Utveckling och överlevnad : en studie av barn i psykosociala riskmiljöer = [Development and survival] : [a study of children at risk living in adverse psychosocial milieu]

Sammanfattning: A study of children at risk living in adverse psychosocial milieu.The aim of this work is to describe the situation of children at risk in psychosocially disadvantageous milieus, how these children cope with their situation, and which survival-strategies they do develop.The work consists of an account on work with children at risk in Sweden and the outcome and effects of this work. A summary of longitudinal research in child development and epidemiology, shows that the reasons for psychopathology are complex and multidimensional. What is not known, is the very process in which the child forms his experiences and resources into a constructive or less constructive strategy for handling the forces that build up a stressful milieu.To penetrate and learn something from such a process a longitudinal study, concerning 12 pre-school children during a 4-years period, is designed. As a guiding principle for the work the term: "strategy for survival" has been chosen, defined as a functional tendency in the child to reduce stress. The strategi of the individual child is evaluated as mainly constructive or destructive. The former is characterized by a flexible relationship between self and surrounding and by undisturbed psycho-motor development, the latter by the opposite. Empirically, the actual strategy for survival in the individual child is assumed to be indicated in the following functions: psychosomatic health, affective reactions and volition, social behaviour and patterns of social contact, psychomotor development and ego functions. To assess the kind of stress, experienced by the child, in relation to which the strategy for survival is developed, the structure and the network of the family, the general attitude of the primary care-taker and the incidence of disrupted positive social relations are observed. The strategy for survival is interpreted as the child’s way of handling his situation in these respects.Methods used are Griffiths’ psychomotorical test, a behaviour inquire, case sheet notes and interviews with children, their families and the staff involved. The results show three girls developing mainly constructive (moderating) strategies, the other children demonstrate more or less destructive, outerdirected or innerdirected patterns. All boys in the study demonstrate less constructive strategies. Compared to the girls they are less socially active, more withdrawn and more compliant. Health problems and psychosomatic reactions are very frequent, especially among children with innerdirected reactions. Virtually all children showed marked delays in ego functions and certain Griffiths’ sub-scales, mostly those related to concept development and personal-social behaviour. Development is seldom smooth and regular but characterized by sudden arrests and spurts, typically related to changes in child care conditions like entering pre-school or school, disrupting a foster parent relationship etc. It seems obvious that the most important single factor for promoting a better situation for these children is the access to resourceful, positive and stable persons in the social surrounding.