Emotionally disturbed children, or as they are generally termed nowadays, children with emotional developmental disturbances, are children that live in continuous conflict with their surroundings. Such conflicts may manifest themselves in more or less conspicuous ways. The least obvious category of disturbed children are those who, because of emotional problems, become withdrawn. Such children live for a great deal of time in their own fantasy world: it seems as if they are not interested in their surroundings. Matters enjoyed by ‘normal’ children, do not appeal to them.
A different, easier to recognize form of adjustment disturbance is found in children who are disobedient in more than the usual way. They challenge the surroundings with what is called ‘acting-out behaviour’. This provocative behaviour may also be seen as a way they use to express deeper-lying conflicts. In other children problems are not expressed by the sum total of their behaviour, but by a single aberration in behaviour such as eating, sleeping and training problems, stuttering or thumb-sucking.
Broadly speaking, there are two different theories regarding the cause of emotional developmental disturbances in a child. On the one hand there are experts who consider such problems primarily as ‘congenital’ – which occur as a result of a combination of hereditary qualities and for instance damage to the brain during birth.
On the other hand there are also many experts who contest the idea that such emotional disturbances are a result of disposition. In their opinion they are the result of unfavourable environmental factors: the parents having not been sufficiently capable of giving the child all that is necessary. However, part of such a comparison is artificial: if an emotional developmental disturbance is the result of a certain disposition, then this would make certain demands of the parents that would be hard to fulfil. In other words: there is usually an interaction between disposition and environment. ‘Acting-out’ behaviour
Some children seem to be perpetually intent on challenging their educators. These children are against the ‘system’ and their emotional life seems to be shallow; it is difficult to appeal to their feelings or conscience. In every possible way they try to fend off any feelings, twist facts and blame others; what others would call feelings is called weakness by them. This sometimes inhibited, impulsive behaviour might be explained by assuming brain damage to be the cause. Quite often it also becomes apparent that in the early years of childhood the mother/child relationship was unbalanced. This inhibits the development of so-called basic trust. The child feels perpetually threatened and unsafe and does not learn to be open towards others.
Minimal brain dysfunction
Emotional developmental disturbances may also manifest themselves in children that have a minimal brain dysfunction (MBD), or in other words the so-called ‘odd ones out’. The term suggests that there is always a defective brain function, or even brain damage present. However, in most cases the nervous system of these children functions quite normally. Factors that may play a part in the development of minimal brain dysfunction are the overbearing attitude of the parents, the presence of artificial colourants in food (soft drinks) or too high a level of lead in the air.
The so-called MBD behaviour includes a wide range of behavioural and emotional disturbances, such as concentration problems, hyperactivity, ‘wooden’ movements, tantrums or problems in making and keeping up friendships.
Four to five children in every 10,000 births suffer from autism, a very serious emotional developmental disturbance in which the child lives completely within himself and shields himself from any contact with the outside world.
These children (mostly boys) frequently show as early as during the first few months after birth, that they are not capable of entering into an interpersonal relationship. For instance, the child hardly ever smiles at the mother and also avoids eye-contact, but may be captivated by, for instance, revolving objects or moving shadows on the wall. The development of speech proceeds slowly. Frequently language is not used to say something but as a kind of magic game. Characteristic is the compulsive repeating of sentences the child has heard (parrot’s speech). Mimicry and gestures lack expression. The intelligence of autistic children may vary from very gifted to fairly low. However, because interrelation with other children or adults is disturbed, they will frequently have to find out under their own steam how the world works. Consequently, intelligent children in particular sometimes learn in a very original manner, although their interests are often very limited. The technical abilities of these children are usually the best developed. They often also possess a great sensitiveness for music and for rhythm in particular.
The cause of autism is still largely unknown. It was formerly thought to be the result of a defect in the mother-child relationship, caused by the mother who was described as cool, emotionally defective and very intelligent. This theory has been virtually abandoned, although the manner in which the principal educators react is naturally of importance to the further devel- opment of the child. Sometimes the reaction of the mother or the father is such that it serves to reinforce the denying behaviour of their baby rather than discourage it. Nowadays the cause is first looked for in a combination of congenital disturbances in the child, although these disturbances cannot be identified on, for example, an EEC
Depending on whether the cause of an emotional developmental disturbance is thought to be in the child (disposition) or in the parents (environment), the treatment will differ.
An approach that is too one-sided may obscure the problems. The therapist may only look for the cause in a functional defect of the child’s brain and, therefore, instruct that the child should avoid food that contains colouring matter, or even treat the child with certain tranquillising drugs such as Valium. Such a procedure may make the parents blind to the possibilities of improving their own educational approach.
On the other hand it is possible to blame the parents too emphatically. Nearly everybody feels a sense of guilt when his child’s emotional development does not follow a ‘normal’ course. When parents are told that they treat their child in the wrong way, without telling them that their child too causes part of the problems, the feeling of guilt will only be increased. Most children with emotional developmental disturbances are able to live at home with their parents and have occasional treatment, for instance with the aid of games or behavioural therapy. Frequently it is also necessary for the parents or the teachers to be guided in their relationship with the child. In certain, more serious, cases of emotional disturbance the child may have to be admitted for a longer period of time to, for instance, a special treatment centre.