Graham Pluck with a story of challenge and survival for millions of young people worldwide.
The ‘street children’ of Latin America
‘Street children’ live or work in the cities of many countries, particularly in low- and middle- income countries of Latin America, Africa and Asia. They are exposed to violence and abuse and are frequently exploited. Levels of substance abuse are typically very high, particularly glue sniffing. On the other hand, many ‘street children’ demonstrate notable psychological resilience and adaptability. The necessity of their daily existence may even drive development of some cognitive functions, such that they outperform children from more conventional backgrounds.
At traffic junctions all over Quito, Ecuador’s capital city, poor children sell fruit, newspapers or chewing gum to middle-class motorists in shiny 4x4s. If not selling, they may just hang around in the urban centres; some are gang members involved in petty crime and violence; others are working, for example shining shoes. Some, particularly those literally homeless and lacking support from families or aid agencies, are involved in the sex industry (Schlaefer, 2005).
This is a version of childhood hidden from most in the developed Western countries. But it is common in Latin America, and indeed in many low- and middle-income countries in Africa, Asia and Europe. The number of children living this way worldwide is effectively unknown. However, we can note that significant portions of the youth populations of some of the most populous countries in the world live or work unsupervised in the city streets… many, many millions of children.
As a British psychologist, living in South America and teaching and researching at one of its universities, I frequently see and interact with the niños de la calle (‘street children’). With an interest in the psychological issues of the region; and as a traveller, I’ve observed street children in most of the countries of Central and South America. In fact, the only Latin American country in the region in which they are notably absent is Cuba. This in itself shows that to consider the issue of ‘street children’ as purely an economic development issue is misleading. Cuba is one of the poorest countries in Latin America, yet manages to keep virtually all its children housed and is the most successful at keeping them out of the labour market. Clearly,
a deeper understanding of the contexts that create the situations of street-connectedness of children must take into account political, cultural, social and indeed psychological factors.
Psychological health challenges
The lives of the so called ‘street children’ in Latin America and in other countries, cry out for attention from psychologists. The levels of potentially psychologically toxic factors that such children are exposed to is shocking. One of the most common observations is precocious and pernicious substance abuse by street-connected children.
In one study of 124 abandoned children (mean age 14) who lived and worked on the streets of La Paz, Bolivia, 58 per cent reported alcohol use, 40 per cent reported glue sniffing and 88 per cent reported the abuse of paint thinner (Huang et al., 2004). Similarly, in Ecuador, a study of homeless children who were in contact with neither families nor care agencies (also mean age 14) reported even higher levels: 98 per cent reported cocaine use and 98 per cent reported solvent abuse (Schlaefer, 2005). In Medellin, Colombia, a study following DSM-IV criteria estimated that 58 per cent of the street connected children (mean age 15) they surveyed met criteria for substance dependence (Ricardo Ramírez et al., 2011).
In contrast to the numerous studies on substance misuse by street-connected youths in developing and middle-income countries, there are few methodologically rigorous studies of mental health. This is surprising considering the scale of the issue and the significant challenges to psychological well-being faced by many children living or working unsupervised in urban environments.
The problem appears to be that although anthropologists have seen the lives of homeless or street-working children as worthy of study, few psychologists or psychiatrists have followed suit. Consequently, the available academic literature is mainly ethnographic in nature. These studies tend to suggest high levels of internalising and externalising behaviours.
A recent systematic review of the health of street children was able to identify only eight studies that had used diagnostic categories or validated measures of mental health (Woan et al., 2013). These suggested high levels of hopelessness, depression, self-harm and suicide among groups of street children in different parts of the world. The lack of formal measures of mental health is even more surprising considering the wealth of information available on exploitation and trauma experienced by children living and/or working in the urban environment.
A study of homeless and unprotected children in Ecuador documented very high levels of sexual abuse and exploitation (Schlaefer, 2005). Of her sample of 226 street youths (mean age 14), all lacking contact with family or aid agencies, all but one claimed to have experienced penetrative sex, and the mean age of first sexual intercourse was 8.6 for boys and 5.8 for girls. For both groups of children, 96 per cent reported experiencing forced sexual activity, and all said that they occasionally exchanged sex for money or drugs.
Similarly, in a study in Medellin, Colombia, involving street-connected children and adolescents aged 7 to seventeen, 84 per cent reported sexual activity. This included 79 per cent of those aged under 12 (Muñoz-Echeverri et al., 2011).
Needless to say, in addition to sexual exploitation, children who live or work on the streets are highly vulnerable to physical violence. A globally focused review by the charity ‘Consortium for Street Children’ suggested that not only are levels of violence experienced by street child populations very high, they are remarkably similar across the globe (Thomas de Benitez, 2007).
In the study in La Paz described above, the majority of children reported having been physically assaulted, by their peers, by family members or by the police. In fact, 90 per cent reported having been beaten with sticks by police officers (Huang et al., 2004). Indeed, violence against vulnerable children living or working in the streets meted out by members of government security forces or vigilante groups is a common theme in Latin American countries.
In Brazil numerous such reports exist. The most notorious was the Candelária massacre of 1993, when, according to Amnesty International, a group of hooded and armed men attacked a group of 50 homeless children as they slept outside a church. Some died instantly from gunshot wounds, others were abducted and murdered elsewhere. The hooded men were later identified as military police officers (Amnesty International, 2003).
In our own interviews with former street-connected children, now attending an assistance and educational programme here in Ecuador, we have heard stories of extreme violence, of sexual assaults and of police brutality. Perhaps not surprisingly, over half of the children we have interviewed meet DSM criteria for post-traumatic stress disorder (Pluck et al., 2014).
This is the reality for many of the poorest and most vulnerable children in Latin America. A recent review of street child research globally noted that views of the public tend to polarise between viewing them on the one hand as being helpless victims of hunger and violence, and on the other hand as drug taking criminals lacking morality (Thomas de Benitez, 2011). It is when the latter perspective prevails that persecution ferments.
Adaption and survival
So do street-connected children of Latin America show significant effects of mental ill health and trauma? Several writers have argued that many children in these situations show remarkable levels of adaptability and resilience. It has been noted that many children who choose to live on the streets in poor countries are doing so as an alternative to poverty and abuse in the family home. In fact, several studies report that when compared with poor children who do not leave home, the homeless children do not show raised levels of psychological distress (Koller & Hutz, 2001).
It is perhaps too easy to continuously focus on the negative, on the mental health, on the victimisation, on the substance abuse. It could be argued that many children working and surviving in the streets are showing real adaptive skills and initiative. For example, one study in Lima, Peru, found that child street workers gave a variety of reasons for working, from needing to buy food or clothes to wanting to help their parents, and although most reasons were basically economic, many said that they worked because they enjoyed it, to meet people or to expand their group of friends (Pacherres, 2003).
Furthermore, some authors have suggested that street life actually enhances development of children, as their experiences give them real and valid learning opportunities not available to conventionally schooled children. For example, Aptekar (1989) has suggested: ‘Street life, rather than taking away from cognitive growth, may actually add to it’ (p.43). In support of this he studied IQ scores in a group of 56 local authority detained boys in Cali, Colombia. All were involved with a street child programme and had had no family contact for at least three months (Aptekar, 1989, 1991).
From his studies, Aptekar concluded that ‘most street children were functioning adequately intellectually, neurologically, and emotionally’ (Aptekar, 1991, p.328). However, measuring IQ scores in low- and middle-income countries is often problematic, as locally validated and normed versions may not available.
In a recent systematic review of intellectual function of groups identified as street children across the world, only five reports could be identified, including Aptekar’s sample from Colombia (Pluck, 2013). Overall, the pattern of intellectual function of street children samples in developing countries was equivalent to patterns observed amongst homeless children and adults in more developed countries; that is, performance about one standard deviation below the estimated population mean (Parks et al., 2007; Pluck et al., 2012).
Nevertheless, it could be that street experience, although not conducive to overall intellectual development, has particular positive influences on cognitive development, depending on the local context. There is evidence for this. Child street vendors in Brazil often work selling candies and the like on buses or street corners. To do this they must buy in bulk and calculate sale prices to maximise profits; in addition they have to quickly calculate total prices and change to be given to customers. Although not attending school, their arithmetic abilities surpass those of non-working urban school-attending children or rural-living children (Saxe, 1988).
So the studies of street vendor mathematics suggest very specific situational drivers of cognitive development. However, there is also some evidence of a more general improvement in cognitive ability. In one study, 36 boys (mean age 14) who had spent at least six months living on the streets of La Paz or its neighbouring city Al Alto, Bolivia, were compared with a similarly poor group (but without experience of street living) on a battery of cognitive tests. It was found that the homeless group were not significantly impaired on any measures, and on one measure performed significantly better than the comparison sample (Dahlman et al., 2013).
Interestingly, this better performance was on the Alternative Uses Test, in which participants are asked to think of multiple uses for common objects. This is considered a test of divergent thinking and of imagination. That the homeless children performed better suggests that their life experiences had driven development of cognitive skills useful for adaption and survival. Certainly, we can see why noticing alternative uses for objects might be a useful skill for extremely poor street-living children.
Strengths and weaknesses
Psychologists and others working with or studying the lives of street children must resist dual temptations – on the one hand seeing everything as victimisation, demanding sympathy, and on the other hand romanticising their lifestyles. But how can we reconcile these observations, of multiple and complex problems, exploitation, violence, trauma and drug abuse with notable strengths, resilience and adaptability? One of the reasons for this contrast is the inappropriate use of the term ‘street child’. It is simply used to categorise too many different life contexts under one convenient expression.
Firstly, it covers children who are literally homeless as well as those who spend many hours working in the streets, but do have a home to return to. A study of 972 child street workers in five Latin American cities (Bogotá, Guatemala City, Mexico City, Quito and San Salvador) reported that only 18 per cent were literally homeless (Pinzón-Rondón et al., 2006). However, in total 48 per cent would be considered ‘street children’ because they were working long hours in the street environment unsupervised by adults.
Although homeless and street-working children in Latin America will frequently describe themselves as niños de la calle, it appears to be a label of convenience originated by outsiders. Psychologists need to focus on more appropriately and narrowly focused groups, such as abandoned and homeless children, children in homeless families, street-side working children, and so on., rather than the overly inclusive category of ‘street children’. In some of these groups, but not others, we may observe trauma, mental illness or stunted cognitive development, in others we may observe resistance, resilience or context-specific cognitive development.
In this review I have tried to give additional context, such as living conditions and social connections, when describing the various samples reported in the literature. However, ‘street children’ remains the common parlance, partly because it is the expression most readily understood by the public, and that most used by charities, who rely on public attention.
Some researchers distinguish between children in the street (street-working, with homes to go to) and children of the street (literally homeless). This is somewhat better. Others prefer expressions such as ‘street-connectedness’ that carry the meaning without nominalising the individuals as somehow being part of the street.
The constant emphasis on the negative aspects of the lives of street-connected young people, lumping them all together, is potentially stigmatising. Not all street children take drugs, not all are involved with crime or prostitution. Indeed many are very hard-working (the study by Pinzón-Rondón et al., 2006, reported that most child street workers in Latin American cities work more than 40 hours a week).
Different street-connected children have very different lives. The concept of the ‘street child’ lumps together, amongst many other lifestyles, the drug-using violent gang-members with children honestly working long hours, in highly polluted environments, to help their families survive the daily battle against extreme poverty. This is profoundly unfair. Indeed, research in Ecuador has suggested that many poor families, particularly indigenous Americans, see street begging or street working by children in a positive light, where they learn financial skills and contribute to their community (Swanson, 2010).
The lives of poor children in Latin American and other low- and middle-income countries often differ markedly from many of those in the richer, more developed countries. In a globalised 21st century, psychologists must stop focusing solely on their local contexts and consider the psychological lives of adults and children around the world. It is not enough for the study of child development in poor countries to be left to the psychologists in those countries.
Psychologists in Britain and other developed countries have a responsibility to study the psychology of people as it is, globally, and to develop collaborations with psychologists and clinicians across geopolitical boundaries. In the past, psychological research has been shockingly biased towards inclusion of participants from rich, developed countries, people who are effectively minorities on this planet. Recent research suggests that such participants are notably unrepresentative of humans in general (Henrich et al., 2010).
Interactions between psychologists in the industrialised-developed countries and those in less developed low- and middle-income countries could benefit from the synergy of fresh approaches. For example, the majority of published psychological research originates in the USA or other English-speaking countries, with only a tiny proportion from Latin America (Arnett, 2008).
However, in Latin America there has traditionally been an emphasis on applied (as opposed to investigative) psychology, where strengths have developed in psychotherapy (Ardila, 2004; Cruza-Guet et al., 2011). Furthermore, research in poorer countries, such as many of those in Latin America, can present opportunities for study and learning not available or not easily accessible in the developed, industrialised West.
The lives of street children is but one example. Related issues are the effects of poverty in general, in countries where the poverty can be extreme and the gap between rich and poor is huge. The effects of formal education on cognitive and brain development can be studied, where there are populations of children with or without access to schooling.
The millions of poor children of Latin America and other countries suffer many problems and challenges. As academia globalises, there are opportunities for psychologists in the developed, industrialised countries to research, propose interventions and raise awareness of problems faced by low- and middle-income countries. This could help, if only a little, to bring the millions of street-working and homeless children of the world out of the shadows and receive the attention that they deserve.
Graham Pluck is at Universidad San Francisco de Quito, Ecuador
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