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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

123

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&#x2019

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