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.

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?

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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Giving Advice, Getting Advice, Wanting Advice

Giving Advice, Getting Advice,Wanting Advice

Reflection

I am listening to the new Radiohead album. It’s layered, moody, and sophisticated;  I play it every day while I sit with my pen and steno pad. I listen a little. I write a little. I think some more. I write some more. I listen some more. My initial reaction is conflicted. The music critics are lauding it, so I attempt to be patient and learn.

My therapist has told me it is time for the next move. She is no longer gently nudging me and giving me support around my household needs. She tells me I have lost too much of my identity. She says my kids keep getting older and I am not progressing. She points out that addressing my social isolation, identity voids, and personal interests will be better served with experiences outside the home. She reminds me that my volunteer activities were not satisfying. She tells me I am missing out. Basically reminding me that the world has continued to spin and I am stagnant. I have actively job hunted for over a year and remain unemployed.  She tells me that by our next appointment I need to meet with the Admissions Counselor at the local university to explore Master’s Programs. In our last session, I felt she was pushing her agenda. I returned home and cried my eyes out. Do I really need for someone to decide what is right for me and tell me what to do?  I don’t want to get another Master’s; I don’t want to return to school. Instead I am signing up for a six week series of writing workshops this summer. So there.

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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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Parenting and Partnering

Parenting and Partnering

Reflection – Friday

I’ve had this CD on repeat — Lord Huron’s Strange Trails. I am drinking a glass of white wine, a Pinot Gris I bought to use in a pasta recipe I will tackle in a moment. But for now, I wonder about having guidelines for us.

I cannot see her playing in the backyard; I had asked her to play in the driveway with her toys. Can you say something? I ask my spouse. I’d like for her to follow directions.

He sighs. “It’s just that you’re so restrictive with her.  She’s outside, she’s playing.” He shrugs for effect.

Wait, what? Come again? Could you repeat that? I laughed and said, “Yeah, whatever!”

There are so many guidelines that I put into place when it comes to her. It’s true. Where she can play, with what exactly, in sight, certain amount of time and so on. Why? Because I have learned with her, that if I give an inch she takes a mile. And if there aren’t any guidelines she will do as she pleases– at the risk of safety and civility. It’s my job to keep her alive and well-mannered. 

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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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Parenting Special Needs

Hard Work

My daughter had a rocky start to her life in this world. She was born into a lifestyle of irresponsibility. The State Child Welfare department removed her from her birth parents due to neglect. I imagine this means not feeding her when necessary, not responding to her crying within a reasonable time, and neighbors calling in concerns. We will never know for sure what happened between those four walls. Next up she lived in a home with a sedentary, food fixated lifestyle. We will never know the details of living in that foster home. Fast forward three years and she moved in with us. At age 3 ½, she was diagnosed as developmentally delayed.

What I do know is she is very bright, adventurous, and eager for social activities. When she is approached by others — familiar and not– she will happily chit chat. She blurts out answers in her kindergarten classroom, unable to hold back her knowledge. She runs ahead, wanting to be first. She laughs loudly at something amusing. She looked up at the sky watching a plane, then announced, “Some day I am going to see the world!”

parenting special needs

A lot of classroom work does not get completed with our special needs little one.

My daughter has to make an effort all day long to use adaptive skills. It is her full-time job. Her teacher observed that she will have to work harder than the others. When she is focused, willing to follow through, and kind to others we have delightful days. When she slacks off, I get the report that it was a “rough” day. Not, “she had a rough one”, but it was difficult for everyone rough day. Each school day, she needs to practice socializing positively with classmates and adults, paying attention and not interrupting, and regulating her emotions. Sometimes just saying to her, “I know it’s hard, you are working hard, and I can tell you are trying” emits a smile of relief. Her little face looking upward to me relaxing and nodding. Other times, I say, “What happened today? what made it so hard to be nice to classmates? Screaming at  ____ and not moving your chair to make room for _____ and pushing _____ on the playground and he fell!” I dunno she says quietly looking down. “Well, something made it hard today…? what makes it ok to be mean to others?”  I dunno is the repeated reply. I give up. Retcha-fretcha-don’t understand is my mumbling rant I make as we walk to the car. I let it go for a while. Then I work on practicing with her. “Let’s go over a situation,” I say. “I’ll be a kid who wants to sit next to the window. Can you tell me in nice words that YOU want to sit there…?”  I know it is not an easy task for her. And so I try to have compassion.

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Developmental Delays

How Old are You?! (Trying to Understand Developmental Delays)

Our First Year of Adoption – Part 5

“I’m freakin’ out!” was something I heard too much. I asked her: what does that mean? She shrugged. I said: say words that you know. What are you trying to say? She whispered: I don’t know. My youngster pointed to her upper chest and asked me the name of the body part.  I answered, “That is your chest.” No! she shrieked and she pointed with both fingers. I replied, “Oh, those circles are called your nipples. Every kid has them. “ No, no! she yelled back. She then snapped at me that those are called her boobies. We picked up my son at his friend’s house. She yelled out the window, “Say goodbye butt. Bye butt! B-utt, b-utt!” My son was horrified. She was not even four at the time when these situations occurred. She had been with us a month.  

Our therapist noted that I would benefit from some additional support. Maybe a group for foster and adoptive parents. Maybe blogs? Maybe my own therapy. I kind of wondered where I could find others who would understand my state of mind. I was baffled over the stuff my four year old was doing. Was she a tyke or a teen?

We were told our child was probably raised by the four teenagers in the foster home. Our therapist noted based on her behaviors, she most likely received a lot of verbal attention and was given food to soothe her distress. Our job was to nurture in an emotional way, paving the way for attachment and adaptive functioning. Our job was to help her be a little kid.

Over several months, I enrolled her in ballet, then swim lessons, next tumbling, and climbing. During class, she often stood there watching and barely moving. There was a marked stubbornness to physical activity when we were at home. We would all try to engage her in games of jumping around, kicking a ball, raking leaves. The four of us just wanted to have fun with her. I said, “Try to move around a little, could you try?” She answered, “I will! Just sign me up for another class.”

The first two years in our home, I taught her how to play with toys. Every day, a few times per day, I sat on the floor with her watching and played out games. I acted out dramatic scenarios and funny sequences with playhouse dolls, horses, and Fisher Price little people. I dressed dolls and cooked them meals, using the play kitchen stuff. I took the dolls to the “doctor’s office” and used the medical kit items to give them exams. I gathered sticks, rocks and leaves from our backyard to make mud stews and fairy houses. She watched every move, with huge wide eyes.  I then moved onto reaching out to her, encouraging her to play and join in. Often I was met with resistance– no, she wanted to only watch. Or a shrug to indicate that she was clueless. Sometimes her tears let me know she felt on the spot.  After a year of doing this daily, I burned out.

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Difficult and Demanding Behaviors

Difficult and Demanding Behaviors in Young Adopted Child

Reflection – Wednesday

I’m sitting here with a pilsner and I’m listening to Modest Mouse’s CD Good News for People Who Love Bad News, thinking about Sunday afternoon and my daughter’s interest in play.

2:40 PM “What Mommy? What’s going on? Why are you taking my hand? Where are we going? Why are you holding my hand? What are you doing?”  I lead my six year-old back to the playroom. A carpeted, well-lit, comfortable room with toys. I reply, “I’m showing you where to play. You don’t seem to understand to stay and play in here.”

“I do understand! I do know where it is! I do! I do! I do understand–”  This litany of arguments continues for another minute even after I leave. I listen.  Then the predictable singing. Calm, pleasing to the ear, sing song singing. She sounds content; I smile a little.

2:48 PM She is back in the living room, where I am working on paying bills and doing email correspondence. “I have a hole in my tights, it really bothers me. I need to show you. Mommy, lookit. Here, lookit. Mommy. Mommy, I am showing you something.”  I do not look up. I am not in the mood to lookit. I refuse to make eye contact. I decide to record the events that are transpiring.

2:52 PM “Hmmmmmrumpf. Ok, I’ll just go back.” She returns on her own to the playroom. Soon after her singing resumes. Sheeesh, I think to myself. But, then she returns.

3:04 PM This time she starts singing and rolling around on the floor. I wait, I count to sixty. I take a deep breath. Ok, now.

3:08 PM I take her hand and gently pull her up to a sitting position. She rises. “What are you doing? Mommy? What are you doing, where are we going? Why are you holding my hand?”

I lead her back to the playroom. A minute later I hear her building with Lego bricks– a distinct sound to us parents.

3:15 PM Footsteps and other familiar sounds emit from the kitchen. “I’m thirsty. I just decided to get some water. That’s all. I got myself some water. (Pause.) Ok?”  Ok! I yell over my shoulder.

3:24 PM Guess who’s back in the living room?  She rolls around on the couch. She looks out the window, she wonders out loud about the weather forecast. She then comments that it’s snacktime. Now, I get it. She has been watching the digital clock. The pestering begins. I observe to her that she had a late lunch. I tell her I’ll get her something small in a moment. Just go play a little more, I’ll come get you.

“I’m hungry! I am starving! I won’t be able to breathe!” (Actual, verbatim words.) “Why a little snack?! Why! Why?!”

My friend told me about her five year old and three year old kids getting out of their room after bedtime. So frustrating, right? Yes, I agree. I totally know that situation. I went through it with my two older kids. We had the most elaborate, detailed bedtime routine ever. Yet, over time and with a few talks with the boys in between, we managed to get through it and outgrow that. There came a time when I realized Hey! they are actually staying in bed and falling asleep within a reasonable time. I remember we started having an evening again, my spouse and me. We got into a routine of talking a little, then sitting on the couch together watching a tv show each night. Good times.

Parenting a child with special needs involves so many OTHER situations. Not just a difficult bedtime routine or meltdown before piano lessons each week. Every afternoon and most hours of our weekends, my daughter experiences distress related to the concept of playing with toys. My hubby and I, we joke to each other about how mean we are, how dare us! we actually direct her to the playroom to play with toys. What will the other families in our social circle think of us. My parenting of her involves unusual strategies. When I am neutral and matter of fact with her,  when the situations are black and white, she does better. Don’t even think about all those shades of gray. I cannot be the funny, silly, spontaneous mom that I am to the other kids– that is, my biological kids that I have had since birth. It’s different with her. I hope and I really believe that over time, this will change. She has a different energy, a different temperament, and different social/interactive needs than the boys. Are these traits genetic? Are these features nurtured from the environment? Would I be feeling this way if I had adopted her at birth? or carried her through a pregnancy? I know from reading material that she is delayed with social and play skills. And I really don’t know where on the spectrum we are and where she is at this time. I do think her early trauma and the experiences in her foster home have impacted on her. I do think that she will change over time and I won’t have to be so consistent and structured. I just wonder often, when? when will she enjoy using her imagination with toys. I looked up my use of the word play, to double check grammar. Here is what I read: activity engaged in for enjoyment and recreation, especially by children. When will we have an afternoon of family members — all members– just enjoying being around the house. Acquaintances say: Oh, yes, I know what you mean. My son is difficult too. Just the other day he lost his 7th jacket. Really? The other day you say?

difficult and demanding behaviors young adopted child

A Christmas card she made for us

*

Full blown temper tantrum. Over what’s that? did I miss something catastrophic? I said in a moment, you’ll have a small snack. And that is a scenario that will set her off — it’s not a snack delivered at the usual time and a smaller amount is not the usual amount. And of course, food was involved. Every day I have to find that delicate balance of humor, having clear expectations and being consistent with them, and compassion. It’s a tricky position.