cover photo

cover photo
The Chaos Reigns
"If we have no peace, it is because we have forgotten that our lives belong to each other." - Mother Teresa

Sunday, July 20, 2014

Layers of the Onion- Part 5 {Behavior}

So let's talk behavior....

So, I didn't see the perfect storm of parenting challenges coming. I am not sure why because it was somewhat obvious what was about to happen. I already had 4 kids and had fair experience with the terrible 2s. But, for some reason necessary warning sirens were not going off in my head. Let's paint the obvious picture here..we were about to adopt 2 toddlers who were about turn 2 with no ability to understand or speak English combined with some not so familiar post institutional and trauma behavior that we had zero experience with handling. Plus, on top of that, as a new adoptive parent, I had zero attachment to these children (you maybe attached to an idea of them...but not actually them), and suddenly you are supposed to be this loving, patience, kind, parent ad midst all their crazy behavior and try to begin to attach to a couple of toddlers who treat you like they actually hate you. (Of course, out of fear from past trauma.)

Yes, I was preparing for it to be hard. But, what I did not register was the fact that my current experience was with biological children. By the time one of my bio kids was about to turn 2, I had already laid 2 solid years of attachment to this now suddenly defiant, difficult child. Although the behaviors pushed my buttons, it was never to the point that I cared more about the behavior than the child. Not only that, but you would be surprised by just how much your 2 year old has learned about your home, boundaries, and family expectations in their 1st 2 years of life. And, most importantly, this newly defiant 2 year old is still giving you sweet positive feedback through-out your day to fill you up between their challenging outburst.
Adopting a 2 year old was a completely different set of circumstances (because all of the above was missing.....  For Jude and Gia,  there was no attachment to me, no cognitive understanding of boundaries, no positive feedback.) Jude and Gia came to us as very unhappy kids and stayed unhappy for many months after we brought them home.

And, on top of these difficult set of circumstances, Mom is the target. 

Let's face it, a child who has lost a birth Mom has a significant wound with a mother figure. (not that Dad's not important...of course he is. They lost a birth father too) But, for young babies, the bond is usually first with the mother and that bond was severely broken. They have been wounded by this mother figure. And, now your the new mother figure. So, adopted Mom starts out of the gate with a disadvantage and sometimes even the source of the child's hurt and anger.

Now, this "mom is the target" state may vary dramatically between adopted children and probably depends upon whether they have had positive or negative experience with their post loss nannies and caregivers. If they have had more negative experiences with these mother figures. (i.e. nannies or foster Mom), I have read they will typically attach to the father first. Sometimes, they have had zero interactions with men, so it is a safer to have a relationship to him.

What also I have learned is a child with past trauma and neglect (i.e. Gia) will replay negative reactions with former caregivers over and over again even though the new caregiver is not hurting or harming them and is treating them quite lovingly. For example, Gia would scream like she was being tortured whenever we changed her diaper, wiped her nose, or asked her to do something that was very reasonable. Gia constantly gave me the "you are hurting and being mean to me" face even though I was being quite loving. And, over time these negative reaction start to mess with you psychologically. There is a term in dealing with traumatized children called Compassion Fatigue, when the behavior has been going on for so long that you have hit your tolerance to continue being compassionate. Another possible scenario is Secondary Trauma... your traumatized child has now traumatized you.  Let's just say I have probably dealt with some level of both of these in the last year. It has been very tough to bring in a child home who was not taken care of at his or her orphanage.

I have learned behavior wise their our 3 different categories of behavior for a child adopted from an institution:

  • Post institutional behavior (basically behavior a child has developed that was effective in an institutional environment, but now far from effective or welcome in a family setting.) This post institutional behavior will change over time with new expectations. 
  • Institutional autism (a child demonstrates behaviors similar to autistic children.) Although the cause is very different than autism. For the majority of cases,  the autistic behavior will also go away with time once placed in a family setting. A small percentage of children will however keep this autistic like behavior for a variety of reasons and not out grow it even in a positive home environment.
  • Attachment disorders. (superficially engaging "charming behavior", affectionate with strangers, lack of affection toward parents, poor impulses, cognitive delays, abnormal eating, speech and sleep patterns.) These behaviors will go away if they can successfully attach to new adopted Mom and Dad.

Gia struggled with all 3 categories. Jude definitely displayed lots of post institutional behavior.

So, what were our strategies? Well, I am not sure how we would have ever managed to get through this first year of challenging behavior without Gia's weekly behavior therapist who came to our house. I had never heard of such a therapist before our adoption.  (We sadly had to say goodbye to her when Gigi turned 3 and was no longer eligible for the program.)  I think the woman at our early childhood service placement program had sympathy on our plight when she heard about the behaviors we were dealing with at home, and found us a great special education therapist to work with for Gia.

Every week, I would bombard Gigi's therapist when she arrived with my latest "How do I make this behavior stop" topic. I couldn't possibly go through all the scenarios we worked through together on this post...but I will hit on a few big topics.

Topic 1: Negative Reactions....

One thing that drove me crazy was these overblown negative emotional reactions to simple "you need to go use the potty."  This is the reaction I would typically get from Gia on a  simple request such as this...

Gia's response: "By asking me to go potty, you are asking me to be banished to the other end of the earth forever".

Can I say exhausting.

So, they technique her behavior therapist had me implement was a strategy called Behavior Momentum. The approach was designed for defiant children (for Gia's case, her response is more of an emotional one not a defiant one), but the therapist said the strategy to change the cycle of behavior would be the same.

So, I would start by giving Gia request for things she was about to do. This was to condition her brain to accept request from adults without the emotional reaction. For example, if Gia was on her way to sit in a chair to eat lunch, right before she sits I would insert a request "Gia, can you sit in the chair? And respond with, "Oh good listening, good sitting in your chair."  Or she was about to start coloring with a crayon. Right before her crayon hits the paper I would say, "Gia, can you draw with the crayon? Oh good listening...good drawing with the crayon."  This approach begins to trick her brain into compliance to accepting request without the negative emotional response.  She is about to do the task...she wants to do the task.... she won't negatively protest the insertion of the request.

I saw a huge decrease in her negative reactions after a few weeks of conditioning her brain with this strategy. This definitely took some time and energy. But, I really think it helped her to begin break a cycle of negative reactions she brought home with her.

Topic 2: Gia's Shrieking....

Shrieking was Gigi's primary form of communication for a very long time. Day and night. So, I needed a strategy to change this as quickly as possible retain my sanity.

First, the strategy her therapist had me try was to never reward the shrieking. For example, if Jude took a toy from Gia, not to rescue to her from the situation (i.e. make Jude give the toy back) until she gave the appropriate response. (I realized I had been rescuing my younger sibling screamers for about 10 years now.) Note to self: stop being that parent.

These were her recommended steps...

Step 1:
First, this meant having her her sign "my turn" (this was prior to Gia having any language) before I would assist in asking Jude to give the toy back.

Step 2:
Once she became more verbal,  I moved to modeling the word "my turn" and asking her to repeat it. I then verbally rewarded her for using her words, and I would assist in getting her toy back.

Step 3:
Once she could pulled the language needed on her own, when Gia shrieked, it changed to me only silently tapping my lips with my finger as a visual cue for her to use her words. Once Gigi gave the appropriate response, I would follow with verbal reward and assistance.

But for months, even when we were finally to the point of me only needing to finger tap as her cue to stop, she would still still shriek as her first response to any negative situation.

I had hit my compassion fatigue point for this shrieking, and I couldn't take it anymore. I spoke to her therapist about options. I guess usually the child will finally stop the behavior on their own when you have hit the silent visual cue stage...but not Gia (she has more severe cognitive challenges with learning simple tasks).

Since Gia could demonstrate over and over again what they the appropriate response was when visually cued, the therapist said "I was time to render the shriek completely powerless."

Her therapist reminded me that for a child who has spent any time in an institution that negative attention was just as rewarding to them as positive attention. (attention is attention) Some kids who have spent time in neglectful institutions are actually addicted to negative attention for a very long time afterwards. So, never give negative attention for bad behavior. Also, my intervening  (even with just a visual cue) was giving her wanted attention for shrieking, so we needed to slightly change the approach.

So, this was the "render the shriek powerless" game plan.  

Let's stick with the toy is taken away form Gia scenario because it is easy to describe....Jude takes a toy from Gia. Gia begins shrieking.

This was the plan...
I don't respond at all, but I move close to the kids, so they know I'm present and watching them. ( if they know I was watching, they were less likely to beat the crap out of each other.)  Shrieking ensues, I do nothing.  If I hear an an appropriate response (words) at some point  like "my turn", I then respond by saying "Good using your words, Gia do you need help?"  But, if nothing appropriate is said (just lots of shrieking by both parties, I do nothing and I wait until the screaming is over (even it take 15 minutes or more) When it is quiet, I then move over and motion Gia's arm to a tap me on the shoulder. And, then respond with, "Oh Gia, do you need help?"

When I first heard of the plan, I thought my house is going to be WWIII.  It is going to be a painful week, but I was willing to try anything.  I was desperate. Her therapist reminded me behavior tends to get worse before it gets better, so persevere in the plan.

And, oh my goodness, did it work!! Within, days Gigi stopped her shrieking as her primary tool.

OK. maybe not completely gone, but think a 90% decrease. She figured out pretty fast it was no longer effective. ( I was amazed.)  For Jude, it took a lot many still going on, not days. But seriously, this was a God sent approach for Gia.

Topic 3: Stranger Danger

So, Gia had been home 15 months and still had no stranger danger. And, this was with Dave and myself as Gia's primary caregivers 99% of time. She still approached unfamiliar men to hold her in the park. She sat on random Mom's laps at the pool. It seriously creeped me out.  This of course had me panicked over scary diagnoses like RAD (Reactive Attachment Disorder).  But, my attachment therapist told me not to panic and diagnose yet. Gia is making good progress, and it may just take her longer to attach because her neglect in the orphanage was more severe than the typical adopted child.  Healthy attachment is still possible with time and patience.

So, her behavior therapist made her a behavior book. Her therapist made Gia many behavior books over the past year that were highly effective in changing her orphanage habits and having Gia cognitively process and understand expectations.

She thought this was something Gigi probably needed to be taught at this point since she was not developing a normal stranger anxiety on her own.  And, Gia spent 2 years of that behavior being normal and acceptable in an orphanage.

The theme of the book was... Only family and friends can hold us and we wave "Hi" to  strangers. We cannot sit on strangers laps.

So, I started reading this book to her, and I have seen a huge decrease in Gia going to strangers.  Whenever we go out, we talk about the difference between a stranger and a friend. I point to people in the park, and ask her, "Is she a friend or a stranger? Can we sit on their lap? She still struggles to answers these question correctly. But, she is now much more cautious around people she does not know. So, we are seeing a steady improvement.

So, the summary here is I thought our life would never be normal again with the institutional behavior Jude and Gigi brought home. But, they are proof it is possible to make significant progress in tackling these behaviors. In the case for my kids, professional help was needed to get things back on track and find a healthy normal. Since their behavior challenges were so extreme, I needed someone to help me compartmentalize the challenges and tackle them one by one. And, since I am a type A person, I always do better, and I'm more successful with a game plan.

Now that their behavior has improved, I think the biggest challenge for me is to drop the negative lens in which I can sometimes continue to view them because they are not the same kids we brought home over a year ago.

Are we there yet? No. We are still working on things like impulse control and listening. But, when I look at their progress in the last year, I am utterly amazed. Pre-school next fall will add more challenges, but also more ways for them both to grow.

Cheers to better behavior.

Monday, July 7, 2014

Happy 4th and Happy Birthday to Gigi

Dear Gigi,

You are now three, which means we now have 3 three year olds under one roof. The three toddlers are still the high demand crew. 

You are a very different child than you were a year ago. I have seen you blossom and grow in more ways than I ever thought was possible.

We have been working on counting to 3 together. You sometimes can master it, but most of the time you say "one, two, seven", and you proudly announce that you are seven years old.  So, happy 7th!

You are a chatter box. You don't know a lot of phrases, but the ones you do know you repeat them over and over again to start or continue any conversation. You are quite the social girl.

Very recently, you started to put sentences together. I have been shocked by this new explosion of language. You have had such a limited vocabulary for so long. It is amazing considering you only had 1 sound "ma" when we brought you home 15 months ago.

You are a giggle machine. You love to be silly. When you are acting crazy and the kids laugh at you, you always respond by saying, "I am not funny" in a mad voice, and then smile and say, "I'm silly."

You still get an extreme sad face whenever I have to tell you "no", but you can pull things together and move on very quickly. You rarely scream anymore (which is a miracle) except when someone touches one of your birthday presents, and you are now very good at using your words. Whenever Jude gets in trouble you will say things in a proper voice like, : "I am not screaming" "Gigi is sharing" basically the opposite of whatever Jude is getting in trouble for. I am not quite sure you are the angel you are portraying yourself to be in these moments. :)

You are getting an attitude. We have to do a lot of "do overs" to correct your tone of voice.  I'm not sure where you might of picked the attitude up from. Lol. I think I need to start working on my tone.

You love sweets. When I asked you what type of birthday you wanted you replied with "chocolate." I clarified and said, "Do you want a Dora, Bubble Guppies, or a Frozen birthday party?" And, you still responded with "chocolate party." Your brain was fixed on the cake part.

We still call you both Gia or Gigi, but you prefer Gigi. Whenever anyone asks you what your name is, you always respond with "Gigi"...never Gia.

You are still very bouncy and are always moving, but you are able to control your body so much more than you could a year ago.

You love the pool, and we have spent a lot of time there this summer. Once you get in the water, you always tell me "Gigi like it. Gigi happy." You are also getting very brave in the water with your floaties. You love to float on your black, jump off the side, and swoop with your head under the water. Your water fear is definitely gone.

You finally sleep...although sleep is definitely not your favorite past times (you would rather run like a wild child until you pass out). You have made amazingly strides in this area. I am so grateful we have finally tackled the chronic insomnia and night terrors. Sleep has made a positive difference in your entire personality and mood. (and your Mom's)

You have shot up like a weed. You are now the same height as Molly (who is 9 months older). I think it might be from all those iron supplements we had to give you for your sleep apnea.

You will start part-time preschool in the fall.  I am excited for this new chapter for you. Since you are so social, I am thinking you are going to love the social aspect of school.

Happy 3rd birthday Gigi. I can't wait to see the changes the next year will bring. We love you!!

4th of July in pictures....

 celebrating birthdays with cousins