‘Soft signs’ of abuse – a step too far?

• 26 February 2017
• Jane Evans
• no comments

Will soft signs help or hinder?

As part of a consultation requested by the Department for Education and Department of Health, NICE National Institute for Health and Care Excellence has recently put out information for professionals who work with children, on paying attention to certain ‘soft signs’ of changes and distress in children’s behaviour. NICE is proposing that these MIGHT indicate that something is wrong in a child’s daily life. It has been causing a real stir on social media for parents, carers and many professionals as they feel ill-equipped to work out normal child-like distress, as opposed to possible ‘soft signs’ of distress. This is NOT surprising!

Knowing about signs of anxiety or trauma?

In the course of speaking, training and writing about anxiety and trauma in children, I can confirm there is a great deal of confusion about how it presents in behaviour and ways to potentially identify it. This isn’t helped because society is often quick to see and label children’s behaviour as difficult, naughty, manipulative, and/or attention-seeking. However, being able to move to a place of seeing behaviour as often the only means a child has to communicate that something is, or has been, really wrong for them is rarely straightforward. To do so with some level of confidence, competence and instinct requires education in brain and body development, pre-birth and early developmental trauma, AND a cultural shift!

What do you think a soft sign is?

A 2-year-old freezes when a door slams. Is this a soft sign?

A 4-year-old can’t sit in a certain seat so they hurl themselves to the ground, scream, cry, thrash about and go bright red in the face. Is this a soft sign?

A 7-year-old can’t be at the front of the line at the end of play time. They start to scream, push another child flying then run round and round the playground. Is this a soft sign?

A 14 year old gets told they can’t go to Art today as they have to do the detention they missed yesterday. They kick a chair flying, slam out of the classroom and leg it towards the school gate and try to climb it to get out. Is this a soft sign?

What does it leave us with?

Imagine if you surveyed 100 people on the above, many would say, “no they are just reacting to not getting their own way, except the 2-year-old whose just startled.” Others would likely talk of tantrums, melt downs, lack of respect and the need for clear consequences to show them they can’t behave this way.

Without a baseline knowledge and insight into how and why anxiety shows up in a child’s behaviour, and what early repetitive trauma can be, and does to a child things could get more difficult for children. Unless professionals feel able to identify and act based on real knowledge, then the proposed NICE guidance may backfire by increasing stress for parents and carers who already dread any public displays of behaviour. Professionals may also find they feel even more deskilled as they are not sure why any of these suggested ‘soft signs’ are possible indicators of abuse or something not being right in child’s life.

The consultation by NICE suggests:

Professionals should look out for signs like:

• Low self-esteem
• Wetting and soiling
• Recurrent nightmares
• Aggressive behaviour
• Withdrawing communication
• Habitual body rocking
• Indiscriminate contact or affection seeking
• Over-friendliness towards strangers
• Excessive clinginess
• Persistently seeking attention.

Permission to be curious

I am not sure what will actually happen with the consultation and have mixed feelings. I am glad that focus is being brought to signs that can indicate a child is really anxious, and may be traumatised. It’s what my work and commitment to children, and their parents and carers, is all about. I like this from, “NICE’s deputy chief executive said it was “permission to be curious”, that’s what I encourage all professionals to be! I just hope parents and carers don’t panic and feel more pressure to control children’s behaviours out of fear they will be miss understood.

Simple suggestions:

Tune into gut instincts as we have a second brain in our gut!

Take time to gently and carefully check in with parents and carers to see how they are doing, they may then reveal a possible family break-up, or something else

Use other professional bodies who act to protect children to check out what you have noticed

When in doubt ALWAYS follow child safeguarding procedures and record everything

Become educated as to what anxiety looks like in a child

Become educated as to how trauma shows up in behaviours

Don’t sit on things when your gut is telling you otherwise!

To work with Jane:

E: janeevans61@hotmail.co.uk