This blog is my place to vent and share resources with other parents of children of trauma. I try to be open and honest about my feelings in order to help others know they are not alone. Therapeutic parenting of adopted teenagers with RAD and other severe mental illnesses and issues (plus "neurotypical" teens) , is not easy, and there are time when I say what I feel... at the moment. We're all human!

Sunday, September 25, 2011

Level System vs Age-Appropriate Parenting

Kitty will be coming home from the psychiatric hospital at 4pm today. After receiving a ton of pressure from staff at the hospital and school to give Kitty all the privileges that normally go with being 16, I decided to create a new chore chart with the responsibilities and privileges done in levels. Mostly to get them to understand WHY Kitty was not being allowed to have unsupervised dates or have a cell phone or whatever they felt she was entitled to based on her age alone. Kitty was so dysregulated that she was not able to handle even the most basic responsibilities.

How the Level System works:
Level privileges requires daily completion of ALL the responsibilities of that level and ALL prior levels. Non-completion of ANY responsibility will move child back to the privilege level containing that responsibility. To move up to the next level's privileges, she needs to demonstrate an ability to maintain that level's responsibilities for a period of time. This will hopefully demonstrate an emotional ability to handle the privilege (for example, not having nightmares before being allowed to watch media I think triggers her).

Basic Responsibilities are Self Care (hygeine, taking meds, eating meals) and Basic Safety (No meltdowns, no threatening self or others.
Basic Privileges are Approved music and books, slightly earlier bedtime, and family activities.

Level 1 Responsibilities are Personal Responsibilities (room and clothing chores) and Emotional Responsibilities (being respectful, and no gossip).
Level 1 Privileges (2 days maintenance required before can get privileges) are regular bedtime, less supervision on media, being allowed to spend the night at Grandma's and go to church/Sunday School with direct supervision.

Chores will be inspected by Mom and must meet her standards. If child is unable to accept feedback then child will be redirected to another activity.

Level 2 Responsibilities include the Chores (maintaining one of the bathrooms) and Emotional Responsibilities (No whining)
Level 2 Privileges (3 days maintenance required) include riding the school bus, having (female) friends over, and being allowed to do stuff and make choices without direct supervision (media, church...)

Level 3 Responsibilities include some Kitchen Chores which can be triggering for Kitty, but aren't the ones that specifically do so and Emotional Responsibility is sleeping well without nightmares (because the privileges include potentially triggering media).
Level 3 Privileges (1 week maintenace required)- Lot less monitoring

Level 4 Responsibilities include Kitchen Chores that are triggering. The Emotional Responsibility is not dissociating or isolating.
Level 4 Privileges (2 week maintenance required) include a cell phone and dating. The cell phone is what triggered this latest episode.

Level 5 Responsibilities include a few more Kitchen Chores, handling her own meds, and being RRHAFTBALL.
Level 5 Privileges (1 month maintenance required) this is the life of a typical 16yo.


I'll be telling Kitty that we expect her to work her way slowly through the steps, and that we expect her to maintain at about Level 2. In order to head off a meltdown, we will be putting everyone on this system for a week to show her why they are at the levels they are at. Bob will have homework as her major chore. We'll probably switch out "Be Where You're Supposed to Be When You're Supposed to Be There" for "No Whining" for Bear.

She's going to hate it. She's going to protest, even though it's as concrete and positive as I can make it... but she's mentally ill, and this is our life. This is really to give to all the people who've been saying we can fix this if we just...


Edited to add how the level system worked for us:

I thought I'd written a post on my decision to throw out the level system and expectations that Kitty can ever be expected to be treated like a 17yo, but apparently I hadn't.

How we "fixed it," mostly involved me learning why Kitty was acting the way she did and providing her with more structure and support, but more importantly, age-appropriate, therapeutic parenting

Low Tolerance/ Overwhelm
It is sometimes necessary to simplify a child’s life a LOT to lessen the feeling of “overwhelm.”  This can be like childproofing – avoiding and removing things and events that can be triggers.  This can be making their world smaller and lowering expectations.

One thing Kitty's therapist recommended was stripping her room. Nothing but a bed, one book, and one stuffed animal. It was NOT a punishment, and not something they could "earn" back (or actually not earn back, because my kids are afraid to be emotionally attached to things as it gives others power over them so they pretended indifference to them. ).

For a time, I even took my daughter's dresser out of her room and had her check out her clothes each day (this cut way down on the wet pull-ups stuffed behind dressers and other places).

We also cut back on the chore expectations she "should" be able to handle. I would break down tasks into small steps and give them to her one at a time. Instead of saying, "Clean your room," which was overwhelming and just didn't happen. I would say, "Empty your trashcan." and when that was done, then I would say, "Put your dirty clothes in your laundry basket." When that was done, I would say, "Put your laundry basket next to the washing machine." Most of the time, I would have to do these things with her (not for her, but be present in the room, often helping clean near her). Chores, Responsibilities, and Other Things My Kids Can't Handle. 

Eventually, she got to where she could do a few tasks at a time, but the chaos in her head will always be reflected in the chaos of her room. I still help her keep it regulated. Therapeutically Parenting the Adult Child

School - reducing or eliminating homework, getting the child in smaller class sizes, limiting or removing after school activities...

We had a long discussion with Kitty about being emotionally 6 (still ticks her off to hear that), and I told her that it wasn't fair for us to expect her to be able to handle certain responsibilities or privileges and that we felt it was cruel to dangle higher level privileges she couldn't achieve over her head.  So therefore, I was going to stop "punishing" her for not being able to do things she wasn't ready for yet.  I also emphasized that parenting her based on her emotional age wasn't a punishment and it would have a lot of rewards.

So now I have "age-appropriate" expectations for her, and she is doing better.  Every now and then she'll want something her siblings have (like any "younger" sibling would!) and we gently explain she's not ready for that.  She doesn't like it, but it is what it is. Therapeutic Parenting Based on Developmental Age

Examples of what age-appropriate parenting looks like for Kitty.. (Obviously this is not how I phrase it to Kitty when I talk about it to her:

  • She has fewer chores and they are very simple and concrete.  
  • She does the same chores every day instead of rotating like the other kids.  
  • She gets to go places even if she'd had a fit recently, because I don't hold her accountable for her behavior like I would a teen.  
  • If I go places like the grocery store I take her with me.  Period. The other kids frequently have the option to go or not, but you don't leave a 6 year old at home alone.
  • She can have "playdates," but they are well supervised.  

It has helped ME immensely.  I'm less frustrated by her inability to do things that would be "normal" for a teen.  I do have to constantly remind myself, "She's only 6!  She's only 6!  She's only 6!"

A couple of months ago, Hubby gave Ponito his old phone, which has internet access, so we decided to give Kitty Ponito's old iPod.  I debated long and hard because it has texting and internet access.  I didn't think she was ready.

I was right.

Now we have to decide how to fix it.  But I'll leave that for another post.

A post regarding the comments on this post.
A post regarding Kitty's reaction to the level system.

6 comments: said...

Hope it goes well, hang in there

Adrian said...

I'm pretty sure I couldn't handle that when I was 16. If the end goal is teenage privilege doesn't it go with the idea that its being used on teenagers? Who will scoff at being monitored in terms of hygiene, much less having only same sex friends over or having a bedtime?
If they can't regulate themselves well enough to actually need an enforced bedtime, then they aren't 16.
I'm sorry to dismiss your idea, but you're inappropriately restrictive to such a degree I had to say something.

marythemom said...

Adrian, that's pretty much my point. She's NOT a typical 16 year old. A 16 year old SHOULDN'T need to be monitored in terms of hygiene, and SHOULD be able to have friends of either sex over and watch PG-13 movies without becoming totally dysregulated. Bob (now 16) can handle all of this stuff without needing any of this regulation (Ponito at 13 mostly can too). Kitty (chronologically 17, but emotionally and socially only 6yrs) can NOT handle this.

This level system was created for lots of reasons, but mostly to show others that we've tried to treat Kitty like she is her chronological age, and she is unable to get past level 2 and really is often stuck at Basic. Once we established this over a period of a couple of months, we felt we had enough evidence that Kitty needs a much more structured and supported life, and we dropped this level system. Kitty now gets the "age-appropriate" privileges and responsibilities that she can really handle without having these unattainable privileges dangled over head.


Adrian said...

Thanks for the explanation. You must care a lot or at least have pretty tough skin to get a 16 year old (Bob) to do chores regularly.
I don't doubt that Kitty can't handle it because of immaturity, and works better on lower age restrictions. I was just wondering how a regular teen could possibly listen to parents enough to get far on the system (which seemed to defeat some of the purpose). I didn't ever seem all that defiant growing up but I'd still do chores pretty rarely, and virtually never at anyone's request (2 people, 1 house, really not many chores period, did them when I was the one who needed dishes or some such). And I grew up with a mood disorder so I couldn't do much like that on demand just from depression.
I've read your blog for awhile and can't help but gawp a bit on how many restrictions you have on your kids, even though it makes some sense and it's your situation and works for you. Even if I disagree a fair bit, you have some good ideas, you really care, and I can't help but feel for your kids.
I wish you'd mention more about what it is Kitty does well, skills, hobbies. In the chaos for her several diagnosis she must have some small talent? :)

Anonymous said...

Do you have a clear copy of the chore chart?

marythemom said...

If you comment with your email (which I will not publish!), then I can email you a copy.