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O R I G I N A L P A P E R
Maltreated Children’s Social Understanding and Empathy: A Preliminary Exploration of Foster Carers’ Perspectives
Nikki Luke • Robin Banerjee
Published online: 11 February 2011
� Springer Science+Business Media, LLC 2011
Abstract Previous research suggests that parental abuse
and neglect can have adverse effects on children’s peer
relationships and self-perceptions. Emerging theoretical
and empirical work suggests that children’s social under-
standing and empathy could play a key role as mediators of
these effects, but we have little knowledge about the via-
bility of such a model in explaining the everyday experi-
ences of children in care. Thus, in order to gain an in-depth
insight into the potentiality of this conceptual model, a
focus group and detailed semi-structured individual inter-
views were conducted with a total of 10 foster carers. First,
a thematic analysis revealed that problematic self-percep-
tions and peer relationships were indeed commonplace.
Crucially, in line with our theoretical model, carers readily
identified children’s difficulties with social understanding
and empathy as relevant explanations for their socio-emo-
tional problems. Carers reported using a variety of strate-
gies to help children, but expressed a need for a clearer
training package of practical strategies that could be used to
encourage social understanding and empathy in children,
with the aim of improving their social relationships.
Keywords Foster care � Physical abuse � Neglect � Child development � Qualitative research
Introduction
Foster carers are regularly faced with the challenge of
looking after children with social and emotional difficul-
ties. Research has shown that physically abused or
neglected children are at greater risk of problematic peer
relationships and negative self-perceptions than their
nonmaltreated peers (e.g., Anthonysamy and Zimmer-
Gembeck 2007; Toth et al. 1997). Understanding the
mechanisms by which such socio-emotional problems may
arise is crucial for informing the design of intervention
strategies and support for foster carers.
Two inter-related constructs likely to play a role in the
developmental trajectory of maltreated children are social
understanding and empathy. Social understanding, incor-
porating what has been termed ‘theory of mind’, involves
an appreciation of mental and affective states, including
beliefs and desires, and the role that they play in social
behaviour and interactions (Carpendale and Lewis 2006).
Empathy is defined in terms of emotional responses to
another person’s affective state, specifically those in which
the recognition of the other’s state produces a similar
emotion in the observer (Eisenberg et al. 1996). Problems
with social understanding and empathy may serve as
mediators of maltreatment effects on socio-emotional
functioning, because existing research suggests that they
can influence the way children behave with their peers
(Dekovic and Gerris 1994), which in turn relates to peer
status outcomes (Anthonysamy and Zimmer-Gembeck
2007) and self-perceptions (Bolger et al. 1998).
Emerging research provides tentative support for the
link between maltreatment and problems with social
understanding and empathy. This is a relatively recent area
of research, and the variables have not yet been fully
explored; for instance, there exists little research on
N. Luke (&) � R. Banerjee School of Psychology, University of Sussex, Falmer,
Brighton BN1 9QH, England, UK
e-mail: [email protected]
123
J Child Fam Stud (2012) 21:237–246
DOI 10.1007/s10826-011-9468-x
maltreated children’s empathic reactions, and none on
more advanced social understanding (e.g., knowing that
one person can misunderstand a second person’s beliefs).
However, the small number of studies that have been
conducted so far are consistent with the proposal that social
understanding and empathy may act as mediating influ-
ences on maltreated children’s socio-emotional well-being.
Maltreated children perform worse than their peers on tasks
measuring false belief understanding (Cicchetti et al.
2003), and are more likely to attribute hostile intent to
others in ambiguous situations (Price and Glad 2003).
Maltreated children also underachieve relative to peers on
tests of emotion recognition (Fishbein et al. 2009), and
their understanding of the causes and consequences of
emotions is poor (Sullivan et al. 2008). Furthermore, this
lack of understanding may affect children’s behavioural
responses: Main and George (1985) found that maltreated
children were less likely to show an empathic response to
another’s distress than their peers.
Notwithstanding the research described above, we know
little about the role played by social understanding and
empathy in maltreated children’s socio-emotional out-
comes. However, this hypothesis fits comfortably with the
propositions of attachment theory, which represents a
dominant theoretical perspective in practitioners’ work
with children (Kelly 2000). The maltreated child’s internal
working model (IWM) of the self in relation to others is
based on the quality of the relationship with the primary
carer, and acts as a template shaping the child’s expecta-
tions and interpretations of subsequent relationships. Mal-
treated children have often received poor or inconsistent
information from caregivers about their thoughts, beliefs
and feelings, impeding their ability to interpret these in
other people (Pears and Fisher 2005). Attachment theory
can help us appreciate the role of social understanding and
empathy as part of the insecurely attached child’s gener-
alised representations of social relationships.
Moving beyond a simplistic view of negative attach-
ment, social understanding and empathic awareness can be
seen as skills which emerge in the context of social rela-
tionships, and whose development may be impaired in
atypical rearing environments such as those provided by
maltreating parents. In line with social learning theory
(e.g., Bandura 1973), children may view the high levels of
narcissism and limited empathy seen in maltreating parents
(Wiehe 2003) as a model of acceptable behaviour.
However, children’s interactions with their parents may
provide a more powerful learning device than passive
observations of behaviour. From a Vygotskian perspective,
parent–child communications provide the context in which
children are taught the tools for successful social exchan-
ges, which are then internalised to become part of the
child’s intrapersonal repertoire of skills (Vygotsky 1978).
Viewed in this way, impoverished or distorted interactions
with caregivers may jeopardise children’s chances of
developing a full complement of socio-emotional skills. As
an example, maltreating mothers engage in less discussion
about the internal states (IS) of self and others than non-
maltreating mothers (Edwards et al. 2005), and maltreated
toddlers’ IS lexicons are consequently delayed and
impoverished (Beeghly and Cicchetti 1995). Moreover,
abusive mothers’ production of less recognisable facial
expressions (in comparison with nonabusive mothers;
Camras et al. 1988) may account for children’s poor
emotion recognition skills (Fishbein et al. 2009). Although
repeated exposure to the displays of anger preceding
harmful interactions may account for the superior recog-
nition of this emotion in physically abused children (Pollak
et al. 2009), inconsistent information about the antecedents
of emotional displays may explain why these children find
it difficult to recognise the situations that provoke anger
(Pollak et al. 2000).
The present study builds on these theoretical consider-
ations and emerging research findings to explore a pro-
posed mediational model. Our review of the literature gives
us reason to expect that interactions with parents in a
maltreating context may compromise the development of
children’s skills of social understanding and empathy, and
that this might impact negatively on their peer relationships
and self-perceptions. We therefore propose that the rela-
tionship between negative parenting experiences and chil-
dren’s peer relationships and self-perceptions is likely to be
mediated by children’s social understanding and empathy.
However, we know little about whether such a conceptual
model provides a viable and plausible account of the
everyday experiences of maltreated children in care.
In order to make an initial evaluation of the viability of
this theoretical formulation, we used focus groups and
individual interviews to explore foster carers’ accounts of
maltreated children’s difficulties with social understanding
and empathy, and how these related to peer relationships
and self-perceptions. As an exploratory study, the choice of
our methodology was based on two considerations. Firstly,
we wanted to draw on the experience of those who had the
most frequent and prolonged contact with children in the
care system. We felt that foster carers could offer a unique
perspective on the details of children’s interpersonal skills
and their impact on socio-emotional outcomes: it is only by
listening to them that practitioners can discover how best to
support them in looking after children. Secondly, we also
wished to ascertain carers’ current conceptualisation of the
potential mediating role of social understanding and
empathy. Gathering carers’ current understanding of the
importance of these skills would also enable us to assess
the need for training on ways to support children in
developing social understanding and empathy.
238 J Child Fam Stud (2012) 21:237–246
123
We approached the current study with two research
questions in mind: (1) Do carers’ experiences with mal-
treated children support a model in which difficulties in
social understanding and empathy mediate the relationship
between maltreatment and problematic self-perceptions
and peer relations? And (2) What is the current status of
carers’ knowledge about—and attitudes towards—ways of
supporting the children who have difficulties with these
skills in order to improve their socio-emotional well-
being?
Methods
Participants
The study consisted of two parts. In the first part, foster
carers from the Local Authority’s Intensive Placement
Team (IPT) attending a regular meeting were asked to
participate in a focus group discussion on the subject of
social and emotional problems in the children they had
fostered. The focus group sample consisted of six foster
carers who were members of the IPT and two social
workers. Five of the carers were female, as was one of the
social workers. The age of participants was not requested.
The focus group was recruited as a whole via their lead
social worker. Group members gave written consent for the
audio recording of the discussion.
For the second part of the study, we recruited four of the
carers from the focus group and a further four carers from
outside of the IPT. Two of these were approached by their
social workers following an appeal to the social work team
by the researcher. One carer was a student at the authors’
university; she recruited a friend who was also a carer as
the final interviewee. All of the carers participating in
individual interviews were female and lived in urban or
suburban areas in the South East of England. As in the
focus group, carers’ ages were not requested.
One carer had been fostering for 2 years, five had been
carers for 6 to 10 years, while two had been carers for
19 years. Of those able to calculate the number of place-
ments they had experienced, two had looked after one or
two children, three had cared for seven to ten, and two
counted between 30 and 45 children. The ages of the
children and young people in these placements ranged from
birth to young adulthood. Five of the carers discussed the
length of their current placement: one was in its third year,
three were currently at 5 to 7 years, and one carer had been
looking after the same young person for 18 years. Only one
of the carers did not have a current placement; her most
recent placement lasted over 5 years, and ended several
weeks before the interview.
Procedure
A provisional interview schedule was developed to explore
the topics of socio-emotional well-being in maltreated
children and the potential role of social understanding and
empathy in influencing these outcomes (see Appendix A
for the final version). The focus group was used as both a
testing ground for our provisional interview questions, and
as a source of data in its own right (Morgan 1996). The
discussion took around 75 min of a 2-h session, and was
recorded using a digital voice recorder. At the beginning of
the session, carers were asked to share their experiences of
children who had difficulties getting on with their peers;
this discussion accounted for most of the session. As par-
ticipants warmed to the discussion they began questioning
each other and less input was required from the researcher.
However, when carers spontaneously mentioned children’s
difficulties with social understanding and empathy as
potential contributors to problematic peer relations they
were questioned about this further. The interview schedule
was largely unchanged following this session, although
following an interesting avenue of discussion during the
session a question was added about children’s ability to
practise their social understanding in emotionally over-
whelming social situations.
Volunteers for individual interviews were contacted by
telephone or email to arrange a convenient appointment.
Interviews took place in private in participants’ homes and
were also audio recorded. The interview followed a semi-
structured design, which permitted flexibility in the use of
questions and probing of participants’ responses (Burman
1995). Interview length was determined by participants’
responses, lasting from 45 to 74 min. All interviewees were
made fully aware of the purposes of the interviews prior
to commencement and gave written consent for their
participation.
The interviews began with questions about the carers’
length of experience and number of placements. Carers
were then asked to provide examples of Looked After
Children who had difficulties getting on with peers
(‘‘Does this child have difficulty getting on with other
children?’’), or who displayed a negative perception of
themselves (‘‘Do they feel very bad about themselves?’’).
Carers were also asked to speculate what might have led
to these difficulties (‘‘Why do you think they might have
had these difficulties?’’). Next, a range of questions cov-
ered specific cognitive, emotional, and behavioural prob-
lems which might lead to difficulties in peer relationships;
for example, ‘‘Have any of the children you mentioned
had difficulties seeing things from someone else’s point of
view?’’; ‘‘Have any of them had difficulties responding
appropriately to someone else’s emotions?’’ Our intention
in asking these questions was not simply to establish if
J Child Fam Stud (2012) 21:237–246 239
123
carers could recognise these difficulties, but to understand
the extent to which carers could clearly identify specific
and detailed examples of children fitting the descriptions.
Finally, carers were asked about the sort of strategies they
might use to support children’s social understanding and
empathy (‘‘How did you try to support them/work to
improve their skills?’’), and whether they felt they would
benefit from training in these strategies (‘‘Would you find
this useful—for you?—for the foster child?’’). See the
Appendix A for a copy of the full interview schedule.
Analytic Strategy
A thematic analysis (Braun and Clarke 2006) was con-
ducted to identify patterns in carers’ experiences with the
children they had looked after. Transcripts of the focus
group and individual interviews were examined and re-
examined for recurring themes as data were collected.
Coding of the data was performed using NVivo, a quali-
tative analysis software package which allows for the
organisation of themes in a hierarchical structure. In the
present study, we started with a number of theoretically-
derived a priori categories corresponding to our research
questions. These categories are listed below:
a. Self-perceptions—direct references to children’s neg-
ative self-perceptions or behaviour implying negative
self-perceptions.
b. Peer relations—references to difficulties in establish-
ing or maintaining peer relationships, or behaviours
that might lead to such difficulties.
c. Carers’ explanations for outcomes—references to
aspects of children’s backgrounds or individual
differences presumed to have led to difficulties with
self-perceptions or peer relations.
d. Social understanding and empathy—references to
children’s specific difficulties with social understand-
ing or empathic responding.
e. Foster carers’ strategies to support children—refer-
ences to specific or general support provided by carers
or others, which might aid the development of
children’s social understanding and empathy.
Within these broad categories, initial coding of the data
from the focus group suggested a number of potential
themes where a particular idea seemed to recur across
participants’ accounts. The themes were revised and
refined as data collection and analysis progressed to ensure
that the final list of themes incorporated the full range of
experiences and beliefs referred to in participants’
accounts. The full set of themes is shown in Fig. 1.
Results
Results are presented here under the headings of the five
major categories. In the interests of brevity, we provide a
narrative summary of the themes relating to self-perceptions,
peer relations, and carers’ explanations for these outcomes.
Then we turn to our core interest in themes pertaining to
social understanding and empathy, with illustrative excerpts
to help us to address our key research questions. Labels
following the quotes indicate the contributions of foster
carers (C1–C10). As an overall summary of the data set,
Table 1 shows the number of individual interviews in which
each theme was clearly identified as a relevant issue.
SELF-PERCEPTIONS
Direct reference to negative self- perceptions
Behaviour implying negative self- perceptions
PEER RELATIONS
REJECTED BY PEERS DUE TO:
Inappropriate learned behaviours
Age-inappropriate behaviour
Out of control
Need to control situations
Needy/desperate behaviour
BUT:
Wish to belong
CARERS’ EXPLANATIONS FOR OUTCOMES
Parenting
Parents’ general behaviour
Child’s role in the birth family
Individual differences
SOCIAL UNDERSTANDING AND EMPATHY
PROBLEMS WITH:
Seeing others’ perspectives
Lack of empathy
Understanding others’ emotions
Recognising motivations/desires influencing behaviour
Negative/hostile interpretations of others’ behaviour
Understanding consequences of own behaviour
Social understanding present but overwhelmed by emotional need
FOSTER CARERS’ STRATEGIES TO SUPPORT CHILDREN
Specific strategies to aid social understanding and empathy
General carer support
Involvement in groups and clubs
Access to support network
Training needs
Fig. 1 Hierarchical representation of categories and
themes arising from foster carer
focus group and interviews
240 J Child Fam Stud (2012) 21:237–246
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Self-perceptions
When asked whether they had looked after children who
felt badly about themselves, almost all of the carers could
provide examples of children who had expressed negative
self-perceptions. However, children’s low opinions of
themselves were not always explicitly stated, and all carers
spoke of some children whose general behaviour led them
to draw inferences of negative self-perceptions.
Peer Relations
The common view amongst carers was that most of the
children they had looked after had had difficulty getting on
with their peers. Carers talked about children who had been
actively rejected by peers, as demonstrated when no-one
turned up to their birthday parties. The foster carers’
responses clearly indicated a number of different behav-
iours which proved challenging for the formation and
maintenance of friendships. Often children would display
inappropriate learned behaviours, such as stealing food;
these behaviours had helped them cope with a difficult
home life, but now created problems in peer interactions.
Most carers also had experience of children displaying age-
inappropriate behaviour. This was seen as more of a
problem with increasing age, when former friends would
begin to grow up and grow away from them. All carers had
looked after children whose behaviour or emotions were
out of control, making it difficult for peers to feel com-
fortable around them. In contrast, some children’s reaction
to their background expressed itself in a need to control
situations, which was not viewed kindly by peers. Other
children were so desperate to have friends that they
frightened peers off with their needy behaviour. Yet,
importantly, in discussing the range of social difficulties for
Looked After Children, carers expressed the belief that
these children were not socially isolated by choice. There
was a clear consensus that the children were motivated to
seek out social relationships with peers and families,
revealing a fundamental wish to belong.
Table 1 Number of interviews in which each theme was mentioned
Category Theme Number of interviews
(max. 8)
Mentioned in focus
group (y/n)
Self-perceptions Direct reference to negative self-perceptions 7 n
Behaviour implying negative self-perceptions 8 y
Peer relationships Rejected by peers 7 y
Inappropriate learned behaviours 6 y
Age-inappropriate behaviour 6 y
Out of control 8 y
Need to control situations 7 y
Needy/desperate behaviour 5 y
Wish to belong 8 y
Carers’ explanations Parenting 8 y
Parents’ general behaviour 3 y
Child’s role in the birth family 4 y
Individual differences 4 y
Social understanding and empathy Seeing others’ perspectives 7 y
Lack of empathy 5 y
Understanding others’ emotions 8 y
Recognising motivations and desires influencing behaviour 6 n
Negative and hostile interpretations of behaviour 6 y
Understanding consequences of own behaviour 7 y
Social understanding overwhelmed by emotional need 6 y
Foster carers’ strategies Specific strategies to aid social understanding and empathy 8 y
General carer support 7 y
Involvement in groups and clubs 4 y
Access to support network 6 y
Training needs 7 n
J Child Fam Stud (2012) 21:237–246 241
123
Carers’ Explanations for Outcomes
When asked for their thoughts on why children expressed
particular difficulties, carers referred to a range of possible
influences. Perhaps unsurprisingly, much was made of the
effects of good or bad parenting. However, carers also
appreciated the influence of children’s observation of par-
ents’ social behaviour. In half of the interviews carers also
discussed how the child’s role in the birth family might
affect their self-perceptions or peer relationships. For
example, one carer traced a child’s attempts to dominate
peer relationships back to the reversal of caring roles she
had experienced with her suicidal mother. In addition, half
of the interviewees expressed the belief that individual
differences in children’s temperaments and coping strate-
gies might moderate the effect of parenting experiences.
Social Understanding and Empathy
Our key interests in the role played by social understanding
and empathy were reflected in several questions to ascer-
tain carers’ experiences of children who had difficulties in
this area, and to determine whether this might help to
explain the relationship between children’s backgrounds
and their social and emotional problems. Overall, this
seemed to be a widespread issue: all carers were able to
provide several examples from current or previous place-
ments. All but one had encountered general problems with
seeing others’ perspectives:
What he did wrong in that school is, he came home to
me the second day and he said to me, ‘I’ve told
everybody that you’re my Nan’, and I said… ‘I don’t mind what you call me, but all the children from your
primary school, only six went to a different school,
all the others went to your school and some of them
were in your class, so they know I’m not your Nan,
and I think you’ve dug a little bit of a hole for
yourself’. And that’s why they tease him, and he just
can’t handle it at school (C5).
More specific difficulties were also described. Examples
where children showed a lack of empathy towards another
person’s emotional situation were given by over half of the
interviewees. Carers explained this in terms of an inability
to understand the other’s emotions:
I lost my horse that I’d had for 20 years just before
Christmas, and I can’t tell you how devastated I
was… And [girl] couldn’t say anything comforting at all, she just kept really quiet, but couldn’t wait to tell
anyone that she knew that the horse had died [laughs]
and how sad it was, but she didn’t actually understand
really. Although she got extremely upset when one of
her chickens died, because that was more personal to
her. So even though she’d felt those feelings herself,
she couldn’t give me any comfort at all (C8).
The lack of empathic awareness was seen as playing a
critical role in the children’s social interactions:
[Boy] has got no compassion at all. That’s why we
bought him the cat, to look after, so that he could see
that other things hurt. If he can’t feel it, it doesn’t
hurt. He’ll say things to people that are really unkind,
but he can’t see it… (C5).
As well as problems with understanding and responding
to emotions, carers also cited cases where children strug-
gled to recognise the underlying motivations and desires
influencing others’ behaviour. One girl failed to understand
that a boy was only sending her text messages to persuade
her to pass on the telephone numbers of her good-looking
friends. For some children, however, the problem was not
lack of understanding but misunderstanding. These were
the children who displayed a negative or hostile bias in
their interpretations of others’ behaviour, which foster
carers perceived to have emerged as a result of their
maltreatment:
Well, she’s got this thing of feeling that she’s under
attack, even when she isn’t. It’s a lot better than it
used to be now, she used to hit out straight away if
she thought that somebody said something that she
felt was an attack on her. Or if somebody touched her
when she wasn’t expecting it and she thought she was
being attacked, she’d hit out or kick. That’s a lot
better, but she still does the verbal reaction to stuff. I
know it’s a protective thing that she’s learned, but she
says really unkind things (C2).
Many children discussed by carers also had problems
understanding the consequences of their own behaviour, in
terms of other people’s reactions to what they had done:
Although they all want friends, they don’t understand
that if you shout and scream at someone they won’t
want to be your friend. But they don’t want people to
do it to them. I mean [boy] used to be terrified if
anyone was aggressive towards him, although he
could be aggressive really easy, be very very
aggressive towards people (C8).
There were plenty of examples, then, of children dis-
playing difficulties with various dimensions of social
understanding. However, foster carers also described some
children who showed this understanding when interacting
with their carers, but were unable to access it when
socialising with peers. This was seen as a case of social
242 J Child Fam Stud (2012) 21:237–246
123
understanding being present, but being overwhelmed by
emotional need in stressful social situations:
You’d talk to her about personal space, and you’d ask
her to explain it back to you and all that sort of thing
she’d get it, but… I think again it’s just that despera- tion of friendships and the thought processes going
out, not even there when it’s happening… I think she gets herself into such a state concentrating on them
being her friend that any, those rules and regulations
don’t even come to the forefront sort of thing, they’re
just at the back of the mind rather than the front, so I
think it doesn’t even occur to her. But if you then spoke
to her afterwards she would be able to tell you (C10).
Foster Carers’ Strategies to Support Children
Questions about the ways in which carers might tackle
children’s difficulties revealed a number of specific strat-
egies used by carers to aid children’s social understanding
and empathy. For most, the principal strategy was to talk
through social situations with the children, encouraging
them to draw on their own experiences in order to under-
stand others’ points of view. This technique had been
expanded by one carer to include everyday discussions
about the possible thoughts and feelings of characters in
television shows. Another carer had encouraged a child
involved in a bullying incident to think about how their
victim might be feeling and write them a letter of apology.
Carers also made use of resources provided by practitio-
ners, including cartoon strips and story books to encourage
emotion understanding and consequences of behaviour,
pictures of faces to develop emotion recognition, and
specialist board games to stimulate discussion of social
cues. The strategies described had met with mixed success.
To close the interviews, carers were asked to identify
any training needs around the areas discussed. Most were
able to name courses they had attended which had touched
on some aspects of social understanding or self-percep-
tions, but none could recall a course that had specifically
covered strategies to encourage social understanding and
empathy with the aim of improving peer relationships and
self-perceptions. All but one agreed that such a course
would be welcomed.
Discussion
Our interviews with foster carers allowed us to draw on
their unique perspective on the day-to-day behaviour of
Looked After Children, in order to address our research
questions. A thematic analysis revealed that problematic
self-perceptions and peer relationships were commonplace
among the children discussed by these carers. The carers
frequently attempted to interpret socio-emotional difficul-
ties in the light of information about experiences within the
birth family. Moreover, in line with our theoretical model,
carers readily identified features of children’s social
understanding and empathy as relevant explanations for
their socio-emotional difficulties. While some children
were perceived to lack the understanding that might help
them negotiate peer relationships, others had acquired this
understanding but were unable to access it during stressful
social interactions. There were also important differences
in individual children’s empathic responses to others’ dis-
tress. Interestingly, carers reported using a variety of
strategies to help children in these problem areas. This
work was seen as a long, slow process, and success was not
guaranteed. Carers said they would welcome a training
package of practical strategies that could be used to
encourage social understanding and empathy in children,
with the aim of improving their social relationships.
Our primary purpose in conducting this study was to
determine whether carers’ experiences with maltreated
children would provide preliminary support for a model in
which difficulties in social understanding and empathy
mediate the relationship between maltreatment and prob-
lematic self-perceptions and peer relations. In fact, carers
often supplied spontaneous examples of children’s diffi-
culties with these skills when asked about their socio-
emotional well-being. Similarly, when specific questions
were posed about social understanding and empathy,
carers’ accounts of children who had trouble with these
skills also made reference to the socio-emotional effects of
such problems. This gives added strength to our proposed
mediational model as a framework for understanding the
psychosocial adjustment of maltreated children in care.
First, carers had little trouble in providing examples of
children displaying difficulties with what might be termed
‘mind-reading’ or ‘mentalization’: the ability to take
another’s perspective and to recognise their motivations
and desires. While developmental progress in these skills
was not a focus of our investigation, age differences might
be expected; however, carers’ accounts included examples
of difficulties with mentalization skills across the full range
of age groups looked after, from infants to young adults.
These difficulties may develop in the context of the mal-
treating family where identifying with the caregiver’s
mental state can undermine the child’s own mental state by
making them feel worthless (Fonagy et al. 2002). This lack
of understanding extended to affective as well as mental
states. In line with previous research (Quinton et al. 1998),
carers also gave accounts of children who had difficulties
in understanding and responding to emotions in others.
For some of the children discussed, the problem was a
misinterpretation of others’ behaviour. Specifically, these
J Child Fam Stud (2012) 21:237–246 243
123
children were perceived to display a hostile bias in the way
they processed their interactions with others. Pollak et al.
(1998) suggest that this may be because the traumatic
experiences associated with particular emotional displays
in maltreating families can guide children’s interpretation
of events and their choice of behavioural responses to
produce a hostile bias.
That foster carers’ accounts suggested that many mal-
treated children showed difficulties with social understand-
ing and empathy was in line with our proposed model.
However, while some children lacked the understanding that
might help them negotiate peer relationships, others had
acquired this understanding but were unable to access it
during stressful social interactions. Even for children mak-
ing good progress in foster care placements, stressful situ-
ations can prompt a return to the defensive strategies they
developed to survive in times of maltreatment (Schofield
and Beek 2005b). It has been suggested that affect regulation
is a precursor of mentalization (Fonagy et al. 2002); our
findings would suggest that even when mentalizing abilities
have developed, the regulation of affect and behaviour is a
necessary requirement for children to put this ability into
practice. This may prove more difficult for children in foster
care, as maltreatment has been linked to inferior affect
regulation (Robinson et al. 2009).
A key part of the foster carer role is to support children
with such difficulties in the move towards more adaptive
cognitions and behaviours (Stovall and Dozier 1998). The
results of our analysis indicate that one avenue for carers
and practitioners to target in tackling maltreated children’s
socio-emotional problems is through enhancing their skills
of social understanding and empathy. Our interviewees
expressed a desire to improve their knowledge of methods
of support for children who have difficulty with developing
or expressing these skills. The majority of our interviewees
felt that they would benefit from specific training on ways
to enhance children’s skills, and that this could have a
positive impact on social relationships and self-percep-
tions. Offering carers the training they need to support
children can combat feelings of inadequacy, which can
have a greater effect on carers’ satisfaction and intention to
continue fostering than even the perceived emotional and
behavioural difficulties of children (Whenan et al. 2009).
The carers’ positive attitude to training in this area is
therefore extremely encouraging.
Helping a socially isolated child to learn the skills
necessary for successful social interactions may have a
significant impact on their quality of life (Daniel et al.
1999). Children who lack these skills are not a lost cause,
and the foster placement should be viewed as a key context
in which change is possible (Wilson 2006). Indeed, Scho-
field and Beek (2005a) identified that the promotion of
children’s capacity to reflect on self and others—precisely
what may be lacking in many of the illustrative difficulties
cited in the present investigation—is a key parenting
dimension for foster carers, and one which predicted good
progress in children’s behaviour and relationships. More-
over, a review of the evidence has shown that in order for
interventions for emotional and behavioural difficulties in
Looked After Children to be effective, they must be
administered directly by or in close liaison with foster
carers (Rushton and Minnis 2002). Given that attention to
social and emotional well-being is part of the UK Gov-
ernment’s statutory guidance for Looked After Children
(Department for Children, Schools and Families 2009),
designing training to address the antecedents of children’s
difficulties with peer relations and self-perceptions is vital.
Conclusions
Our interviews with foster carers have provided support for
the proposed model, in which difficulties with social
understanding and empathy mediate the relationship
between maltreatment and children’s problematic peer
relations and self-perceptions. Additional work is now
required to explore the model further as a potential
developmental explanation for maltreated children’s socio-
emotional difficulties. Clearly, we must recognise that the
experiences related here are associated with a particular
group of individuals and may not reflect the reality for all
carers. Accordingly, it is crucial for further research to
evaluate the model presented here with larger and more
varied samples, and with full attention to the perspectives
of the Looked After Children themselves. In addition, we
propose a longitudinal test of the proposed model, in which
the role of social understanding and empathy as predictors
of maltreated children’s self-perceptions and social rela-
tions is assessed over the course of Looked After Chil-
dren’s changing experiences.
Such work will benefit from the use of a battery of
measures to produce a more detailed assessment of chil-
dren’s social understanding and empathy than is currently
offered. The experiences related here by carers support the
idea that maltreated children are not a homogenous group,
as it was apparent that individual children displayed
varying strengths and difficulties in social understanding
and empathy. This is only to be expected; for example,
physically abused children might be hyper-sensitive to
displays of anger and more likely to show a hostile bias
(Keil and Price 2009), while neglected children are likely
to have had an impoverished education in all types of
emotion (Pollak et al. 2000). Knowledge of these differ-
ences will help in the design of individualised support
plans that can be delivered by foster carers to improve
children’s socio-emotional well-being.
244 J Child Fam Stud (2012) 21:237–246
123
Acknowledgments We are indebted to the foster carers and social workers who took part in the focus group and individual interviews,
and to all those who helped in the recruitment of participants. Special
thanks also go to the staff at the Local Authority’s Fostering and
Adoption Team for their advice and support in conducting this study.
Appendix A: Interview Schedule
Background
How long have you been a foster carer?
How many children have you looked after?
What age range do you foster?
Tell me a bit about your current placement.
Self-Perceptions and Peer Relationships
Thinking about this child/these children, do they…. …have difficulty getting on with other children? …feel very bad about themselves? What kind of reputation do they have?—How do other
children respond to them? Teachers? Other adults?
Have you also seen this with any children you’ve
fostered previously?
In your experience, how common are these difficulties in
foster children?
Why do you think they might have had these difficulties?
What is it that makes you think that?
Social Understanding and Empathy
Have any of the children you mentioned had diffi-
culties…. …seeing things from someone else’s point of view? …understanding someone else’s emotions? …understanding why someone else has done something? …responding appropriately to someone else’s behaviour? …responding appropriately to someone else’s emotions (e.g., when you are sad they become happy/angry/
frustrated)?
…controlling their own behaviour? [If yes:] Do you think that’s because they don’t understand what is
appropriate behaviour, or do they understand but can’t
control it?
Support and Training
How did you try to support them/work to improve their
skills?
Why did you choose to do it that way?
What effect did it have, if any?
Can you think of a child you’ve fostered who…. …got on well with other children? …felt good about themselves? Why do you think these children didn’t have the same
difficulties as the others?
What is it that makes you think that?
Have you received any training on…. …why children’s parenting backgrounds might lead to these difficulties? (If yes, what and how much?)
…ways of supporting children in these areas/working to improve their skills? (If yes, what and how much?)
If no, would you find this useful—for you?—for the
foster child?
What sort of effect might it have?
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