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Wednesday 22 August 2012

Back to School w/RAD


We have gone back to school and are in our 3rd week now at our house. For foster parents that have school agers with attachment issues, this can be tricky.

For us, our first grader does well in school and is liked by her teachers, so there are not the behavioral issues that many parents of kids with attachment disorder deal with around back to school time.

With Jenny, 6yo, our issues tend to be the more sneaky behaviors. For example, she may "forget" to bring home important communication from the teacher, she tries to eat breakfast at school when she had a full breakfast at home, gets up during class to get a tissue or a drink of water and may ask lots of questions intended to disrupt instruction time, asks to go to the bathroom excessively, takes numerous trips to the nurse for minor scratches or tummy aches, headaches or other made up ailments, tries to get special treatment (wants to sit closest to teacher, holds her hand, sits in her lap, asks for more of something that the whole class may be getting). Many of these things can even go unrecognized by the teacher or seen as minor infractions compared to the kid whose throwing blocks at her head.


Here are some common issues that kids with attachment disorder have in school

This list covers several things teachers may encounter. One that we have seen with Jenny is what they call "Nuisance Behaviors"

Nuisance behaviors: These are frequently occurring minor infractions (such as interrupting or asking excessive questions) that disrupt the simplest of everyday interactions. These nuisance kinds of behaviors serve a dual purpose. First, they serve as ongoing reminders that the AD student is not under the teacher's domain. Secondly, they are "probes" that the AD child sends out into the environment to acquire information about the situation. From others' reactions to these "behavioral probes", AD children begin to piece together who is punitive and who is supportive; who will respond and who will ignore; who has a short fuse and who has a longer fuse, etc. The AD child uses the responses to his probes to figure out how to "work" the adults. When the AD child feels confident that he knows how to maneuver the teacher, the "honeymoon" will be over.


With our first placement of teen brothers, we had complaints from teachers about more outwardly disruptive behaviors in class, inability to focus on work, regressive behaviors (also listed on the link) coupled with his demonstration of real intelligence and ability to do good work.

Work production: The AD child most often either refuses to do assignments outright or does them in a haphazard, perfunctory manner. Occasionally, these children will apply themselves and often turn in a credible product when they do so. These seeming "lightning bolts" of intelligence, motivation, and effort are generally all too appealing to the adult world of teachers and parents; and that is precisely their purpose. The AD child dangles these moments of production in front of the adults to tantalize them into a game of trying to figure out what to do to get the AD student to perform like this more often. Taking this bait and entering this game is exactly like stepping in quicksand. The more the adults struggle to get the child to perform, the deeper the adults sink into the muck. Meanwhile, the AD child is "laughing all the way to the bank".

Since he was our first, we were pretty clueless on attachment disorder. I can't tell you how many times I found myself just puzzled at his ability one day and his complete inability the next. I absolutely took the bait and drove myself nuts trying to come up with ways to motivate him.

This brings me to homework:


There are great ideas here about how to deal with homework issues.

Don't go crazy trying to stay on top of your child's homework. If they are really struggling and need extra help with concepts (this can be hard to determine since they fake lack of understanding really well), get help before or after school or during lunch from the teacher, get a tutor if needed, but make it the child's responsibilty to organize themselves (give them tools to stay organized and tips, but don't clean out their backpacks for them, track down assignments etc), explain good study habits (like planning ahead for tests and projects, writing down assignments, taking notes, asking questions of the teacher etc) then step back and let them do it.

There are a few letters written to teachers that I have found on various sites that explain attachment disorder and give teachers tips on how to deal with classroom behaviors and the importance of communication with the parents. This one from Nancy Thomas is pretty thorough.

Here is my honest opinion about this approach with teachers: Although this is of high importance to me and my family, it's just one student of many to the teacher. Not to say that teachers don't care, that's not it at all. But teachers have not committed to parenting this child and educating themselves on all the things they possibly can about attachment disorder. So, if the child is not causing major issues in the classroom, I'm not sure the teacher is going to really want to read through and take to heart all that this letter says.

You also run the risk of sending the message to the teacher that you want to micromanage her. The teacher may very well think, you are one parent with one child and they have taught many, many students over the years - "I got this" may be their attitude. And truthfully, that would probably be my attitude as a teacher. So, for me, it's tough finding the right balance between giving the teacher necessary info, not allowing the child to triangulate the adults in this situation and letting the teacher know I am not questioning her expertise.

Some things in this letter, however, that I think are particularly important and should be brought to the teacher's attention are:

1. CALL THE PARENTS. They will likely not be real warm about this child and can be perceived as too harsh until you get to know them better. Have them in to talk with you about this issue. They are often hostile to outside commentary because no one without RAD information really knows what these folks are living with every day. Call them and talk about what you see in the classroom and ask if they have any other strategies for managing things.

2. Make it perfectly clear in your interactions with the child that YOU ARE THE BOSS of the classroom or activity. Remind the child, unemotionally but firmly, that you are the boss, you make the rules.

3. YOU ARE NOT THE PRIMARY CAREGIVER for this child. You cannot parent this child. You are his teacher, not his therapist, not his parents. Remind the child that her parents are where she can get hugs, cuddles, food and treats.

4. CONSEQUENCE POOR DECISIONS AND BAD BEHAVIOR

5. DO NOT ACCEPT POOR MANNERS OR INCOHERENT SPEECH. The child must say "May I please be excused to use the restroom?" Not "I gotta pee". And yes, they will wet themselves rather than ask appropriately just to upset you and make you think you're responsible for making them stand there too long. "I see that you wet yourself. That must not feel very good." And go back to whatever you were doing. Feel free to not respond to slurred or incoherent speech. The child will learn she cannot manipulate you into asking for a repetition or clarification. If you feel you must, tell the child you will not be able to hear him until he makes the choice to speak clearly and then turn your attention elsewhere. The child should say, "Yes, Miss Janice", "No, Mr. Sayers". "Yeah" and "nope" and "I don't know" are no longer part of the child in therapy's vocabulary – do not tolerate them in your classroom, they are disrespectful.

6. SUPPORT THE PARENTS. The child who is losing control at home and in the classroom because folks are "on to him" will get a whole lot worse before he gets better. Listen appropriately. Absolutely redirect this child to her parents for choices, hugs, decision-making and sharing of information you believe is either not true or is designed to shock or manipulate you. Follow up with the parents.

Hope something in here helps you all have a better school year!




Saturday 18 August 2012

Food Issues, part 2

In my first post about food issues, I listed several behaviors around food that we see regularly in our home:

1. refusal to eat
2. gorging with food
3. asking for food constantly
4. sneaking food
5. eating in a panicked or rushed state
6. picking at food, inspecting it, playing with it
7. eating strange food
8. bad table manners (intended to disgust those around them)
9. hiding or hoarding food


Like I said in my original post, food issues are always present because we eat every day, multiple times a day.

Shirley came to us at 18mos, she is now 2 1/2yo. When she was first placed, she would stand near her high chair and scream as her way of indicating she wanted food. On a couple of occasions, if I did not get her food quickly enough, she would go to the trash and eat food out of it.

Her sister, Jenny, would constantly ask about food, wanting to know what and when the next meal was. She would ask for food all day long even immediately after eating.

A year later, Shirley does not eat out of the trash (but will eat food she finds on the floor, on the ground or in the car no matter how old or gross it may be) and Jenny knows the rules of the house which include not asking for food between meal times and is typically very compliant with that. She still, however, asks for more food at every meal and snack and will eat far past no longer being hungry.

Due to the structure we have in place around food in our home, there appears to be huge improvements in this area. Both girls have learned to slow down (now, Shirley rarely gags on her food, where before this was a daily thing), both have learned to chew with their mouths closed at least half of the time, both have learned not to ask for food between meals and snacks, Jenny has learned that saying "I'm hungry" is the same thing as asking for food, both girls have learned that eating like a pig (getting more food on themselves and the floor than in their mouths) tells me you're not really that hungry and both girls have learned that I say when they have had enough to eat.

But step outside our home, take them to a party where there are other people and food, send them on a visit with bio mom, take them to church where there is food, send them to school and daycare and they seem to have lost all of that learning.

They turn into begging puppies around any person outside of our household.


And boy, do people love to fall for this one.

At church, they ask for snacks for the 1hr period they are away from us (right after breakfast and right before lunch). Jenny eats a full breakfast at home before school, then goes to the school cafeteria after I drop her off and has another breakfast.

At visits with bio mom, they eat so much food, Shirley regularly comes home and vomits or has diarrhea. Shirley guzzles all of her drinks (even makes herself throw up on water) as if she will never have another drink. The parent aide tells us Jenny sneaks food out of her purse at visits and basically eats non-stop for the whole 4hr visit.

Shirley comes home from daycare covered in food like a 1yo just learning how to eat table food would look.

I'm sure I am being way too pessimistic about the improvement and that in reality, they have learned some element of self-control around food, some table manners, some reassurance that we will provide them food regularly, but it often feels like a year of masking an emotional issue that isn't actually healing. As I mention here, a sign of a healthy attachment includes a healthy relationship with food (#23. Uses food appropriately. Recognizes when hungry and full.) And this is a glaring reminder how far they have to go.

I know, it takes time. Lots of time. *sigh* I have no patience.


In the meantime, I think I want to get these for all of our kiddos:






Wednesday 1 August 2012

Let's Play Dumb - Part I

This started turning into a very lengthy post, so I decided to make it part 1 on the subject (I have a lot to say :)

Oh the joys of living with kids who want everyone to believe they can't do it or don't understand. They're good at it too. They almost get me to believe they really can't or don't know. But, they're kids and no matter how good they are at manipulating a situation, they eventually slip up. They eventually show you they are more than capable. You just have to be paying attention.

One thing that I know that they don't: I've now parented and provided respite for nearly 20 kids in the past 3yrs and ALL of them displayed these same behaviors. I've seen it before, I've parented it before and I've seen kids get past this stage with the right interventions. So, unlike their teachers at school, their friends' parents, their parent's friends, extended family members, people at church, their neighbors etc., I'm on to them and I won't be fooled.

So, what do I mean by playing dumb? Here are a few examples (if you are a foster parent, I'm sure you'll recognize a at least a few of these behaviors):

1. Asking questions you know (or at least highly suspect) they know the answer to - if they should know the answer, they probably do. If it's something where they appear to be oblivious to the situation around them or the conversation around them, it's fake. One thing about traumatized kids is they are typically hyper-vigilant. They hear and notice everything! They are paying attention to everything! So, if they pretend to be oblivious, it's just that - pretending.

2. Pretending not to know how to count, know their colors, their ABCs etc. - if it is age-appropriate to know these things, they probably do (at least more than they let on). This one is difficult because it's not uncommon for abused and neglected children to have developmental and learning delays which makes it more difficult to distinguish what is a real delay and what is an act. Here is one sign to look for: if they get it wrong 100% of the time, it's probably fake. Random chance would allow for a child who really doesn't know the answer to get it right sometimes. If they get it wrong every time, they're probably trying to (which means they know the right answer). Even neglected and abused children will eventually learn these things. Recognizing colors, letters, numbers are things that even when they aren't explicitly taught, kids will pick them up from their environment. So, if they seem to not be picking it up, they are likely pretending not to know (or they have a serious cognitive disability, in which case, you would probably know - it would be more obvious and effect many areas of development).

3. Appearing to not know basic life skills - knowing how to eat with utensils, knowing how to get dressed properly, knowing how to walk normally (without walking into walls, tripping and falling over nothing etc), knowing how to talk/communicate appropriately (even non-verbal kids can do this or attempt to do this), and follow 1 or 2 step directions (even very small kids can do this).

** I don't want to seem insensitive to kids that have real delays and need real help. Certainly, we don't want to overlook them. The reason for this post is to give foster parents who find themselves questioning their own sanity - wondering how their child could seem to know so much sometimes, then seem completely incapable other times - a different way to help their children. If your kiddo is faking incompetence, doing things for them, explaining over and over, getting frustrated and allowing them to continue to feign ignorance and lowering expectations of them, is not helping them.

So, what to do?:

This is a great video by Christine Moers where she talks about some of the things she does when her kids play dumb:



Here is another video that addresses nonsense questions and chatter (which can be a way of playing dumb, also a way of controlling the flow of conversation or just being annoying to those around them):



In part II, I'll address nonsense questions and chatter specific to the kids we are currently fostering, what we do, what has worked and what hasn't. In part III, I'll talk about the oh so funny, oh so frustrating daily shoe fiasco and what we do about it :)