Women with children

General Considerations

The safety and needs of children are a critical issue for women escaping situations of violence, which often influences their help-seeking and related service decisions. Shelters which are not accessible to children create a barrier for women to obtain support and benefit from available services.

Children of women leaving situations of violence and entering shelters experience a range of vulnerabilities and challenges, including risk of re-victimization and the effects of trauma, all of which can have long-term consequences. Highlighting the importance of providing opportunities for children to benefit from their time in the shelter, the evidence shows that:

• Children who have witnessed domestic violence may experience similar outcomes to those who experienced physical abuse, correlating with their age and development.
  • Infants and young children (birth to five years) can be particularly vulnerable and sensitive to the experience of living in a violent household.
  • Children from two to five years, who do not have the capacity or opportunity to express their experiences, are at particular risk to show aggressive behaviour.
  • Pre-school age children are more likely to feel responsible for the violence between their parents.
  • School age-children (six to twelve years) may worry about the vulnerability of their mothers and siblings and experience more anxiety and conduct problems. They may also isolate themselves from peers and other supports in attempts to conceal the violence.
  • Adolescents tend to experience less fear and anxiety, and feel less responsible for parental violence, although they may take responsibility for the care of younger siblings. Adolescents may also experience effects from long-term exposure to family abuse, which can result in greater risk of delinquent and violent behaviour.
• In a significant percentage of domestic violence cases, children are also directly abused (physically, sexually and emotionally).
• Children often experience a range of adverse effects from abuse including physical, emotional, learning, behavioural, social or developmental problems, and their educational performance and achievement may also be affected.
• Children may experience accumulated effects in cases where co-occurring problems exist such as parental drug use, alcohol addiction or mental health problems.
• Children whose parents separate due to domestic violence may also have to cope with disruption to their lives and routines, including temporary homelessness, loss of friends, pets and personal belongings.
• Domestic violence can undermine the relationship between mothers and children.
• The nature of parental relationships in domestic violence situations can cause children's confusion about the meaning of concepts such as love and intimacy.
• Stress from witnessing violence at home can cause disruption to children’s normal coping patterns and support systems. This is compounded by the adjustments required when entering the shelter, along with a possible loss of time with their mother from her response to these changes.
• Boys who are exposed to domestic violence are 2 to 3 times more likely to become perpetrators themselves in the future.

(Davis and Carlson, 1987; Dodge et al, 1990; Fantuzzo et al, 1997; Graham-Bermann, 1996; Jaffe et al, 1990; Kitzmann et al., 2003; Maclean, 2004; Mullender, 2000; Mullender et al., 2002; Statham, 2004; and Wolak and Finkelhor, 1998- all as cited in Byrne-MacNamee, 2009; Bott, Morrison and Ellsberg, 2005; Johnson, Holly, N.Ollus and S.Nevala. 2008).

Given these circumstances, shelters can provide important services to children that can reduce the long-term effects of violence and increase protective factors that prevent the perpetuation of intergenerational violence. Most services have been developed in the context of domestic violence cases and, as with the broader evidence, based heavily on the context in North America.

Practices for promoting shelter services for women with children include:

• Developing shelter policies that prevent the exclusion and promote the inclusion of children and youth in the services provided.
• Promote practices that strengthen and promote women’s parenting role.
• Planning and designing space and services appropriate for children into the shelter infrastructure.
• Using age-appropriate assessment tools and methods to understand the impact of violence on children and their corresponding needs.
• Providing services for children aimed at reducing the effects of violence and promoting their safety.
• Including children and their inputs in assessment and case planning processes, documenting individualized goals and outcomes for each child and their family (see sample case planning tools).
• Improving staff knowledge of and skills in responding to the common effects of violence on children in order to provide relevant services to them, ensuring that their needs are integrated into programmes and that they are engaged in the service delivery process. This involves providing training and development to support the integration of services for children within the shelter (including in the assessment process).

Assessing the impact of the child's experience with violence

Children's needs should be assessed separately from, as well as in partnership with their mother. The presence, input and perspectives of mothers is considered only one aspect of the assessment process, as the impact of children’s exposure to violence is best evaluated through independent interviewing.

An assessment framework should be used which:

• Assists staff to take account of the different dimensions of each child's life (i.e. home, school, friends, activities, family relationships).
• Is based on screening protocols that are appropriate to child’s stage of development, supports positive engagement with children, and may facilitate input from the child through creative forms of non-verbal expression. This can include symbolic representation, drawing, using imagination and role-play to symbolize people and events; identifying emotions with picture codes; made-up words to represent people or objects; symbolic play to represent one object as another.
• Observes children (particularly pre-school age and under) both alone and in the family setting (Jaffe et. al, 1990; Buckley et. al., 2007; Welsh Women’s Aid, 2008, 1998; Wolak & Finkelhor, 1998, all cited in Byrne-MacNamee, 2009).

Assessment Tools:

Ages and Stages Questionnaire – 3^rd edition (Bricker, Squires and Twombly, 2009). This tool is designed for developmental and social-emotional screening for children from one month to 5 ½ years. This tool is shown to have good reliability and validity. The questionnaire can be used to explore children’s strengths and trouble spots, educate parents about developmental milestones, and incorporate parents’ expert knowledge about their children into the assessment process. Available in English.

The Brief Infant-Toddler Social and Emotional Assessment: Screening for Social-Emotional Problems and Delays in Competence (BITSEA) (Briggs-Gowan and Carter). This tool is used to assess social-emotional and competency developmental delays in children ages 12 – 35 months. The tool uses a 42-item Parent Form which can be completed in the shelter. A Child Care Provider Form can be used to examine the child’s behaviour across settings. This tool is especially suited for settings with limited time, resources, and/or technical training. Available in English.

Pre-school Child Behaviour Checklist (CBCL1½ - 5) Nelson Education, 2000). Used with children ages 1.5 - 5 years, this tool is for measuring externalizing and internalizing problems. It covers parents' ratings of 99 problem items; descriptions of problems and disabilities; and information regarding parents’ concerns about their child, and the best things about the child. This assessment tool is designed to show indicators of whether a child’s vocabulary and work combination are delayed relative to norms for children ages 18-35 months. Parents' reports are used to assess children's expressive vocabularies and word combinations.  Available in English.

Responding to children's needs to reduce the impact of violence

• Shelters should provide services that support the achievement of major early childhood developmental skills, and reduce the impact of stressors faced by children exposed to violence, which can help the development of young children. Services within these categories include:
  • Efforts aimed at reducing or preventing risk and its impact (e.g. legal strategies such as protection orders or integrating children’s needs in risk assessment processes).
  • Protection-focused services, adding resources to counterbalance risk (e.g. including children’s needs in safety plans completed with their mothers).
  • Processes to strengthen competence, such as parent-child relationships and social skills. Although most promising practices for work with children to reduce the effects of violence are intended for use over a longer period, often at least several months, this may not be practical in many shelter settings. Staff in emergency or short-term shelters can use components of these practices to support improvements in parent-child interaction and contribute a positive impact on children’s social/emotional competencies. Common components of interventions coach mothers to:
    • improve awareness of the impact of exposure to domestic violence on children’s neurologic and development;
    • develop understanding of how their children’s needs are demonstrated through their behaviour;
    • accurately understand child motivations by clarifying mothers’ assumptions about these motivations; and
    • respond to children through empathy and emotional receptivity. All efforts may support mothers to encourage their children to talk about their experience, feelings and related thoughts (Cairns, 2010; Masten & Coatsworth, 1998 as cited in Gerwitz and Edleson, 2007).

• Interventions that promote the enhancement of protective factors, which can improve the children’s functioning, considering other influential factors related to: the extent of the violence, the child’s characteristics, and parenting factors. Specific efforts supporting protective factors for children include:
  • Strengthening relationships between the child and the safe parent, since quality parent-child relationships can mitigate the negative effects of domestic violence on children.
  • Supporting children's resilience in the face of adversity, such as:
    • Competent parenting
    • Intellectual resources
    • Social competence
    • Easy temperament
  • Reinforcing children’s sense of safety, as children who are less aware of the violence, have good coping strategies and support systems have better outcomes, and may recover from abuse more rapidly once they feel safe.
  • Supporting resilience as a developmental process or progression in which new strengths and vulnerabilities emerge over time and under changing circumstances.
  • Minimizing the number of risk factors that children are exposed to and encouraging protective processes. This can reduce negative outcomes and lead to more secure attachment relationships.

(Diener, Nievar, and Wright, 2003; Luthar, Cicchetti, & Becker, 2000 and Egeland et al., 1993, Werner & Smith, 1992; Garmezy & Masten, 1994, all as cited in Gewirtz & Edleson, 2007; Wolfe et al., 1986; Mullender et al., 2002 and Holt et al, 2008, as cited in Byrne-MacNamee, 2009; and Holden et al. 1998)

Tools:

Refuge for Babies in Crisis (The Royal Children’s Hospital Integrated Mental Health Program, Victoria, 2012): How crisis accommodation services can assist infants and their mothers affected by family violence. Available in English.

Honoring Children, Mending the Circle: Cultural Adaptation of Trauma-Focused Cognitive-Behavioral Therapy for American Indian and Alaska Native Children. (BigFoot and Schmidt, 2010). This resource provides guidance on blending AI/AN traditional teachings with cognitive-behavioural methods. Available in English.

Safe from the Start (Salvation Army, Australia). The Safe from the Start resource kits were developed through an intervention with women’s shelters addressing the impact of witnessing domestic violence among children aged 0-5. The Resource Kit includes books, DVD, CD, puppets and activity cards sourced from the United Kingdom, United States, Canada and Australia, with materials used throughout Australia, New Zealand, Canada, Singapore and Maldives. A Train the Trainer programme is also available. Available in English. See also a report on the project.

Guiding Principles Safe Havens: Supervised Visitation and Safe Exchange Grant Program (Office on Violence Against Women, US Department of Justice, 2007). This resource is a guide for professionals working with abusive fathers in supervised visitation and safe haven programs.  The guide includes six principles for visitation programs that work with abusive fathers and includes a narrative section, standards and practices for each section. Available in English.

Talking to My Mum: Developing Communication between Mothers and Children in the Aftermath of Domestic Violence (Humphreys, Thiara, Skamballis and Mullender, 2006). This resource provides a workbook for shelter practitioners to use with children, to support them in talking with their mothers about their experience in the shelter and in relation to their experiences with domestic violence. Available for purchase in English.

Living Alongside a Child’s Recovery: Therapeutic parenting with Traumatized Children. (Pughe and Philpot, 2006). This resource draws upon learnings from child development, attachment theory and understanding of child trauma and its effects to provide guidance for parents on how to design a therapeutic physical environment, the importance of routine and security for children, and how to approach issues of hygiene and organisorganising mealtimes. This resource can be used to support individual and group work practice. Available for purchase in English.

Violence against Children: Has it Happened to You? (Raising Voices, 2006). This booklet is for actors working with children and adolescents. The booklet provides examples of the various experiences children and adolescents may have with violence based on the context in Uganda. The material may be used to facilitate group discussions and plan activities to address violence against children and may be adapted to various contexts. Available in English.

The Kids Club Intervention Program (Graham-Bermann). This intervention programme is designed to provide a supportive environment for children ages 6 to 13 to share their experiences, learn that they are not alone in their exposure to violence, and identify sources of worry and concern. Training is available for professionals to learn to implement this programme. A Kids Club Program is also available for pre-school age children at Sandra Graham-Bermann. Available in English.

Youth relationships manual: A Group Approach with Adolescents for the Prevention of Woman Abuse and the Promotion of Healthy Relationships. (Sage Publications authored by Wolfe, D.A., Wekerle, C., Gough, R., et al.)  This manual provides knowledge-raising and skill-building for social action to end violence through 18 sessions. The book is in English and can be previewed from Google books or can be purchased online from any book retailer.

Fourth R Curricula (Ministry of Education Ontario, Canada). The Fourth R consists of a comprehensive school-based programme designed to include students, teachers, parents, and the community in reducing violence and risk behaviours. It contends that relationship knowledge and skills can and should be taught in the same way as reading, writing, and arithmetic, and therefore the classroom-based curriculum is referred to as the Fourth R (for Relationships) core programme. This curriculum consists of lessons that meet the Ontario Ministry of Education’s learning expectations for Grade eight and nine health education and Grade 9-12 English, and the outcomes for other courses in other provinces. The programme is taught in the classroom, using a thematic approach to reduce risk behaviours including: violence/bullying; unsafe sexual behaviour and substance use. All of the curricula are available for purchase in English.

Working with Young Children and Their Families: Recommendations for Domestic Violence Agencies and Batterer Intervention Programs (Abigail Gewirtz and Resma Menakem, 2004). This protocol is for professionals working with perpetrators of violence. The report is part of series of papers on mobilizing community and programmatic resources to provide responsive assistance to children and families affected by both domestic violence and poverty. This particular paper addresses methods of providing support and safety for children while maintaining safety, autonomy and choice for battered women. Available in English.

Model Protocol on Working with Battered Women and their Teenage Boys in Shelter (Washington State Coalition against Domestic Violence, 2003). This tool provides a sample guide for organizations supporting survivors with adolescent boys, based on the context in the United States. Available in English.