Changing the language of care

My earliest memory of stigma was being called a 'weirdo orphan' in the playground. I was deeply hurt by this, more so because I already considered myself to be weird. The representation of 'normal' that had been taught to me was modelled around the nuclear family. Kids live at home with their Mum and Dad and if they don't, they are different. 'Volatile… aggressive… argumentative… attitude problem' – just some of the terms I recall being used to describe me as a child. These words reflect the protective shell I created for myself as I tried to navigate my world, a world shaped by loss and change and the accompanying emotional turmoil.

The anticipation of these words shaped my attitude towards others and towards life. I may have seemed 'uncaring' or 'aloof', but that was a manifestation of feeling not good enough. It has taken years and lots of hard work to modify my world view and I remain hypersensitive to the words of those around me. Not only words used about me, but those used about the children and young people I work with as I navigate the world of Educational Psychology.

I want us to critically reflect on the language/words we use, as professionals, in reference to Care Experienced children and young people. Ultimately, I want change. The magnitude of this ask is huge. Language is cultural and professional discourse can become so ingrained and habitual. People desensitise themselves to the words and terms that can be emotionally scarring to those they describe. But if we take on this challenge – if we commit to making change in ourselves as individual practitioners and together as a collective group – we can and will make a difference in children's lives.

New working models

'Kids in Care' have always been stigmatised. When my husband and I watch crime-based fictional films or dramas, we always comment 'I bet they turn out to be Care Experienced'. Our tone is light-hearted, but I carry the weight of this culturally-ingrained stigma each day. It has shaped my 'internal working model', to use John Bowlby's term, the cognitive framework that develops in childhood through our interactions with the world and our attachment relationships with people in our world. Our working models are invisible glasses we wear each day that guide the way we perceive the world, ourselves and others.

The good news is that neuroplasticity means these relationships and models can continue to morph throughout our lives, and so those working directly with children and young people have an important opportunity to support the continued development of internal working models. We want to create glasses that elicit a positive view of the world, self and others. The first step, I believe, involves thinking about the words we use when talking to and about children and young people.

And such discourse is in the spotlight now. WhoCares? Scotland is a (charity) membership organisation actively challenging media portrayals: shining a light on TV and film characters destined to become sadistic murderers because of a childhood in children's homes, reminding the world that there are real human lives involved when a mop is used to depict a child in an advert recruiting foster parents. Several agencies and organisations working directly with or in the care sector have called for reflection and reform. Most recently, I watched a video on the BBC news website portraying the work of Voice of Young People in Care (tinyurl.com/sxd4v3e4), who collaborated with young people to create a new dictionary of terms to be used when talking to and about children in care. The video captured magnificently my hope for the field of education.

The conclusion of the Independent Care Review led Scotland to make a Promise to drastically change the way our children are cared for – to put 'love' at the centre when supporting children (and families) in and on the edge of Scotland's Care 'System'. Acknowledging that such radical overhaul calls for a change in culture, a change in how society views Care Experienced people, the Care Review questions the language of care. Terms such as 'Looked After Children' (LAC), 'unit' and 'respite' are highlighted as 'stigmatising' and 'compounding a sense of being different'. Alternative terms are not explicitly suggested yet, but when they are… will we be ready?

Care Experienced

'LAC' is a term that has been under scrutiny for some time. Children have questioned whether it means 'they are lacking in something'. As a Care Experienced person, I find this term rather de-humanising. It compounds the idea that kids in care are separate to kids who are not in care. It reinforces the expectation that their life is not normal. It allows us as professionals to acknowledge that they may be adversely impacted by this 'abnormal' or 'adverse' experience. It gives room for us to accept lower expectations. It predates the predicted poorer outcomes of Care Experienced people (see Morrison & Shepherd, 2015 in Communicare; and a report from Education Scotland). It is the first word, of many, that we often hear used when talking to and about our Care Experienced children and young people. It sets a precedent.

I use the term Care Experienced to describe myself, and this term is now used by the Scottish Government. It has helped form my personal narrative and led me to be more accepting of my identity as an individual who was raised away from my biological parents. It has also granted me a sense of belonging to a community of wonderful individuals who also identify as Care Experienced. It acknowledges, beyond terms like 'Care Leaver', that much of our experience will stay with us forever. It is an inclusive term used to refer to any individual who is or has been in care at any point in their life. This might include residential care, foster care, kinship care, those who are adopted and those who live at home with a supervision requirement.

Using a term like 'Care Experienced' also helps maintain focus beyond the ceasing of a Compulsory Supervision Order or, the commencement of a Permanence Order. The length of time a child has their 'looked after' status is sometimes short, yet the impact can be lifelong. The difficulty is in the need to identify whether children on school rolls are currently subject to a legal order or not. This helps justify terminology like 'LAC'. People know what it stands for, so generating 'LAC lists', holding 'LAC reviews', and asking the question 'is he/she LAC?' is just the day-to-day.

Associations

Terms such as LAC bring cultural associations. Words that describe children in distress who are needing support. Words that taint education and wellbeing planning as they are sprinkled throughout the paperwork. Words that influence the opinions and expectations that professionals have of children and young people they have never met. Words like 'violent', 'controlling', 'manipulative' 'unmanageable' and 'aggressive'. Terms like 'problem behaviour' and 'chosen behaviour'. Would we use these words to describe a child whose parents have the capacity or are likely to read the paperwork and ask questions? It feels easier to talk to social workers and even foster parents about 'problem behaviours' and 'unmanageable kids' than it does to talk to well-informed biological parents. You are less likely to be challenged. You are also likely to be reinforcing the negative self-view the child or young person may already have.

I've not been immune from this myself. The first report I wrote as an Educational Psychologist was about a boy with extensive social work involvement and diagnoses of Autism, Hyperacusis and Learning Disability. I described his behaviours as 'physically aggressive and socially inappropriate'. Whilst his anxiety (along with his Autism and delayed social emotional development) was discussed in detail and highlighted as the cause of observed behaviours, I still feel uncomfortable that I used these terms to describe a child in crisis. I also spoke of him being charming and caring and socially motivated but what sticks with me now is the 'aggression' and the 'inappropriate' behaviours. I wish I had said that he was 'highly anxious and struggling to navigate this complex social world and sometimes this can lead to physical behaviours…'. I didn't say that. But I want to be better.

When writing my thesis, I opted to use 'LAC' to describe the children living in residential care that my research focused on. I did so because the term Care Experienced was relatively new and I worried that people would not know what I meant. For a long time, I went along with the use of a term that makes me feel deeply uncomfortable personally and professionally because it was so widely used. I get that uncomfortable feeling to this day, and I can no longer avoid vocalising my desire to remove this term from our vocabulary. Admittedly, I don't overtly challenge every person I hear say 'LAC', but I repeat back and model the language I want to see. Every opportunity I get, I talk about language and the impact it has using 'LAC' as an example.

A long road

WhoCares? Scotland published a report overviewing their involvement in a Care Records Campaign in June 2019 (tinyurl.com/3s2s447e). They shared personal stories of people who have accessed their care files. Those involved explained, 'It can be distressing to read how professionals have spoken about a Care Experienced person and the people important to them in their files and judgemental comments can be extremely upsetting'. When moving to a new house I stumbled across some reports written about me. I lived in Kinship Care with my Gran from age three and in one report it spoke of no-one else 'claiming me'. The absence of my biological Dad in my life has certainly influenced my internal working model and the presentation of me as this object that was not 'claimed' by her parent hit me hard: like I was some piece of lost or abandoned property that sits in a box for some time longing to be owned before being candidly discarded. It regurgitated old feelings of being unwanted and feeling insecure.

The author of this report will not have known that her words would cause such an emotional reaction so many years later, but it did. Immediately I began thinking about all the children and young people for whom I have written reports and whether I would be able to sit next to them with my head held high should they ever wish to read them.

If I could speak directly to Care Experienced children and young people who believe they are all the things professionals say they are, I would tell them that I too was 'volatile' and now, I am spontaneous and fun. I too was 'aggressive and argumentative' and now, I am passionate and determined. I had an 'attitude problem' and now, I have grit and character. Maybe those that spoke of me in my younger years would still see me in the same way, but I have changed the way I see myself thanks to other, more positive influences in my life. This has gifted me opportunities to grow and have goals and to achieve those goals. To those positive influences I thank you, with all my heart.

To those children and young people that I have written and spoken about, where I didn't show enough regard for my language, please know that I am sorry and I am still learning. I will continue to work on myself because words are exceptionally powerful. The novelist Angela Carter says, 'Language is power, life and the instrument of culture, the instrument of domination and liberation'. Words can motivate and inspire. They can also damage and disempower. The words we are exposed to from birth not only drive our language development, but they shape the lenses through which we view the world. They form the narrative through which we think of ourselves. Words change lives.

So to those professionals who like me are still learning, please don't rely on children and young people having a significant other to override the negative impressions that professional discourse can leave. Be that significant person. Change your narrative, challenge the narrative of others. Next time you are preparing a minute from a meeting or writing a report, ask yourself if you would be happy to read this directly to the child or young person. Ask yourself if you would be happy to learn they read it themselves a few years down the line. Ask if your words would be non-judgemental, humanising and sensitive enough for your own child. Overriding 'the norm' takes time. In recent years we have explored language around gender and sexuality. If Care Experience were a protected characteristic too, our journey to understand and improve the language of care would be well on its way. It is not, and this is the start of a long road, but we will get better… we must.

- Carmel Jacob-Thomson is an Educational Psychologist working for a local authority in Scotland. 'I am an Independent Report Writer for Children's Hearings Scotland. I am also Care Experienced and consider myself an activist for Care Experienced people. I am a Board of Director for WhoCares? Scotland, a charity that provides independent advocacy and campaigns for a lifetime of equality, respect and love for Care Experienced people. I was a workgroup member (Health and Wellbeing workgroup) for Scotland's Independent Care Review.' [email protected]
Twitter: @Carmel_Jacob