"The ones who act up are reacting in a more healthy way," says Ms Bernie Price, the head social worker at the National Children's Hospital, Temple Street. "I would worry more about the ones who withdraw."
She is talking about the effects on children in care of being kept in hospital while waiting for the Eastern Health Board to find a fostering or residential place for them.
"Children tend to do one of two things," she says. "Either they withdraw, become very quiet and subdued and retreat into themselves, or else they escalate their behaviour and become very aggressive, disruptive and demanding."
Toddlers regress, losing their competence in speaking and forgetting their toilet-training.
Social workers and other hospital staff are concerned by the young age of some of the children placed in their wards, according to Ms Mary Heffernan, head social worker at Our Lady's Hospital for Sick Children, Crumlin. In the 21/2 years to July 1998, 35 children under the age of two were placed in the hospital as social admissions.
"These are babies. They haven't got complicated problems," she says. For this reason she is puzzled that they cannot be placed with foster parents from the start.
Worse, according to Ms Price, they are being kept in hospital at what is "a significant time in a child's life when they need the attention of one significant carer".
"Children would tend to form an attachment with anybody who shows an interest in them at that age," says Ms Brenda Mehigan, head social worker at Tallaght Hospital. "Then these people are gone again."
Older children, in hospital because they have been removed from the family home, "watch the parents of other children coming and going, spending all day, and there is nobody for them. It is very hard to communicate to a young child why they are being left there."
Particularly distressing, says Ms Price, is the situation of siblings where a fostering or residential place is found for one of them and the other has to stay on in the hospital. Their views are echoed by Ms Madeleine Clarke of Barnar do's. "It's hard enough that they have incurred abuse and that they are the ones who have to be re moved from the home rather than the perpetrator."
At the very time they need to be made to feel secure they are placed in a medical environment where staff are changing constantly and where the routines are new and strange. The whole sequence of events, she says, "leaves them in a situation where they feel `this must be my fault'."
The Association for the Welfare of Children in Hospital also told The Irish Times it was aware of the practice and concerned about it.
The Eastern Health Board said it "does not wish to have any children who are not ill stay in hospital awaiting placement. When such instances occur, the board's child care workers work with the children within the hospital to alleviate any possible effects caused by their hospital stay."