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!

Wednesday, October 31, 2012

Shameless neglect

Sorry I've been neglecting this blog!  I've been swamped trying to get stuff done.

In preparation for starting my sewing business, I'm designing and sewing custom dresses for both the girls and myself for this year's Christmas pictures.  Bob's is done, but I ran into HUGE issues with my dress.  I'm trying a new, uber complicated pattern and it has to be significantly altered to accommodate my "generous cleavage" so I made a mock-up dress... and it's very unflattering.  So now I'm making a second mock-up before cutting into the fabric I've chosen for my dress.  I also plan to use the left over yardage from my dress for Kitty's dress so I haven't started her dress until I know what I have left (which is making her crazy).

We don't celebrate Halloween around here because it seems to be a big trigger for Kitty (she usually starts with the high stress and psychiatric hospitalizations around this time, and it goes through her birthday in April - some years later).  This year we're going to watch a movie and eat pizza and candy.  I did invite Ponito's girlfriend and her mom to come over... so I'm on my computer instead of cleaning house.  *sigh*  It's really disgusting too.  Oh well, they won't be here until after 6 so the kids have 2 hours to help me clean house.

I've also been editing the book of one of Hubby's coworkers.  It's supposedly been "professionally edited," but she should ask for her money back!  I meet with her tomorrow with the sample of my work, and I get to tell her that I think the book needs a lot of rewriting... not looking forward to that.

I'm really excited about the weight I've lost.  17lbs so far.  I've dropped 2 dress sizes.  I never get rid of my old clothes as I change sizes, because I do tend to fluctuate a lot, but for some reason I couldn't find any jeans in my "new" size.  Luckily my neighbor has gained some weight recently and had some jeans in the old size (I traded her for the jeans I just... hmmm, not sure what the right word would be here... not "outgrew"... I guess "outshrunk"?  OK, so I made up a new word!

Going to try to commit to blogging every day of November, so wish me luck!  I'd love to see some topic suggestions in the comments!

Saturday, October 20, 2012

More accusations of Dreamkilling - Legal guardianship

In therapy I finally told Kitty that we are planning on getting legal guardianship.  We were having yet another "conversation" about out classes at the high school, and she was complaining to the therapist how unfair it was that I wouldn't allow them.  "Out classes" involve being bussed from the special school to her home campus for 2 or more classes, usually ones that aren't available at the special school.  Kitty hates that she is the only one in her history class at the special school and says that's why she wants to go back to her home campus.

Kitty and I'd previously had a long conversation about why Hubby and I don't want to allow out classes.  Almost all of which involve the fact that the school never agreed that she needed to be at the special school (despite all the documentation we presented), and only allowed her to go because we filed due process (like suing the school).  When we were fighting to get her into the special school, we were stuck with status quo whenever we disagreed - which meant that Kitty stayed where she was - on the regular campus.  Now that she's at the special school, status quo is finally the special school.

One thing we learned the hard way with Bear was that if he had any out classes then the school could give him more out classes without having to ask our permission or hold an IEP meeting (because it wouldn't change the number of hours of special ed).  Most of the time he would act out and they would reduce the number of out classes again, but it took some pretty severe behavior.  His senior year they just moved him to the regular school full-time, despite our concerns.

Kitty wants to "try" a couple of classes at the regular school, and if she can't handle it then she expects to be able to go back to the special school full-time.  I've explained to her repeatedly that aside from the fact that she's finally stable and I think that's got a lot to do with the lesser amount of stress at the special school (and a med change), the school district NEVER acknowledged a reason for her to be in the special school in the first place, therefore she wouldn't be able to convince them that she can't handle it and needs to be back at the special school full-time.  Right now we have status quo on our side.

Kitty aka Cleopatra (the Queen of Denial), doesn't want this to be true, and as usual prefers to believe I"m just being mean.   At therapy she started talking about how she's going to talk to the IEP team (her annual meeting is in December) and tell them this is what she wants, and when she's legally an adult then she'll get it.  I tired of trying to convince her that it was not in her best interest, and finally just dropped in the thought that we were pursuing legal guardianship, which we've touched on in the past.

She exploded.  She yelled, cussed and told me she wanted me to die... not anywhere near the worst meltdown though.

The therapist helped me get her calmed down.  We finally got out of Kitty that the guardianship itself wasn't what bothered her (although she definitely didn't like us having the control over her).  No, most of what bothered her was that she wouldn't be able to have any out classes.

Once she was calmed down enough to hear me, I pointed out that she wouldn't be able to have a vote at an IEP meeting until she turned 18 which is not until April (when the school year is almost over).  That wouldn't make a big difference to this year's History class (she really hates not having anyone else in the class with her.  I assured her that at the December IEP meeting we were already planning to discuss other options (that didn't involve out classes), like asking for a schedule change for the next semester.  I also told her I'd consider out classes next school year (it's her senior year so they can't force her full time that quickly).

She was still a little mad at me, but dissociated from it.  It hasn't come up again.

We also talked about Bear's letter to Kitty, but I'll save that for another post.

Thursday, October 18, 2012

Attachment therapy

Facebook post by a friend of mine, and my response.

"The American Professional Society on the Abuse of Children convened a task force on Attachment Therapy/Parenting because of the numerous high profile criminal child abuse and death cases associated with these practices. The task force found (in the journal *Child Maltreatment* Feb 2006) that the parenting method that Nancy Thomas promotes is "inappropriate for all children" and recommended child welfare workers investigate where it is used as "suspect abuse." (Thomas is mentioned by name in this report.) The American Psychological Association adopted the APSAC task force's recommendations and findings. ...The mental health profession, as well as the general public -- to say nothing of our court system -- knows that using abusive "therapy" and parenting methods *never* helps a child. There also have been numerous criminal cases of abuse and even death, where people have used Attachment Therapy parenting (aka Nancy Thomas parenting).A child with RAD, as described in the DSM-IV, can be challenging, but not overwhelming. Their problem is being either very withdrawn or overly friendly with with unfamiliar people. While there is no science-based treatment for RAD at this time, most legitimate professionals advise gentle, consistent, and patient parenting. RAD is rare, and so it is likely that you aren't parenting a child with RAD either.What Nancy Thomas and other proponents of Attachment Therapy talk about is an unrecognized diagnosis ONLY used by Attachment Therapists called "Attachment Disorder" (AD). AD is a catch-all "diagnosis," meaning all adopted/foster or other children can potentially get this diagnosis if sent to an Attachment Therapist. The critera for AD are so broad as to be useless. For example, even "good behavior" characterized as the child "stalking his prey."Any child diagnosed with AD (or "RAD" since the two are conflated by Attachment Therapy proponents) does not have a good diagnosis. And it is necessary to have a good diagnosis in order to proceed to the next step of treatment. So it is fair to say that children caught up in this "therapy cult" are not getting the help they need.Dismissing critics because they might not have lived with a difficult AD ("RAD") child is often just an attempt to inoculate "awesome moms" from charges of child abuse. What you're really saying is: "If you lived with a horrid child, you'd use abusive methods, too."Attachment Therapy and its parenting methods have been around for four decades, having treated thousands of children. Where are the success stories of Attachment Therapy/Parenting? Where are all these grateful children-now-adults? Where are the happy families created by this highly authoritarian parenting method? What we see is lots of divorced families. And the survivors of Attachment Therapy are severely wounded young adults, alienated from their families, with horrific stories to tell:

.... I'm sorry that you don't comprehend what I have written. You are saying that the RAD diagnosis in the DSM-IV is inadequate, but it has been developed from research. In over four decades, Attachment Therapists have failed to show that their AD diagnosis is valid. Actually, they haven't bothered to change the definition of RAD because their version is laughably absurd. The RADQ, however, has been shown to be a dud for helping therapists to diagnose anything.From what you say, your children appear to have been diagnosed with "AD" (not RAD), and that is no diagnosis at all.What makes the AD diagnosis laughable? AD is a patently a quack diagnosis, and typical of all quack diagnoses, it includes *all* behaviors, developmental and speech problems, and even normal behaviors. That's what I meant by catch-all.AD was especially designed to ensnare foreign adoptees. For example, Attachment Therapists claim that lack of eye contact (on the parents' terms!) is a major sign of AD, although many foreign adoptees and children raised in subcultures within the USA have been taught that looking an adult in the face is a sign of disrespect.Worst of all, the AD diagnosis demonizes adopted children. That snarky Nancy Thomas is great at this, claiming these "little pukes" are each a Ted Bundy in the making, and that she doesn't even allow them to pray because she can't be sure who they aren't praying to! Are you defending an attitude like this?Several mothers who stopped Attachment Therapy and its parenting told me that everything gets so much better immediately for both the child and the mother. Unfortunately, it appears few mothers do stop it.I don't mean to be personal here, but I have a lot of questions about this "therapy." Why are the parents so amazingly loyal to a model of parenting that routinely mocks children and treats them harshly? Why are their no second thoughts when professionals call this parenting "child abuse"? Who lacks attachment here anyway -- the parent or the child? What loving parent would treat children like that bully Nancy Thomas professes to do? And why is there this incredible craving by the "awesome moms" for universal and unquestioning approval? Is this a cult? Typical cult one else can have a valid opinion unless she is an "awsome mom". Do you realize that Nancy Thomas continues to defend the death of Candace Newmaker by stating she had an undiagnosed heart condition? The child's autopsy did not indicate this, but a paid witness for the defense said it was a possibility, based on pure fabrication. According to Nancy Thomas, a fetus "knows" if he/she is unwanted, and, even if the child is to be immediately adopted as a much wanted child, the child has RAD. She believes that most children in foster care have RAD. The quality level of writing and logic NT exhibits is a measure of her professionalism and creedance. Blind faith following of this person's absurd teachings appears to be cult-based as success is anecdotal and no true scientific based data supports it. Nancy Thomas' concepts are dangerous. ...This line of argument is a tactic to divert blame from caregivers for using a form of "therapy" and parenting that others, such as grandparents and teachers, see as highly abusive. Often children caught up in this "therapy cult" are consistently good students, with no behavioral concerns by other people in the community; and only the "Awesome Mom" claims they are the are wicked.Nancy Thomas says she got the term "Awesome Mom" from the Old Testament, claiming that this is an adjective used for Jehovah. The intent, she explains, is to make the child fear their adoptive mother, just as Christians are supposed to be God-fearing. Thomas and her follows might be said to have a bit of a god complex, i.e. women who say they should never be questioned, even by their spouses.Regarding valid therapy: for the official Reactive Attachment Disorder diagnosis, there is currently no scientifically validated therapy, but many professionals suggest that consistent, patient, and gentle parenting is the best approach.Holding Therapy, on the other hand, is literal "torture" using any of the various definitions of the word. Only if there was research that showed the benefits of Attachment/Holding Therapy outweighed the risks could it possibly be considered. That evidence doesn't exist. Moreover, the fact that many children have been harmed by it means that it would be unethical to use children as research subjects. There is also evidence that Nancy/Beth Thomas parenting is ineffective, causing the Awesome Moms to escalate the abuse.Curiously, Holding Therapists threaten children they restrain with abandonment by their adoptive parents. Is it really the children who are unattached, or their parents?For my part, I think that there is entirely too much beatification of foster parents by foster parents. You don't need to abuse a child to know child abuse when you see it. And you don't need to by a psychotherapist (which I am not) to know a quack diagnosis when you see it.... Why is the "Attachment Disorder" (AD) diagnosis quacky? For a few things, it includes contradictory signs. It is also not age-dependent. (Some of the signs are appropriate for certain ages.) It is hung up on eye contact (from the days when Attachment Therapists claimed they could cure autism). Kids are dx'ed as AD whether they make eye contact or not -- both are considered signs of AD. Even good behavior is interpreted as AD (the child's motives are assumed to be malevolent, such as "stalking their prey"). Curiously, treatment for this bogus diagnosis includes threatening the supposed unattached child with abandonment by his adoptive parents. It would be a curiously funny diagnosis if not for the fact that it has the potential to do great harm. ... You can't imagine what it takes to parent these kids unless you actually do it.---This is a statement often heard by proponents of Attachment Therapy and Nancy Thomas parenting. It is nothing but a cheap attempt to deflect criticism and rationalize child abuse. ...I sure wish I had a dollar for every time a proponent of Attachment Therapy/Parenting (AT/P) attempted to deflect the issue of child abuse with the "you don't know what they're like" excuse. Child abuse is child abuse. Health care professionals (such as myself) are trained/required to report suspected child abuse to the authorities. And AT/P even meets the definition of "torture" as defined by the UN Convention on Torture. So there are no subtleties here.Attachment Therapists will tell you guys that heart surgery is also hard to watch, but heart surgery has research behind it so that surgeons can gauge the likelihood of a beneficial, even life-saving outcome. We know from years of good research on child development that the type of practices used in Attachment Therapy/Parenting are potentially harmful, depending on the resilience of the child. The likelihood is that parents who use these practices will be estranged from their children when they are adults, and the AT/P people themselves admit that the divorce rate is high among parents who engage in AT/PAT/P exists for the benefit of the mothers and the greedy, sadistic therapists. The practice is marketed to the "awesome mom" and is specifically designed to appeal to you. Let's take a look at this program: 1.) Dad's role is to always support mom; 2.) friends and family should pamper the moms with gifts, massage, etc; and 3.) the children should be gratefully and unquestioningly obedient. Many Attachment Therapists have spoken publicly about how much parents enjoy seeing the therapist get rough with their child from behind the one-way mirror. It's for the mothers' benefit, which is why the mothers stick with the program no matter what." the moms with gifts, massage, etc; and 3.) the children should be gratefully and unquestioningly obedient. Many Attachment Therapists have spoken publicly about how much parents enjoy seeing the therapist get rough with their child from behind the one-way mirror. It's for the mothers' benefit, which is why the mothers stick with the program no matter what."


I agree that Nancy Thomas' techniques are tough.  Since our RAD kids were much older when they came into our home (11 and 13) we never even attempted her techniques, but after a few years of living with RAD teens, I saw that my kids responded best to "tough love."  Teachers and people who hold them accountable, demand respect, and call them on their bad attitudes and inappropriate behaviors, while obviously caring about them, had my children's  respect and they did better with/for them.  People who try to love and nurture them, give them lots of second chances and a blank slate every time they misbehave... are walked on, patronized, triangulated and manipulated...  I started out trying to give them all the nurturing, unconditional love they missed, and they drained me dry, didn't learn anything, treated me (as the representative of all mothers and therefore an evil abandoner) abusively, drove a wedge between me and the rest of the family, and STILL felt unloved because they believed I wasn't strong enough to keep them safe.  Luckily after years of attachment therapy with my daughter I was able to be stronger and provide them the structure and discipline they need.

With the "poor little me" attitude fostered by well-meaning adults and a belief that all adults are stupid and there to be manipulated, my son is struggling in "real life" - where no one gives a crap that he had a tough childhood.  My daughter (chronologically 17) is emotionally and socially only 6, and struggles with emotional regulation (she often needs me to do it for her, and has had to be placed in physical holds to keep her from hurting herself or others as she calms down.  Even after she was calm, she often needed continued holding afterword to allow herself to rebuild our connection) and while her RAD is healing it caused extensive neurological and emotional damage.  She now has emerging borderline personality disorder in addition to her other mental illnesses.

My son who was "too old" for attachment therapy never really attached.  To outsiders, the strict structure and rules we gave him often looked abusive and we found very little support from all but those who knew him very well, BUT every time we or the school "lightened up" because he was doing well, he would act out until the structure war reinstated.  He finally succumbed to the opinions of others who said he "should be"  independent and moved out.  He stopped taking his medication and went back to drinking and doing/dealing drugs.  Within 6 months he was in jail for a first degree felony.  NOW he realizes that he needed the structure and support we provided.

I agree that some attachment therapy is abusive, "rebirthing" for example, BUT I don't think we should throw out all attachment therapy as evil... ESPECIALLY if you don't have something to replace it with!  Because I can tell you that attachment disorders are VERY real.  Every child and family dynamic is different and what works for one kid and his/her parent(s) most likely will not work for another.  Parents of kids with attachment disorders need to be given LOTS of options to find what mix works best for their family.  NO ONE else knows exactly what will work for me or this child.

I don't do "strong sitting" with my children.  I don't demand they treat me like a queen.  I also don't have children who are trying to kill me (although I have friends who do).  I don't use attachment therapy because it appeals to me or because it's to my benefit - it's NOT!!  Therapeutic parenting is the hardest thing I've ever done in my life.  My children direct much of their rage at me as the representative of the primary caregiver, so yes, I do need Hubby to provide back up and support.

I'd much rather hug and love on my adopted kids, but that's not what they NEED!  They NEED to learn how to have a reciprocal relationship.  They need to learn that mom's can keep them safe and provide what they need - often that means taking the control out of their hands and putting it in mine (which is NOT part of my personality which makes it HARD).  They need to surrender control and trust that we'll take care of them.  That's HARD for them!  It feels like life and death.  They fight it!  If it doesn't happen though, they will NEVER be able to have a relationship - that means loving another person, nurturing their own children, holding a job, living with a roommate... these are skills with which my children's disorder causes them to struggle and fail.


My adopted children didn't receive a lot of ("care, kindness, dignity, affection, trust, respect, generosity, love, forgiveness, honesty, support, encouragement, admiration, and empathy") in their early lives and cannot accept it now.  I'm trying to teach them to trust/ respect/ accept, things they consider themselves unworthy of (like love), because they KNOW they are horrible, unworthy, stupid, ugly... They KNOW that if they trust people to see the real kid inside, then those people will abandon them and/or use it against them.

How do you teach someone that they are worthy and loveable?  How do you show them they can trust you when their perception of reality is so distorted?  I have had to remove so much and make their lives so simple, because more overwhelms them.  They live in a war zone (entirely in their own heads) and those early years when they didn't get what they needed (positive interaction, a consistent caregiver...) led them to have permanent brain damage.  Their world is full of people who are out to get them.  Even when people give them these things (kindness, trust, love, generosity...), my kids distort and deny it.

Thursday, October 11, 2012

Confessions are Good for the Soul?

Bear tends to confess about misbehavior after he feels that there will be no longer be consequences or that he might even get kudos for dealing with it.


  • A year and a half after Bear lived with us, he confessed that during his first few months with us, he was smoking mariju*na.  We'd strongly suspected (thought I smelled it in his room), but didn't have any proof at the time.  Not totally sure why he told us, but do know that since he was no longer doing it, and it had happened so long ago, he was sure there was nothing we would do about it.  I'm assuming it's part of the brain damage causing him to not "get" cause and effect, that he assumes not having a consequence is the end of it.  He never has been able to understand that the true consequences is that we don't trust him.
  • While in residential treatment (6 months after he came to live with us, Bear went into psychiatric residential treatment for 6 months), Bear went to the staff and confessed that he'd been dipping (packing his lip with chewing tobacco), and gave them his supply.  Since he hadn't been caught with the tobacco, he got praise for confessing.  Does it say anything about us that Hubby and I both looked at each other and asked, "How much was left in the container?"  We were right, it was almost empty and he had no way to refill his supply.

During a recent telephone conversation, Bear told Hubby that after he moved out he began taking and selling drugs, in addition to some other illegal behaviors.

We'd already mentioned to Bear that Kitty was upset with him because he'd sold drugs to her friends.  He denied it immediately of course, but I'd made it very clear at the time that I wasn't asking him if he did it, or even accusing him of doing it, and didn't want to hear his denials.

This is how we deal with Bear's lies.  We don't ask him.  We don't put him in a position where he can/will lie.  We simply ignore his attempts to lie, keep his life as structured as possible so he is not in a position to get into trouble, and present him with consequences without asking for his side of what happened.  In short, we assume that everything he says will be a lie and that he will break the rules if given the opportunity.  It's beyond guilty until proven innocent.  It's guilty or didn't have an opportunity to do it... yet.

It sounds horrible doesn't it.

In the phone call, Bear told Hubby that he wished he hadn't left the special school (where there was a LOT more supervision). He wished he hadn't moved out (where there is a LOT more supervision).  From what I've learned from Bob, we're pretty sure that he didn't start drinking, smoking, doing drugs and "fooling around" with girls, until he moved out.  He needed the structured environment we were providing.

I understand "typical teenage rebellion."  My mom was pretty strict, and in some ways, I was a pretty sheltered child.  I got into some trouble while in high school (occasionally drinking and not where I said I would be, but no drugs or sex), but generally I was a "goody two shoes."  Like most kids, when I got to college, I got a little wilder (lot of cussing, but never drugs).  Within a couple of years, I went back to my "core values" and eventually became the mature, responsible adult that I am today... (obviously I wasn't struck by lightening - it's safe to resume reading!)

When people realize how structured we keep the lives of Kitty and Bear, we hear a lot about how anyone would rebel.  That we should be preparing them for "real life"  by allowing them to take chances and make mistakes while still in the safe environment of our home and/or have the legal protection of being under 18.  Even his psychiatrist said we should let him try "real life" and pick up the pieces afterward.  We tried.

It took us a long time to get here, but I now believe that our kids will never be "typical teens."  I don't believe that Bear has the "core values" to go back to when he gets the "teenage rebellion" out of his system.  I know he doesn't have the cognitive ability to make responsible choices anytime soon.  His last neuropsychologist's recommendation was that he stay at home longer and mature before he is ready to take on "real life."  Unfortunately he is legally an adult now and we couldn't make him follow our and the neuropsych's recommendations.

Now that he's coming to grips with this idea, I don't know where to go from here.

I do find it interesting how much it bothers him that Kitty is mad at him for this.  He seemed very upset that she even knew about the drugs.  Bob knew too, but Bear doesn't seem interested in her.  Don't know if this is because Kitty is his bio sister or because she's actually expressed her feelings about this and Bob hasn't.

Wednesday, October 10, 2012

Dream Killer strikes again - study skills

We were having an unusually peaceful therapy session today, so toward the end we talked briefly about what would happen after high school.  Kitty mentioned that she'd thought about taking a year off of school, because she "needed a break," but her sister, Bob, had told her that people who took a year off of school tend to never go to college.  Her therapist asked if she'd planned to get a job during that time, and Kitty said she hadn't really thought about it.  I casually pointed out that to live in our house you had to be in school or have a job, and pointed out that if she wasn't in school or working, and wasn't living at home, then she'd have no way to support herself.

We switched back to what she needs to go to junior college, and Kitty was able to hear and contribute to our conversation regarding the fact that without accommodations she didn't have all the skills to go to college yet (study skills, note taking, handling large class sizes...).  We talked about other alternatives, like technical school, but Kitty had no interests other than teaching preschool.

We talked about how the school wasn't doing a lot to help Kitty get the study skills she needs (whether that was because they weren't bothering to try anymore after several failures or surrendering to fact that Kitty's brain is damaged and unable to learn this).  So Kitty's therapist started talking about how to get study skills, note taking skills, homework, and organizational skills.  She brought out her laptop and pulled up a website that had articles about acquiring study skills.

Kitty decided to read aloud from the article about note taking, and I wondered yet again how she could be doing as well as the school claims.  She struggled with about every 10th word.  She'd never even heard of outlining (one of the suggestions).  Even after we described it to her she had no idea what it was. One of her IEP accommodations is that she's to be given the notes on class lectures and I was going to suggest she try rewriting those (another suggestion in the article), but she said the teachers never lecture.  Which of course is how she learns best.  She said mostly she is given worksheets with blanks to be filled in.  She was struggling with the word banks for the blanks because there were too many words so they were overwhelming.  So her teacher broke down the word banks into smaller groups (sounds like about 3 words for 3 blanks instead of all the words for the whole page).

Maybe my expectations are too high, but that sounds ridiculous for a child they say is mostly on grade level and are talking about being ready for junior college (although she's on the "high school track").

Kitty also stated that she has to write things down verbatim, doesn't know how to summarize, has trouble remembering to turn things in.  Kitty talked about going to one of those places that cost a lot of money (we eventually figured out she meant Sylvan learning center).  I told her those places weren't really for people with learning disabilities like hers.

I went ahead and reminded Kitty that Grandma is a certified teacher (including special ed) and could put together something specifically designed for Kitty, but Kitty doesn't like Grandma very much at the moment.  We talked about how over the years Grandma has tried to help her, but Kitty wasn't interested.  Kitty suggested a neighbor is a teacher and could help her, but I pointed out that this neighbor has 2 jobs and 4 kids and wouldn't really have time to help (not to mention she has an elementary education degree, not special ed).

We agreed that we would discuss her need for study skills at the next IEP meeting (again!), and the therapist suggested she practice for 20min a night.  Kitty was down on this idea until we talked about using a child development textbook and having her read and practice summarizing.

Kitty is still being told by the school that she can go to college and become a preschool teacher, and she walked away from therapy feeling the therapist agreed.

I asked Kitty to wait in the lobby for a few minutes while I talked to the therapist (something I rarely do).  I wanted to talk about legal guardianship and whether or not it's the right thing to keep encouraging/ allowing Kitty to believe that she can become a preschool teacher.  The therapist pointed out that all work and study skills learned are good skills and she can use these in whatever job she ends up working in the future, and I agree...
                      ...BUT we learned the hard way with Bear that if we allow the child to focus exclusively on one career (in his case the military), then when it doesn't come to pass then they are at a total loss.  Bear just shut down and lost his way.  He couldn't accept this and find a new path.


After the therapy session, Kitty started asking what the therapist and I had talked about.  I tried to fob her off with telling her we'd talked about Bear (which we had), but she wouldn't let it go and since Kitty still seemed pretty calm and open, I eventually admitted that I'd talked to the therapist about whether or not I should continue to encourage Kitty in planning to work at a preschool by purchasing her a child development book.  Kitty was not happy that I still don't believe she can become a preschool teacher since she's "good with children."

I repeated a few of my concerns.  Having worked as a director of a child care center I brought up the fact that even as an aide the day care center will leave her alone with the children for hours (early morning and evening being the times it's most likely to happen) and Texas has HORRIBLE child to staff ratios (1 person as long as they are 18 with a high school diploma, can and WILL be left alone with 4 infants, 11 two year olds, or 15 three year olds, or 18 four year olds...).  The biggest one is that while if you're an accountant like my sister or an engineer like Hubby and you make a mistake... no one dies.  If you make a mistake with preschoolers then a child could DIE.  Kitty pointed out that could happen to anyone, but that was proving my point.  There are LOTS of reasons why I don't think this is a good career option for Kitty, but that's a big one.

Kitty tried to argue with me, but the reality is she has no good arguments and she knows it.  It's mostly that she doesn't WANT it to be true.  She quickly just said she didn't want to talk any more and she rode home in silence.

Friday, October 5, 2012

Legal Guardianship

Legal Guardianship FAQs

An “Incapacitated person” is “An adult individual who, because of a physical or mental condition, is substantially unable to provide food, clothing, or shelter for himself or herself, to care for the individual's own physical health, or to manage the individual's own financial affairs."

1. Ability to make informed judgment as to marriage  YES [X] NO
Kitty has no concept of what to look for in an appropriate spouse, and is very much a victim waiting to happen.  Bear chooses people based on how similar they are to him (like attracting like) and has been engaged several times - luckily his relationships never last long enough to actually get married.
2. Ability to make informed judgment as to voting  YES  NO
I'm not sure I have an opinion on this one!  Seems like they're just as informed as anyone else :^) 
3. Ability to apply for and receive governmental benefits  YES [X] NO
Absolutely not.  Neither one has the ability to fill out forms, and don't seem to know how to even start accessing services.  Bear reads and writes on a 5th or 6th grade level.  Kitty apparently can read and comprehend at a higher level, but writes at a 3rd grade level.
4. Ability to operate a motor vehicle  YES [X] NO
Hell no.
5. Ability to make decisions regarding travel  YES [X] NO
Budgeting, knowing where it is safe to go, getting a hotel room, purchasing tickets, feeling safe on a plane, train or bus...  Apparently Bear can do this.  Kitty never.
6. Ability to seek or retain employment  YES [X] NO
Kitty shows no interest in the actual process.  I don't think she could actually fill out an application independently or handle the stress of a "real" job.  Bear could at least seek and attain employment - he just couldn't RETAIN employment.
7. Ability to contract and incur obligation  YES [X] NO
Neither has an understanding of money or budgeting.  Bear always believes he's going to get and keep a fantastic job that will allow him to pay for contracted services.  When he gets money he is very generous and gives it away easily.  When he doesn't have money he demands others "repay" what he gave them (never agreed to prior BTW!  Kind of like "Indian Giving")
8. Ability to sue or defend lawsuits  YES [X] NO
Both have a concrete, black and white sense of right and wrong.  Neither have the processing ability to understand complex legal documents or concepts.
9. Ability to manage property or to make any gifts or disposition of property  YES [X] NO
Neither has an understanding of money or the value of property.  Bear doesn't understand what is wrong with "Indian Giving."
10. Ability to determine residence  YES [X] NO
Bear obviously cannot maintain relationships with roommates or other people he chooses to live with.  He has chosen known drug dealers as appropriate people to live with.  He cannot afford to live independently and has apparently slept outside and didn't eat when he didn't budget well or couldn't find someone willing to take him in.  Kitty would need to live with someone who could support her and manage her estate - she does not appear to have the judgment to choose appropriately.
11. Ability to consent to medical, dental, psychological, and psychiatric treatment and to the disclosure of those records  YES [X] NO
They can choose to have treatment, but they do not have a good understanding of their diagnoses, would have great difficulty understanding side effects and efficacy of different treatments, and both are in pretty severe denial regarding their health issues.  Both have strong psychosomatic issues and low body awareness (Bear has waited weeks to tell me he's peeing blood, but both would pop Tylenol for minor aches and pains all day if I let them).  When Kitty was tired of being poked and prodded at the beginning of the Summer for some pretty serious health issues, she began refusing treatment and denied she even needed them.  Neither can maintain their medications.
12. Ability to handle a bank account  YES [X] NO
Neither has an understanding of money or budgeting.  Both have serious learning disabilities in math.
13. Ability to make decisions regarding financial obligation  YES [X] NO
See #7, 9 and 12!
14. Ability to enter into insurance contract of every nature  YES [X] NO
See #3 and 7

Getting ready to start the process of legal guardianship for Kitty who is now 17.5 yrs old. Anyone have any advice? We need to do this as inexpensively as possible. A big part of me doesn't want to do it, but she has made it very clear that as soon as she turns 18 she's going to let the IEP team know that she wants out of the special school we worked so hard to get her into, and once she's out, we'll never get her back in (we had to file due process to get her in in the first place). Plus, she wants to be a preschool teacher and the school is wasting her time, trying to give her vocational skills to pursue this unrealistic goal.

She's just starting her junior year of high school. She was hospitalized 6 times during the first semester last school year, before she went into RTC for 4 months. They discharged her from the RTC because she didn't have the cognitive or emotional ability to work the program. She is not ID (intellectually disabled -the new PC term for mentally retarded), but has a low average IQ that drops into the 50s if she is overwhelmed or in a loud, chaotic environment. Emotionally and socially (but not intellectually or developmentally) she is stuck at 6 years of age. She cannot handle the anxiety from trying to be perfect around people who might figure out that she is an unlovable, unworthy, stupid, ugly, crazy mess (her beliefs, not mine).

Her current psychiatrist assures me she will sign any papers we bring her for legal guardianship. I was worried the pdoc wouldn't, since Bear's psychiatrist with the local MHMR program refused to do so for Bear. So this is comforting, but also really sad too.

Hubby and I discussed how long we would keep legal guardianship.  Many years ago my brother-in-law married a 24yo girl whose aunt and uncle had legal guardianship of her.  They gave permission for her to marry and removed legal guardianship.  When my BIL abandoned her and his children, she went back to the Aunt and Uncle.  When we talk about why we would take legal guardianship of Kitty, this is one of our big concerns:

Reasons for getting Legal Guardianship of Kitty as an adult:

  • To prevent her from getting control and sabotaging her special school placement
  • To continue to have legal input in planning her school transition plan
  • To be able to still legally have an input at her IEP meetings in her senior year of high school
  • To have input in where she lives senior year and after graduation
  • To help her get SSI income and ensure it actually goes for her support and living expenses
  • To help her find and keep an appropriate job
  • To ensure she continues to get the medical treatments, therapy and medications she needs
  • To help her make choices that lead to a healthy lifestyle (nutritious food, hygiene, chores/ clean environment)
  • To protect her from inappropriate relationships, particularly with those who would take advantage of her emotional immaturity, and to help her develop the ability to have appropriate relationships.
  • To stop her from attempting things she's not ready for and getting hurt and scared... or worse.  Especially from damaging her self-esteem, relationships or becoming suicidal.
  • Most of all, to continue to provide the emotional support she needs and will need

Effects of Early Trauma

The Psych Approach
Published: September 27, 2012 399 Comments
In the 1990s, Vincent Felitti and Robert Anda conducted a study on adverse childhood experiences. They asked 17,000 mostly white, mostly upscale patients enrolled in a Kaiser H.M.O. to describe whether they had experienced any of 10 categories of childhood trauma. They asked them if they had been abused, if their parents had divorced, if family members had been incarcerated or declared mentally ill. Then they gave them what came to be known as ACE scores, depending on how many of the 10 experiences they had endured.
The link between childhood trauma and adult outcomes was striking. People with an ACE score of 4 were seven times more likely to be alcoholics as adults than people with an ACE score of 0. They were six times more likely to have had sex before age 15, twice as likely to be diagnosed with cancer, four times as likely to suffer emphysema. People with an ACE score above 6 were 30 times more likely to have attempted suicide.
Later research suggested that only 3 percent of students with an ACE score of 0 had learning or behavioral problems in school. Among students with an ACE score of 4 or higher, 51 percent had those problems.
In Paul Tough’s essential book, “How Children Succeed,” he describes what’s going on. Childhood stress can have long lasting neural effects, making it harder to exercise self-control, focus attention, delay gratification and do many of the other things that contribute to a happy life.
Tough interviewed a young lady named Monisha, who was pulled out of class by a social worker, taken to a strange foster home and forbidden from seeing her father for months. “I remember the first day like it was yesterday. Every detail. I still have dreams about it. I feel like I’m going to be damaged forever.”
Monisha’s anxiety sensors are still going full blast. “If a plane flies over me, I think they’re going to drop a bomb. I think about my dad dying,” she told Tough. “When I get scared, I start shaking. My heart starts beating. I start sweating. You know how people say ‘I was scared to death’? I get scared that that’s really going to happen to me one day.”
Tough’s book is part of what you might call the psychologizing of domestic policy. In the past several decades, policy makers have focused on the material and bureaucratic things that correlate to school failure, like poor neighborhoods, bad nutrition, schools that are too big or too small. But, more recently, attention has shifted to the psychological reactions that impede learning — the ones that flow from insecure relationships, constant movement and economic anxiety.
Attention has shifted toward the psychological for several reasons. First, it’s become increasingly clear that social and emotional deficits can trump material or even intellectual progress. Schools in the Knowledge Is Power Program, or KIPP, are among the best college prep academies for disadvantaged kids. But, in its first survey a few years ago, KIPP discovered that three-quarters of its graduates were not making it through college. It wasn’t the students with the lower high school grades that were dropping out most. It was the ones with the weakest resilience and social skills. It was the pessimists.
Second, over the past few years, an array of psychological researchers have taught us that motivation, self-control and resilience are together as important as raw I.Q. and are probably more malleable.
Finally, pop culture has been far out front of policy makers in showing how social dysfunction can ruin lives. You can turn on an episode of “Here Comes Honey Boo Boo,” about a train wreck working-class family. You can turn on “Alaska State Troopers” and see trailer parks filled with drugged-up basket cases. You can listen to rappers like Tyler, The Creator whose songs are angry howls from fatherless men.
Schools are now casting about, trying to find psychological programs that will help students work on resilience, equanimity and self-control. Some schools give two sets of grades — one for academic work and one for deportment.
And it’s not just schools that are veering deeper into the psychological realms. Health care systems are going the same way, tracing obesity and self-destructive habits back to social breakdown and stress.
When you look over the domestic policy landscape, you see all these different people in different policy silos with different budgets: in health care, education, crime, poverty, social mobility and labor force issues. But, in their disjointed ways, they are all dealing with the same problem — that across vast stretches of America, economic, social and family breakdowns are producing enormous amounts of stress and unregulated behavior, which dulls motivation, undermines self-control and distorts lives.
Maybe it’s time for people in all these different fields to get together in a room and make a concerted push against the psychological barriers to success.

What’s Your ACE Score?

There are 10 types of childhood trauma measured in the ACE Study. Five are personal — physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect. Five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. So a person who’s been physically abused, with one alcoholic parent, and a mother who was beaten up has an ACE score of three.

More articles posted by my friend that really resonated with me.

Monday, October 1, 2012

Medicating Children of Trauma - Edited

State is tackling pills for foster kids

Nearly 1 in 4 foster children in Ohio has been prescribed mind-altering drugs.
In Ohio and across the country, foster children are more likely than other youngsters to be prescribed psychotropic drugs, which can bring serious health risks and side effects. The medications also are expensive, costing millions to the tax-funded Medicaid program that insures foster children.
Yesterday, state officials announced a $1 million initiative to improve psychotropic-drug management by closely monitoring prescriptions and improving coordination of physical and mental-health care for Ohio’s 12,000 children insured through Medicaid.
“The rate of prescribing has gone up, but it’s not clear that the rate of mental illness has gone up to the same extent,” said Dr. Mary Applegate, medical director for Ohio’s Medicaid program.
“We are seeing kids who are taking two or three or four of the same type of drug at the same time.”
The effort comes about a year after a federal report based on a two-year investigation found higher prescription rates among foster children.
Psychotropic medications are used to treat mental illnesses such as depression and bipolar disorder. Although foster children tend to have a higher prevalence of such ailments because of a greater likelihood of trauma and stress, usage still appears too high.
Pam Harris of Greene County said her 13-year-old son was on eight medications at one point, and she was overwhelmed trying to coordinate care by pediatricians and psychiatrists while she looked after him.
“The pediatrician wants to prescribe to help keep everyone safe, and then we may wait six weeks to see the psychiatrist. They don’t coordinate, and it’s frustrating to see the side effects,” Harris said. “I asked the psychiatrist about side effects and he said ‘Ask the pediatrician.’ I asked the pediatrician and he said ‘Ask the psychiatrist.’  ”
Then 5, her son suffered tremors and other problems after he started taking medication for what doctors believed was an attention-deficit disorder. When his behavior turned aggressive, he was given more drugs and immediately gained 10 pounds. Problems persisted, and he had to move out to ensure the safety of his siblings.
“Any parent or caregiver of a child with severe emotional disorder facing the prospects of having their child or foster child placed on psychotic medications struggles with very mixed feelings,” said Terry Russell, executive director of the National Alliance on Mental Illness of Ohio.
“On one hand, knowing that such medications can literally be lifesaving ... and improve their child and their family’s quality of life. ... On the other hand, parents are also fearful because they know such medications can cause serious side effects if they are not properly used or monitored.”
Advocates for children and the mentally ill joined state officials at a Statehouse news conference yesterday to support the initiative, saying it will help ensure safe use of psychotropic drugs and improve overall care.
“Through the initiative, the state will determine which children are receiving more than two psychotropic drugs at a time, their ages and their diagnosis, the maximum dosage, dosage for children,” said Crystal Ward Allen, executive director of the Public Children Services Association of Ohio.
“These are all big unknowns, and it’s often a challenge in the child-welfare system to be the custodian without the medical expertise.”
State officials said they will monitor prescriptions of such drugs and inform doctors when multiple medications have been prescribed or when safe dosage has been exceeded. Often, Applegate said, more than one doctor is involved in a child’s care because a child moved, and the physician is unaware of other prescriptions.
Last year, taxpayers spent nearly $37.7 million on prescription-drug costs for foster children, with some prescriptions costing as much as $500 a month. Officials have not projected any savings through the initiative, but avoiding duplicative prescriptions, lowering usage of such medications and increasing use of alternative treatments such as counseling will reduce costs.

A friend posted this article recently. I wanted to share my thoughts on the subject.

I think one reason we see a high rate of prescription drugs for our kids is there is such a prevalence of mental illness in foster kids. I've seen a lot of "like attracting like" among my kids and other kids in the foster care/ mental health care system (can you say Kleenex girls?). 2 bipolar parents (or alcoholic or emotionally disturbed or whatever) often means scary genetics for the child. Plus being raised by a mentally ill parent, frequently leads to abuse as well.

I know a lot of times there is a huge resistance to giving children meds, and while I agree that there are times some foster children are over medicated, I also believe that it often means kids are struggling and they can't heal if they feel like they are existing as though they are in the middle of a war zone or they are struggling with basic coping skills, unable to function.

Medication Cocktails
The article makes a big deal about kids taking more than one of the same type of medication. I know that for bipolar people, taking two or more different mood stabilizers is frequently recommended to stabilize the person. Especially when there are multiple diagnoses, it can take a med cocktail to help the child stabilize, and unfortunately our body chemistries are unique, and with growth and puberty added in... well one can necessarily feel like a human guinea pig.

Over the Counter Sleep Meds
My kids suffer from PTSD (like most kids of trauma) and sleep is HARD! If you don't get enough sleep, then you can't learn in school and it's harder to control your emotions - sleep deprivation is a common form of torture! If you're living in a war zone in your head (PTSD), or you can't focus (due to ADHD), then you aren't learning (my kids have HUGE gaps in their education). If you're struggling with depression or anger (bipolar, RAD, mood disorder NOS, ODD...) then you're so busy fighting or coping that you can't learn the developmental lessons or how to get along in a family.

I'm not recommending we drug our kids into zombies (although we did have to do that once for a short period of time to keep our son and family safe while we waited for a bed to open up in an RTC), and yes, there are some nasty side effects from medications that aren't tested on children... but without meds, my children would have been virtually unadoptable and my son would have ended up dead (self-medicating with drugs, gang life, suicide...) or in juvie many years ago.

Years of the right medications gave my son time to mature, learn, and attain coping skills... When he decided to stop taking his medications at 18, he learned very quickly that he needed them, but I also believe that the consequences of his actions off the meds were much less severe because of that time of growing/ healing.

Edited to add:

Proper Diagnosis and Medication
When our kids came to us, they weren't properly diagnosed or medicated.  Bear was diagnosed with PTSD, mood disorder NOS and possible conduct disorder.  Kitty was diagnosed with ADHD (unmedicated for some unknown reason), ODD and "attachment issues" (which the caseworker claimed couldn't be true, because she was such a loving child who always hugged the caseworker *roll eyes*).

After we'd known them for long enough to get an accurate psych eval, they were diagnosed with:

  • Bipolar Disorder (which apparently they'd been diagnosed with before entering foster care and had been removed for some reason - possibly because many doctors don't believe in child-onset bipolar, or maybe because it made them seem less adoptable, but if the latter was the case then they sure left a LOT of other stuff in!), 
  • Reactive Attachment Disorder (I asked their foster care therapist why this wasn't seen before and she claimed not to have seen it - it's possible that in previous foster homes no one had tried to bond with them), 
  • ADD/ADHD, 
  • brain injuries (cerebral dysrhythmia - strongly effecting memory and processing), which is probably tied into Kitty's learning disabilities, but for Kitty also effects her emotions.
  • Complex Post Traumatic Stress Disorder, 
  • emerging personality disorders.  
The discrepancy was huge, their medications were all wrong, the kids were raging and miserable, and their "misbehavior" had made a mess of their lives.  I won't say medications fixed all their problems, but... without it I know we couldn't have adopted Bear - he wasn't safe, and Kitty has come SOOOO far with her healing that she couldn't have done without alleviating some of her symptoms through medication.

For a follow-up to this post check here.