Executive Functioning and Adopted Children, Can’t Do or Won’t Do?

We went to see a family therapist just over a week ago, one that specialises in children in care and adoptive families. We were referred last year but for reasons that I still don’t understand (and makes me very cross) our PASW felt that their services would be of no benefit to us so our referral was declined. To cut a long story short we went back to the community paediatrician with a long written list of the issues and she referred us for the second time. Neither the therapist or the CP could understand why were declined by PAS in the first place, this time without the intervention of PAS our referral was accepted. Ours, we were told is the sort of family that the service is aimed at, no question about it.

The appointment came, the therapist sat and listened to our concerns and said that he had spoken to our PASW so knew some of the background. He said that she was under the impression we didn’t need any further help. Do I chuckle good naturedly or scream with frustration? I went for a chuckle. Yes, we were happy to finish seeing the PASW she wasn’t telling us anything we didn’t already know, was offering us nothing new and lovely as it was nattering over a cuppa  it felt like a bit of a waste of time. At the time I was feeling confident that we were moving along the right tracks, we were ‘coping’ with the unwanted behaviours. The PASW had visited the school and insisted on extra help for Girl. An IEP was put into place and that was ultimately what we wanted, a recognition that school and education were stumbling blocks for Girl and were part of the triggers for some of her behaviours. We felt as though we were moving in the right direction.

Some months later I think we came to the realisation that the school were giving us lip-service to appease the PASW. Forced into a position that they didn’t believe in, they still don’t understand Girl, they don’t understand attachment and the struggles that adopted children can have with the little things. They are not seeing what stands out like a sore thumb to us. Perhaps because of class size, perhaps because she has two teachers and numerous classroom assistants, perhaps because at school she is no bother she is compliant, easy, kind and sociable she blends into the background, exactly what the first paediatrician pre-adoption predicted might happen.

Her IEP targets have been moved at each review, she is no further forward and in some things I have noticed she has gone backwards, such as counting, she can now no longer count to 20 confidently, she gets very muddled. One of my friends suggested that because in Reception they count daily then in Year 1 they count in different styles 2-4-6-8, 10-20-30 it’s confused her and forced her backwards. That makes a lot of sense to me. It’s only now, three terms later that they are beginning to give her more frequent extra lessons and help.

So back to the therapist. He could clearly see that school was not giving her the support she needed and suggested we do a parent and school test called a BRIEF. It stands for Behaviour Rating Inventory of Executive Function. He felt that the form would steer the school in the right direction and focus their attention on Girl a little more carefully. He explained that some schools are reulctant to involve an EP (eductaional psycholgist) just on the basis that somebody is adopted and may have attachment issues, EP’s are a precious but limited resource; that we needed to get some focus before attempting to get the school to involve the EP.

I have to be honest I came out of the meeting feel a tad underwhelmed, we had been given the usual flannel that parenting adopted children is difficult, twice the work of most other children, he actually said ‘parenting one adopted child is the same as parenting two children’. Yeah, yeah we’ve heard all this before, it’s hard, I get it. I am so disillusioned by the whole service that I failed to see that we were being given some genuine support.

When the parent part of the form arrived yesterday I didn’t fully understand what the title meant so I Googled it, I read the information attached with the form and a friend (who happens to be an educational psychologist) sent me a more in-depth piece of research literature on the subject by Family Futures. It was only after reading the last piece that I had a dawning realisation that we might finally be getting some real, proper help. That the therapist hadn’t been giving us flannel, he truly understood and possibly has recognised what is happening with my Girl.

What I read (as I understand it and put in very simple terms) is that during pregnancy and post birth the immediate environment and experiences can affect the normal development of the babies brain, neglect, abuse, drug misuse, emotional neglect etc. That 80% of the neural pathways are formed in the first two years of a babies life. OK we’ve heard all of this before with attachment, we know this bit. What  Family Futures have realised in their studies is that it can go deeper than the emotional issues of attachment and what people have perceived as ‘Won’t Do’ is sometimes more likely to be ‘Can’t Do’, that many of the children they tested had some weakness in Executive Function and had experienced high level of trauma in the first couple of years of their lives, they have termed this as Developmental Trauma Disorder. Executive Function is the ability to plan and manage everyday tasks using past experience.

Family Futures have been moving away from attachment and parenting style strategies which concentrate on the ‘won’t do’ and more towards strategies that recognise that the children ‘can’t do’. Non-competitive strategies which place the parents, teachers and carers as mentors rather than managers. It’s non-competitive and removes the power struggle of control. They have in place a model of therapy they call Developmental Re-parenting which addresses both the emotional and psychological and basically means that carers revisit earlier developmental stages.

I’m sure I could tell you a lot more but I think you get the general gist. If you want to read more the following is a link that you can find on Google using the terms Family Futures Executive Function and is the scholarly article my friend sent.

Is it that they won’t do it, or is it that they can’t?

So based on everything I have read I have a feeling that our new therapist is on the same page as those of Family Futures and I am starting to feel a smidgen of hope again.

5 Responses to Executive Functioning and Adopted Children, Can’t Do or Won’t Do?

  • Vicki says:

    I’d like to meet your therapist! Sounds like you’ve got a really good one there!

    I hope school are prepared to work with you on the BRIEF, that sounds like it could be quite an interesting exercise. It’s not something I’ve heard of before but will be looking it up, and checking out the links you’ve suggested.

    Sounds like a real positive step forward…

    • AdoptiveMummy says:

      I hope so too. Apparently Family Futures use the BRIEF on every child that they assess nowadays.

  • Natyjoco says:

    I came to the same conclusion as yourself and while researching the question can not or will not dilemma I found Pathalogical Demand Avoidence.

    • AdoptiveMummy says:

      Oh, I just looked that up on Wikipedia (never heard of it), very interesting. Thanks for pointing me in that direction.

  • Natyjoco says:

    If you look up the teaching guidelines for PDA it is very useful and explains what works teaching my boys. I believe my boys can’t do it’s taken years to see that, it also takes a lot of anger and frustration out of the equation. Can you share where I can read more on development trauma disorder?
    http://www.pdacontact.org.uk/frames/index.html

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