Development Assessment

Development Assessment

Reflection – Friday evening.  I’m sitting here with a Smirnoff’s Ice – Raspberry and listening to Pearl Jam’s Vitalogy.  I recount the day’s events, as well as the dreaded child development assessment. 

I had one of those days today when I wake up and get the three kids out the door to their three different schools.  Then I get to have my time.  My time to fall apart.  It’s ok to cry.  And it happens.  A day when everything yucky comes to the surface.  Like the children’s book by Judith Viorst.  I had a crappy, weepy, awful day.  Could anything go well to lift my spirits?  My week started with a few appointments Monday, Tuesday, and Wednesday afternoons for my daughter.  The child with special needs.

I endured a three hour interview on Monday at a children’s hospital’s development and rehabilitation unit.  My daughter got to draw, eat a snack, and answer a few questions, like:  Who lives in your household? Do you have friends?  I got asked all the other questions filling up the remainder of the three hour time. Questions like:  Could you talk more about that? Could you describe situations?  Could you talk more about that so I can visualize how that looks?  This was precisely the reason why I had dreaded this appointment, I was wiped out that evening. 

I will receive a detailed report in a few weeks.  But at the end of this interview, the psychologist offered a brief assessment:  Most likely, my kid was deprived her first year in life and also in her foster home of three years.  She didn’t get her emotional needs met.  There was likely a food scarcity in BOTH homes.  I interrupted to point out that several of the people in the foster home were morbidly obese…

The clinician reported that food scarcity is common with obesity — the unstructured meal times, the ups and downs of food amounts.  She went on to tell me that my child received little to no structure and stimulation in the foster home which would explain the simplistic play behaviors, the lack of coping skills and the obsession with food and tv.

I thought to myself while she talked: I know, I have heard this, why were we on a six month waitlist to be seen here?

The psychologist said to lower my hopes and expectations as she won’t be changing anytime soon. “You basically need to lay down a different foundation, as you slowly remove the old one.”  Really? I said, somewhat sarcastically.   She continued, “Yes, expecting her to change quickly would be like letting your original foundation just crumble and fall apart without any support in place.”

Somewhere I hear my sister and brother-in-law laughing.

She said my kid CAN change over time, a long time, if the parents and every teacher is consistent each and every time with the same rules and repeated direction of adaptive coping skills.  Wow, I thought. Long time. Each and every time. Every single adult at home and school. Yeah! No problem.

Perhaps my depression is now better understood. Tuesday I informed my child’s therapist after another play therapy sand table session what was discussed at the children’s hospital.  She had more to say on this matter.

Friday rolls around and I couldn’t stop crying.  Every time I thought I had gained composure, I looked at myself in the mirror to get cleaned up. And every time, I saw my puffy eyes and eyelashes coated in Kleenex dust.  And every time, I whimpered: is she ever going to change?!  

I picked up my child at dismissal time at her school.  She tossed her name badge to her teacher when she saw me.  I waited for her teacher to make eye contact with me and to call out my child’s name.  Then my kid turned to face her teacher and pestered:  Did I have a good day? Did I? Did I? Did I have a good day? Did I?  Her teacher continued to dismiss the other twenty first graders, but stopped.  “Well, let’s talk to your mom about what happened.”

As I hustled closer so that Ms. T could tell me how my child stole a dinner roll from someone, I bumped into another mom’s arm.  I looked back and apologized.  The woman was wincing and rubbing her right shoulder.  Yup.  That was the finishing touch to my sh*tty day.

Dealing with Severe Behaviors

Beyond Fed Up – Dealing with Severe Behaviors

Does your child lie or steal? Is your child defiant and/or aggressive beyond age appropriateness?

I have the book for you: Beyond Consequences, Logic, and Control by Heather T. Forbes and B. Bryan Post.  Check out the website: www.beyondconsequences.com

Three years after we adopted our child from foster care, I was so fed up with the lying, stealing, and defiance. Beyond fed up. There were days when I could barely look at her, I was so fed up.

I am a reasonable person. I handle stress and frustration in decent, appropriate ways. And yet, three years of nearly daily misbehaving, I said out loud to my spouse: I wish a caseworker would pick her up.  

I reached my breaking point two weeks ago. She had been stealing items from lockers at her school, en route to and from the restrooms. Her teacher implemented the buddy system at my request, for my child’s “special needs.” Still she continued to find opportunities to steal from others. Her teacher would gently pull her aside and question her. She would flat out lie.

I asked her to think about the other child. “What do you think that other kid is feeling, huh? You took his or her ________?” (Fill in blank: snack, hair barrette, pencil, book, homework assignment, sandwich, bead.)

“I dunno.” She shrugs.

I turned in private to my spouse, “She doesn’t care. There’s nothing. What a disrespectful brat.”

The lying and stealing occurred at home too.  But the defiance; that was the behavior that broke me.  Over anything and everything five times per week, then pure joy over the same anything and everything once or twice weekly. What the hell? It was too much.

I pleaded with my therapist. “Are there any medications to help with this?” My therapist answered, “Have I recommended this book yet?” She held up a copy.

I skipped ahead and read the chapters on lying, stealing and defiance. Our triad. Chills went up and down my spine. Did they know my daughter? I wanted to ask the authors: Were you a magical fly on the wall, watching us the past few years?

I read the testimonials of parents who had (yes, past tense) children exhibiting these awful, maladaptive behaviors daily/weekly for years. The parents admitted to hating life and having homicidal impulses. I could relate.

I felt comforted reading. There was hope.

I felt guilty and defensive. I had been trying my best here, my intentions were always good.

The authors explained where these behaviors come from, there were detailed explanations. I went back to the beginning of the book and started with Chapter one. The explanation that most resonated with me was: these kids are poor self-regulators. No one did it properly that first year, or those first few years. And they use these extreme behaviors to survive.

My daughter was gypped her first year as a baby, she was neglected by her birth parents. She lived in the same foster home for a few years and did not have her emotional needs properly attended to, resulting in almost four years of being in survival mode.

Lying, stealing and being defiant are her ways to cope with life.

She holds onto her lie, like fingers gripping the edge.

“I saw you do it.”

“No, I didn’t.”

“I just saw you do it, right in front of me.”

“No, I didn’t.”

It was maddening to deal with this daily.

Her stealing behavior is likened to having a drug addiction the authors Forbes and Post reported in their book.  It’s a quick fix to feeling agitated and stressed. One time, two times, multiple times a day a child will steal to alleviate the discomfort. Problem is, it’s a quick fix and does not last.

The defiance– old school theorists wrote about the child wanting control. Forbes and Post write about their new view on this behavior. Again, discussing how the child is not able to properly regulate and living in a state of fear.

I am about a week in to trying to parent differently. I have noticed moments of a calmer state. For her and for me.

I am better about addressing the cause, and not getting all wrapped up discussing the situation.

 

“Yes, sorry you’re having such a hard time. Whenever you’re having a hard time, you steal stuff.”

 

“Can we go out for ice cream?”

“Nope, not today. When you make better choices we can. Didn’t your teacher tell you about  quiet area in the classroom, or how you can raise your hand for her help, or you can always go read a book on the rug?”

“Yes.”

“Ok, so those are better choices. Stealing is not a good choice.”
It’s a relief to know that we are not raising a criminal. There’s hope. I don’t understand why after three years she is still in survival mode. But at least I have an explanation.  I feel I can move beyond our despair. 

Sandplay Therapy

Sandplay Therapy

My daughter is doing sandplay therapy.  Our counselor discussed the concepts and I consented to this form of therapy.  The two of them are in a room with a sand box table. They sit opposite each other. Along a wall are a few long shelves crowded with figurines, dollhouse furniture, beads, stones, and animals — all sorts of props. The therapist gives a simple instruction– create something, or set up a situation, or go ahead. 

Near the end of the session time, I am invited in. My daughter points to what she has placed in the sand and tells me a comment or two about what is happening. “The lion is sitting near the tree, getting shade. This stone here is for the lizard to lounge on.” That sort of talk. After she leaves the room, our therapist offers a few interpretive statements. “It’s very early, it’s only our third session. But again today, there are mostly animals, only 1 or two people, well one is a fairy, and there are situations that involve safety.”

Am I up for this?

We have returned to therapy after two years. Last Spring, we started her on psychotropic medications prescribed by the clinic’s child psychiatrist. I’ve attempted to follow through on our therapist’s recommendations at home.  But she continues to stump us.  Even our therapist said to the psychiatrist during the last medication appointment: There is something unusual about her, I can’t pin point it.

So for various reasons, I agreed that using sand therapy to tap into her unconscious struggles would be of benefit. I am very curious about this process. I am mixed about receiving valuable information, and being confronted with my difficulties. I even entertain and prepare myself for possible themes:

Mean, restrictive mother

Appeasing, inconsistent father

Rejecting, older brothers

Harsh homelife with too many rules

I asked Beth, “So….I’m just wondering how this works. Do you plan for eight sessions, or do you go week to week and decide when you have themes?”

Beth explained she follows the child’s work and when there appear to be consistent themes, they’re done with the sand therapy.

Somewhere deep in my mind, I hope that we will get some answers. Some treasure that has been hiding, buried for years. Latent explanations for the lying, sneaking and stealing behaviors still plaguing our weekly lives. I understand she engages in these primitive antics when anxious. Yes, I understand. But what is driving the anxiety? What is it?

What is the Right Dosage of Ritalin

June 20, 2016

We are in the process of determining the right dosage of Ritalin for my kid. We went in for another medication review appointment with a child psychiatrist.  I noted the improvements — there are two. She has been better about taking re-direction and there has been a noticeable decrease in emotional meltdowns at home. However, the non stop chattering, interrupting, and pestering remains the same. Likewise, her teacher noted she still has strong reactions to little things in the classroom to the extent of requiring a school staff person to be called in to help calm her down.  In her defense, the end of the school year can be difficult for a lot of children. It’s emotional.  The psychiatrist discussed things further with me — asking questions, asking for descriptive situations. The doctor recommended a slight increase in the dosage, a slight titration. We would meet for another medication review in a month.Right dosage of Ritalin

The bio-chemistry relationship involved with psychotropic drugs continues to fascinate me.  Could we have a little more of this so that we get a little less of that? A little more chemical input to decrease the behavioral output. I was hoping that once my daughter could pull in the reins on her running thoughts, I would be able to do therapeutic exercises to help her stop, pause, and make a good choice.  Maybe medication is similar to finding a fertilizer that works best on the yard — bringing out the desirable green grass, encouraging new growth, and suppressing the unsightly weeds.

I tried not to examine each blade of her existence. Yet, I wanted to carefully keep note of behaviors improving, antics remaining the same, or difficult ones increasing in frequency. We had a little of each. What a relief to have fewer emotional meltdowns over for example, “Please go play outside, it’s nice and sunny and your brother wants to practice his drums in the playroom.” Still the same ones of non-stop chattering and nonsensical arguing. And then the last one. More stealing and sneaking behaviors– taking notecards from my desk, emptying out brother’s emergency inhaler (placed on his bedside table), and climbing onto the counters to reach an item on a high shelf. I even tried out this one because I doubted her abilities. I climbed up on the countertop. I remained on my knees to account for her 42 inch height and reached my arm up high. Yup, it was doable. It was totally possible to reach the now consumed 8 pack hamburger bun package. Silly me for placing it there, for thinking that our family of five could have Sloppy Joes later this week. Instead we had pasta with meat sauce, a tangy BBQ flavored meat sauce.

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Isolation as a Special Needs Parent

Isolation

We went camping with 12 families over the long holiday weekend. We were invited to join this large group for a three night trip. We had not gone camping for a while — my youngest not able to handle the usual activities of hiking, quietly sleeping with others in a tent and appreciating the outdoors. So initially, I was ready to spend just one night with her, ready to pack up our belongings and drive back home if necessary. Instead we decided our family would join the others early Saturday and return home late Sunday night. We all wanted this to work out.  I know the names of all the parents and kids. I can identify the makes of the SUVs and vans they all drive. I can closely guess the grades the kids are in and the professions of the parents. Yet, I really don’t know most of these families that well. What I did find out during that weekend was that in our group, about ten households had an issue. I came to this awareness from listening to a parent of each family unit describe something troubling going on with their child — behaviors, medical concerns, mood disorder and social issues, sexuality, and learning problems. We all had children with special concerns. We all needed to seek professional help for our kids. I didn’t feel so alone anymore. I saw my daughter in a different light– a more gentle glow. And my hubby and I relaxed a little. We were not going to stand out, we were not so different from the others. All those times we suffered behind our closed doors, disturbances were occurring in the privacy of other homes.

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Starting on Ritalin

Starting on Ritalin

Week 9

We started Ritalin the beginning of this month. “You’ll know within two weeks if this is working, it’s pretty fast acting,” said the psychiatrist. I am strangely excited and encouraged. Why can’t most difficult situations have a fast acting response time.

Last weekend my husband took the boys and the dog to stay in a cabin. One night, two days away, four creatures not around the house. Just the two of us left behind to deal with each other. The pair that has had difficulties tolerating and enjoying each other. We had a delightful time.

 She had been on the medication for four days. We had tried another ADHD medication, a non-stimulant, for over a month and the only change we saw was irritability. Uh, no thanks, could we take that off the plate? So here we are, going into week 9 after that initial medication evaluation and trying out Ritalin.  Our doctor told us that most kids respond well, most respond quickly, and most experience only a few side effects. Since our medical specialist informed us that her heart murmur is in no way a reason to avoid stimulants, we received the green light to proceed with this category of medications.

Starting on Ritalin young child

Changes could occur from a pill

Off they went with a frozen pizza, sodas, Fruit Loops, pancake mix that requires only adding water, dog food, one change of clothes and toothbrushes. Not my choice of foods, his idea. Not my idea to pack so lightly, his choice. Have fun! I yelled. I braced myself for endless difficulties of being with my daughter. It’s not pleasant to feel this way towards your child. Sometimes I need to be nudged, if not pushed into certain situations. I really don’t think of myself as overly cautious. But I’ll admit, I am not eager to enter an arena of battles. I know that  I need certain circumstances to be in place to make me deal with a problem.

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Parent Needs

Parent Needs

Week 5

We have completed a few weeks on medication for ADHD impulsivity. Maybe by the next appointment, we’ll feel or see some improvement. I think it is too soon to expect results. It’s too soon, right? I’m not missing something here, am I? I’d like some kind of sign that I have permission to job hunt. I have parent needs too.parent needs

I’ve lost a lot of self confidence over the years of staying home. I am efficient with running errands, planning meals that garner leftovers for another meal, and scheduling the kids to have appointments at the same time.  But with the outer world, the one outside my front door, the world is changing. Fast. Sometimes I feel like time is running out. When will it be the time for me to leave the house, when she’s in high school? Who knows what behaviors she’ll need professional help with then? There is always a good reason with special needs kids to remain a stay at home parent. 

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ADHD Medication

Waiting for the Effects of ADHD Medication

Week 4

We did not go away for Spring Break. Get the tissues out, boo-hoo. This happens for us with my husband’s career. I’ve been really supportive to his work and demanding hours. I get it. It’s just that sometimes seeing everyone around us pack up their cars, hearing everyone’s plans for the week off, and feeling the need for something different to our routine, I feel sorry for myself when we stay home during any of the school year breaks. This year I changed that.

My solution has been to rent a cabin for a few days about an hour away. We take the dog, we bring food for all the meals, and for two nights he is able to put work on hold. The boys take a respite from their electronic devices. They flip a coin over who will sit next to the pooch; the loser sits near her. My husband attempts to delegate duties of packing the car. This never goes well. He does most of it, huffing and muttering up and down the driveway. I opt to stay inside programming the auto-feeder for the cats. Every time we go on this kind of trip, we manage to leave an hour later than planned, our bodies are crammed into the vehicle, trash bags for suitcases stuffed in every space and my hubby annoyed that his guitar never fits. The excitement increases over car ride games. I pop in an old Pearl Jam cd. We’re off!

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Stealing Food

My Young Child is Stealing Food

Week 2

young child is stealing food

How about stealing time to play!

Stealing food from children. Really? That is how Mrs. M wrote it in her message. We are starting week two of medication or in other words, it is day eight. I know in my heart that I am uncomfortable with my child needing medication. But as I put it to her brothers, it’s like needing glasses. All that squinting, missing homework assignments written on the whiteboard, not seeing the lacrosse ball– my kid needed corrective lenses for better focus. Did this completely change his life? Yes and no.  The non-stimulant ADHD medication will hopefully change her life and ours for the better. After I had returned to our therapist for a consultation, after having a medication evaluation and after a few days of starting the medication, I got a long email from her kindergarten teacher. As soon as I opened it, I braced myself. Four paragraphs. What now?  Well, turns out that for the past 6 or so weeks food has gone missing from her students’ lunch boxes. And surprisingly while we were on a family trip for three days, nothing happened. Yet when we returned, the missing of items resumed. Mystery solved? Yes. Problem corrected? No.

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ADHD – Impulsivity

ADHD Impulsivity

Week 1

It was time. She was having rough days 9 out of every 10 school days.  Her impulsivity was significant — she was lying, stealing, and sneaking food each weekend. Every once in a while, we had that uneventful day. The last one still fresh in my memory.

“Isn’t it great I had a good day?” she asked me, her wide toothy grin in the rearview mirror. She has the look of wanting validation.  “Yes, it is. It’s a day you can have every day.”

ADHD impulsivity

Her special needs are not immediately visible.

Again, she revisited the topic. “Isn’t it so special! I had a great day! Are you happy, Momma?”  I answered, “Yes, I am. I know you can have lots of good days.”

The self-praises continued that afternoon. By dinner time she had revised once more, “I love having good days! I was so special today, right Momma?”  I made the silent coyote signal with my hand, gesturing for her to be quiet. Then I corrected, “It’s not special and you are not behaving special. Your teacher said it wasn’t a bad day. That’s what she said!”

And there it was, my words cutting through the glee. Yes, it is time. Our former therapist emailed me back with instructions to fill out the intake paperwork so that we can schedule a consultation with her. Within 18 hours, I had completed the hefty packet and hand delivered it to her office. I wrote her: when are you free?

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