result of habit, and habit the result of training. That a child already had tendencies that would direct his beehavior, that a child had an inner life le that might be far more important in the development of his character than his outer life, were concepts far in advance of the early workers.

We know now that every child coming into foster care must be regarded as an individual needing help, and that there should be no place in our thinking for generalities about good and bad environments.

Good environment not enough

We now know that a child may be placed in a good environment and not be affected by it. Nowhere is the expression, "you may lead a horse to water but you cannot make him drink," more apt than in relation to a child who is picked up from one setting and dropped into another.

The reasons why foster-home placements sometimes fail are many. To cover them all one would have to touch upon the way the foster home is studied by the agency, the matching of the home and the child, the preparation of the home for the child. One would have to consider the parent who never will be able to accept with good grace the placement of her child in foster care, also the many aspects of the inner life. of the child. This paper deals only with that part of the child's inner life that has to do with his relationship with his parents.

If placement is to be more than just transferring a child into a good environment, we must realize that the child does have an inner life, in which he maintains a parent-child relationship. Secondly, we must accept the evidence of numerous cases that physical separation of parent and child does not necessarily interfere with the parent's influence upon the child. On the contrary, the separation may fead to the child's idealizing the parent. This may become clearer if we go back to our two stories.

Let's begin with Mary. Psychiatrists tell us that it is in the preschool period that little girls really become feminine. It is not at all uncommon to hear an adult say of a 5- or 6-year-old girl, "What a little flirt she is" or "she's already a little woman." We know also that a little girl gets her concept of

womanhood from her mother. The child's growth in the direction of becoming like her mother is marked by two-way feelings, of love and hatred. The little girl admires the mother and is jealous because she has characteristics now denied the little daughter.

These conflicting feelings cause tensions in the little girl which may be eased if she remains under the loving care of her mother. However, if the little girl is removed from her mother, the child still loves her, and the yearning to be loved by her continues. But with this is a natural resentment, for she feels that the mother did not love her enough to want to keep her.

Child is loyal to own mother

In the foster home the little girl finds another mother who is kind and loving, and the child accepts this substitute love and appears to adjust well to this new home. But what about the real mother? Whenever she makes one of her infrequent appearances, or whenever the question of the little girl's going home for Christmas or a week end arises, the foster mother shows, directly or indirectly, her disapproval and her unmistakable opinion that the mother is a decidedly poor influence.

In the meantime, what has the social worker been doing? She has been skirting the subject of the child's mother, which is as bad as the open criticism by the foster mother. This action probably arises from the fact that we should like children to have ideal parents, and when we find a most un-ideal lot and see the grief they cause their children, we cannot bear it. We avoid the subject of the disreputable mother to save our own feelings, and we overlook the fact that if we talked to the child about her we should be talking about something that the child knows more about than we do.

And so the little girl gets the impression that everyone thinks she should not love her mother. However, her yearning to love and be loved by her mother continues. She condemns her own resentment and is aware only of her loyalty and of a strong need to defend her mother. Love and hatred then are both repressed, which simply means that they have gone underground, where, unknown both to the child and to the people around her, they

Robert is one of the many foster children who have grown up happy and well-adjusted. His foster parents have always encouraged him to keep in touch with his relatives.

continue to be active in forming her personality. The little girl, as she grows up, seems to get her mother back by becoming like her. At adolescence, boy-crazy behavior shows up, and now everyone says, "Isn't it too bad, she's become just like her mother. And after all we've done for her!"

But we find that one important item was missing from the "all we've done." That was giving the little girl a chance to talk about her mother. Mary should have been not only allowed to ask questions but even encouraged to do so.

Someone should have acknowledged to her that of course she loved her mother. Almost everyone loves his mother; there's something wrong if you don't, not if you do. Once the child learned that no one would condemn her for loving her mother, and that she no longer had to defend her against criticism, she should have been encouraged to talk freely, even to tell of her resentment and anger that her mother had let her down, had failed to be the kind of mother that she should have been. Talking would have released some of the child's tensions and left her freer to pattern her life after that of the foster mother's.

Now take John, who had never known his mother. Did she influence his life so

much that he lost the only home he ever had? Can you imagine that a child can grow up in a home that he knows is not his own, and never, never wonder about who he is? Who were his mother and father? What did they look like? Does he look like them? What kind of people were they? Why didn't they keep him? Why do they never come to see him?

Is it not logical to think that at adolescence John's normal drive to be free of the restrictions set by adults was stepped up by his resentment because these people were not his own? Why should he obey them? They weren't his own parents. After all, what did he owe them? That may not be logical reasoning, because maybe he owed them a lot, but on whom else can he get rid of the resentment that comes not only of not having parents but of not even knowing anything about them?

Barring the rather obvious point that maybe this boy needed to be adopted instead of being kept at loose ends in boarding care, would it not have been better for the social worker to have talked with him from time to time, explaining that his mother had not been able to care for him, that she had wanted him to have a good home with a father and mother, that she had asked the social worker to find one for him, and that these parents were like real parents to him? With some of his longing to know about his own parents fulfilled, his wish to belong, his loyalties, and his feelings of love might have been securely moored to his foster home.

What can we learn from these two stories? First, they reaffirm what we already know, that the child continues to maintain some kind of relationship with his parents long after being separated from them. This relationship may be one that exists entirely in the child's inner life, with no counterpart in reality. In it may mingle love, anger, disappointment. Whatever these feelings are, part of their power over the child comes from the fact that they are hidden. Feelings that have no outlet have a strong effect upon personality.

To this point we have been developing three ideas: (1) Elimination of a parent from the life of the child does not necessarily eliminate that parent's influence upon the child. (2) Strong conflicting feelings about the parent may be present in the child. (3) The

strength and influence of these feelings are increased by their concealment. How social worker can help

Now what meaning do these facts have for the everyday practice of a social worker? First of all, social workers should take the initiative in helping children work out some of these conflicts about their own parents. What Anna Freud calls "the images of the parents" must be kept clear in the child's mind, even if a parent is dead, or committed for life to a hospital for the insane, or if of the parent's own volition he is completely out of the child's life, as in the story of John.

Only in this way will the feelings attached to his curiosity lose some of their strength; only in this way will some of the sting be taken away; only in this way can the longing for his own people be satisfied in some measure and his longing to be loved directed toward the foster parents.

There are three ways by which the social worker may help the child in this.

First is talking with the child about the parents. This is not easy. But the difficulties lie solely within ourselves, and most of them center around fear. We are afraid to hear children speak ill or disrespectfully of their fathers and mothers. Criticism of parents not only goes against our upbringing but arouses in us the fear that if we let the child criticize his parents openly, we are teaching him that he may be critical of any authority. This might mean he could react in the same manner toward the foster parents, and ultimately toward all law and authority.

These fears are groundless. On the contrary, if a child has resentments and disillusionments because adults have neglected him or pushed him around, it is reassuring to find in the social worker a person who agrees openly with him that his life has been hard and who lets him know that she doesn't blame him for feeling as he does. Such a person can help reestablish his faith in adults.

Strange to say, we sometimes fear the child's love for a delinquent parent. We are afraid of this love because we all know that a child often becomes like the person he loves. On the surface it seems that if we tell a child that of course he should love his mother or father, we are telling him to become like

the parent. Again this need not be so.

Another reason why it is not easy to talk to these children about their parents is that we are afraid to talk about the parents' behavior. Think of the sex offenses committed by some parents. Think of their laziness; think of their filth; think of their alcoholism.

We could have greater peace of mind about the parents' behavior if we could see beyond the behavior to the person, and could see that his behavior represents his fumbling attempts to be happy. In this respect he is no different from curselves.

Child is not deceived

Only if the social worker sees beyond behavior to the person, only if her feelings about the child's parents are warm and friendly, will she be able to talk with this child about them. If she attempts to sound broad-minded while she is really sitting in judgment, if she is afraid of the parent or of his influence, if she attempts to cover critical feelings with a veneer of tolerance, the child will know it. In that case, he will simply add her conflicts to his own.

It is this "how" of talking to the child that is hardest. It must be a matter-of-fact "how," in which liking for the parent and acceptance of the child's two-way feelings are implicit.

Once we have mastered the "how," the "what" becomes easier. First, we must tell the truth. A child can stand the truth when with it goes the worker's sincere interest in the child's happiness, her warm regard for his parents. and her recognition of his hardships. What we tell him will depend also upon what the child tells or asks us, provided our manner encourages him to ask questions.

Though it seems to be a paradox, a child can give up the past more easily if he can keep part of it with him in the sense that he is free to talk about it. He can loosen his bond with his parents more easily if he is not called upon to abandon them entirely.

The "when" of talking to a foster child about his parents, the timing of our telling, is particularly important. One cannot avoid talking about the parents at the time the child is placed in the foster home, when the reasons for placement are being explained, but

one should give only as much information then as the child can digest. As the child becomes more secure in the new home, more details about his parents can be given him. Age is another factor to be considered; what one would tell a 5-year-old would be very different from what one would tell the same child at 15. And we cannot tell a 5-year-old about the mother or daddy who went away and then drop the subject forever after. We must keep it open and help the child to formulate his own questions, which change as he

matures.

In addition to helping the child ask questions about his parents, the worker can help him feel that his parents are not shut out of his foster home by seeing that he has photographs of them and mementoes of home. Why don't foster children have large, framed pictures of their parents in their rooms? Many have snapshots, but why shouldn't the parents have a place of honor on the child's dresser?

Mementoes of home would also help the child. I wonder why, when we are preparing a child for placement, we don't suggest that he take some favorite object along that will always remind him of home. The picture and the memento could then be mentioned casually from time to time.

Foster parents should be helped to see that casual conversation with the child about his parents is desirable. If

the little girl's pretty hair is just like mother's, why not say so, just as the foster mother might remark that her own daughter looks more and more like grandma? Why couldn't we say casually to a child that daddy has a birthday next month? Let's see, how old would he be now? It is through such discussions about the details of family life, through the jokes about grandfather's mustache cup, through comments about whom one resembles, through remembrances of birthdays, that we come to have a sense of belonging. Through such little things do we feel that we have roots in the past. There is a place for some of this in the life of a child in foster care. By these devices foster parents keep open the subject of the child's own parents.

Of course, we shall have a difficult time getting foster parents to do these things. However, let's not forget that foster homes are to serve children, and the support and guidance we give foster parents must always be in that direction.

The third thing a social worker can do to help the child with his relationship to his parents lies in the realm of work with the parents. Admittedly the steps suggested here require careful, time-consuming work. Good child placement is neither easy nor cheap, and one is often led to wonder if as good results could not have been achieved if an equal amount of thought, effort, and time went into working with the

child's parents before placement was considered.

When it seems as if placement of the child is necessary, whether because of circumstances beyond the parent's control, or because the parent desires it, or because the parent really cannot cope with the responsibility of keeping the child, we must help this father or mother to play a modified role in the child's life. The manner in which he or she adapts to this new role will be influenced by the kind of treatment received from the social worker and the agency she represents.

Sometimes after a parent has ceased to visit the child and has therefore lost contact with him, it seems as if this may have happened because no one ever made the parent feel important. Defeated as a parent, faced by this defeat at every visit to the foster home and at every request not to bring so much candy, not to stay so long, not to upset the child to such an extent, many a parent finally gives up.

Only when we recognize why the parent brings too much candy and stays too long, only when we catch some insight into a father's or mother's life, and feelings, and needs, only when we feel with and for this person as a human being, apart from being a parent, can we help him see that he has not wholly given up responsibility for the child.

Children need to have parents visit. Anna Freud points out that we have been wrong even in asking parents to wait for a few weeks until the child seems to be settled in foster care. It is better for the child to have the parent visit soon after placement, even though these visits seem to increase the child's homesickness and grief. And visiting is not the only way parents can help in a child's adjustment; some children are helped by knowing that the parent is paying for the care.

There is one implied but final conclusion in all this. The more we recognize the importance of the parent in the life. of the placed child, and the more we come to know and to like the parent, and the more we come to respect him or her as a human being, the less often shall we place a child too hastily and without making every effort to preserve for him his own niche in this universe, which is simply his place in his own home.

F

INLAND works to protect the health of its children through "neuvolas," or well-baby clinics. The neuvola not only serves as the place to examine children and their mothers, but also operates as the focal center of public-health programs for the community.

The first large neuvola was established in 1922 in Helsinki by the Mannerheim League, which is the child-welfare branch of the Finnish Red Cross. Since then the league has been encouraging all the communities in Finland to build or equip neuvolas and has been giving practical assistance in getting them started. So successful has this effort been that most of Finland's 500 communities now have some kind of neuvola, and in accordance with the new public-health law every community will be required to put one into operation within the next 2 years.

Quarters of neuvolas vary

Obviously, since each community assumes the responsibility in setting up a neuvola, there is considerable variation in the physical arrangements. The finest is the one at Malmi, in south-central Finland, which is endowed by the Rockefeller Foundation. At the other extreme are the neuvolas in some of the poorer communities, especially in those damaged by the war, where the housing situation is particularly acute. In one village I found that the public-health nurse had rented one room; it was partitioned in the middle by a sheet hung on a string; one section was the neuvola; the other was the nurse's living quarters. There is also a wide variation in equipment; the better ones have ultraviolet lamps, good examination tables and scales, pleasant waiting rooms, and so forth. Others have nothing more than a paper-covered straw mattress on a crude examination table. Many are without scales. (To meet this shortage the American Red Cross has sent 200 baby scales to Finland.)

However, the purpose of the neuvola

is everywhere the same, namely, to safeguard child health. The presence of a public-health nurse, who is in charge of the neuvola, is the result of the Mannerheim League's work. (The league alco worked to bring about the new publichealth law, which will require each community to provide a nurse for each 4,000 of the population.)

The neuvola has regular examination days, generally several times a week; the doctor comes once or twice a month, also on schedule. Mothers are encouraged to bring their babies every week soon after birth but later a visit every 2 or 3 weeks is considered sufficient.

You can tell when it is clinic day at the neuvola. In the summertime you will see a lineup of small, low, wooden carriages with wooden wheels. In the winter, you will see these same carriages, equipped with wooden runners; and many of the little "kick sleds" one finds everywhere in Finland. (The kick sled is merely a little chair mounted on long metal runners. The baby is tied securely to the seat; and the mother holds on to the back of the chair, stands behind. on one of the runners, and pushes or kicks backward on the snow or ice with her free foot.)

Inside the neuvola there is the usual noise found in baby clinics.

Some neuvolas provide little baskets or boxes for the babies' clothing; less elaborate places provide nothing more than chairs on which clothing can be piled.

Undressing a baby for examination is a complicated business, since, to put it mildly, the babies are bundled up well to protect them from the cold. A wrap called a bunting is very popular; it is roomy, and square in shape except for a rounded hood; nothing of the baby is visible except his face.

First the baby's record card is taken out of the files and then the baby is weighed and measured and examined, by the nurse, or on certain days, by the doctor. The nurse recommends changes in diet, gives advice on various prob

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This public-health nurse, on the staff of one of Finland's neuvolas, or well-baby clinics is setting out to visit babies whose families live far from the center of the community,

lems, answers an anxious mother's many questions, and also gives out leaflets on various aspects of child care. In addition, the nurse distributes vitamin preparations, cod-liver oil, baby powder, powdered milk, and so forth. Immunizations of various kinds are given, and if the parents wish, their children may receive the BCG vaccine, which helps to provide immunity against tuberculosis. In order to make some of the neuvola services available to people who live far from the center of the community, the nurse takes periodic trips to the country. On these trips she often carries with her a portable scale. In the summer she travels on foot or on a bicycle; in winter by horse and sleigh if they can be had, but more likely on skis or by kick sled.

Then there are "mobile neuvolas." each of which consists of a team, including a doctor and a nurse, and a midwife if there is one available. These teams visit remote areas, where few if any medical facilities are available. In pleasant weather the clinic's, work is done in the open: in bad

weather the team uses whatever facilities the local Mannerheim League chapter has available, often the home of the nurse or teacher. The mobile neuvolas give the same services as the (Continued on page 30)