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.
School Report Time
It was parent-teacher meeting day yesterday and time for school reports, I was a little apprehensive about it as we felt that the school were not seeing the ‘real’ Girl. We got to the school and outside the classroom was a table with all the children’s work books and a sealed envelope with the school report. We took a chair whilst waiting for our appointment; I chose to open the report and the Hubster picked one of the workbooks.
Now this is going to sound really strange. As I sat reading the report my heart was sinking. The report was very, very good, gushingly good. Immediately I felt mistrustful, it was like reading about a different child, all the things we struggle with at home Girl was getting right in school. They were seeing a Girl who could dress independently, a confident and sociable little girl, a girl who had no problems following instructions, who could think independently for herself. At the same time I was reading this, Hubster was pointing out that in her writing book on every page were the words ‘with support’, with support’. Now I am not saying I am unhappy about reading a good report, it’s surely what every parent dreams of but when you know your daughter has so many difficulties you expect to see some of that reflected. So what is going on here? What is missing? Why the conflict in what we are reading and what we are seeing? I felt myself welling up, desperate that nobody was seeing what we see.
However, this is where it all changed. The teacher called us in to our meeting and immediately thanked us for the document I had sent in on Attachment in the Classroom by the national Children’s Bureau (it is very, very good, bookmark it, you never know when you might need it). She had read it and then passed it round to the teaching assistants and also on to Girl’s new teacher. She then went on to say that upon reading it she had started to notice of a few behaviours that Girl was displaying, her emotions and the way she shrugs into herself when not feeling comfortable with a situation, the document fully backed up everything we had been telling her. She told us there had been a few incidents of aggressive behaviour that she had to talk to Girl about (why are we only just learning about this?). She pointed out that Girl seemed to like playing roughly with the boys at playtime (full marks teacher) and could easily get carried away with the aggression of the fighting games. I pointed out that they would need to keep an eye on that because if not pulled up in time she could easily hurt somebody through lack of self-control.
Lastly she acknowledged that Girl was having difficulties with her reading, writing and phonics and that they would be keeping an extra eye on her. Hoo-bloody-rah! We had a discussion about how her writing seems to be going backwards, that she seems to be ‘unlearning’ things. The teacher said they don’t like to bandy about the word Dyslexia and they don’t normally diagnose until 7 years of age but with her background, the adoption, the development delays it was a distinct possibility, that her difficulties were enough to worry them.
I also mentioned to the teacher about not doing much of the hoemwork with Girl. This is something I worry about but we both find it too stressful. The teacher did not seem concerned at all so that is a weight off my mind.
So that’s it, I am so pleased to know that I was not getting it totall wrong but a little sad that I was actually getting it right too, do you know what I mean?
(Oh and by the way she is bloody brilliant at maths and art!)
Tic, tic, tock
Girl is managing to keep her temper under control and I am very proud of her for that, one tiny little outburst in the past week but I have this theory. The more she is reigning in her temper the worse the tics are getting, it’s almost like a different release for what she is feeling, we are seeing new and quite specific tics being added all the time to the palilalia and zuzzing noises and I can’t help but tell her what she is doing, in the hope that she can try and take some control of them. She has no idea what she is doing of course and I know she can’t help it but I worry that people or more specifically her friends at school are going to start noticing because the tics are getting odder, more frequent and are no longer confined to noises.
Girl’s latest and most noticeable tics include repeatedly bobbing her tongue out very quickly like a snake while she is talking (and actually while she is being quiet too) and yesterday she started clicking too. I am filled with angst. On top of this the conversations are getting harder and harder, she just cannot process anything we tell her and it is frustrating to say the least.
Yesterday in the car on the way home from school I told her that a little boy from her class wanted to invite her round to play on Thursday, we ascertained that today was Monday and I got her to go slowly through the days of the week, she said Monday, Tuesday, Friday, so I got her to think about it and she did it correctly, because she can do these things but often says the first thing that comes into her head. I then repeated back to her slowly ‘so today is Monday, then Tuesday, then Wednesday, then Thursday and then you can play at your friend’s house.’ Thirty seconds later, ‘Mummy, what day is it today?’ (I count quickly to ten in my head and try to hold in an exasperated sigh) ‘OK Girl, we already worked out what day it is so have a think about what we just talked about and tell me what day you think it is?’. ‘Thursday’ came the reply. Start over. This is pretty much a typical conversation and I find it quite difficult to cope with them, I can’t work out how to get her to process what is being told to her and keep it in.
Along with the tics we are seeing a rise in controlling, demanding and bossy behaviour and feel like the time-bomb is close to explosion but you know what? I know when it comes we will cope and that is definitely something to be positive about, no matter how bad meltdown is with a united front we get through it.
Direct Contact Issues
As you may have already read in my previous post we had a direct contact visit with Girl’s sisters and grandfather last weekend. I mentioned that Girl seems to be struggling with the arrangement and since the contact certain behaviours have started to reappear and sadly she has been on a downward spiral all week. We have had a week of walking on eggshells and despite our best efforts and creating a Super Saturday of epic proportions it has ended in a huge meltdown tonight.
Something about contact makes Girl feel unsafe and I think it’s that her sisters and grandfather are a link to her old life, a life where it’s certainly possible to lose everything you know. I think something touches her subconscious mind – perhaps the sound of grandfather’s voice or a familiar smell? So, Girl has been testing us all week, pushing the boundaries further and further and further. Tonight mid-meltdown I was told that she does not need a mommy and daddy, does not need a nanny and granddad, that we are all rubbish, that she can take care of herself. So, so sad, this to me says she has put up a protective wall around herself, is regressing back to what she feels is a safe position of trusting nobody. I don’t get hurt by these words, to me they are so useful, a clear indictation of what is going on in her mind. It’s Girl’s way of opening up to me.
So to today, it began in a bad way with lots of hyperactive behaviour and winding her brother up to manic proportions. She also tried to encourage Boy to do something very dangerous immediately after she had been warned against it herself, almost like she wanted him to hurt himself. We have had lots of repeat whispering, lying, refusal to follow simple orders or be helpful in anyway. Most of this behaviour we had seen by 9.30am this morning so we decided we need a Super Saturday, a walk in the beautiful countryside, fresh air, peace and quiet. It did work to a certain extent but we still had a lot of bossy and controlling behaviour, lots of glass half empty moaning (which drives me to distraction, it doesn’t matter what or how much we do Girl can always find something to moan about).
The behaviour once home immediately escalated again and ended up in a meltdown at bedtime, always a difficult time because she does actually have some control here, I can’t exactly pin her to the bed and force her to go to sleep and boy does she know it!
It has taken me two hours to calm her down tonight, I kept my cool whilst being attacked physically and stayed true to my Poker Face method, which although works I actually hate with a passion. It seems so wrong that I have to sit in the doorway to block exit from the room, that I have to keep some distance at a time when really she probably needs some comfort, I wish I could just give her a cuddle and talk to her about what is bothering her but the closeness just exacerbates the problem. It seems the best I can do for her is to just contain her in her room and let her fight it out until she is exhausted, it seems far from ideal to me but at the very least it gives me some control.
Tonight it felt like after a month of very good behaviour that we were back at square one. Based on last time I used the routine (which was also the first time) I am predicting that tomorrow night we will have more of the same but to a lesser extent, that it will take less time to calm down, that she will need to push the boundaries again to test whether she can trust me to have the same reaction (i.e. none) , that I will still love her and care for her no matter what she does.
I do not know what to do about the contact issue. I guess what we will have to do is just ride the storm, at least we know to prepare ourselves. In time I am sure that Girl will come to trust us and appreciate the continued contact.
Don’t Take It Personally…
I have to repeat the words ‘don’t take it personally’ to myself all weekend like a mantra but it’s so hard not to take things to heart or believe my own advice and after a particularly tough and emotional weekend (which I will tell you about later this week) the words are still ringing in my head this morning.
My son and I have a particularly good relationship, or that is we have a good relationship until the rest of the family come home and then it just seems to fall to pieces and what started as a few minor incidences is turning into a standard, consistent behaviour and I feel like it’s breaking my heart into little pieces.
All week while Girl is at school and the Hubster is at work Boy and I have a lot of fun. He has such a lovely, cheerful, fun personality; he loves to be close, playing, laughing and giggling, cuddling and tickling and he loves nothing more than helping mummy with the housework but when the family starts to come together at the end of the day the personality rapidly disappears.
The Hubster rarely sees the special Boy that I know that he is, he sees a grumpy, demanding, wilful little boy who will fight against everything. In the evenings and at weekends my little boy will not let me do anything for him without kicking or screaming or shouting for daddy, he will not make eye contact with me and he does not want me to play with him, tickle him or help him. He does not eat, he throws things in temper, he deliberately causes mischief for attention, he craves daddies attention but on his own terms.
I remember at two Girl being a little like this (though sort of different), the minute the Hubster came through the door that would be it, it was all daddy, daddy, daddy but our adoption was difficult right from the start because of her experiences in foster care and it was easier to accept that she needed her daddy at the end of the day. Now, although we have some difficult times Girl and I have a really good relationship, she is actually a bit of a mummy’s girl and after the really tough start we had I never thought I would say that!
The difference that worries me is that Girl could be a little monkey all day and just continue with the testing behaviour into the evening. However, with Boy the change in behaviour is so pronounced that it is causing me real anxiety and I have come to dread weekends because I just cannot be a mummy to my little boy, not for want of trying, he just won’t let me.
I’m finding this post particularly hard to write as I just feel so low. I know enough, have read enough books to know that it’s not personal, I know that in time Boy will get past his current difficulties, after all two is a difficult age for any child and it’s less than a year since he left foster care so he must still have some pretty traumatic memories of life-changing events but I feel like I am wishing time away, I live for the end of the weekend so we can get back into mid-week routine, I watch the clock ticking round to bedtime because I find the constant rejection hard to bear, the negative behaviour, the not eating, the screaming and wilfulness, the hitting and kicking, the battle for attention between the kids.
I don’t know how to end this post, I feel like I have a million thoughts still to write down but have run out of words. It really does help to write things down, even from this outpouring I can see one massive positive, jumping out of the page at me and that positive is Girl. Despite everything she and we have been through we are getting there, we have lived and learned and that gives me massive hope for Boy. Now, how long till bedtime?
Am I a Neurotic Mummy?
I have a headache. Not a headache in the normal sense of the word but a headache from going round in circles thinking am I neurotic mummy? Am I one of those moms who constantly thinks that if their child isn’t perfect there must be something wrong with her? If I hadn’t been given so much information would I just think my daughter was a bit naughty and wilful? What would happen if I parented in a normal style, relaxed and stuck with it? Is my daughter’s behaviour worse than other children’s behaviour? How much of this behaviour is down to genetics?
Today the headache is worse than normal, I confided in a neighbour about our problems and she asked me if I was over-thinking things, that she had similar problems when her kids were younger and that she suffered Post-Natal Depression, it was like a body blow. I am confused and my brain is tired with self-doubt.
All I can think that makes me feel any easier about all these self-doubts is that there is a big difference between our children. My children have been through the most traumatic thing that could happen to any child, twice. The loss of a mother at birth followed by the loss of primary caregivers, not forgetting that girl was so developmentally delayed that they even considered Cerebral Palsy.
I know if I lost a close member of my family it would take me a long time to grieve, I would probably get mad or sad. How can I expect my children to just accept their losses without some ugly behaviours rearing their head?
So if being a neurotic mum means that my kids are treated with, well…kid gloves, does it matter? Call me what you want, I’m just a mum who cares.
Recent Comments