children with disfigurement, early years discrimination

Creating an inclusive environment for children with disfigurement

How can you handle children’s surprise at a new classmate’s disfigurement in a way that is positive for everybody? Jane Frances of Changing Faces offers some practical ideas.

When a child who looks different joins your nursery, children will stare and ask questions. This can be awkward as we have been taught that staring and personal questions are rude. But small children’s natural curiosity is generally considered a good thing. How can you handle difference, surprise, concern and curiosity in ways which are positive for everyone?

Ensure that all staff understand how looking different affects everyone.
Get to know the parent(s) and the new child before the child starts nursery.
Establish some dos and don’ts for managing reactions such as staring, asking questions and touching the child’s unusual feature.

Difference, looking and being looked at

Many things can cause facial disfigurement:

A condition present at birth eg birth mark, cleft lip.
An injury, eg burn, dog bite.
Illness or treatment of illness – eg septicaemia, cancer.
A condition that develops during childhood eg eczema, vitiligo.

Some conditions are permanent and relatively stable, eg loss of an eye, facial paralysis. Others change over time, eg psoriasis.

Medical treatments can include surgery and laser treatment, eg to remove or reduce birthmark, or ongoing management, eg eczema.

Reactions to disfigurement

Everyone who looks different experiences staring, questions and comments, especially from people who haven’t met them before.
New people either over-focus on the unusual feature or try to ignore it – in either case it is hard to ‘act natural’.
Lowered expectations due to the social myth that a child with a facial disfigurement doesn’t have much of a future, leading to underachievement at school.
There is discrimination throughout society in favour of people with conventionally ‘attractive’ facial features.

To ensure that children with disfigurements have a fair chance in life, disfigurement is recognised as a disability. See Early Years and the Disability Discrimination Act 1995 – What service providers need to know, from the National Children’s Bureau, 8 Wakley Street, London EC1V 7QE, (www.ncb.org.uk).

Why does this happen?

We usually have our ‘first lesson’ about disfigurement as a small child. We saw someone who looked unusual and asked the grown-up we were with, ‘Why is that man’s face like that?’ We were told, ‘Sshhh! It’s rude to stare!’ Our natural surprise, concern, and curiosity were met with a strong general rule – a taboo – against asking or talking about looking noticeable.

Allowing looking

Looking is natural when we meet someone new. We look more when someone looks unusual. It is often called staring and sometimes people try to stop children doing it. It is unpleasant to be stared at but making friends begins with looking and being looked at. The other children are likely to look carefully, perhaps with surprise and interest. Some may reach out and touch the new child’s distinguishing mark or feature. Others may ask a question. If these expressions of interest and visual contact are prohibited, the child who looks different will find it harder to join in and make friends.

Home visits

Allow time to get to know the family and for them to get to know you. Ask how they deal with other people’s reactions to the way their child looks. Ask how they talk about the condition, injury or illness that affects the way their child looks. They may need time to think about this. What do they call it? How do they describe it?

Preparing staff for to manage other people’s reactions

Before the new child’s first visit, run a staff information session.

General introduction to disfigurement and reactions – see above.
About this new child – prepare this in collaboration with the child’s parents. Include your observations about the child’s development, strengths and needs, educationally and socially (as for any child joining your nursery).
What to say and do about staring, touching and asking questions.

Answering children’s questions

Respond to curiosity as it arises. (Don’t try and ‘prepare’ children for a new child who looks different. Don’t try and pretend ‘we’re all the same underneath’). Questions about another child’s appearance are just a part of children’s huge curiosity about the world.

Why is her face like that?
Can I catch it?
Does it hurt?
Will it go away?

Even if the curious child does not speak but looks closely or reaches out to touch, it will be best to treat their interest as a question. Brief, straightforward answers work best (using words and phrases agreed with the family).

That’s just the way Chloe’s face is.
Danny has a scar. He was hurt but he’s okay now.
Sabina’s skin gets very dry and sore. You can’t catch it.
Muna has one ear like yours and one folded up ear.
That’s Jojo’s birthmark. It’s part of his skin – it doesn’t rub off.
When it gets sore we put cream on it.

Then move the conversation on naturally. For example, ‘Keiran has a big eye and a small eye. His eyes are brown. What colour are your eyes?’

A new ‘first lesson’

Next time a small child ask you ‘Why is that man’s nose like that?’ you can say something like, ‘That’s just the way his nose is. Mine is pink with orange freckles. What’s your nose like?’

For more information and advice or a copy of A Teacher’s Guide to Supporting a Child with a Disfigurement – 3-6 Years (£10 incl p&p) please contact:

Changing Faces
Tel: 0845 4500 275
www.changingfaces.org.uk

Jane joined Changing Faces in 1997 to establish their schools service. This service has developed and evaluated a range of practical strategies and interventions to enable children who look different to get on socially at school. She is the author of Educating Children with Disfigurement – Creating Inclusive School Communities (Routledge Falmer 2004).

This article first appeared in Early Years Update - Dec 2006

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