Be Prepared

I’m no Boy Scout but, as an adopter, I do think it might be worthwhile nicking their motto. When you look up its meaning, Wikipedia says it means “you are always in a state of readiness in mind and body to do you duty”. Now, although I do not consider adoptive parenthood to be my ‘duty’, I have committed myself to it and do find myself in a constant state of readiness. I couldn’t tell you what I’m ready for necessarily (often a lie down in a darkened room) but I do tend to expect the unexpected.

I wouldn’t say that Little Bear is unpredictable. Well, I sort of would. He’s predictable in that I know the full range of behaviours he might display and I know him well enough to anticipate how events or states might impact him. I can often predict what he might do next or what he might say or how he might react. However, what none of us can really be sure of is what kind of day it is likely to be when he wakes up in the morning. I’m starting to realise that there can be quite a variance. Also, no matter how well we know Little Bear, he will always have the ability to occasionally throw in a curve ball or say or do something out of the blue. As well as this, even though I can often anticipate his behaviour, it is still the sort of behaviour you should be ready for. For example, if your child is a runner, you can’t go round being surprised when they run off. You won’t expect them to run off every second either but you will always have at the back of your mind that they might. You’ll be prepared to grab them or sprint after them, just in case.

On Sunday, I had a lovely afternoon with Little Bear. Big Bear had gone on a playdate then out for tea and to the cinema with Grizzly. Little Bear and I stayed at home. We got the Lego out and sat in the playroom for ages building things and pretending. Little Bear was calm and played happily with the same game for an hour or so. When I could tell he was tiring, I made him some tea and let him have it in front of the TV for a rest and also because his brother had gone to the cinema. Afterwards I ran him a bath and we had a big game of floating racing cars. He read his school book then I read to him. He chose Green Eggs and Ham and realised after a few pages that he could actually read that too. He kept saying “no, I can read this one Mum” in a slightly surprised tone and continued to prove his point until he had read the last 30 pages or so. He was an absolute joy. We had a lovely time. It felt like quality time. I felt he had benefitted from us being on our own. All was good. I really enjoyed him.

On Monday morning, I was lulled into a false sense of security. My prediction of Monday was based on Sunday’s rose tinted lenses. This was foolhardy. I should have been more prepared.

Monday wasn’t a really bad day but it was very different day. I’m pretty sure that Little Bear didn’t stop talking. At all. All day. I’ve read somewhere about ‘verbal scribble’ which is a very apt description. Little Bear verbally scribbled all the live long day. We went to the park. We wanted to walk. Little Bear wanted to play football. We played football then we walked. He didn’t want to walk. We were ready to leave for lunch. He didn’t want to leave or get out the tree. We went for lunch. He didn’t want lunch; he wanted to go to the park. You get the picture? Everything was a bit of a battle and he REALLY wanted to do a lot of things. Each time we did the thing, he REALLY wanted to do another thing. It was as though nothing satisfied him and he was constantly seeking life’s secret elixir, without any success. It was a tiring, trying of patience kind of day. It also involved loudness, constant interrupting, difficulty sitting still and a need to be fed otherwise eating wasn’t going to happen either.

I should have been prepared for the presence of dysregulation because it’s an omnipresent possibility. I’m not sure why I wasn’t but it’s certainly nicer to begin the day assuming you are going to enjoy your child rather than count down the minutes until bedtime.

Based on how Monday went, I wasn’t too excited about today. Grizzly was going to be at work and I was mostly going to be having 1:1 time with Little Bear.

This morning, he surprised me with one of those unexpected, out of the blue curveballs: a life story chat at 7am. There is nothing like a mention of birth siblings to wake you from a sleepy stupor and get your ‘be prepared to answer whatever array of questions might be coming your way hat’ on.

Life story work is one area I can’t really predict with Little Bear because it happens so infrequently. Months go by with no mention at all and then all of a sudden, bang, a big question when you least expect it. However, because we are adopters and because we know he might do this now and again, it is in the backs of our minds and we are sort of prepared for it in an expecting the unexpected kind of way. So today started with perusing of the life story book and the fishing out of some photos. I think the chat went okay. Little Bear seemed satisfied with his information and I didn’t go away deriding myself for having said the complete wrong thing.

We dropped Big Bear off at my Mum’s for his grandparent time and headed into town together. Having not had particularly high expectations of the event, I was relieved that we had a lovely time again. I suspect that 1:1 is much needed for Little Bear and hence he generally copes better in those situations. He needed new shoes which put a spring in his step; I tactically fed him toast at the right time (and a hot chocolate in an espresso cup which is quite possibly the cutest drink a child could have); we stuck stickers; we coloured; we stroked a rabbit; we went to the library. It was lovely and I really enjoyed him. Little Bear climbed a few things and tried to swing on a few things and found it hard to sit still. But I knew he would: I was prepared.

Sometimes situations arise that with the best will in the world you can’t anticipate and they can lead you to question what you really are prepared for. When we got to the library, rhyme time was on. I didn’t know this; it was a coincidence. In this instance, rhyme time was full of parents and very small children – babies and young toddlers. The group were singing nursery rhymes and listening to stories. Little Bear was rooted to the spot, transfixed. Initially I didn’t pay him much attention, encouraging him to look through the books. When I realised he was in a bit of a trance, I watched him, watching them for a few seconds. He looked shy, curious and a little mesmerised. Having just read The Boy Who Was Raised as a Dog by Bruce Perry, it was fresh in my mind that children who have been neglected have often missed out on early rhythmic interactions and the singing of lullabies and nursery rhymes. It was also fresh in my mind that older children still need to experience these things in order to heal their trauma.

I looked at him looking at them and tried to weigh up the situation. He was twice or even three times the size of most of the other children. I had no idea whether you were meant to officially join the group or pay. I wasn’t really prepared for this situation. However, I concluded that the bottom line was that Little Bear, whether in the body of a lanky 6 year old or not, was developmentally well matched to the group and as uncomfortable as that felt, I would need to suck it up. “Do you want to join in?” I whispered. The answer was basically yes, so long as I came with him. I crouched beside him, to make us slightly less conspicuous, as he sat on a chair in the group.

Little Bear loved it. He was completely entranced by the songs and sat really well. He couldn’t have managed to join in when he was 3 or 4 and probably not even 5, but at 6, it was just perfect for him. Having missed out on all those early experiences and having had such significant language difficulties, Little Bear doesn’t actually know any songs. Some sound familiar to him but he doesn’t know the words well enough to sing along. That doesn’t stop him trying and results in a tuneful hum with some louder words thrown in for good measure. I watched him side-on, feeling a little embarrassed but making myself get over it, while he sat straight-backed, earnestly joining in, wide-eyed and trying his very best. I loved Little Bear so much in that instant that my heart hurt a little bit. I wasn’t prepared for the situation but I am prepared to do whatever I can to help him.

The next second his hand was going up to suggest a rhyme. I was intrigued by what he would say and slow to anticipate what was inevitably coming next. Little Bear suggested ‘jingle bells’ and broke into song and he was about two lines in when I woke from my daydream and realised this wasn’t going to be the clean version. Yep, Uncle Billy and all that…

The Scouts are right: be prepared. You don’t quite know what might be coming next.

 

 

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Be Prepared

Anxiety

This is one of those blog posts that I am not too sure about writing because it is going to require a high degree of honesty, soul-baring and general over-sharing. However, I think I should write it because all the recent discussion about mental health encourages us to talk more. That is one of the main aims of the projects I’ve seen mentioned and shared around social media. It’s a good aim. We should talk more. Talking can save lives.

I’m not going to tell you anything that dramatic but I am going to be honest about something which is fairly common and has impacted me in my lifetime: anxiety.

The reason this feels topical and like I want to write about it today, rather than at any other point in my life, is that Big Bear has recently begun suffering with anxiety and I don’t want it to be something we sweep under the carpet or hide like a dirty secret.

Big Bear plays football for a club. He joined because he wanted to and to begin with he absolutely loved it and it gave him a lot of confidence. He trains every week, gets very excited about going and has a whale of a time. He also has a match, usually each week too. To begin with, Big Bear took us by surprise by how well he could play (having never previously been particularly bothered about football) and generally played up front, becoming his team’s best goal scorer. He loved it and all was well with the world.

However, on match days, over recent months, we have noticed a deterioration in his ability to cope. Big Bear begins to anticipate the upcoming match a few days before and it starts to play on his mind. It’s hard to tell whether he is excited or nervous about it. On the day of the match he will often wake up early and go to the toilet a few times. He will try to eat his breakfast but often can’t and then experiences tummy-ache. He might go to the toilet a few more times. By this point he is usually a little ashen and really struggles to get his kit on and get to the match. Sometimes when he has got there and seen his friends he has been ok and has ‘run it off’ so to speak. At other times, he has barely managed to stand up let alone run about. Obviously his goal-scoring record has deteriorated alongside his mental health as nobody is capable of playing well if they haven’t eaten and if they are consumed by anxiety. I suspect the poor performance is only serving to propagate Big Bear’s internal pressure on himself and he is now trapped in some sort of negative thought cycle.

It is such a shame to observe as he is only 8 (nearly 9) and far too young to be crippled by anxiety. We have done all the obvious things. There is no pressure to play, let alone score and we make that very clear. We only want him to enjoy it and he doesn’t have to be in the club if he doesn’t want to. So far, he has wanted to persevere. Initially he wouldn’t talk about the anxiety so it was hard to help him. Over time he has got more open about it and has made suggestions about things to try that might help him e.g. specific things he thinks he might be able to eat; having a relaxing shower; having a little wander before breakfast. The coaches know about it and quite often have little pep talks with him, telling him there is nothing to worry about. Although this is well-meaning and meant in a supportive way, when you are anxious, you are pretty sure there are things to worry about so although it’s kind, I’m not sure how effective it is.

Unfortunately, our shared endeavours are not paying off and if anything the anxiety is getting worse. Not only does Big Bear now need to visit the toilet frequently but he has started vomiting too. The poor child seems to have inherited both mine and Grizzly’s weaknesses.

People say ‘but what is he worried about?’ If it is not the scoring of goals or the desire to please, what is it?

The thing is I know what it is, because I’ve been there too. It is a very difficult fear to overcome: the fear of fear itself. I know that sounds ridiculous but there you are. There is no justifying the actions of an anxiety-fuelled mind. It does what it does and expresses itself through your body.

I can’t remember when it first started to impact me. I certainly wasn’t as young as Big Bear but I think my mum would say I was a worrier as a child. It was probably in my late teens or early twenties that things set in with gusto. There wasn’t a trigger; nothing happened to me. I didn’t have any ACEs (Adverse Childhood Experiences) or any reason to be anything less than fully joyful. However, I developed IBS (Irritable Bowel Syndrome) and it made me pretty ill. It was hard to get to places early in the morning due to far too much toilet activity and I lost weight. I spent quite a lot of time feeling like death warmed up and it certainly impacted what I was able to do in my daily life. It was worse when I was doing exams or something stressful like placements at university. I look decidedly bony in my graduation photos. I mainly survived by abusing Imodium, not eating until I felt I could digest (often after lunchtime), having a couple of ‘safe’ foods and always knowing where the toilets were.

Those closest to me knew about it but it was embarrassing as afflictions go; we aren’t really a Society which talks about bowel movements openly so I tried to hide my IBS and was ashamed about having it.

I experimented with eliminating foods to see if that would help. I did cut out coffee and alcohol, both of which improved things a little but it wasn’t food that was irritating my bowel; it was anxiety. Just like Big Bear, there wasn’t a specific thing I was worried about. I was mainly worried that I would have an IBS attack and that would ruin whatever it was I was supposed to be doing. So basically I was worried about IBS which made the IBS happen and there I was trapped in the cycle. Getting engaged nearly tipped me over the edge. I was 26 by then and as soon as the proposal happened I was immediately anxious about having IBS on my wedding day, 18 whole months away. Clearly that is ridiculous and I knew it was then but when your mind is inclined to go that way, it is virtually impossible to stop it. Anxiety is such a self-fulfilling prophecy that of course all the months of angst and anticipation did result in IBS on my wedding day. I coached myself through being ok in the morning and I did pretty well but it hit later on and I wasn’t able to eat my own wedding breakfast.

My IBS (that probably never was) is now fully cured. It’s the strangest thing. You would have thought that having children would make it worse as they are such a cause for ongoing concern but if anything, having Big Bear saved me from it. I can only think that before kids you tend to think you are really busy but in actual fact I clearly had too much time and brain space for navel-gazing. After kids, my mind was so taken up with keeping them alive and developing them and running a home and having a job that those corners of my brain where anxiety used to lurk got filled with something more useful. I am not immune to some worries and my brain does naturally go to worst-case scenarios but with age I seem to be able to over-ride those thoughts more and can largely keep them in check.

I do remember getting to a point where I saw that my life was ruled by IBS and I decided I wouldn’t tolerate it any more. Despite all my issues I had got my degree and held down a job I liked and was good at. The IBS made everything more difficult but it had never completely ruined anything. I had survived every single situation in which it had tried to undo me. I think I stopped fearing it. I just accepted I might need the loo more than your average human and that would be ok. Just as soon as I didn’t worry about it, it ceased.

When I started writing this I wasn’t too sure how I was going to go about helping Big Bear but in blogging it out I may have answered my own question. I think that Big Bear also fears the symptoms of his anxiety and by trying to stop the symptoms from happening we have only served to make him more anxious when they do and more desperate for it to stop. Perhaps a cleverer approach would be to talk to him about how many people suffer anxiety and get nervous before matches or big events. Sometimes people do need to use the loo more or might be sick but that’s ok. Yes, that probably will happen to him at his next match but it doesn’t matter. He doesn’t need to fear that happening. It’s normal. Nobody is going to die. If he starts getting into a state we don’t need to make a fuss, just give him a drink and carry on.

I can empathise with him as clearly I have been there and I can certainly help him with not feeling like it just happens to him and I hope, by being open about it, we can normalise it a little. By keeping things secret or trying to hide them or not acknowledge them, we only serve to perpetuate the fear. Anxiety is parasitic; it feeds off your deepest worries and burrows into your brain. It gets pretty comfortable there if allowed but the more you bring it out and show it to people, the less powerful it becomes.

I now suspect that we have some sort of genetic propensity towards it as it is too coincidental that Big Bear is now presenting similarly and has never witnessed me suffering with IBS symptoms in his lifetime. A quick Google suggests a genetic predisposition is a thing when it comes to anxiety, which is unfortunate. And of course there is the brain-gut connection which clearly states that anxiety can cause digestive difficulties.

Little Bear, despite his much rougher start in life, seems far less impacted by such things so far. It just goes to show that birth children have their issues too and it has certainly been Big Bear giving me my grey hairs recently.

For now, we have decided that while Big Bear will continue attending training because he has fun there, he won’t play any matches for a while. He is too young to be throwing up with nerves every weekend and I don’t want to re-inforce that behaviour pattern at all. However, when he tries again, I think we’ll play it much cooler. If he has physical symptoms of anxiety, that’s ok. We won’t reinforce his thought that it’s wrong by coming up with various solutions and we’ll see how we go. Perhaps he won’t be ready for competitive football until he’s a bit older and that’s ok too.

Today Big Bear has gone on a school residential where they do all sorts of adventurous things and I’m really hoping it will give him the confidence boost he needs, as well as him having some fun and hopefully enjoying some anxiety-free adventures with his friends.

And as for me, now that I’m a decade older, I’m much more aware that we all have our foibles and weak-spots. It isn’t something to be embarrassed about. It’s part of what makes us human.

Anxiety

Transition

Transition is usually a concept that people begin discussing in the summer, as term time draws to a close. However, in conjunction with Little Bear’s school, we have decided to begin working on it and talking about it much earlier than that. In fact, Little Bear’s transition to Year 2 has already begun.

Last year, when he moved up to year one, he did pretty much what the other children did: spent that last two weeks of the summer term in his new classroom. This seemed ok at the time. In fact, it seemed pretty good because most schools don’t transition before the summer holidays, just going straight to their new classes afterwards. However, in reality, we hadn’t done anywhere near enough work and planning around the transition and things went pretty pear-shaped (see Adoptive Parent: Behaviour Detective  & School Worries).

My personal feeling is that getting a TA was the biggest difficulty for Little Bear. Obviously it’s brilliant that we managed to secure funding and he certainly needs the support. However, from Little Bear’s point of view, a new adult, who he had never met before, appeared and went everywhere he went. She told him what to do and he wasn’t too sure whether he trusted her. He didn’t know what the rules were with her – were they same as with his teacher or as with mum and dad? Would her rules be the same every day? What would happen if he didn’t do what she said? Would she shout? Would she just let him do anything he wanted?

The only way to figure all this out, if you’re a child who has experienced trauma and loss, is do all the things you’re worried about and find out. If you test a person who isn’t prepared to be tested and isn’t quite sure what you’re doing or why you are kicking them or refusing to do anything they say, that person might find it all a bit tricky to navigate. That person probably won’t know how to react and may try different things on different days. Because they are not consistent in upholding the rules or dealing with your behaviour, it is likely that as a child with developmental trauma, you will feel unsafe. When children feel unsafe, they go into survival mode: fight/flight/ freeze or flop. In Little Bear’s case, it was fight mode and hence his behaviour escalated for a while.

This is not a scenario that we are keen to repeat at the beginning of year 2. On the positive side of things, Little Bear’s TA, Mrs C, has worked really hard to understand him and to support him in a way that works. Their relationship has now settled and they work really well together. Little Bear’s behaviour has improved dramatically and he is learning lots. Mrs C is going to move to year 2 with him which should provide him with a good level of stability.

However, Little Bear will be moving classrooms and he will have a different teacher. This will be a big deal for him because he has had the same teacher throughout Reception and Year 1 and he loves her. One of the big problems with transition for children who are Care- experienced is that moving on usually involves saying goodbye and that can trigger all sorts of issues from their earlier lives.

Not only will leaving her behind be hard for him but it will inevitably mean getting a new teacher and having to get to know a new adult who Little Bear won’t be sure whether to trust or not. We could have all the issues I described above again. Thankfully, no one wants that to happen and as school were so shocked by what they witnessed from Little Bear last time, they are keen to do better this time.

Little Bear himself is all too aware that he has to go to a different class at some point and has been expressing his worries to us for a few weeks now. He is scared of the new teacher and doesn’t want to leave his current one. Although his grasp of time has improved, it is still not fabulous, so telling him how many weeks or months he has left in year 1 doesn’t seem very reassuring for him. Instead of waiting until nearer the time, we have decided to start preparation now as the best means of reassuring him and reducing his anxiety.

I thought it might be useful to share our transition plan and all the things that are happening that will hopefully help Little Bear with moving on:

  • Today we had an official transition meeting. It was attended by us, Little Bear’s TA, his current teacher and his next teacher. We shared concerns and crucially told the new teacher about relevant background information. This didn’t happen with Mrs C until after she had been working with Little Bear for a while which was a backwards way of doing things and did impact upon her ability to understand him and set her expectations of him. In order to understand Little Bear’s behaviour, it is essential to know key factors in his background that precipitate his current behavioural and emotional challenges.

I think Mr. New Teacher seemed a little shocked.

  • We also shared tried and tested strategies that are currently in use at home and at school for supporting Little Bear. We talked about allowing him calm down time before discussing his behaviour with him; consistent and clear boundaries; praise; the need for repetition and managing dysregulation amongst other things.

 

  • Little Bear knew we were having this meeting, as he always does when we have one and as much as possible I put a positive spin on them so that he knows they are about helping him and making sure he feels safe: I don’t want him to think it is a chat about all the ‘bad’ things. We always ask him if there is anything he wants us to say to the teachers or to ask them about.

 

  • Little Bear has been going into his future Year 2 classroom for a few weeks now with Mrs C. Initially they popped in to do ‘jobs’. They have since stayed in there a little longer and explored the toys and books. More recently he has been going in during his 1:1 time to complete his work. Mrs C has started popping out for a few minutes on the pretence of needing to do something so that Little Bear gets used to being in there on his own. This is clever because Little Bear still has a tendency towards opportunism and he may be tempted to see what he can get away with without Mrs C by his side. It will give Mr New Teacher the chance to start laying out his boundaries.

 

  • Over the next weeks, the plan is for Little Bear to spend more time with Mr New Teacher so that they get to know one another better. Little Bear has already shown him his work a few times when he has done something good, which is a very positive interaction for them to have.

 

  • Before the two week transition at the end of term, Mr New Teacher is planning to visit us at home for five minutes so Little Bear can see that we trust him and that we have a relationship with him too. The consistency across all settings and people is so important for Little Bear and we hope this visit will make him feel safer. He will also love being able to introduce Mr New Teacher to our pets etc.

 

  • Little Bear’s current teacher has been talking about the transition with all the children and reassuring them as a class.

 

  • The teachers plan to put together a ‘transition pack’ for Little Bear with photos of the new classroom, teacher etc. for us to look at over the summer.

 

  • The school are aware of the need for Little Bear to still have contact with his current teacher once he moves to his next class so he will have the opportunity to pop into her classroom for ‘jobs’ or to share work and equally she will pop to see him.

 

The plan feels fairly comprehensive and I’m really grateful school are facilitating it. The biggest risk factor is whether Mr New Teacher listens to what we have said about the best ways of supporting Little Bear in class or whether he will feel preached at and will just want to try things his way. We know, from bitter experience, that new adults tend to wish Little Bear came with an instruction manual. He doesn’t, but we have cobbled one together over the years and if the willingness to listen is there, so too are the effective strategies.

Transition

Ensuring Children’s Speech and Language Needs Are Met: A Call to Action

As most of you know I am a speech and language therapist and my son, Little Bear, has Developmental Language Disorder   (DLD) so it is no surprise that meeting children’s communication needs is kind of a big deal for me. A recent report has come out reviewing speech and language therapy services for children and the findings are a little damning. It is called Bercow10 as it is written by John Bercow (of MP and having-a-bit-of- a-naughty-wife fame) in partnership with ICAN and the RCSLT and is a follow up to the original Bercow report which was written 10 years ago. It is a very important document and I want to share some salient points with you. As many of my readers are involved with adoption in some way, I am going to focus in particular on the bits of the report that are relevant for looked after children, children with mental health needs and children who become involved with youth offending. However, this is something that EVERYBODY needs to know about so please don’t look away, even if you don’t have any obvious connections to the content.

The report begins with an important message: “The most fundamental life skill for children is the ability to communicate” but it goes on to say that “as a nation, we have yet to grasp the significance of this”. This certainly seems to be the case as there are more than 1.4 million children in the UK with speech, language or communication needs (SLCN) yet it is not something we really hear talked about and most people have never heard of DLD despite it being one of the most common disorders of childhood. We hear a lot about the ‘obesity epidemic’ as it has a physical impact on children and a financial impact on the country. Bercow says that SLCN has a developmental impact on children as well as a social and economic impact and should similarly be considered an issue of public health. Being as SLCN impacts upon a child’s education, social, emotional and mental health and their future life chances it is a much bigger issue than it is given credence for.

A good starting point is to raise awareness of SLCN and what that means and what it looks like. If you want to know more about how Little Bear has been impacted by his language difficulties, see these previous blog posts: Living with Speech and Language DifficultiesCommunication Difficulties: Update

Children from disadvantaged backgrounds, whether that is due to social disadvantage or maltreatment, are disproportionately affected by SLCN: in some areas as many as 50% of children have language disorder and Looked After Children have poorer language on school entry compared to those who are not Looked After. Children considered high-risk for harm, such as those on a Child Protection Order face a higher risk of SLCN as do children who live with domestic violence. Across the care system as a whole, 63% of children have SLCN, compared to 10% in the non-care experienced population. This makes our most vulnerable children even more vulnerable to poor life outcomes. Children with SLCN in early years are twice as likely to develop social, emotional and behavioural difficulties and are at greater risk of depression or anxiety. Children with poor vocabularies are twice as likely to be unemployed as adults compared to those with age-appropriate language skills.

The statistics are pretty scary. What is also very worrying and makes my heart break a little is that many children’s difficulties are missed or misdiagnosed. Studies have shown that 81% of children with social, emotional or behavioural difficulties, including those with conduct disorder or ADHD have significant undiagnosed SLCN. If we extrapolate that a little, the picture seems even worse. These children, who cannot learn in school (because the curriculum is not accessible to them and teaching is not differentiated for them), often go on to engage is risky behaviours – drug-taking, crime etc. and unfortunately many will go on to find themselves in the youth justice system. Another study shows that 60% of children in the youth justice service have low language skills, often lower than an average 11 year old. Imagine having to be interviewed and appear in court when you cannot access classroom language let alone legal jargon. Many of these young people are then expected to engage with various programmes to aid with their rehabilitation. Statistics suggest that 40% of young people cannot access the content of these ‘verbally mediated interventions’ due to their language difficulties.

If children do not get their needs identified at any early stage and do not receive the therapy they require, the consequences can be dire. This is what Bercow means when he talks about social and economic impact. I think this particularly upsets me because had life been a little different for Little Bear, he could all too easily have fallen victim to this pattern. His behaviour did come before him and had we not been able to see beyond that and not recognised his DLD (and developmental trauma), things could have been very different. Before Little Bear was adopted at the age of 3 and a half, although there was a vague indication in his paperwork that he might have some language delay, he had not been formally assessed by a speech and language therapist. I was shocked at the severity of his communication needs the first time I met him and his language was later assessed as being more than 2 years delayed. I’m not quite sure what other signs would have been needed for a referral to have been triggered but he was certainly at risk of falling through the cracks.

I think there are two key things here. Firstly, if a child is presenting with social, emotional or behavioural difficulties, they should have a speech and language assessment as a matter of course. Behaviour itself is a communication and people in general need to get much better at looking beyond it. The second thing is that other professionals need to become more knowledgeable about SLCN; teachers, health visitors, the police etc. all need to be aware of the ‘red flags’ and seek help to prevent life escalating away from vulnerable children.

The bleak picture I’m painting could possibly all come good if there were excellent speech and language therapy services available to meet need once children were referred. However Bercow is pretty damning about this too. There continues to be a post-code lottery when it comes to availability and quality of services: of all the 2500 respondents, only 15% felt services were available as necessary. More than 50% of people had waited longer than 6 months to receive the therapy they needed and 34% had waited more than a year. This is a statistic I can empathise with as we had to wait over 8 months for Little Bear to be seen for the first time and a year for therapy to begin (see A bit of a rant).

This isn’t good enough. I was lucky to have my professional knowledge to fall back on and could begin helping Little Bear from day one. However, most adopters or foster carers do not have that level of knowledge and couldn’t be expected to. A year is too long to wait for a child who has already been neglected and needs immediate support. Due to Little Bear’s behaviour, our adoption began at crisis point. Thankfully we were able to identify there was a communication element to his needs, as well as developmental trauma, and could begin to tackle it. As most adopters do not happen also to be speech therapists, they would be unlikely to be pre-armed with the knowledge and strategies required. The impact of not receiving support in a timely fashion could be catastrophic.

Our story does provide some good news though, thankfully. The thing is that when quality speech and language therapy is provided, it is extremely effective (see Speech Therapy Works). Despite starting pre-school at the level of a 16 month old across all areas of development, with communication being one of the most difficult areas for Little Bear, by the age of 6 his language levels had improved to within the expected range for his age. Admittedly he received a high level of input, both at home, in clinic and at school but that input was effective. Our story shows that as bleak as this situation seems to be, it doesn’t need to be hopeless. If change can be brought about, services can be improved and awareness can be raised, we can literally transform lives.

Bercow 10 doesn’t just highlight problems, it makes practical recommendations for change under the following headings: communication is crucial; a strategy for system change; an accessible and equitable service for all families; support that makes an impact; early identification and intervention are essential. You can read the full recommendations document here: Bercow10 recommendations

And if you are feeling very keen, you can read the whole report here (it’s really well written and a lot more accessible than I expected): Bercow10 whole report

What can you do to improve outcomes for children?

In order for change to happen, people need to know about the current situation. They need to know about Bercow 10 and its contents. @GillianRudd has begun a petition to bring discussion of Bercow10 to the government to ask them to ensure the implementation of the recommendations so that children’s communication needs can finally be met appropriately. 10,000 signatures are needed for the government to respond to the petition and 100,000 for it to be considered for debate in Parliament. You could help by signing the petition and asking one person you know to sign it too. Just follow this link: petition

Please share this post far and wide to get the message out there.

It is essential that schools, health visitors, psychologists, CAMHS services, doctors and the Police know about Bercow10. Could you share the link with your child’s school or other professional?

If you want to get even more involved than that, see the Calls to Action section of the website: Calls to Action 

Thank you very much in advance for signing petitions and sharing etc. Change has to happen.

 

 

*This post is based on my personal reading and interpretation of the Bercow10 report. If you want to know the sources of my statistics, please see the report.

Ensuring Children’s Speech and Language Needs Are Met: A Call to Action

Unwanted Changes

Things have been going really well for a few weeks here. That way where you begin to think you might have cracked it and that having no specific difficulties is the new normal way of life. I wasn’t getting complacent about it; if anything it was making me feel a bit uncomfortable and suspicious, not because I want to have difficulties but because it seemed a bit too good to be true. About a day after having that thought, some problems predictably began to arise. I don’t think it is anything major at this stage, hopefully not, but we are at the point of thinking Little Bear’s behaviour might be escalating and we are keeping a close eye on what’s going on.

There are two issues, both school based. At the start of the school year we had some School Worries and then various things happened to resolve them (see Alleviating School Worries). Since then there have been niggles but generally an upward trajectory with Little Bear and Mrs C, his TA, getting to know one another better. Over the past two months or so I would say they have got into their groove. Little Bear feels safe with Mrs. C; he listens to her and accepts her authority. Mrs. C has come to understand Little Bear and what he needs and how to help him. Consequently Little Bear’s behaviour has been very settled and he has made fabulous progress. We have been very pleased with how everything has been going.

Unfortunately, Mrs. C is now experiencing some personal issues; a member of her family is very poorly and understandably she needs to take time out to care for them. She is still coming in most days but sometimes only helping Little Bear for an hour before leaving. Obviously I know it can’t be helped and I really feel for her, having been through it all last year with Supergran, but at the same time, with my parent hat on, I’m a bit gutted. Consistency is so important for children who struggle with attachment and trauma. It has taken a long time for this relationship to be properly established and just as things have settled seems an unlucky time for disruption to happen. Mrs. C is Little Bear’s safety net at school now. He knows she is there to help him and without her I suspect he is a little lost.

We are lucky in that Little Bear has made good progress and can now cope with a bit less support and still get some work done, where he couldn’t have managed to earlier in the term and would have become very disruptive. However, we are all too aware that things can escalate quickly when much needed support is taken away. We are keeping an extra close eye on how Little Bear is and checking in with his teacher more frequently.

The school are not currently covering Mrs C’s time when she isn’t there as it likely to be a short term situation but we are concerned that they may need to if Little Bear shows us he isn’t coping.

When I picked Little Bear up yesterday he appeared dyregulated and really struggled to listen on the way home. He did daft things like hide in someone else’s front garden and tried to put a Hula Hoop in his ear that he would not normally do these days. Could this deterioration in behaviour be a sign he isn’t coping quite so well as we thought?

Well, it could, but equally it could be due to the other school issue that we are also concerned about. For some reason that I can’t fathom, the school have changed the entire dinner menu. They have changed it on the premise of it becoming healthier. In practise, they have removed all carbohydrates. Cauliflower rice or celeriac mash anyone?

I’m all for healthy eating and children having their vegetables, of course I am, but I do think this menu has gone about three steps too far. Little Bear loved buying some toast at break time and I always encouraged it because he gets very hungry and I felt it was regulating for him. I am sure there is some evidence about children who have experienced trauma needing more fuel because they expend so much energy trying to stay within their window of tolerance (if anyone knows what I’m on about please point me in the right direction). I also think Little Bear has to work harder due to his Developmental Language Disorder, another reason to keep his energy levels up.

Anyway, needless to say he can’t buy toast anymore because bread is the food of the devil or some such nonsense.

The lunchtime menu now has one choice only so I guess you eat it or you don’t. Previously there were always two choices and personally I feel there still should be – aren’t children allowed to have preferences? My feeling about the food now is that it would probably be delicious for me, a grown up with developed taste buds, who is conscious of my waistline but either I have failed as a parent or my children are lacking in some way as they are very unlikely to eat it. I don’t know many children who would eat harissa lamb or Greek salad or greek yoghurt and berries for every pudding, to be honest. Apparently they have done it on purpose to get the children tasting more things.

The thing is I feel as though they have misunderstood the function of a school lunch. In my eyes yes, it should be as healthy and fresh as possible, but it should be appealing to most children because the most important thing is that they eat it, fill their tummies and are able to approach the afternoon well-regulated and able to concentrate. I think that pushing boundaries and trying things can happen at home or during special events at school but the last thing I want is for Little Bear to push his posh nosh round his plate, not eat any of it and spend the afternoon swinging from the lampshades. Being well-fed is crucial for Little Bear’s behaviour regulation. If he is hungry he will not be able to control himself and he certainly won’t be able to learn.

I feel as though the school has inadvertently created a very exclusive menu which will inevitably exclude many children. There has been no consideration for children who may have restricted diets due to underlying conditions such as Autism or children who have had limited life experiences. Before Little Bear came to us, he didn’t eat any vegetables and perhaps only one or two fruits. The fact that he will happily eat a range now feels like a success to me; I don’t feel the need to push him beyond his comfort zone and I don’t appreciate the inference that my child (or my parenting) is somehow lacking by him not wanting to eat anything on the exclusive school menu. I feel as though it has somehow become an elitist basis on which to separate the parents – those who have succeeded in getting their children to eat like grown-ups and those who haven’t. Bring back jacket potatoes and roast dinners I say, are they really that detrimental to our children’s health?

As an aside, the children are no longer allowed to bring a cake in when it’s their birthday either which I find very sad. I know we are meant to be concerned about childhood obesity but neither of my boys sits still and Little Bear has a six pack to be jealous of. I think he can eat a slice of cake now and again without any of us getting too concerned.

Anyway, menu-related rant aside, I am mainly concerned about Little Bear’s wellbeing and him pushing his friends about and trying to shove crisps into his ears could well be due to hangry-ness. Little Bear not eating his lunch could well be a disaster and could easily lead to an escalation in his behaviour. I am trying to keep a close check on whether he is eating at school, though it is proving difficult as, according to him, yesterday’s lunch was soup and porridge which even by the new menu’s standard seems unlikely.

I know change is unavoidable but on this occasion I really wish they’d left things well alone. For our children, those who have been through enough already, small things can be big things and medium-sized things like not having your trusted adult or being expected to survive a day without carbs can be enough to upset their wagons completely. Here’s hoping this is just a small bump in the road and not the next dip on the rollercoaster.

Unwanted Changes