This is ue on Friday the 29th at 12:00 A.m. eastern time

Rena has always had a problem with obesity. She has had diabetes since she was 11 and has fought her overweight condition and high blood pressure since she was a teenager. She starts each new diet with great enthusiasm, but she soon returns to her old eating habits. Rena is beginning a new diet developed by a leading movie star, and she has great hopes. She tries not to remember the 400 pounds she has lost and regained in the past 10 years.

To begin:

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To obtain information:

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To focus:

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To clarify:

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To identify client strengths:

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Case 3

Jim joined a smoking cessation group at the medical center a month ago. As all participants do initially, Jim told the group about his tobacco habit and stated that his wife was adamant that he quit. He and his wife became parents for the first time two months ago, and she fears the effects of smoke on the baby. It was only last night, though, that Jim shared with the group his worries about beginning a topical precancerous treatment on his face and about his baby’s lack of response to stimuli.

To begin:

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To obtain information:

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To focus:

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To clarify:

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To identify client strengths:

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Exercise 7 Responding

After reading the following examples, write three different responses: a paraphrase, a clarification, and an open-ended question.

Helping Situation 1 I can’t seem to keep my mind on my work these days. I forget what I am doing, I find myself staring out the window, my kids keep yelling at me, I can’t get my work completed. I know that my boss is not pleased with me. I’m not pleased with myself. Everyone is giving me a hard time. I don’t sleep very well. I am a mess.

Paraphrase:

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Clarification:

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Open-Ended Question:

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Helping Situation 2 My momma told me that I had to come to see you. My teacher found out that I was coming, and she told me to tell you what I knew about my dad. I am not sure what to say. My daddy loves me. He says that he loves me special.

Paraphrase:

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Clarification:

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Open-Ended Question:

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Helping Situation 3 I am not sure what the problem is (pause) ... I just don’t know....

Paraphrase:

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Clarification:

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Open-Ended Question:

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Helping Situation 4 Mom and dad are not doing too well. Mom cannot dress herself anymore, and she needs help to prepare her food. She cannot remember what day it is, forgets to take her medicines, and does not know many of her friends. Dad is taking care of her as best as he can, but his abilities are limited, too. He is worn out from caring for her, and he does not have time to do anything for himself. We are crazy from worry.

Paraphrase:

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Clarification:

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Open-Ended Question:

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In More Depth: Talking With Children

There are multiple ways that helpers provide services to children in need either by supporting families who have children with special needs or by working directly with children. Children begin the helping process with an intake interview, much the same way that adults do. Many helpers indicate that, although the focus of service is the child, they gather information from other sources such as parents, school officials, and written case records. Ultimately, most helpers also want to hear from the child. Children have particular physical, cognitive, and social developmental characteristics; because they are a unique population, special knowledge, skills, and values are required of the helper to conduct this first interview.

This section provides information on the characteristics of children between ages 6 and 12, what psychologists label middle childhood, and presents guidelines for talking with these children, especially for the first time in the intake interview. This age range is a unique time in a child’s life: “Keep in mind that the school child’s head is not where yours is. It’s not just a matter of physical growth—it’s perhaps more a matter of intellectual change—the fact their intellectual feet are still not firmly grounded. Too, their heads may be closer to the clouds. And perhaps that’s why they see magic more clearly than we adults do” (LeFrancois, 2001, p. 374).

Let’s look at the physical, cognitive, and social development for children in middle childhood, as well as the problems or challenges they may experience.

Physical Growth

There are physical measures important to note in children in middle childhood. A marked growth spurt occurs as girls, on average, gain more weight and height. Both girls and boys decrease their fatty mass as their bone and muscle develop; this trend is consistent with good nutrition. Children also continue to develop their fine and gross motor skills. The increase in physical abilities allows them to expand their interest in creative efforts and sports requiring coordination and physical strength. Obesity emerges as a problem for many children this age due to overeating (Lamerez, Kuepper, & Bruning, 2005), poor nutrition, lack of physical activity (Weiten, Lloyd, Dunn, & Hammer, 2009), cultural or psychological factors, such as using food as a reward or a punishment, and genetic factors (Malina & Bouchard, 1991). Other physical problems are sensory-related, such as visual or hearing impairments and difficulties linked to such diseases as muscular dystrophy and diabetes. Children are also reaching puberty at younger ages. This change in physical maturation is problematic because cognitive and social development remain the same (Shaffer & Kipp, 2010).

Cognitive Development

Two important concepts help explain cognitive development in middle childhood: the use of concrete operations and intelligence. Children who are able to think concretely demonstrate skills such as engaging in conversations, performing reversible thinking, using rules of logic, and understanding concepts based upon concrete objects of their past experiences (Piaget, 1960). Children have conversations; they engage in dialogue, listen, and respond appropriately. They take turns in conversation and demonstrate an interest in others. The following conversation between two 7-year-olds during school playtime illustrates this:

SUZIE: Can I have your hammer?

JORGE: I am using it.

SUZIE: What are you making?

JORGE: A puzzle with this wood.

SUZIE: Okay. But I want the hammer.

JORGE: Not now. I am busy.

Children also perform reversible thinking; this means that they may have an idea or understanding and then change that understanding. The following conversation illustrates the change of thinking when Paula, age 9, discusses the subject of ghosts with her mom. Note that her mother uses a concrete illustration of a ghost, instead of an abstract idea.

PAULA: Are you scared during Halloween? I mean, if I am a ghost.

MOM: Is there something that makes you feel scared?

PAULA: Ms. Brewer at school says that after Halloween all of the ghosts will disappear.

MOM: Paula, let me show you what she means. See this ghost that I made for the door? After tonight I will take it down and put it away. Here, let me show you. (Mom takes the ghost down, puts it away, and shuts the closet where she puts it.)

PAULA: But I think that I will disappear.

MOM: Here, let’s practice putting on your costume and then taking it off and putting it away. [They do this.] There, now you know that disappearing ghosts means putting away decorations and costumes.

PAULA: Can I make the kitty disappear?

MOM: Well, the kitty can go outside and you will not be able to see her. But we still have to take care of her. She is still there.

Because children are beginning to use logic, they can use it to make sense of their world. They also have the ability to use rules of logic to construct knowledge. In the conversation above, Paula is learning about the concept of disappear. Because it is an abstract concept, her mom uses concrete examples to explain what the concept disappear means, as it relates to her “being a ghost” for Halloween. Paula uses a rule of logic to extend the concept of disappear to the kitty. In this example, her mother must help Paula understand that the rules of logic for the ghost disappearing do not apply to the kitty.

MOM: Paula, let the kitty out. Now has the kitty disappeared?

PAULA: I know where she is. When she goes out, she has a favorite place to sleep in the sun.

MOM: Why don’t you check and see if the kitty is there? (Paula checks.)

PAULA: Yup, she’s there.

MOM: Has she disappeared?

PAULA: Nope. I can’t see her from the window, but I know where she is.

Children from 6 to 12 years of age recall information from the past. They display long-term memory as they ride a bicycle, play video games, and make baskets at the free-throw line during a basketball game. As children tell stories about themselves or recall specific actions from the past, they show their autobiographical memory (Brouillet & Lepine, 2005).

Intelligence provides another way professionals consider children’s cognitive abilities. One theory is that intelligence is a quality or a measure of functioning and is based upon characteristics or traits. General intelligence focuses abilities that are innate within the individual and include solving problems, reasoning, and analyzing. Specific intelligence includes abilities such as knowledge of vocabulary, general information, and arithmetic skills (Engle, Tuholski, Laughlin, & Conway, 1999). Another way of viewing intelligence is by seeing how individuals adapt to the world. This approach, called successful intelligence, considers the context of intelligence and the control of the environment. This means that children choose the environments in which they function and then change them (Sternberg, 2008). Children demonstrate successful intelligence as they choose their friends, change their social interactions from setting to setting, and decide what they do in their spare time.

Understanding a child’s intelligence may assist a helper prepare for an initial contact with a child. A child’s written case file may contain scores from more traditional intelligence tests such as the Wechsler Intelligence Scale for Children (WISC). Alternative information about successful intelligence or multiple intelligence may be gained during the initial interview and may help the helping professional choose ways in which to communicate and establish rapport. Often professionals use tests to determine the intelligence of children. A later chapter addresses the use of tests to measure specific traits. There is also a caution about how to use test results in interpreting what we know about clients. This caution applies equally to the children helpers test.

Social Development

Areas of social cognition, self-esteem, and relationships represent the social development of children in middle childhood. From the age of 6 until 12, children change how they view themselves in relation to others. Children begin to see that others have a point of view, but also believe others would change to theirs if they knew what it was. Children then change to a self-reflective point of view where they acknowledge both their own and others’ points of view. Finally, they adopt a mutual point of view (Feldman, 2010). Once they understand the points of view of others, they may be willing to consider differences, express empathy, and facilitate self-change. The mutual point of view is just beginning to develop during the latter stages of middle childhood.

Understanding the self-esteem of children provides helpers with information about children and how they feel about their competencies and self-worth. Children usually have a general sense of their overall worth. Then they judge themselves according to specific competencies, such as their scholastic ability, athletic competence, social acceptance, behavioral conduct, and physical appearance (Feldman, 2010). Judgments about self-worth are founded on how children would like to be and how they believe others view them. The opinions of parents, influential adults, and friends are most important. Physical appearance is often one of the most important areas. Self-worth is linked to self-concept, emotion and mood, and motivation. A positive sense of self-worth is related to a good self-concept, happiness, and self-efficacy. A negative sense of self-worth is related to low self-concept, unhappiness, and depression.

Friendships become increasingly important during middle childhood, especially in the preteen years. Best friends and a circle of friends contribute to the social development of the child. Five categories of social status describe the different experiences children have with friendships (Gottman, 1977). The “sociometric stars” are liked by a majority of their peers. The “mixers” interact often with their peers; some are well-liked and some are not. The “teacher negatives” experience conflicts with their teachers; some are liked and some are not. The “tuned out” are less involved with peers and ignored. The “sociometric rejectees” are not liked very much. If a child is rejected by peers, reactions include anger, retaliation, and aggression. Children without friends suffer from depression, bullying, and loneliness (Substance Abuse and Mental Health Services Administration, 2003).

Victimization of children is a serious problem that affects a child’s growth and development. There are several types of victimization (Finkelhor & Dziuba-Leatherman, 1994). Pandemic victimization describes the occasional suffering related to high-profile kidnapping or violent crime. Acute victimization includes physical abuse, neglect, emotional maltreatment, medical neglect, and sexual abuse, and it is fairly prevalent in our society (Substance Abuse and Mental Health Services Administration, 2003). There are physical and psychological consequences of acute victimization, such as emotional withdrawal, aggressiveness, truancy, delinquency, poor school achievement, and poor social relationships.

Before we introduce ideas about how to talk with children in middle childhood, let’s explore information about child development that might be helpful to you.

Exercise 8 James and Samantha

1. List the facts that you believe are most relevant to you as you conduct an intake interview with children ages 6 to 12.
Physical Development:
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2. Read the following summary about James and Samantha. You also read about James and Samantha in Chapter Three. 
James and Samantha James is 10 years old and his sister, Samantha, is 8. Both attend Boone Elementary School and were living with their aunt and uncle; their parents are in prison. In the middle of the school year, the aunt told the children that they were going to move that evening. The children picked up their clothes and a few toys and moved into a shelter. They didn’t know that this was a shelter for women and children who were being abused. The children were brokenhearted to leave their school. They had good friends there. Samantha says that she understands why she needs to go to another school, but James is angry that he has to transfer. Finally, the staff at the shelter tried to work out transportation back to the school, but school officials told the children’s aunt that they could not transfer back into the old district. The school specialist has referred James and Samantha to you.

3. Review the child development facts that you listed in Question 1. How would each of those facts help you interview James and Samantha? Add any facts that you did not list for Question 1. 
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Now that you have studied child development for children in middle childhood, let’s look at guidelines for talking with children in this stage of development.

Guidelines for the Intake Interview

Helpers who are beginning their work with young clients often need to shift their thinking from “working with clients” to “working with children.” Many times when a professional uses the term “client,” an adult male or female comes to mind. Because of their age and lack of experience, working with children requires special care and consideration. There is an immediate power differential because young children are taught to have respect for adults, especially for those in authority. Children are involved in a developmental process; successful helpers consider where the child is in the developmental framework and begin the helping process with the child’s ability and level of development in mind.

Getting Ready for the Intake Interview

In some ways, beginning the intake interview occurs before the child comes to the office or before the helper visits the child. The helper prepares the physical space to make the child comfortable. This preparation also helps the helper establish rapport. Here are some guidelines to follow when preparing the room in which the intake interview will take place (Henderson & Thompson, 2011):

· Provide a relaxed atmosphere. This means use comfortable chairs and tables that are child-size and child-friendly. Set the furniture so the child can be face-to-face with you and not have to look up.

· Provide an atmosphere that is bright and not too cluttered. Children love bright colors and decorations with animals, dolls, and animated characters with which they are familiar.

· Establish a spacious atmosphere. Leave open space in the room. Do not put a desk or table between you and the child.

· Provide a barrier that the child can use to create a safe distance from you if needed. This means that the child can choose where to put the chair, or can hold a pillow or a blanket, or can move a table between you and him or her.

· Have toys, drawing material, desk, and dolls that might help facilitate conversation.

You will use these materials to involve the child in activities. Usually, helpers gain information as the child draws, paints, role plays, or the like. Even preteens may want to use art or music to talk about their situations rather than just engage in conversation. Also, games and other materials indicate to children that your space is a good place for them.

These suggestions are still relevant if the helper is meeting the child or the family at the home. Sometimes the helper can talk with the family about arranging a special room for the meeting, indicating that a place where the child would be comfortable is optimal.

The child may be nervous at the first interview. At the very least, children may have questions about the helping process and what is expected of them. Children often have questions that differ from those of adults. Many times children do not have a choice about receiving services. Even though the helper, and perhaps the parents, knows that the child will benefit from services, the child does not understand this. Here are some questions the child may have (Henderson & Thompson, 2011):

· What is helping?

· Why do I have to do this?

· What’s wrong with me?

· Will this hurt? Will I get a shot? Medicine?

· Do I have to go?

· Do I have to do this just once?

· What do I do?

These questions indicate fear of a new situation, talking to a stranger, and answering questions and not understanding the helping process and the need for it. You must be able to answer these questions using language that children can understand. Here are some ways to approach these questions:

CHILD: What is helping?

HELPER: I am a professional helper. My job is to help you. I am going to...

CHILD: Why do I have to do this?

HELPER: People who care about you think I could help you.

CHILD: What is wrong with me?

HELPER: I don’t think anything is wrong. My work is to get others to help you.

CHILD: Will this hurt? Will I get a shot? Medicine?

HELPER: I will not hurt you. Today we are going to talk and play. I want to know you better.

CHILD: Do I have to go?

HELPER: I am not sure where you will go. If you have to go anywhere, someone you know will go with you.

CHILD: Do I have to do this just once?

HELPER: You and I will see each other today. Then we will decide what else we need to do.

CHILD: What do I do?

HELPER: We can start by drawing this picture. Can you draw your family and your house?

The Focus of the Interview

As discussed earlier, any information that you can learn about the child before the initial interview helps you prepare. Two factors guide your initial interview with the child: the goal of your interview and the information you need to obtain. For example, if you are working with a child who has a chronic illness, you may need to engage the child to establish a relationship, determine how the child is feeling physically, what the child knows about his or her medical situation, and what social and emotional effects the illness has on the child. Of course, other sources of information may include parents and medical staff. Another child may be eligible to receive services because he or she is living in foster care while his or her parents are incarcerated. Interviewing this child for the first time, the helper may focus on the emotional status of the child, his or her comfort with the foster care family, and knowledge of the child’s parents’ situation. Additional sources of information may be the department of human services; the public schools, if appropriate; information about the foster parents; and the status of parents in the criminal justice system. Regardless of the situation, the focus of the initial interview is establishing rapport with the child, exploring what the child currently understands about the situation, understanding the strengths of the child, understanding the fears and concerns of the child, and explaining the helping process.

Exercise 9 The Case of Tannie and Lindie

The following case lets you apply the concepts to conduct an intake interview with children in middle childhood.

I received a call from Inez Tucker, the principal of the local elementary school in our county. She and I had worked together before on several cases involving students for whom home life is particularly difficult. Since the implementation of “No Child Left Behind,” each school in the school district targets students who are in danger of failing and tries to address barriers to their academic success. Often, these barriers involve home and neighborhood factors, as well as individual social and emotional problems. Inez asked if she could meet me for lunch, explaining that she had a complicated case that would take about 30 minutes to explain and discuss.

I met Inez at our appointed time at a small café downtown. The owner saved us a corner table in the back where we could talk without interruption and without being overheard. Confidentiality is important for both of us. Inez came with only a few notes and started by explaining how difficult this case was for her.

“Two weeks into the school term, a young mother brought her two children, Tannie and Lindie, to school. None of them spoke English. Speaking what we took for a South American Indian dialect, the mother tried to communicate. Three teachers in our school speak fluent Spanish, and two are native speakers. None of them spoke the indigenous dialect. After considerable effort on the part of several of us, including the three Spanish-speaking teachers, to talk with the children and the mother, I asked a kitchen aide to join the conversation. He speaks a mixture of Indian dialect and Spanish. The teacher also asked the children to join the conversation. Although the aide could not translate exactly what their mother and the children said, he could help us understand some of the conversation.”

Inez took out her notes and read to me the following facts that she believes she has learned about this situation:

· The children, both girls, are 9 and 10 years of age.

· The mother and the girls live three blocks from the school.

· The mother has no job.

· The mother can neither read nor write.

· The children can neither read nor write.

· The family has no permanent records.

· The children have never attended school.

Inez continued her story: “Since the girls have been coming to school, they have been receiving special tutoring. They go to class in the morning, but after an hour’s time, they begin to walk around the classroom. The teacher walks them down to my office. I have begun to let them play with toys in my office until the resource teacher comes to get them. She is working to teach them the alphabet, and she is teaching them words that might be useful to them. They have been in school five weeks now and they have come to school about half of that time. They really don’t understand the language and they don’t understand the culture of the school.

“I know that there are lots of needs, both for the family and for the girls. But right now I just want to hear from them about how they are doing. I would love to have more information about them, so I can understand what they are going through, how they like school, and what we can do for them.”

Inez then asked me if I would interview them. I would begin my work with an intake interview.

I scheduled a time to talk with the girls after gaining the mother’s permission to do so. I decided to interview both of them together. I thought that they would be more comfortable meeting with me together. To prepare, I followed three steps: considering current knowledge of the children; considering knowledge of developmental issues; considering use of an interpreter.

Preparing for the Interview

Review the discussion on attitudes and characteristics of interviewers in Chapter Four and the guidelines for interviewing children in this chapter. With this information in mind, create a plan for the interview, using the following questions to guide your thinking:

Working with an Interpreter

As you begin to prepare for the interview with Tannie and Lindie, you realize that you will need an interpreter. The likely candidate is the aide. Because you already speak fluent Spanish and are fairly fluent in French, you have never needed an interpreter. You find an article about interpreters in a professional journal and read it to see if you can discover any guidelines that might help you plan and conduct this interview.