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.

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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Social Isolation – Parents

Social Isolation – Parents

Week 6

WeeWMrs. M tells me my six year old had a rough day in her classroom– she snapped at others and snarled, “Don’t look at me, stop staring at me!!” while screaming and crying. Mrs. M and I wonder if this irritability is a negative side effect of her current medication. She’s been on it for over 5 weeks. I am frustrated and disappointed and sad for her.  I know she wants friendships. I know she wants that closeness, that special feeling of being understood and accepted. That shared giggle. The eye contact and physical closeness when seated together by choice at the lunch table. The request to play a game and she says yes. The yearning to disclose an experience, to tell another of a personal situation. I know she wants it.

I feel like I have had difficulties forming meaningful friendships the past ten years. Do I unintentionally annoy people, do I snarl? We’ve moved a few times, I have three kids a range of ages, we have not joined a congregation, I have not worked outside the home, we live in a city. I could go on and on with possible barriers.  My therapist tells me I have justifications every time she explores this area of difficulty. I don’t want to come across as defensive. I want to be a good client– open, receptive, honest, willing to try.  Why do I even have any struggles? There’s famine in the world. People are serving our country and returning disabled. There are refugees risking their lives seeking a safer place.

I hate being a whiner.

I want to connect.

I feel more alone now as a parent of a child with special needs.

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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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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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