The first thing that needs to be examined is what substance abuse is. According to Kroll (2003), substance abuse can take many forms such as alcohol, drugs and polydrugs that lead to psychological, social and physical harm. Substances that fit in this category include: methadone, heroine, cocaine, crack, cannabis, ecstasy, and others. Child maltreatment is defined as abuse, neglect and acts of omission which place the children at risk for harm (Kroll, 2003). According to Wolfe (1999), there are four types of child abuse or maltreatment: physical abuse, sexual abuse, emotional abuse and neglect.
The U. S. Department of Health and Human Services conducted three studies and created a refined definitions for each type of child abuse such as 1) the harm standard, where a child has suffered some kind of clear abuse, like a broken arm, and 2) the endangerment standard, which includes harm standard in addition to any abuse experience that puts a child at risk for harm, like witnessing violence with family members (Sedlak & Broadhurst, 1996). Additionally, according to Sedlak & Broadhurst (1996), the endangerment standard occurs three times more than the harm standard for children each year.
This is an important fact to keep in mind considering the impact that this has upon children with these risks factors. Research suggests that parental substance abuse can negatively affect children in their family relationships, social communication abilities, personal-interaction functioning, attachment issues (putting children at risk for disorders) and create an increased a risk for being a victim of violence and acting out in violence towards siblings or peers (Kroll, 2003).
Because of the detrimental effects of parental substance abuse; observation, interventions and treatments must be implemented in order to lessen the severity and long lasting effects of the damage for children. According to Goldman, Salus, Wolcott, & Kennnedy, (2003), research supports that parental substance abuse is a contributing factor for one to two thirds of abused children.
Children, whose parents abused alcohol and other kinds of drugs, were three times more likely to be subject to all four types of abuse, especially neglect. According to Wolfe (1999), neglect, both physical and emotional, is defined as a failure of provision for a child’s physical, emotional and educational needs. Physical neglect includes insufficient supervision, kicking the child out of the house, not providing shelter, not providing safety or food, and refusal to seek medical attention for the child when needed.
Emotional neglect includes giving children permission to engage in or use any alcohol or substances that are illegal or may harm them, family abuse or any abuse in the presence of a child and failure to provide needed affection or psychological care. Educational neglect includes lack of providing access for the child’s educational needs and opportunities, or allowing a child to be truant (Wolfe, 1999).
Emotional neglect in young children have been linked to distress and fear symptoms such as: regressive behaviors, problems sleeping, bed-wetting, nervousness and somatic signs of stress like stomach aches, headaches, ulcers, and diarrhea. For older children who have experiences witnessing family violence they may tend to display overtly inappropriate or acting out behaviors such aggression with peers, and symptoms of low self-esteem (McCloskey, Figueredo, & Koss, 1995; Wolfe, Jaffe, wilson, & Zak, 1985).
Neglected children may also show inconsistent behavior patterns such as extreme passivity to undisciplined activity; a result of an unresponsive caregiver (Crittenden & Ainsworth, 1989). Other behavior adaptions found in young children who have been neglected are; poor impulse control and an over dependence on teachers for nurturing and emotional support (Erickson, Egeland, & Pianta, 1989).
Substance abuse can interfere with a parent’s cognitive functioning, thus, affecting mental functioning, decision making, and protection mechanisms. In addition, the needs of the children may be neglected due to the priority to spend money and time for their “substance” of choice rather than household expenses or a child’s care-taking needs, or get involved in other unsafe illegal behaviors, putting the children’s safety or health in jeopardy (Goldman, Salus, Wolcott, & Kennnedy, 2003).
According to Wolfe (1999), when a child is violated by someone that they are “preprogrammed to trust and love, it is a violation of his or her core self and can have lasting effects on interpersonal relationships and adjustment” (Wolfe,1999). Additionally, maltreated children have shown to have some common inadequacies in their lives such as lack of: stability in their home lives, lack of opportunities for learning pro-social behavior, and lack of positive, healthy adult interactions (Aber & Cicchetti, 1984; Azur, Barnes, & Twentyman, 1988; Wolfe, 1987).
Kroll (2003), conducted a study in the U. K. , examining the child welfare system and was able, through research and personal interviews obtain information about the damaging effects that a substance abusing parent can have on the children and other family members. He refers to the substance abuse as “the elephant in the room”. This metaphor fits very well due to the way a dysfunctional, substance abusing family deals with their lifestyles: denial, secrecy, maintenance and distortion. This “elephant” in the lives of a family affects every single family member’s behavior, responses and cognitions.
In addition, Kroll & Taylor (2003) conducted a detailed literature review and findings revealed repeated themes of denial, distortion, secrecy, separation , loss, violence, fear, abuse, role confusion, role reversal and chaos in the families with parental substance abusers; thus demonstrating more negative effects upon the families. Furthermore, Kroll (2003) contends that through extensive research, a “central organizing principle” of denial and secrecy became evident with these families where parental substance abuse existed.
Denial and secrecy results in confusion, anxiety and distortions for children because they see and recognize the elephant in the room but “when the adults behave as though there is no elephant, the child experiences a distorted reality” (Kroll, 2003). Kroll (2003) contends that the more the child experiences distorted reality, the more the child learns to distrust his or her own perceptions and judgments. Feelings of loss and pain are also experienced by children of substance abusing parents.
According to Howland Thompson (1998), the kind of losses a child experiences are: the loss of love because the child feels as though the substance is a priority above them and their needs, the pain of feeling unloved and unwanted, fears of feeling abandoned, the loss of having a trustworthy, responsible parent and loss of a normal lifestyle where they can bring friends home and freely interact with other children in and out of school, free from anxiety of experiencing any kind of substance induced, inappropriate or embarrassing behaviors by their parent(s).
Violence, family conflict, abuse and threats are common consequences in a family that organizes themselves around the substance abusing member (Robinson & Rhoden, 1998). Kroll (2003), asserts that personal accounts of children revealed the frequency of verbal insults and derogatory remarks about a child’s appearance, abilities or of not being wanted or loved were common.
Humiliation and betrayal, emotional abuse and physical abuse were reported by children of substance abusers, leaving the children to feel as though there is no one to turn to for safety; living in constant states of anxiety because of the unpredictable behavior of the substance abusing parent(s) (Kroll, 2003). Barnard & McKeganey, (2004) contend that children that growing up in these kind of lifestyles, are taught to view outsiders with suspicion and mistrust, in fear that someone will find out about the parents’ substance abuse and this would lead to separation. Prevention and Interventions and treatments
According to the CDC (2010), prevention is the ultimate goal to halting child abuse before it begins. There are several strategies that have proven to be effective in the prevention process, they are; supporting parents and teaching positive parenting skills. Some of those skills would include good communication, appropriate management of discipline, and responding appropriately to the physical and emotional needs of the child. This can be accomplished through programs that focus on prevention of abuse, improving parent-child relationships and providing parental social support (Center for disease control and prevention, 2010).
A four step approach is suggested by the CDC, they are: defining the problem, by gathering and studying data (serving a tool for decisions regarding needed resources), Identifying risk and protective factors, deciphering which groups of children are more at risk (to conduct research and develop programs to reduce these risk factors), Develop and test prevention strategies, whereby information is gathered and evaluated to provide strategies of child abuse prevention, and Ensure widespread adoption, whereby CDC shares information of prevention strategies, providing funding or assistance with technology for communities wanting to adopt these strategies (Center for disease control and prevention, 2010). Sipes (1992) contends that in order to prevent child abuse, communities need to have opportunities and access to unique resources that are diverse and appropriate to meet the needs of the cultures represented. In addition, more concentrated efforts are needed where societal influences are a factor, such as: poverty, environmental conflict, and health risks as these are risk factors for child abuse.
One of the obstacles to implementing any prevention strategy would be limited resources and urgent demands; due to these factors many communities have been making adjustments to how they handle situations more in a crisis management mode, meeting the needs of the child and the family (Wolfe, 1999) A study conducted by Bernard & McKeganey (2004) investigated the impact that parental drug use has had on children in addition to offering some solutions for interventions and help for the children involved. Findings demonstrated that substance abuse obstructs good parenting and the ability to provide a nurturing environment. Bernard & McKeganey (2004) assert that more of an emphasis needs to be placed upon children intervention.
Parental drug use mpacts the home and family environment and child care-taking in many ways, such as undermining household stability when the child’s needs are not met due to the primary needs created by the drug problem (Bernard & McKeganey (2004). According to Wolfe (1999), successful intervention for child abuse include strategies that focus on positive parenting skills, increased knowledge, and coping skills for at- risk subgroups in the form of group therapy, workshops, and individual counseling. Treatment approaches should center on parents and families yet, more specifically, need to be designed to meet each family’s diverse situation, and include such components as: anger and stress management, good parenting skills, access to support groups and access for treatment of substance abuse and marital conflict (Wolfe, 1999).