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, October 2, 2022

Nonsense Questions and Chatter

 



Nonsense Chatter

I really can’t stop talking cos you might forget I’m here

It keeps your focus on me as I bend your weary ear

Lots and lots of nonsense questions

I just switch off from your objections

 

What’s the purple ist purple that you have ever seen

What are we having for dinner and why is the grass green

I’m scared I’ll be invisible if I cease to babble on

I need to keep your interest to feel like I belong

 

I cannot sit here quietly cos of wobbles in my belly

So I make lots of noise and I interrupt the telly

What if you don’t feed me or make me go away

You’ll always know I’m here if I’ve got lots to say

 

It’s all about survival and making sure you’re near

The nonsense in my questions stem from all my fear

I know this drives you crazy and can make you feel insane

It all comes from my trauma and underdeveloped brain

 

I need your reassurance that you’ve not forgotten me

Let me know you’ll listen when you’ve finished cooking tea

Try to be more playful and say your ears are full

But they’ll be far more empty when I get home from school

 

If my questions are ridiculous, relay them back to me

It’ll interrupt my trauma and might be quite funny

Gently touch my shoulder and remind me that you’re there

Let me know you understand the need behind my fear

 

And lastly but not least, please do not forget

Developmentally I’m younger and my brain’s not caught up yet!

 

Sarah Dillon - National Association of Therapeutic Parents

 

Attention Seeking? 

At first, my daughter's nonsense questions and babbling about TV shows or the latest drama at school (things and people I know nothing and care nothing about), felt like she was trying to keep all the focus on her and/or to drive me crazy. I found myself starting to avoid her. Then I noticed a pattern. When she was feeling anxious and overwhelmed, she started doing what my mom called "pressured speech." 

When I realized this behavior was caused by my daughter's anxiety, it made it easier to provide Calming Techniques and fight to make her world smaller and less overwhelming (by providing Structure and Caring Support). I also look at what may be causing this anxiety and stress Chores, Responsibilities, and Other Things My Kids Can't Handle


Persistent Nonsense Questions & Chatter

It generally starts with nonsense chatter. "Look at that car. I have a green shirt. I'm taller than this kid in my class. His name is Eric or Tom or something. I'm going to play outside when I get home. I don't like green beans."

This is all said very quickly and with no space or thought in between.

If I ignore it, then they move into the questions. "What color do you think that is? What are we having for supper? Why was Hitler mean? What is the difference between an alligator and a crocodile?"

Also said quickly with no thought in between.

There are several reasons for this kind of talking.

Control - If they dominate and control the conversation it makes them feel in charge. {If You Find Out I’m Not Perfect, You’ll Leave}

Anxiety - The hyper vigilance causes them to be nervous and this produces nonstop talking. We've all had this feeling now and then. Just not every day. Several times a day.

Lack of Empathy - Then you throw in the lack of empathy or caring about another's feelings, and you have this self-centered, self-absorbed thought process.*

*Note: Kids with trauma and attachment issues generally operate at a younger emotional/social developmental age. Studies show that around 3 years of age, children start to show genuine empathy, understanding how other people feel even when they don't feel the same way themselves. "Cognitive empathy," or the mental ability to take others' perspective, begins rising steadily in girls at age 13, but boys don't begin until age 15 to show gains in perspective-taking, which helps in problem-solving and avoiding conflict. {TherapeuticParenting Based on Emotional/Social Developmental Age}

 

Ways to Handle Nonsense Chatter and Questions:

Nonsense Chatter Yourself: Sometimes, I start doing it back. "Hey! Did you know I have absolutely nothing to say but I am so nervous and anxious I just can't stop talking. So, I go on and on and on forever and ever. I might not ever stop." Said exactly the way they do it. They usually start laughing and run away. I follow and then we are all laughing.

Reminding: I have explained to them what nonsense chatter is and why they do it. Sometimes I just say, "Nonsense Chatter." And they know and stop.

Limits For Nonsense Questions: I have limited them to 8 questions a day. They start off blowing the whole 8 in the first 5 minutes of the day.

After they’ve reached their limit, the answer to every question is the opposite of whatever they want it to be. It doesn't take long before they say "Wait. I am not wasting a question on that." So, when they say "What color is that car?" I say " I think it is a shade of green. That is 1 question." "What are we having for supper?" "Spaghetti. That is 2 questions." And so on.

[Limits for Nonsense questions and chatter. A fellow trauma mama gave her child a certain amount of time each day (about 5 minutes) to chatter and speak nonsense. When the child wandered up to the mama and started talking, the mama would say something like, "I really want to hear what you have to say, but I can't give you my full attention right now. I will have time to listen to every important thing you want to tell me." Every time the child came up to her, the mom would say, "I can't wait to hear all about that when we get together later." 

Then when she had a few minutes, especially if the child was busy, then she would seek out the child and plop down and say, "You have my full attention. Tell me what you wanted to say to me this morning (or whatever inconvenient time the child had chosen." Then my friend would give the child her undivided attention, for about 5 minutes.] 

Absurd Answers: Another way to handle it is to give an absurd answer especially if it is an absurd question. They may see dad walk by and go into the basement and then say, "Is dad at work?" So, I reply, "Yes". They laugh and say "No he went into the basement. " "Oh". This is one of those behaviors that you really can turn into laughter if you lighten up and don't take it too seriously. Have fun with it.

Another Resource: Why Won't My Child Just Behave?!


We all love having at least one person who really gets us. Who sits and listens. Be that person for your child... It is so hard raising our kids. heartbreaking, exhausting....there is hope.


Thursday, August 18, 2022

Hot Temperatures Equal Hot Tempers?




Recently, a fellow trauma mama made a connection for me between the temperature outside and my child's behaviors. With more research, I realized that internal temperatures and emotional temperatures (did you know anxiety and anger can raise the body's internal temperature?) can have just as strong an affect on people's behaviors. 

I live in the South where outside temperatures can be over 100 degrees for months. I knew that certain medications can cause heat intolerance which can ruin a day of fun in the sun and have dangerous physical side effects (like heat exhaustion or heat strokes). 

What I did not realize was that higher temperatures can affect behaviors. Elevated behaviors like feeling irritable, depressed/aggressive (in children, depression often shows as anger), and miserable. 


Heat and Mental Health Issues

There's a reason we say we are "hot under the collar," "steamed," "boiling mad," when we are extremely angry and "don't sweat it" when we're trying to stay cool, calm, and collected. Temperature affects our feelings and behaviors, and even how we sleep.

"Extreme heat has significant impacts on mental health alongside serious physical health impacts. Some groups, including people with pre-existing mental health conditions, are especially vulnerable.

Extreme heat has been associated with a range of mental health impacts in research over many years, including increases in irritability and symptoms of depression and with an increase in suicide. It can also affect behavior, contributing to increased aggression, incidence of domestic violence, and increased use of alcohol or other substances to cope with stress.

Research has also linked high temperatures to problems with memory, attention and reaction time. Sleep difficulties associated with extreme heat can contribute to and further exacerbate mental health symptoms."

Several factors contribute to people with mental illness being especially vulnerable. People with schizophrenia can experience difficulties with body temperature regulation and changes in temperature can change symptoms of mood disorders. Some psychiatric medications, including some antidepressants and antipsychotics, can affect the way the body regulates temperature."

https://psychiatry.org/news-room/news-releases/extreme-heat-contributes-to-worsening-mental-healt


Heat and Stress/Anxiety  

Higher temperatures add to the existing stresses of daily life. This can increase the likelihood of risky behaviors, resulting in the increased rates of emergency room visits. 

“Increased temperatures can trigger anxiety and cause higher cortisol levels and palpitations, nausea, and fatigue. 
These symptoms can feel similar to a panic attack, which can make us more anxious when we notice them. Humidity can also cause symptoms of dizziness and dehydration..”

One study found that temperatures above 70 degrees Fahrenheit (21 degrees Celsius), decreased reports of positive emotions like joy or happiness, and increased reports of negative ones like stress or anger, when compared to average daily temperatures of 50 to 60 degrees Fahrenheit (10 to 16 degrees Celsius). 


Heat and Sleep

Heat also impacts our sleep. Researchers have found that increased nighttime temperature was associated with increased occurrences of self-reported insufficient sleep (insomnia). Extreme heat can affect your ability to fall asleep, stay asleep, and feel refreshed from sleep. 

Sleep deprivation can easily result in worsened mental health. The two have a bidirectional relationship that anyone can experience. Specifically, a lack of sleep can trigger the onset of certain conditions—and conversely, mental health conditions can worsen sleep problems. 

“A lack of sleep can impact our physical, mental, and emotional health,” says Sarah Bitar, marriage and family therapist. “With the disturbances of sleep come disturbances of all other connected systems of operation in the human body.”  This Is How Sleep Affects Your Mental Health


Seasonal Affective Disorder in Summer (i.e., Summer Anxiety)

After long winters, most of us look forward to warmer days, more sunshine, and lots of opportunities to have fun. However, social gatherings, vacations, changes in routine, and physical responses to heat can make any pre-existing anxiety or depression worse. 

We’re used to hearing that Seasonal Affective Disorder (SAD) happens in winter months as a result of shorter days and less sunlight. About 4-6% of the U.S. population struggles with SAD.  Of this group, about 10% experience summer anxiety and depression. 

Summer Anxiety is a form of Seasonal Affective Disorder that happens during the summer. Experts believe that summer SAD may be due to too much sunlight. This throws off our circadian rhythm, our body’s natural sleep-wake cycle. As a result, people with summer SAD, struggle to sleep as much as they need to.  There’s also evidence that struggling with higher temperatures and humidity contributes to summer anxiety. ~Summertime Anxiety


Medications That Make People Vulnerable to Heat

A lot of the medications our kids take can affect the body's ability to regulate temperature, making the person more vulnerable to heat.

Many kids with trauma and mental illness issues take meds for anxiety, depression, insomnia, ADHD, bipolar disorder... It's common for these meds to be off-label prescriptions (this is a common practice for physicians, currently about 1 in 5 prescriptions are off-label) -- meds that were originally designed for things like high blood pressure, anti-seizure meds... meds that can cause heat intolerances:

  1.  Blood pressure medications (Ex . Clonidine, which is often prescribed for anxiety)
  2. Thiazide diuretics 
  3. Beta-blockers (off-label prescribed for anxiety, migraines, reducing tremors)
  4.  Antihistamines (off-label prescribed to treat anxiety on a short-term basis)
  5. Decongestants
  6. Overactive bladder treatments
  7. Stimulant medications for ADHD (such as Adderall (amphetamine/dextroamphetamine) and Ritalin (methylphenidate). 
  8. Psychiatric medications (Ex. Tricyclic antidepressants such as Elavil (amitriptyline) and Pamelor (nortriptyline), Antipsychotics such as Haldol (haloperidol) or Thorazine (chlorpromazine) Dopaminergics such as Sinemet (carbidopa/levodopa) 

https://www.singlecare.com/blog/medications-that-cause-heat-intolerance


High Body Temperatures (Psychogenic Fever/ Functional Hyperthermia)

Some patients develop extremely high core body temperature [fever] when they are exposed to emotional events, whereas others show persistent low-grade [fever] during situations of chronic stress. In addition to the emotional events that provoke negative affect such as anxiety, anger, or fear, other psychological stressors that induce remarkable hyperthermia [high body temperature] include separation from nurturing persons (emotional deprivation) and suppression of negative emotion. Stress interviews, i.e., recalling and talking about stressful life events, also increases [high body temperature].

Although some patients have no complaints except for the high [body temperature], others complain of numerous symptoms. These symptoms include insomnia, fatigue, headache, nausea, and/or abdominal pain. Some patients are neurotic and have high anxiety. Psychogenic fever is also observed in patients who have traumatic experiences in their early lives and with psychiatric disorders such as anxiety (panic and post-traumatic stress) disorders, mood (depressive and bipolar) disorders, somatoform (conversion) disorders, catatonia, and borderline personality disorders. For these reasons, they worry about their high [body temperature] and may consult their physicians asking for treatment.

This type of fever typically doesn’t respond to regular fever reducers. Instead, anxiety medications may offer relief. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843908/


Tips to Stay Cool!

  • Taking deep, slow breaths whenever you feel your anxiety rise can help slow down your heart rate and calm your body and mind. See more Relaxation and Calming Techniques.
  • If you must go outside, stay in the shade and wear light-colored, loose fitting clothing. Avoid going outside during the hottest part of the day (between 11am and 3pm).
  • Stay hydrated. Drinking lots of water can help ease symptoms of anxiety as well as physical symptoms of dehydration.
  • Keep your extremities (hands, feet, and head) cool -  “Our hands and feet are equipped with vessels known as AVAs [arterio-venous anastomoses] that are especially effective at heat removal. Keep your hands and feet bare, and submerged in cold water. Tap water is sufficient, as that usually comes out around 68 degrees, but cooler temperatures are better. Just don’t make the water too icy; if extremities are too cold, blood vessels shrink to reduce blood flow, and that makes it actually makes it harder for your body to cool." ~ https://www.texasmonthly.com/news-politics/texas-heat-tips/ 
    Soak your feet in cold water for 10 minutes before going to bed, as heat is lost more quickly through your extremities (feet and head). Wetting your hair is another alternative. Wet your face and arms with a washcloth or towel, or use a water filled spray bottle, then stand in front of a fan. Apply wristbands soaked in cold water, as this will have the similar effect.
  • Apply cool wet cloths, cold water or ice packs (armpits and groin for short periods) to the skin, as these areas are where your blood flows closest to the surface of your skin. This will help cool you down. Have a cool or lukewarm shower or bath just before going to bed. This cools the body directly and can help reduce the temperature of your skin.
  • For people dealing with anxiety, it can be helpful to remind ourselves that our body isn’t necessarily in danger when we experience uncomfortable symptoms from the heat. Knowing that the heat amplifies symptoms of anxiety can help us to recognize and monitor symptoms that occur in hot weather. We can aim to recognize uncomfortable symptoms such as sweating or palpitations as our body’s natural reaction to the heat, rather than believing we are experiencing anxiety or a panic attack. It can also be helpful to find ways distract yourself from overthinking about these changes.
  • Exploring the root cause of your anxiety can better help you manage its symptoms. A therapist can support you in this process. Finding a therapist who has experience treating anxiety can help you develop coping skills that may offer temporary and long-term relief.
  • Set your thermostat to 65 degrees: Many experts agree that 65 degrees Fahrenheit (18.3 degrees Celsius) is the best temperature for sleep. While it might sound relatively cool, this thermostat setting helps your body maintain its natural core temperature for sleeping.


SUMMARY

If your body temperature can rise when it's hot outside, when you take certain medications, and/or when you are stressed (and our kids with trauma and mental illnesses are often stressed). How likely is it that this could be a large contributor to a child feeling irritable, aggressive (in children, depression often shows as anger), and miserable?

It's definitely something to consider.

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

Kitty keeps her home's thermostat set at 66 degrees and drops it to 62 at night (because the only way she can sleep at night is snuggled up in her blankets with her pets. She says that when she gets too hot most extreme, sweat dripping on her face, her skin becomes itchy, and has violent screaming outbursts. Mildest is slight irritability. The longer she's uncomfortable the more intense it becomes, from mild impatience to screaming, "Get out of my f-ing face!"  it's any higher she feels irritable and I will admit that until I started researching this, I dismissed her explanations as being thoughtless, entitled, exaggerated, and wasteful she was being childish, ridiculous, and annoying. 




Monday, February 14, 2022

Questions to Ask When You're Considering Placement of a Child



23 Crucial Questions to Ask at Foster Care Placement Meetings:

  1. Ask to speak with current caregivers to understand the child’s current schedule and routines.
  2. Get a list of previous placements, how long they lasted, and why they disrupted.
  3. What prompted the termination of parental rights? Did either parent voluntarily surrender, and why? Try to get the psychiatric history of the birth parents.
  4. What circumstances put the child in foster care. Is any of the child's history known, in particular any traumatic events? 
  5. If adopting, why didn’t past foster parents adopt this child/children?
  6. Was the child exposed to alcohol or drugs during pregnancy? A clear answer is often not available unless the child is young, and hospital records from birth are available. Still, you can get information on the birth mother’s lifestyle and habits to understand the possibilities better. Also, ask if the child’s siblings have shown evidence of fetal alcohol spectrum disorder (FASD) or prenatal drug exposure. Keep in mind that prenatal alcohol and drug exposure is prevalent for children in foster care.
  7. Does the child have siblings, and where are they now (adoption, relatives, residential care, etc.)? Why are they not being placed together?
  8. Where are the biological parents now? Are these relatives or extended family in the area near you? What is the expectation for ongoing contact with birth parents, siblings, or extended family?
  9. What type of relationship did this child have with birth parents?
  10. Does the child have an Individualized Education Plan (IEP) for school? Is the child struggling in school? What is his/her attitude toward school? What school did the child attend previously?
  11. Does the child make and maintain age-appropriate friends?
  12. Ask for a list of diagnoses, and what behavior may have led to the diagnosis.
  13. Who made the diagnosis? Foster parent? Pediatrician? School? Medical Specialist? Ask for the documentation.
  14. What kind of medication is the child on now, if any, and what medications has the child taken previously?
  15. Are there any current health or behavioral concerns or need for ongoing therapy?
  16. If the child has been in therapy, how long? What types of models of treatment have been used?
  17. Has or has this child ever had a diagnosis of RAD (Reactive Attachment Disorder) or any other type of attachment disorder? What has been done for this child to deal with this? (Therapy, holdings, play therapy, etc.)
  18. Has the child acted out sexually now or in the past? What type of behaviors, and when was the last time?
  19. Are there safety concerns with pets? Younger children?
  20. What kinds of hospitalization (including trips to the Emergency Room) has this child had? What tests were done? Ask for the documentation.
  21. How does this child perceive herself? Does the child understand adoption, and does she want to be adopted?
  22. If the child is not a member of your race/ethnicity, how does he feel about being a member of a family of a different race/ethnicity?
  23. Ask to see the child’s entire file, not just a summary. Arrange for a time that you can read through the file uninterrupted.
  24. Ask yourself: if this child were to get no better after placement in your home, could you handle his/her behaviors just as they are now?

More Questions To Ask

Questions to ask Parents/Family members
1. Tell me about the child
2. Activities enjoyed
3. How often do you speak to/visit with the child?
4. What is your plan or goal for your child? Desire for reunification?
5. What help do you need from me, DSS to achieve that goal?
6. Other family for visitation/placement/support resources

Questions to ask Child
1. What are your interests?
2. How do you feel about school? What do you like about school?
3. Have you visited/spoken to relatives? How often? How did it go?
4. Do you like the foster/group home?
5. Any problems? Who did you tell? Outcome?
6. Where would you like to live? What do you want for your future?

Questions to ask DSS Social Worker
1. Confirm placement and contact information
2. Do you have contact information for the child’s Therapist, Psychiatrist, Foster Parents, Family
Members, etc.?
3. Request updated information (placement, etc.)
4. Date of last facilitation meeting? Request results from it. Request copy of current case plan.
5. Has the child been assigned a parent (educational ) surrogate (only if necessary)?
6. Have you visited with the family? How often? How did the visits go?
7. What services/programs is the child part of? (ECI, public school pre-K, CASA)

Questions to ask Foster Parents
1. How are things going? How is his/her behavior?
2. Does he/she get along with the family? Are there other kids in the home? Are they foster kids
or biological kids? 
3. How does the child do in School? Homework?
4. What is the child’s regular schedule? Routines? Activities? How does the child handle changes in routines or activities?
5. Concerns (get details about any incidents)?
6. Does he/she talk to/family members? How often? Behavior after?
7. Is the child in therapy? Is he/she on medication? Does he/she take it?
8. Appointment up to date? (medical, dental, vision)
9. Does he visit family members? Who? Where? How often? Who provides the transportation
10. Does the child participate in any after-school/recreational/ activities?

Questions to ask Group Home Manager
1. How does the child get along with the staff? Other residents?
2. Has he/she integrated himself into group home life?
3. How is his/her behavior in general? Any specific incidents? Request incident reports
4. Is he/she receiving therapy
5. Is he/she taking his medication?
6. What are his/her strengths?
7. What area does he/she need more support in?
8. Does he/she participate in group home events? What activities does the group home offer?
9. Does he/she follow the rules? Does he/she obey the curfew?
10. May I have a copy of his/her treatment plan? When is the next treatment planning meeting?
11. Does he/she talk to /see family members? How often? (specifically those named in case file)
12. Does he/she visit family members? Who? Where? How often? Who transports?

Questions to ask Therapist
1. How often is the child seen? Does he keep his appointments? If not, why?
2. Is he/she open to therapy? Is he/she engaged?
3. May I have copies of any assessments, reports, and visit notes?
4. Recommendations? (Anger management, structured activities, mentor, family therapy, etc.)
5. Is there any other type of therapy that would be beneficial that he/she is not receiving?
(family,group,play)

Questions to ask Foster Care Agency Worker
1. Activities
2. Concerns
3. Visits w/family
4. Therapy/medication
5. Appointments
6. Notes from most recent treatment team meeting/next scheduled team meeting?

Questions to ask Mental Health Professional
1. What has he/she been diagnosed with?
2. Has he/she been prescribed medication? Which ones? Dosages? How often evaluated?
3. How often is the child seen?
4. Can you fax me a copy of your most recent Psychiatric evaluation?

Questions to ask School Guidance Counselor
1. May I have a printout of his/her attendance records?
2. Who is contacted when he/she is absent? How are they contacted?
3. May I have a copy of his/her most recent report card/progress report?
4. Has he/she completed his community service hours? (High school students)
5. Has he/she taken the HSAs? What were the results? ( High School Students)
6. Does he/she have a record of misbehaving? Request incident reports (suspensions, expulsions)
7. Has an IEP been requested? When? By whom? Status? Can I get a copy of it?
8. What resources are available at the school? (tutoring, test prep, online assignments /grades)
9. What classes are required to graduate? Is the child on track to graduate on time?
10. What extracurricular activities are offered?
11. Parent/educational contact information

Questions to ask Childcare
1. Does he/she attend class regularly?
2. How is his/her behavior?
3. In your opinion, is the child on track with other children developmentally?
4. What is the child’s regular schedule? Routines? Activities? How does the child handle changes in routines or activities?
5. What activities are available for the child? Does he/she participate?
6. Does he/she follow the rules? 
7. Does he/she ask for help when he does not understand something?
8. What can I do to help him/her be more successful?
9. What are the child’s strengths?

Questions to ask Teachers
1. What class do you teach? ( Information is online)
2. What time does he/she attend your class? (Information is on schedule)
3. Does he/she attend your class regularly? (See attendance records)
4. When he/she attends class, is he on time? (tardies are shown on attendance records)
5. Is he/she prepared (homework, books, paper, and pen)?
6. How is his/her behavior?
7. How many homework assignments have been given? What were his/her grades on each?
8. How many tests has he been given? What were his/her grades on them?
9. Are extra credits offered?
10. Does he/she actively participate in class?
11. Does he/she ask for help when he does not understand the lesson?
12. In your opinion, is he/she able to do the work?
13. Do you offer tutoring?
14. What can I do to help him/her be more successful in school?
15. What are the child’s strengths?
16. Request a copy of the syllabus/classroom expectations

Questions to ask Probation Officer
1. What are the terms of his probation?
2. Is he complying with the terms of his probation?
3. How often does he have to visit you?

Note: This list of basic questions is only a quide. All of the questions may not be appropriate for each
case. You may need to ask different people the same questions to make sure that everyone is on the
same page. Also, ask everyone that you speak to when is the best time to contact them.


Keep track of everyone's answers! DOCUMENT, DOCUMENT, DOCUMENT!!
Not only to help you remember everything, but this can help you get services for your child and can help protect you and your family from false allegations.