special technical conditions. When we offer a place to listen to separated children, they express thoughts in which they reveal their intense fears from their parents, their sense of confusion, discomfort in their presence, but we ban talking about them and the judge so their fears are important (cf. Mr. Berger)(, 2002). Reveal what the children entrust us would implement confetti the 1970 Act.
This individual listening of the child is lacking most in the institutions. Funding for the supervision of the listeners should be a priority.
We insist on the following point: for almost all of the children in our care, from a psychological point of view, the separation is not experienced by them as a failure. These children maintain a psychic with their parents, a red wire untouchable even link when the physical link is spaced. Do not live with her parents cannot be equated to be cut off from them. The link is maintained, but the child is not immersed in pathological and désorganisatrices interactions. Furthermore, these children evolve sufficiently to be able, within a few years, to visit their parents without our presence, and without feeling threatened by the psychological difficulties of the latter. But they do not wish to return to live with them. This ability not be disrupted by contacts with their parents is that they can really take advantage of the healthy part of their father and their mother, while this is not the case of many children who were left of manner in contact permanently with their parents, who live almost never a good time in their presence in such a context.
Despite these results, we find that the emotional movements triggered by such situations among professionals concerned all goals available criteria as long as these stakeholders will not meet a legal underpinning, and therefore social and groupal, enabling them to think otherwise. It is the only element that will allow a professional to have the ability to support the conflict, confrontation, and this not only at the time of the decision, but in the long term. For the moment, apart from rare exceptions, all the institutions concerned can only repeat the same positions subjective and non-evaluated, only the word being "revamped".
The future of the child protection is based on the placement of children of judges, on the one hand because they are independent, in particular from ideologies emanating from the policy, on the other hand because they are best placed to find the mismatch of the Act and the manner in which they often "writhing" the psyche of the child to enter hard in the current legal framework. The question may seem irreverent, but still deserves to be asked: why judges of children to submit Act? We want to mean by that that the issue is not "How to interpret the law?", but "that is what prevents the evolve." Yet would an application from judges of children, and to make the law a living Act, which changes our knowledge as the other laws, not likely to be taken into account? Only judges can impose more requirement in the balance sheets and results, ask their partners to be more clinical rigor and to be more attentive to the difference between the capacity for change of the parents and the current needs of the child. Before reports very unclear or subjective, it is probably difficult for a magistrate to form an opinion. Moreover, it cannot leave aside the question: far can apply to an individual, he was judge of support alone throughout the day conflict level important? The usual role of a judge is to arbitrate conflicts, to be the representative of the statutes enacted by the representatives of the company, while the children judge, whether he likes it or not, often involved in the conflict with parents when it takes an educational measure or placement. Would it not be interesting that a collective judicial device to invent is implemented for certain situations?
The issue of investment indicators is inseparable from many other issues: what balances offer the child to the idealization of the parents? Will what listening device put in place? What adult will be the stable referent of the child before, during and after separation? What benchmarks will be used to assess whether the implementation of profile visits is necessary? What specific means give to assess progress or the lack of progress of the child? And most importantly, two questions:
What objective is actually covered by the investment? It should be used to help the better psychological growth of the child, and to be sure, we need to give us consistent follow-up and clinical evaluation means. But from our point of view, it cannot have a priori purpose concerning his fate. The risk, if asked at the outset is the return of the child in his family, is that any clinical reading family interactions and behaviour of the child is abraded and oriented.
If a long placement is necessary, will stability possible despite the change of judges, the potential positioning of the Court of appeal? Currently, a "from the right" judge may break the consistency of the device. If we are going after a certain procedural rigour, the surest way to know whether a child separated from his parents is still in danger after a certain time of placement, is to put it back in its natural environment and observe what happens. Not only the failure of this return is very common, but on this occasion, many children, removed from a home environment where they felt safe, lose confidence in protective society capacities, to the point that they will never again invest other home sites will be proposed to them.
In no other area there is a such hiatus between the knowledge acquired and the decisions taken.
Bibliography
Berger M.
1997, The child and the pain of separation: divorce, adoption, placement. Paris, Dunod.
a 2001, live with crazy parents or ill-treated, Groupal, no. 9, pp. 57-70.
2001 b, milestones of evaluation of the Bellevue Hospital for parental failure situations, Dialogue, 152, p. 33-62.
2002, The failure of the protection of children in danger, or the change impossible. Being published in fate.
Berger M., Rigaud C.
2000, Are the Act and the psychic development of the child always compatible? The children's professional Journal, no. 5, 63-66.
2001, Publicized visits. Journal of Neuropsychiatry of childhood and adolescence, 49, pp. 159-170.
David M.
1998, The family placement. Practice theory. Paris, ESF.
Mouhot F.
2001, The fate of the children of social assistance to childhood, become, 13, 1, pp. 31-66.
Root c. Woods
1983, 2RCS. 173-184
Steinhauer P.
1996, The lesser evil (Chapter 5). Paris, Gaëtan Morin éditeur.
Maurice BERGER
Professor of psychopathology of the child at the University Lyon II, head of Psychiatry of the child to the CHU de Saint-Etienne
Article published in the Journal of the right of young people - N ° 212 - February 2002
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