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.

I Have Breast Cancer

I had it. You have it. Breast Cancer sucks.

I looked at my phone wondering why she is calling me. Our kids no longer attend the same school. We are at most casual acquaintances. I answer a little hesitantly. She identifies herself and pauses. Then she continued: I had a mammogram, and I, well I heard that you too, uh….um. I have what you had, I have DCIS in my breast. I have breast cancer.”  Her voice is trembling.  The former social worker in me surfaces. I ask direct questions so that she can regain composure:

When was your mammogram, where did you have it done? When is your next appointment? With whom? Have you met with a surgeon yet?

She answered each question. She took a deep breath.

I said, “I’m so sorry. I am sorry this is happening to you. You must be overwhelmed. It’s strange to hear the words breast cancer.”

She agreed and added, “Why is this happening to me?”

I wonder that too, every day. And yet it is happening. My friend summarized it as: we all got married, we all started having kids, our kids started school, then sports, and now we’re at the age where some of us are getting breast cancer diagnoses.

Can we chalk it up to a developmental milestone?

After my caller went through her series of appointments, I gave a brief version of my summer. My June of being diagnosed and agonizing over treatment options, my July of surgery and recovery, and then August finally ending my summer of 2016. The kids returned to school. Labor Day is here. I am ready for the summer to be over, for my recovery time to be completed, for this ordeal to be ending.

I hope I was supportive. I hope I was educational and helpful. I hope she felt heard.

It’s strange to hear the oncologist say to me: come back in three months for your follow-up. It’s strange to have conversations with people about having breast cancer. It’s strange to experience a thrill over being contacted, being someone who has gone through something and can offer guidance.

She agreed, “It is strange to now be seeing an oncologist.”

My follow up is at the end of October. A ways off. Strange how much can happen in a few months.

 

Raising Teens in 2016

Raising Teens

We had been hearing her name a lot over the course of a few weeks: Maria is traveling to Canada for Spring Break. Oh, Maria is so tired from the traveling. Maria loves pancakes. Yea, Maria really enjoyed that movie too.

That sort of talk from my fourteen year old. Every weekend he sleeps in each morning till we notice the late hour and call out. He eats breakfast at 11A and lunch at 3P. I guess it didn’t bother me so much. He was bringing home good grades from honors classes. He’s still going to two hour sports practices each week. I wished he would be more social with friends face to face. During this school year, we noticed a dramatic increase in gaming online with a group of people. They chit chat about their lives, tease each other, tell jokes. But we don’t know these kids, their families, the locations of their homes. This year, my son has spent less time inviting friends over.

One day, he took a shower, came running down the steps and announced he was meeting up with friends at the school. He hopped on his bike and said he’d be back in a few hours. This was before 10a on a Saturday. Who are these people? I later found out SHE had texted him with the invite.

In the weeks that followed, he seemed in a stable, content mood. He settled into a routine every afternoon after school of having a snack while texting on his phone. He reported a bunch of kids were eating their lunches in the science teacher’s room these days, “It’s fun, a nice change from the cafeteria.”  So I started.Raising teens

I guess I was curious and not satisfied with the limited information I was getting verbally from him. I guess I wanted to assess the language used in the texting. And I just wanted to make sure they were not getting carried away with exchanging photos of a certain nature. I read the news, too. I was aware of what was happening in the world of teens and various forms of social media.

Their conversations were sweet — asking about homework, commenting on something that had happened in a shared class, a question about the other’s home life. I peeked in on these exchanges every few days. I felt guilty but justified. My friend supported me, telling me that she too had read her daughter’s phone messages. “So it’s not like the tv movie mom finding the diary under the mattress and then ruining their trust?”  Not in this day and age! Was her response. We need to know what our kids are doing, saying and sending each other.

The end of the year there was a field trip and a dance. There appeared to have been some events that occurred on the bus ride back to the school as well as the dance the following day. She inquired about his reaction on the bus. He explained in detail. Seemed to make sense to me that he didn’t feel like answering a truth or dare question from her friend.

“But why?” she persisted in her questioning. But why, what? I wondered. He didn’t feel like answering.

And later, my son wrote that he was upset, “Could you please let me know things are ok, I need to hear from you this weekend.” I ached inside for him. What happened? Could she write back soon to relieve the suspense?!

That week, he seemed more sullen.  I tried to be the cool, available mom. I waited patiently a few days, then asked, “Hey, I haven’t heard (her) name is a while, anything happening?”

My son replied, “Oh, not anymore. There were some things that happened at the dance. I thought she wanted to dance, then I couldn’t find her. Then I heard she was looking for me. It was messed up. I can’t really deal. I don’t know what she wants. It’s no biggie. We’re still friends.”

I was privately sad and proud of him. He seemed to really enjoy the flirting and the fun. But I respect that he didn’t have the interest for ambivalence.

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Parenting and Sports

Parenting and Sports

Reflection – Sunday

I’m sitting here with a chilled Warsteiner, drinking straight from the bottle thinking about this past week. I’m listening to Mumford & Sons’ Babel.

My eldest went to sleep away ultimate (frisbee) camp this past week. Yup, it was expensive. It was also the only away from home experience for him this summer. Plus, I want to encourage him to remain in sports.parenting and sports

We got a few text messages the first two nights– complaints of how it was not fun, the opposite of what Mom had said it would be, and that it was demoralizing. He wrote he was hating it. My son admitted to feeling troubled over being at the bottom of the heap in terms of skill. I cringe and laugh every time I get blamed for something. How would I possibly know what sleep away ultimate camp is like?  From my years of running track and playing on the tennis team at my small town public high school?!

Where I grew up and when I was growing up, most of us played at the rec level. We did not have tryouts. We did not have club. There were a handful of kids whose parents invested in private lessons. There was a country club in our town and a tennis club in the next one over. But a week long camp at a college where he slept in a dorm room? I felt thrilled that we could give him this opportunity.

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DCIS Treatment Options

DCIS Treatment Options 

Part II

Ever since I got the voicemail. I feel different — my outlook is different, I breathe differently.  My doctor’s nurse left a message informing me to come in the following morning with my spouse to discuss the findings of the biopsy. We knew this meant the cells are not benign.

Everything was different now. I had been struggling with identity issues related to being a stay at home parent and unemployed. I had been feeling depressed. I had been feeling concerned about my life goals. Now, I’m not yearning for anything. I’ve moved away from a feeling of wanting to take inventory, wanting to move forward, wanting to accomplish.  I don’t feel that way anymore. I feel that would be indulgent– to want. I feel a strange calmness.

After I heard the message, I went through something. Nothing amazing or poetic, I didn’t see a different spectrum of lights or an amazing palette of colors or hear angels trumpeting. I just went through some typical Kuebler-Ross stages on and off, quickly, and out of order. I blamed myself for increasing my alcohol intake to a daily drink in the past year. I blamed myself for not running weekly and feeling lazy about working out. I felt anger about worrying so much over family members, so much that I had developed cancerous cells. I hoped and prayed that if my prognosis is good I would make significant changes to my diet and lifestyle. I got weepy looking around the schoolyard at dismissal time. I hoped to have many years of waiting for my 6 year old to be released by her teacher, to watch her classmates disperse to the field, parents, and play structure. I didn’t care about finding employment or my identity again. I knew what I wanted: to live and to be with my kids. It was a long night.

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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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Stealing and Lying Behaviors

Stealing and Lying Behaviors

Reflection – Tuesday 

Parenting — the good, the bad, and the ugly behaviors.  I am sitting here with a pilsner and listening to The Essential Johnny Cash cd. I think back on what happened earlier today.

I was waiting my turn.  I stood behind a few other parents — we have the difficult ones, the children who have rough days. Other parents wait across the blacktop or are in deep conversations, quickly glancing up and nodding to Mrs. M that they are present for dismissal.  I moved up the line.  Mrs. M informed me of how my child hurt another classmate’s hand. She goes on to briefly describe other parts of the day.  I asked her where on the spectrum in her class of twenty does my child’s behaviors fall; how typical are her behaviors? Mrs. M quickly responded: far from typical. Mrs. M bent down and said gently to her, “I really hope that you have a better day tomorrow.”

stealing and lying behaviors

Despite all the difficulties, we assure her she is well loved.

Why do I feel defeated, why do I personalize my children’s difficulties?  A few times a week I am hearing from her kindergarten teacher an entire day of disruptive and/or aggressive behaviors. The time has come.  When we returned home, I took a deep breath and composed an email:  Can we return to see you again? She is not doing well.  I need help too.  

I have been reluctant to write to Beth, to ask if we can return to therapy. I thought I could figure this out, try another reward system, give it time and let her mature on her own. I fluctuate between acceptance of having a special needs child and wanting to defend her actions, to rationalize her personality traits. My youngest has a different energy than her older brothers. She loves to be silly, she wants people to laugh at her, she’ll do anything to get attention. She does not care for rules — she decides when she wants to follow them.  She is chatty, she is loud. Well actually so are the boys — at times. They know when and where to be comical, when and where to rebel, and how to make friends. Does everything challenging need to be directly related to her adoption from foster care?! Is she going to have special needs for the next 12 grades?

I was perusing the hundreds of informational websites on adoption. I came across an interesting post from creatingafamily.org. There was a list of questions that potential adopting parents should consider. One was: if she were to not get any better than the way she is now, could you handle her behaviors?

I know we have made tremendous progress in our home over the past three years. Yet, this past weekend was a doozy.  She snuck food, she took items from family members,  and she lied. She fed the dog an entire box of frozen appetizers from Trader Joe’s. That is what she answered when I found the empty box. Or did she lie and consume all 15 pastry pups herself? We waited nervously for 12 hours monitoring our dog’s digestion. She took items from her brother’s room. I confronted her, inquiring about the items. With a quizzical face she answered, “I don’t remember doing that…”  I observed to her that the dog was circling her, did she have food with her? She answered, “Not in my hands.” I searched the entire playroom, then found sesame seeds in a lego container. Not my jumbo bagels, I had three left! I had just re-arranged our kitchen by placing all the yummies on higher shelves in the pantry cupboard. I didn’t know how else to protect the contents of the larder.  My husband said to her:  do we really need to put cabinet locks everywhere? even here (pointing to the base cabinet), where the condiments are? would you eat this?  She informed him she would not be interested in the sealed glass jar of thai curry sauce as the glass jar would make a noise when she opened it.

* OMG *

The food obsession, stealing items from others, and lying. I don’t understand how and when she had become wily; she’s become a master of deceit. Will I be able to handle these behaviors lasting a lifetime? Maybe being able to tolerate is a better way to phrase that question. Maybe it’s a question I don’t want to give much thought.  I think about her negative behaviors.  All of them involve an outburst of some kind — emotional or physical, and a lack of judgement.  She has no impulse control.  She doesn’t have that skill, that ability to pause; she just reacts. Is this anxiety? a heightened sense of arousal due to her early trauma? is this a form of ADD/ADHD?

I know sage advice is to not take things personally. For me, it’s difficult to heed that saying when parenting is involved.  I’ve invested time and emotions into raising my kids. I’ve entwined myself with their difficulties.  And yet, something is off, something feels different.  Her hypersensitivity and impulsivity are looming large — lengthy words and heavy conditions. We don’t have a grip on either or both. It’s been three years and she is now 6 ½. I took a deep breath, I tell myself:

We are parents to a special needs child. She is floundering at her school and at home. It’s time to return for professional help.  We need strategies and we may need medication.

Beth, please email me soon.

Anxiety and Trauma

Anxiety and Trauma in a Young Child — Let Me Explain

Our First Year of Adoption – Part 3

Our new therapist Beth reviewed anxiety and trauma related behaviors. She described what anxiety looks like in a young child, like ours. She noted we may hear non-stop questioning of the same issue. I experienced this first hand. Every day, a flurry of questions related to dinner. When will a meal be served, what will be served, will she receive this meal, who else?  I remember how S asked about the dinner meal and I would answer. Not a big deal for me, everyone is curious about dinner. She then started asking earlier and earlier in the day, and more often throughout the day. After a week, she sat there with her breakfast and while chomping, she asked, “So what are we having for dinner tonight? …ok and what about tomorrow? What are we havin’ for dinner?”  Tearful distress when I laughed in response.  Beth went over the non stop chatter to fill the void. Yup, we knew that expression. Lived with it. S opened her mouth from the moment she opened her eyes, and closed it when she fell into a deep sleep.  Beth described S as an empty well, explaining that she had not experienced love and nurturing before. As a result she has a lot of anxiety around feeling loved. Oh yes. That must be why it is nearly impossible for her to be alone in a room and to be denied attention.

anxiety and trauma

All households have differences

Beth reported underlying this constant stream of neediness were key questions: will I stay here, will I be accepted, will they take care of my needs. Beth told us three birthdays, three Thanksgivings, three Christmases, and three school years for the older kids. Then, she will relax. What’s that? Beth noted S experienced three of each event in the foster home and was suddenly removed from that home. She was then transferred to our home. So yes, three of each. Then she can relax.

Beth talked to us often about how our young child knows only a handful of feelings, most likely happy, sad, angry, and curious. We needed to explain and describe other feelings. She was probably experiencing different versions of anxiety and not understanding that particular emotion. Saying things like, “I wonder if you are feeling _____ about (the situation)” would help her understand feeling anxious, bored, frustrated, nervous, worried, eager, and irritated. Beth discussed from time to time the need to go over her story. It was not necessary to repeatedly go over details like one is cramming for an exam, but rather to talk about her past like you do with any kid and a special memory. Beth suggested reminding our daughter of just the significant events. When she is older, if and when she wants to, she can tell others her story.

Part 4 – Her Story

Therapy for Us

Therapy for Us – Off We Go!

Our First Year of Adoption – Part 2

When our child first came to us, she was in therapy with a counselor. She was assigned to our child when the judge changed the permanency plan to adoption. The counselor’s focus of therapy was to “prepare” for the adoption. Now, I don’t know what exactly was covered in those sessions from January to June. I know that the biological mother made an appearance and said goodbye. After our daughter moved in with us, we continued with weekly sessions. The counselor inquired how things were going? were there any new problems? did she have any accidents? was she eating? sleeping? were we following her advice on talking about first mommy, second mommy, and me as the third mommy?

The counselor did a certain weekly exercise with my daughter. She got out a floor mat that had 12-15 faces with different facial expressions. She piled rocks on the side. She said to my child: put rocks on the faces you have been feeling this week. Sometimes S piled them all on the happy face. Other times each face received a stone. Another time, a different arrangement. I had to reach down deep to hold back my smirks. During one session that my husband and I both attended, the counselor was persistent on addressing the timeline of parents for our daughter. She went over Mommy number one and Mommy number two. She asked several questions and reviewed the actual answers with our child: your first parents were so-n-so, do you remember? and your next parents were the foster parents and their names are such and such. She kept drilling this information to which our child started grunting in response. She regressed before our very eyes, letting out non-verbal gutteral sounds. It was painful to watch. My mouth went dry. I looked sideways at my spouse– his mouth and eyes open, frozen like. I endured these sessions for a few months, then I insisted to our caseworker that WE needed help.

therapy for us

This should be read by all forever mommies

We were blessed to get approval to transfer to a counseling clinic in our part of town. There, the therapists are trained specialists in the areas of foster care and adoption. The first few sessions, our new therapist Beth observed S and myself interacting in the playroom office.  She then interviewed my husband and me. Another time, she interviewed just me. Finally, after weeks it was time. In that session, she informed me that she had read over the case records and previous mental health assessments. Then she started talking of why my daughter behaved, reacted, and responded the way she did. I can only say that the best analogy is having a translator interpret a small provincial dialect. The fog lifted. I heard words that made sense. There was finally clarity.

 

 

Forming Attachment

Forming an Attachment is Hard with Adopted Children

As a foster and/or adoptive parent, you will use this word endlessly. Attachment. I remember in college viewing black and white videos on Margaret Mahler. She was a psychiatrist who originated the two year process of separation-individuation between mothers and babies. This is significant to forming one’s sense of identity. There are two things that have stuck in my memory. One is that when you heard her voice in the voice over, in her East European accent, she repeatedly made a little whistle sound. I remember thinking that’s an unusual speech impediment. The other key recollection is how young the subjects were in this classic study. Babies.

“The attachment needs to come first and be strongly established,” our therapist Beth informed us. Until then, there is anxiety around the following:  will I be accepted, will I be loved always? will this last? is there a trust? She told us that working on the problematic behaviors now is ok, but most changes will occur once the attachment is strong.

forming attachment is difficult

attachment

Our adopted daughter is tight with my husband. I see the beginning of an attachment to him. I hear it in her requests to have him make her lunch, to take her to school, and in her sobbing when she watches out the window as he backs out of the driveway to run an errand.  I know it’s hard on him that she is this way, it’s actually not as gratifying as it should be. He feels badly and a little guilty that I don’t have IT yet. Our therapist explained it is more complicated with me, the female parent, the primary caregiver. Our daughter has formed relationships with not one, not two, but now a third mother figure in her short lifetime. She knows that I am the keeper of the household. Beth tells us that more is at stake in investing feelings with me. I’m a strong person. I’ve worked in mental health. On a logical level, I get it. But it does hurt. And sometimes I let out a sarcastic remark: You really want to wait for Daddy to get home to make your lunch…? Ok! Whatever!

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