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

Chores, Responsibilities, and Other Things My Kids Can't Handle


Level System vs Age-Appropriate Parenting

Kitty will be coming home from the psychiatric hospital at 4 pm today. After receiving a ton of pressure from the 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. 


This was 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 require daily completion of ALL the responsibilities of that level and ALL prior levels. Non-completion of ANY responsibility will move the 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 is not a punishment! This will hopefully demonstrate to us that she has the emotional ability to handle the privilege (for example, not having nightmares before being allowed to watch the media that I think triggers her).
{Handling Dysregulation and Meltdowns}

BASIC

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

LEVEL 1 

Responsibilities: 
Personal Responsibilities: cleaning room with help and clothing chores 
Emotional Regulation: being respectful and no gossip
Privileges: (2 days maintaining Level 1 responsibilities is required before the child can get Level 1 Privileges
Regular bedtime, less parental supervision on media{like TV and MP3 player), allowed to spend the night at Grandma's, and can go to church/Sunday School with direct supervision by an adult.

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


LEVEL 2 

Responsibilities: 
Chores: maintaining one of the bathrooms
Emotional Regulation: No whining
Privileges: (3 days maintenance required
Riding the school bus, having same-sex friends over, allowed to do activities and make decisions without direct supervision (media, church...)

LEVEL 3 

Responsibilities: 
Kitchen Chores: but not the ones that usually trigger meltdowns
Emotional Regulation: sleeping well without nightmares (because Level 2 media privileges can potentially trigger nightmares).
Privileges: (1-week maintenance required)- 
A lot less parental monitoring.

LEVEL 4 

Responsibilities: 
Kitchen Chores that have been triggering in the past (ex. emptying the dishwasher)
Emotional Regulation: no dissociating or isolating.
Privileges: (2-week maintenance required) 
include a cell phone and dating
{The cell phone is what triggered this latest episode that sent her to the psych hospital}

LEVEL 5 

Responsibilities:
a few more Kitchen Chores, handling her own medications, and being RRHAFTBALL.
Privileges: (1-month maintenance required) the "normal" life of a typical 16 y.o.

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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. For Bear, we'll probably change "No Whining" to "Be Where You're Supposed to Be When You're Supposed to Be There." 


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, emotionally/ developmentally delayed, and this is our life. 



This level system is really just a tool to give to all the people who've been saying, "You can fix this if you just...". I do not expect it to work for us.
It does help me justify in my own head why we treat her so differently. 


***************************************************


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. Here it is:



Instead of using the Level System we focused on WHY Kitty was acting the way she did and providing her with more Structure and Caring Support, but more importantly, Age-Appropriate, Therapeutic Parenting

The Why: 


Low Tolerance/ Overwhelm

How We Handled It:

Simplify and Cocoon
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 triggering.  This usually means making their world smaller and lowering expectations.

Stripping the Room

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 acted indifferent to them).
-This also made it easier for the child to keep his/ her room clean!


Parental Regulation

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

Working Together
Sending my child to "clean her room" or "do the dishes" was usually completely overwhelming for the child. But if we did it together, the child was usually able to handle it. Especially if I made it fun and more like a reward (the child gets to hang out with mom). This also helped when the child was on line-of-sight supervision.

Chore Expectations


We also cut back on the chore expectations she "should" be able to handle based on her physical age. Instead, we focused on chores that were emotionally age-appropriate. Yes, she could handle certain chores, when she was emotionally regulated, but when she was dysregulated that ability dropped to almost nothing. 

Parenting based on her emotional/ developmental age (which at the time was somewhere around 4 to 6 years old) meant she was given chores that were developmentally age-appropriate - which meant she couldn't handle the chore charts and lists that her siblings had. She usually only had two or three simple chores (emptying the trash cans in the bathrooms, cleaning the kitty litter, and bringing her laundry to the laundry room). She struggled with even these.


Simplifying 
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." 

I find leaving notes works well when assigning chores. It's harder to argue with a piece of paper!

Parental Support

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). This also involved helping her stay emotionally regulated. Sometimes, I would have to stop and redirect her to some other activity because she was becoming overwhelmed and agitated.

School - 
We tried to remove as many stressors as possible for her at school. Reducing or eliminating homework, making sure the teachers were aware of what was going on {New School Year Letter}, getting her in smaller class sizes, limiting or removing after-school activities...



Healing
Eventually, with lots of therapeutic parenting and attachment therapy, Kitty healed to the point where she could handle being given more than one step at a time (a short list with about 2-3 steps), but the chaos in her head will always be reflected in the chaos of her room. 

Parental Regulation

I still have to help her keep things organized and clean. A tendency toward hoarding will always be an issue for her. {"Adult" Boarder vs Family Girl}

I also help keep her emotionally regulated, although her need for that has lessened now that she's an adult in a relatively stable environment. {Calming Relaxation Techniques, Therapeutically Parenting the Adult Child}


Explaining Therapeutic Parenting Based on Emotional/ Developmental Age 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 emphasized that parenting her based on her emotional age wasn't a punishment and it would have a lot of rewards.

Age-Appropriate ExpectationsSo 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 
  • Her chores 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 have to go to places like the grocery store I take her with me (although I try to avoid having to take her to stores and other overwhelming places).  The other kids frequently have the option to go or stay home, but you don't leave a 6-year-old at home alone.
  • She can have "play dates," but they are well-supervised.  
Finding the JoyHaving age-appropriate expectations 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!"

Encouraging Positive Behavior
Encouraging positive behavior in our kids can be difficult, especially when we're frustrated and exhausted. Having age-appropriate expectations can make this a little easier because it is easier for them to be successful. 

Unfortunately, rewarding/ direct praise will often have the opposite of the desired effect on our kids. {If You Find Out I'm Not Perfect, You'll LeaveOne option is to praise the child to someone else when you're sure the child will overhear. Or you can try leaving notes. Sometimes, I randomly offer a treat or activity because they've "worked so hard" and/or "everyone has been cooperative/ helpful lately." Sometimes, I'll casually drop an "Atta boy!" "Good job" -type message and then quickly leave the room before they have a chance to react.   


**** 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 that.  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:

stellarparenting.com 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.

Mary

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.