Adopted Children & Eating Issues

A really interesting chat broke out on Twitter earlier this week between several adopters. It was one of those chats where you realise that all your children do something that hitherto you didn’t really identify as being an ‘adoption thing’ but actually, now everyone is doing it, it must be. The thing we were talking about was eating. We have quite a few behavioural issues around food here but this chat was more about the mechanical side of things: disruptions to the process of taking a bite of food, chewing it and swallowing it. The chat really began around children holding food in their mouths for much longer than average, something which seems to be common in many adoptive households. We also noticed that many of our children overstuff their mouths and choke more often than you’d expect.

The big question was why? We had a healthy debate and several of us stuck our oar in. As with most complex issues my first reaction was to blog it out so here is my summary of the main factors:

The reason for holding food in their mouth could be a sensory one. It could be that a child is under-sensitive to sensory information in their mouth and can’t ‘feel’ the food there very easily. If this is the case it is likely they would be better at eating/chewing/swallowing food which has a more extreme taste or texture or temperature. Spicy foods or those with a lot of crunch or those which are sharp or bitter will provide the mouth with more sensory information than bland foods, helping a child to ‘know’ it’s in their mouth. The difficulty here of course, is that you child will have their own taste preferences and these will influence the range of food they will eat. I think this category could apply to Little Bear but he really doesn’t like spicy foods. He does like a good crunch though, especially from a crisp, but won’t tolerate it from a raw carrot. He has no difficulty dispensing with cold ice cream!

The converse of this point could also be true: some children are over-sensitive to sensory information in their mouth. These children are often sensitive to different textures finding some pretty disgusting. It’s possible that these children hold food in their mouths because it is preferable to them than swallowing it. Other signs of this could be spitting food out or an active gag reflex.

Often children need to get used to a bigger range of textures before being asked to eat the consistencies of food that bother them. Because of how the sensory system is wired, the next best place after the mouth to explore texture is with the hands (and if they can’t manage this, then with the feet). In typical development, young infants naturally put their hands in their food and explore it. This is an essential developmental step and some older children need support to revisit it to help with eating issues. Sometimes the foods they struggle to tolerate can be played with and explored manually before them being brought close to the lips then perhaps just touching them with their tongue tip. This should be a gradual process (weeks not hours) and needs to be managed sensitively. It should be done with a child, not to them. You can also lessen sensitivity through general tactile work – exploring different materials etc. It doesn’t necessarily have to be done with food though that does work well.

I suspect there is a third sensory category when it comes to eating which would be ‘sensory seeking’. I don’t think you would see food being held in the mouth with this aetiology but you might see over-stuffing as a child tries to get the most sensory input they can. I think you would see a constant need to eat and perhaps wanting to eat stronger flavours/ more extreme textures/ more extreme temperatures. It wouldn’t be a huge leap to think that children who seek oral sensory input would also chew/suck non-food items, though I think it is possible to seek oral stimulation without the food side of things.

However, there are other possible issues at play. What about experience? As most of our children were not with us when they were babies, we have very little information about their weaning. We don’t know if they were allowed to experience the getting messy-putting-their-hands-in-their-food stage. We don’t know what range of tastes they were given or even if the types of food they were weaned on were appropriate for an infant. We don’t know whether that may have led to sensitivities and a greater likelihood of gagging. We don’t know whether they went hungry or whether they were force-fed. All these options could cause potential eating issues now.

We do know though that tastes develop based on experience – the more times you try a food, the more likely you are to like it. We also know that there are ‘windows of opportunity’ within the weaning phase and if children are not exposed to tastes at these points, the window can close.

I strongly suspect that Little Bear hadn’t tried a wide range of foods before he came home. He certainly wasn’t too familiar with vegetables. If children haven’t been exposed to many different tastes and textures, they won’t eat a wide range. Things that are new to them will seem alien and it is likely their first reaction will be of dislike. They are likely to pass these foods around their mouth/ spit them out etc.

Research suggests that rather than assuming they definitely don’t like that food, we should keep offering it to them. Obviously you have to be extremely careful with making children eat foods they don’t want so this is pretty tricky. We used to do a lot of hiding vegetables – in sauces or soups and Little Bear happily took them that way. I also used a bit of good old bribery (some of you won’t like this) e.g. you can have pudding when you’ve tried one bite of x/y/z vegetable. We’ve had good success with this and I’m really proud of the range of vegetables Little Bear will choose to eat now.

The other aspect of experience that is important is that our muscles develop alongside the foods we eat. If we just eat sloppy or dissolvable textures all the time, our chewing muscles won’t develop. Many children who have experienced neglect have low muscle tone in general. Some have such low tone that their face can appear droopy and they need specific stimulation of those muscles to improve the tone, often completely altering their appearance.

I suspect that Little Bear was mainly given a mushy diet in foster care and didn’t experience a range of textures like fish or meat. I have noticed that he is more likely to hold chewier items in his mouth and this could be because his muscles are underdeveloped and chewing is actually really hard work for him. I chatted this through with a friend who is experienced in children’s eating and drinking difficulties a while ago and she suggested building texture up gradually. You can’t expect a child to go from eating Weetabix one week to steak the next. There needs to be a gradual build-up of chewiness. I think this has led to an improvement here. Little Bear will now happily polish off a range of fish, sausages, bacon or chicken (if it’s soft enough). He will eat beef but it is still noticeably effortful for him, it stays in his mouth a long time and can result in it being spat out.

My friend also pointed out that if you aren’t experienced in chewing (or sometimes this just happens randomly) you don’t develop the side to side movements of your tongue that you need to push food from one side to the other as part of the chewing process. She said you can develop this outside of eating by playing games that involve trying to touch a specific item in a specific place with your tongue or just the teeth on one side. I used to add a little game onto the end of tooth-brushing involving Little Bear playing ‘tag’ with his tongue and the brush.

Although I don’t want to get into the behavioural side of things too much, it is also pertinent to consider a child’s general presentation. Do they have difficulties with attention control and concentration in general? Little Bear does. Could it be that he gets distracted mid-chew and forgets he has food in his mouth? I do tend to give him frequent prompts and reminders to keep chewing. I also need to remind him that his mouth is full so he shouldn’t put the next mouthful in yet.

So far, that is quite a lot of possible factors that could be affecting our children’s eating. However, I haven’t really mentioned swallowing/choking and the factors above don’t really explain why some children who were removed from neglectful situations very early or even at birth still go on to have these types of difficulties. Could something be going on in utero?

It’s certainly possible because the bit of the brain that is most developed when a baby is born is the brainstem. This is also the bit that controls basic functions such as eating and drinking. The cortex and higher brain regions mostly develop after birth and are consequently very susceptible to environmental damage such as lack of stimulation. Because the brainstem develops during pregnancy, one assumes it is more susceptible to damage from things that happen in utero than any other bit of the brain. We know that recreational drugs, including nicotine and caffeine, as well as alcohol and stress hormones such as cortisol cross the placenta and impact an un-born baby. I have struggled to find specific research about particular pollutants affecting the eating and drinking areas of the brain but it isn’t a huge leap to imagine it’s possible. Is there something different about the structure or connections in our children’s brains that lead to the types of mechanical eating difficulties we are seeing? Perhaps.

At these points I like to reassure myself with the concept of brain plasticity – the ability the brain has to build new connections and new pathways; to learn to do things it couldn’t do before. I read that the brainstem is less plastic than the cortex but it is still capable of plasticity. Maybe change in the areas it controls is more difficult to achieve and may take longer but I like to think it’s possible.

It seems our random Twitter chat has led us unwittingly into a fairly complex area. My feeling is that this little corner of behaviour is under-researched and I suspect I have raised more questions than answers. If anybody knows of any articles that could tell us more, please send them my way. In the meantime this one was sent to me and I think it’s well worth a read: Article about the impact of trauma on the developing brain

 

 

 

*I probably need to point out that all children are different and will all have been impacted in different ways and to greater or lesser extents by their experiences to date. The reasons given here are just some of the possible reasons and may or may not apply to your child. They are also my personal thoughts and based on my reading only.

 

 

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Adopted Children & Eating Issues

Re-visiting the CPR

Last week Little Bear was really struggling. We’d had a lovely first 4 or 5 weeks of the summer holiday and then suddenly there was a sea-change. Little Bear was just so angry. He could barely contain himself. A request like ‘please tidy the game away’ led to ten minutes of growling, gritted teeth and very elaborate deep breathing. He hated me several times per day and called me an ‘idiot’ countless times. It was obvious something was the matter but it was difficult to say what. With it being a week or so before school starting again I assumed it was anxiety for that.

On the Friday, Big Bear was busy doing something else so Little Bear and I had a day out on our own. It was one of those trips where I wasn’t really feeling it because I knew it could be a really difficult day and sitting around watching TV seemed quite a lot more appealing. However, having now been Little Bear’s mum for three years, I also knew that he needed that day out. He needed me to show him that I still really loved him and wanted to be with him, of my own choosing, despite him having a rotten week and being less than pleasant to me. I took a deep breath, reminded myself there were only a few more days before I got Five Minutes Peace and off we went.

We didn’t get off to a brilliant start because the road we usually use was shut so I had to turn around and go another way. In his fragile state this really bothered Little Bear. He announced the day was ruined and we should just go home. He protested all the way there that we now had to drive on a motorway and he hated motorways. Apparently it was the worst day ever.

However, once we were there, we had fun. We played at the park and because there was only he and I, it was easy to trail him and just follow him wherever he fancied going. We saw animals, went on a little train, had a go on an inflatable slide. We’d brought a picnic and I was surprised that Little Bear wasn’t in a hurry to eat and go. He wanted to hang out on the rug for a while so he played on my phone and we snuggled. It was lovely and I guiltily thought about my feelings from before we came out. We had ice cream and painted some pottery.

When Little Bear got tired we headed for home. Then, boom! In the car: an unexpected life story chat. A big one this time. Could this have been behind his behaviour all week?

Little Bear was thinking in particular about his birth siblings whom we only have annual Letterbox contact with. We have talked about them before and looked at their pictures but then months go by and Little Bear doesn’t say anything and I wonder whether he has remembered any of the chats. Well, he has. He’s remembered everything and I suspect he ruminates on it all a lot more than he lets on.

He told me he had been dreaming about them which is interesting because I recently read that our pre-verbal memories can appear in our dreams. He told me he misses them and got tearful. It was hard trying to explain why he can’t see them. I told him about Letterbox for the first time though and I think this year he will be able to get involved.

I was hit with a realisation: we might need to explore changing our contact agreements going forwards. It isn’t really ok that he can’t see his siblings, is it? To some extent we have been able to pretend they don’t exist – out of sight out of mind. Little Bear has previously not mentioned them or shown any understanding of who they are so that seemed ok. Although, really, it isn’t ok. They are his siblings. They do exist and now he has a sense that they should be together.

I feel it’s imperative that we listen to him and that, if necessary, we are willing to challenge current arrangements. The message from adult adoptees is loud and clear: listen to us, do not deny us our roots. I think for us to be the best parents to Little Bear we can be, we need to be willing to listen to what he wants, even if it is difficult or inconvenient for us.

Grizzly and I had a big chat later on. It would be easy to react immediately and to try to set the ball rolling. However, there are many things that need to be considered. Allowing direct contact with Little Bear’s siblings could risk leading their birth parents right to us. At the moment, being anonymous and in an unknown location feels important. What could be the possible consequences of taking that risk? It’s hard to say and near impossible to predict with the information we have.

Also, it is very difficult to communicate the difference between an idea and the reality of a situation to a 6 year old. Meeting the siblings would be a huge deal. I know he sort of remembers them but they would essentially be strangers and it could be extremely overwhelming for him. At this stage he wouldn’t be able to tell you which name went with which person. Perhaps a bit more of a connection needs to be built first.

For now we are going to hold the nugget of the idea in mind. We’ll involve Little Bear in Letterbox and, happily, we’ll be able to give him the reply this time. I think we’ll see how that goes before we jump in any further.

That was only part of the big conversation though. The enormous question of ‘why did my birth mum want to give me away?’ reared its head for the first time. I explained she hadn’t wanted to and how it all works. I very quickly exhausted the basic narrative that has covered his questions so far: your birth parents weren’t good at looking after children. Then I had another realisation: if he asked me more questions about details of exactly what happened I might not be able to answer them very well. My memory of the details (beyond the content of his Life Story Book) was fuzzy to say the least. If anything, I’m guilty of creating some sort of weird rose-tinted view of his birth parents. I have them painted as a victim of their circumstances and that they hadn’t actively done much wrong. I had even got to the point of wondering why the children had been removed when they were trying their best.

My strange little internal view of them was at odds with what I know about how child protection services work. It didn’t stack up. So I realised I had better go back to the paperwork and refresh my memory of the details of what really happened.

So that’s how Grizzly and I ended up sitting here, in our pyjamas, on a Friday night, when most people are out-out or watching Netflix, pouring over Little Bear’s CPR (Child Permanence Report – the lengthy report you are given about your adoptive child that gives the full history of how they ended up in Care).

It was much worse than I remembered.

I haven’t read it for more than 3 years and when I read it last time, I hadn’t even met Little Bear. I suspect that what I looked for in it was quite different to my current viewpoint. Then, I was alert to how many times he’d moved, what things had specifically happened to him, whether mum used drugs or alcohol. I suppose I was looking for red flags. I probably didn’t pay too much attention to the bits about his siblings because they weren’t going to be adopted. Because Little Bear was the youngest, there wasn’t a lot about him specifically in the report. However, now that I’m reading a report about my youngest son, not a child I haven’t met yet, I’m attuned to other clues. This time, I wanted to get an idea of his birth parents (an accurate one) and what the home environment was really like. I needed to know about the reality of their day to day lives. Who are these people? How do they tick? What were the risks back then? What are the risks likely to be now?

The picture I now have of them is much less rosy, let’s just say that.

This time I paid much more attention to the siblings – what had they been through, how were they likely to be coping now? The thing is that they aren’t just random children who don’t matter to us; they are our son’s siblings. They do matter. In fact, the journey of one in particular is hard to read and it was the bits about them at which I cried, not any of the bits about Little Bear.

I don’t think the birth parents can really change to any dramatic degree. I don’t think they have the capacity to change the things that would make a difference. Things for the siblings though are very much subject to change. A lot is going to depend on the care and guidance they have now. They could be a product of their earlier childhoods or they may have been able to overcome that early adversity. They could gravitate back to birth parents or take their lives on a completely opposing course. We don’t know. I don’t know if we’ll ever know but if we go down the route of increasing contact, we’ll need to ask some questions. There is certainly a fine balance between giving your child access to their past and keeping them safe in the present and future.

For the first time I feel the weight of responsibility of being a custodian of Little Bear’s story. The choices we make now and the things we do or don’t do could have a huge impact on how Little Bear will feel about being adopted in the future. I read so much about adoptees feeling marginalised and misunderstood that obviously I want to avoid the mistakes they feel were made for them. At the same time, I feel the pain of their adopters who no doubt wracked their brains and their hearts, as we do, trying their best to figure out what the right decisions are.

 

*I have absolutely no idea how I managed to create a rose-tinted view of LB’s birth parents. Perhaps it was subconsciously more palatable? Either way, I can highly recommend revisiting the CPR at moments of doubt, even if I was haunted by some of the information for a couple of days afterwards.

 

Re-visiting the CPR

Five Minutes Peace

I think I might need to preface this blog by saying that I really love my bears. You know I do. It’s just that I might well have reached the point in the holidays where I’m kind of ready for them to go back to school…

I started off, pre-holidays, super-keen and excited to have some quality time with them. The first two weeks were far easier than I could have asked for and we had fun doing all our craft projects, chilling at home, going out for ice cream etc. Grizzly was off for the second two weeks and we went away for one of them. We had some lovely family time and both boys have spent days with just me and just Grizzly. Mummy Days and Daddy Days. All good.

I wasn’t even too worried about weeks five and six because I still had some activities up my sleeve, some days out planned and we were feeling all loved up. How hard could it be?

Err…

I think it’s the noise more than anything.

Mum! Mum! Mum! MUM! MUUUUMMMM!!!

Mum!

Dad?

Thump, thump, thump from the foot against the floor/ the sofa/ the wall. Ting, ting, ting, ting, ting on the bell from the Pit game that we’ve become obsessed with. Bang, crash, wallop from the bowl falling out the cupboard and the thing being launched across the room.

Penis. Penis face. Willy. Boobs. Boooooobies! Because, err, boys?!

The sound of my voice for the gazillionth time saying, “I don’t want to hear any rude words. Please stop saying ‘penis’.”

A barking noise. A horse noise. A wolf noise. A zombie noise.

A really loud, indescribable, vowel hooty type of thing.

The very worst: Little Bear has found a whistle.

Mum!!!! Mum? MUUUUMMM!!!

Growling (so pleased that one has re-appeared) and screaming. Muttering (and sometimes yelling) ‘imbecile’, ‘idiot’ and ‘I hate you mum, you’re really annoying me!’

As one assumes that countering with, “For the love of God, put a sock in it” is not good parenting, I am finding that I’m spending more and more time hiding in the bathroom and thinking up trips out that allow me to engineer five minutes peace. It’s like the book of that name and I’m really feeling for Mrs Large right now. And just like in the book, when you hide in the toilet, they find you and sit directly outside, incessantly talking. That’s if you’re lucky. If not, the smallest one barges right in and hops on your knee. The noise is inescapable.

I think now, towards the end of week 6, my brain is starting to protest. Its saying, ‘this assault on your auditory sense is too much. It’s a bombardment. Move away. Seek shelter’. Yesterday and today I have taken them to park-type places where they have begged and nagged and attempted to bully me into playing with them. Part of me has felt bad (because at the start of the holidays I was so well-intentioned I said yes to everything) but now I’m getting a little claustrophobic and just need them to leave me alone for half an hour. Most other parents I see are sitting on benches while their children run around; why can’t I? There is a long answer to that question involving attachment-needing behaviour and yada-yada but I’m asking rhetorically. Nay, I’m begging, for just five minutes peace.

In my meanness over the past two days I have ushered them off to play, amidst a few protestations (Big Bear thinks he’s too cool for parks and Little Bear can’t possibly play without me) which I have ignored for my own sanity. I have noticed that when I’ve sat back, it has taken them maybe 10 minutes to settle into the play and then they’ve inevitably made a friend or agreed to play together and actually they are having a perfectly lovely time. Today I should have been enjoying my cup of tea while they tried to build a den out of those polystyrene sheets that are meant to fit together but they couldn’t figure it out and I kept getting the guilts that I wasn’t jumping up to help them. I had a stern word with myself that this was a good chance for them to do some problem-solving and if I didn’t just sit there quietly staring into space for a while, it would not be cheerful mummy who would be looking after them for the rest of the day. It would rageful mummy who cannot deal with all the noise and who has got quite overstimulated and just needs FIVE MINUTES PEACE!

So sit back I did and eventually Big Bear built a pyramid den encasing his brother inside which seemed to suit everybody.

Phew. The holidays are quite intense. I’ve said it before but I have no idea how people manage to home-school their children. It would be like this all the time. All. The. Time. I don’t think my brain could take it.

It is probably a good job that there are only 4 more days to go. No doubt they’ll go back to school and I’ll fill my poor brain with worry over how Little Bear is coping in the next class and also with the fact that I’m missing them and don’t quite know what to do with myself. I’ll probably think it’s too quiet and turn the radio on.

I have to admit that I’m looking forward to some alone time. Some walks and some writing. Some time when I can hear my thoughts. No cacophony. No obscenities being chanted. Five minutes peace.

Five Minutes Peace

Prep Groups

Our lovely voluntary adoption agency has now asked me several times to come along to prep groups to speak to prospective adopters. I like doing it and I went again last week. I have since been reflecting on the role of visiting adopters in prep groups and the things which are said and unsaid.

I think my appearances at such things total 5 or 6 now, over a 3 year period. Each time I’ve been I think I’ve probably told a slightly different story. I haven’t changed any facts but I’ve naturally talked about different things depending on the point we were at in our journey, things that were happening around the time of my visit or how I was feeling on the given day. I’m not quite sure how I managed to speak at them at all, the first time I did it, as it was only a couple of months into our adoption and certainly during the bit I now refer back to as ‘The Bad Bit’. I can see myself in my mind’s eye, sitting in front of those strangers, trying to be strong, for them as well as me, and I’d like to go back and give myself a hug. It was hard to do but I felt it was important.

I don’t find it hard now really. I tend to get emotional when I talk about Little Bear’s progress and how far things have come, rather than when I talk about the hard bits. Because I do talk about the hard bits. I have worried that my Agency will add me to some sort of black list after one of my visits as I’m so graphic with the truth. However, as I’ve got braver and more knowledgeable, I now feel that if a group of prospective adopters can’t handle our story in all its murky glory, they are perhaps not cut out for adoption. Our story is by no means the scariest you will hear but I have certainly seen fear in people’s eyes when I’ve been telling it. Obviously I don’t set out to instil fear; I would never purposefully scare anyone. However, I don’t see my role as treating people with kid-gloves either. Prospective adopters need to know the truth. They need to know what real adoptive families are like and that includes hearing the less palatable details of some of the challenges we face.

I try to give a balanced narrative. After all, I think our adoptive family is pretty awesome and the highs have been more than we could have asked for. In the most part we are very happy. But we have had some really hard times, we have been challenged to our core and felt a desperation you would never associate with parenthood. Prospective adopters need to know that this ain’t no fairy tale. I can’t have them going home thinking you pick the perfect child, they move in, no one looks back and you all skip away into the sunset. That would be doing a great injustice to them and their future children.

I know that listening to one adopter probably won’t make great shifts in a person’s thinking and people will hear what they want to hear to some extent anyway but I hand them my truth, because I think I have a responsibility to do so, and it is up to them how they use it.

There are a few key points that I would want to make to any prospective adopter and I suppose I may not have been consistent in doing so when I’ve popped up at the groups because of how the questioning has gone or what has been on my mind at the time. These are things that are not necessarily covered as a matter of course in the groups but I think are important for people to hear:

Firstly, you might not love your child straight away. I think it can be easy to assume you will, because the stars have brought you together in the matching process and you suspect everything happens for a reason. You may well be meant for each other but, honestly, it can take time to feel that. When you have been through a lengthy matching process and you are nervous and excited about finally meeting your child, not feeling that love can really throw you off course emotionally. Guilt, doubt, it all creeps in. I always try to remember to say to prospective adopters that it doesn’t matter if that love isn’t there at the start, or even after a few days or weeks. I think it took months for us. It is normal not to fall in love with a child you’ve just met. They are a stranger and it is ok if it feels that way for a while. Don’t beat yourselves up about it, love will come.

The second thing I try to tell people is difficult to discuss in a different way. It’s about money. Our experience was that adoption is costly. We were extremely fortunate that it wasn’t a precluding factor but at the time, we kept thinking about people on low-incomes and certainly felt it would have been unaffordable for some. I’m aware that people’s experiences are very different depending on where they adopt or where their children are in foster care and some areas seem more able/ willing to reimburse costs than others. Our experience was of clocking up hundreds of miles in the car driving back and to meetings, panels etc. including crossing a toll bridge. We did get those costs reimbursed in the end but we were out of pocket for a good 6 months. We also paid for our own accommodation as introductions were several hours from home. Whilst away, we obviously had to eat and go on days out etc. to keep two small children busy (all a little more difficult when you don’t have your own home to use) which added up cost-wise. We weren’t offered any sort of living allowance (I know some places do offer it) and we didn’t get a settling-in grant for car seats/ bed/any essential equipment we needed for Little Bear. The total costs were greater than you might anticipate and the LA wouldn’t cover anything more than petrol. There isn’t much that can be done about this (despite the rights or wrongs) but I think prospective adopters should be aware so they can ask the relevant questions and consider the practicalities.

I guess the third thing I try to get across is that in adoption, nothing is solved quickly. I am a great believer that children can and do recover from trauma but that recovery doesn’t happen the moment a child steps over the threshold. It doesn’t happen if you deny the trauma exists or if you attempt to forget the past. Helping a child to recover from trauma is a lengthy, challenging process, which requires a high level of perseverance. It takes years, not days or weeks. Adoption is a long game and you need to go into it prepared to work really, really hard.

If I haven’t made people run screaming from the room with all that, plus tales of violence and developmental delay, I feel they deserve the reward of hearing some positivity. That’s the point at which I get a bit choked up and oogey-gooey. I know that one of these times, the dam will break and I will weep in a room full of increasingly terrified people but none of us wants that.

My final point is around questions. When I’ve finished talking in a slightly uncomfortable monologue, people really need to ask some questions. Not just because it’s pretty awkward for me if I bare my soul and the entire group reacts with silence but because if you are going through adoption assessment, you should have at least one question. In my opinion, you should have a gazillion and one questions. Adoption is a huge, life-altering decision. I have no idea how you could be faced with all that reality and not be able to form one question. When I go along to the groups, it is with the intention of answering any question as honestly as I can. I don’t mind at all if people ask me so many questions I have to stay longer than planned. Questions are good. Some people may never have met another adopter before; they should bleed me dry of information. They should ask any obscure or difficult or mundane questions they might have. I honestly think that any adopter who has agreed to go along to prep groups would be ok with being asked all the questions.

Last week was a brilliant group. They were really engaged and asked many, many questions and it felt like it boded well for their future. Once, a while ago, I finished my awkward monologue and nobody spoke. Not one person. I invited questions, made a joke of the silence but not. One. Person. Spoke. The Social Workers did, obviously, but none of the prospective adopters. I thought it was me and my story and to be honest, I didn’t agree to do prep groups again for a while after that. There was no satisfaction in it at all and I went home feeling worse than when I’d gone, which is not something you hope for in a voluntary role. So, please, if you are a prospective adopter and an experienced adopter comes to speak to you at prep groups, please speak with them. Drum up at least one question. Do it out of courtesy for them but do it for yourself too. Prep groups are part of the assessment process and the Social Workers will be observing. Plus, surely there is just loads of stuff you want to know?

The funny thing is, is that despite all my honesty and re-living all our dramas for the prospective adopters, I still get really excited for them too. All the hopes and dreams of their future lives with their future children are infectious. I remember it so well and despite everything, I’d do it all again to get my Little Bear.

 

Prep Groups

Reflections on Adoption Three Years In

Wow. I honestly don’t know how we’ve got here already. How can it be three whole years since Little Bear whizzed into our lives? The last year has flown quicker than any other but in some ways it feels as though Little Bear has been here forever.

At each of our anniversaries I have written a blog post reflecting on how the year has gone and how my thoughts and feelings on our adoption journey have changed over time. You can read the first two here: Reflections on Adoption One Year In

Reflections on Adoption 2 Years In

For some reason, this year’s feels a bit harder to write. I think it might be because everything is feeling pretty (dare I say it?) normal… I guess that expecting the odd challenge is now woven into our everyday so it is only larger hurdles that feel noteworthy. They come and they go. We can have weeks, months even, of relative peace these days then we hit a rough patch, like we did towards the end of term and things get a bit trickier for a while. I suppose we still have the peaks and troughs pattern that we probably had last year, only now the peaks are bigger and the troughs a little shallower.

With it being our ‘famiversary’ (a term I have shamelessly pilfered from a fellow Tweeter) our minds have naturally turned to reflection. Today I have also been to speak at prep groups for prospective adopters so of course I have once again cast my mind back to the early days of our adoption in order to tell them our story. All this thinking has proved bitter-sweet. The beginning of our adoption story is not a happy one. I would describe the Introductions process onwards, incorporating the first 6 months or so, as one gigantic trough. A crater, if you like, so deep and barren and challenging that we spent quite a lot of time wondering how to get out. The good news is that it has been an upwards trajectory ever since, peaks and troughs notwithstanding. But it is sad for all of us that we had to begin in that place.

The level of challenge at the time was such that I couldn’t always separate my exhaustion and desperation from the little person seemingly causing them. Time, as people so often tell you, has given me distance and clarity and now when I look back, I am so sad for the scared little bundle that arrived on our doorstep, his bag, containing all his life’s belongings, bigger than he was. The bag contained mainly clothes and nice ones at that. It contained some toys, but a smaller range than you might imagine for a child of 3 and a half. There wasn’t a book in sight.

Little Bear himself was tiny, his head fitting in my hand like a baby’s would. When I look back at photos of him he looks much younger than he was. He also looks ridiculously cute to the point where it surprises me. I suspect the reason for that is because his behaviour was anything but cute and my memories of him are of a much bigger, stronger, angrier, harder boy. It’s funny how your memory plays such tricks. It’s funny, but it isn’t amusing. How awful that I couldn’t see that vulnerable tininess at the time.

The other unpalatable fact is that Little Bear was meeting his developmental milestones when he entered foster care yet was more than 2 years behind age expectations when we met him, some 2 and a bit years later. He wasn’t toilet trained, couldn’t walk safely without reins, used a high chair, had a bottle at bed and couldn’t make himself understood to us, his new family. He couldn’t count, didn’t know his colours, his own name or have words for everyday things such as the tele. He was due to start school in one year’s time. I wrote about my feelings on some of this in Developmental Delay

Little Bear’s tongue had a very unusual cracked appearance and he took medication for constipation. He was dehydrated.

Most of the time these days I suppose I don’t think about all of this but when I do, I vacillate between fury and heartbreak. My gorgeous little boy was trapped inside of himself; his potential all but wasted. I’d go back in time if I could, bring him home sooner. Of course that was never a possibility, but you can’t help wondering how things could have been for him; how much farther ahead he would be; how much angst and frustration and rage could have been saved.

As if that wasn’t tricky enough, we were expecting the other boy, the one from the paperwork. He had Little Bear’s name and picture but the description and the behaviour of the fictitious on-paper-child and the realities of the in-the-flesh one were something of a contrast. We were completely unprepared for the prospect of violence and aggression coming into our home, especially as we had specifically stated we couldn’t cope with it. We may not have been quite so over-faced by Little Bear’s behaviour, had we have known about it in advance.

The facts of the start of our adoption are thus: a little boy, who was completely lost and terrified but who had no way of verbalising his scary thoughts landed in our house. He didn’t appear to be anything like the child we had agreed to adopt which was somewhat terrifying for us (understatement of the century). To say things were touch and go for some months would be accurate. Was it ‘love at first sight’ and did he feel like ‘the one’? Well, I think you know the answers.

Yet here we are, three years on and I can tell you, unequivocally, that I love him like I’ve given birth to him. It’s hard to summarise how we got from there to here; you’d have to read my blog in its entirety, but we have. I look at my tall, muscly boy who is so strong but not at all aggressive, and it’s hard for me to compute that he is the same one who came home. He’s loving, can be polite (!), hilariously funny and so sharp. To his credit he has worked his tiny backside off, all the while creeping closer to age-expectations. Not only can he count but he’s learning his times tables. He can read, write and do a whole myriad of other impressive things. He’s an extremely well-behaved and considerate little brother.

It is impossible to imagine that there could have been another child out there who could have been a better match for our family. I questioned the match. Many times. I questioned it most often at 4am when I just got back into bed after 3 hours of providing middle of the night ‘supervision’ and was too exhausted to sleep and couldn’t face the day ahead. For a long time the match seemed questionable. But it isn’t. The match is perfect. Little Bear is The One. He feels like he’s my son, just in the same way that Big Bear feels like he’s my son.

Adoption is such a strange thing. What an abnormal way of gaining a child! Yet, I’ve struggled to pick things apart this year because our life feels so normal. All that stuff at the beginning of our relationship is getting less and less relevant. This is us. A family. Mum, Dad and two boys.

Someone asked me today if Little Bear identifies as being adopted, first and foremost and how you manage to truly integrate a child who isn’t genetically yours. I think they were worried that talking too much about adoption could make their child feel less theirs and were wondering whether just not mentioning it might work better. I’m not sure that I managed to articulate my answer properly because it is a tricky concept to get across. What I tried to say was that Little Bear is very much my son. I don’t think he could feel more like he is. It isn’t physically possible. He is one quarter of this family, just the same as each of us are. He doesn’t get a smaller proportion because he’s adopted. We are each an equal member. We have a strong sense of family unity and I would say he identifies as a Bear. He identifies as mine and Grizzly’s child and as Big Bear’s brother. He identifies as a grandchild to our parents and a nephew to my brother. However, I know that he does also identify as adopted, because he is. There was some sort of incident in school recently where another adoptee in Little Bear’s class got upset about being adopted. Little Bear stood up, in a show of unity and said, “I’m adopted too”. I can totally picture it and it looks like Spartacus every time.

My point is that a child can be fully integrated, a true member of a family and still be adopted. The two are not mutually exclusive. I think to fail to acknowledge his background would be a huge disservice to him. I can see how acknowledging your child had a life before you could be a threatening concept for a new adopter but it needn’t be a threat. I know the concept of a child being yours and someone else’s feels like it could be uncomfortable, like there wouldn’t be enough room for everyone, but there is. Love is a funny thing. It’s pretty stretchy.

Someone else gave birth to my son and he felt like a stranger when I met him. But love came and it grew. It grew so much that parenting him now feels like the most natural thing in the world. He’s my son and while we definitely do acknowledge he came here through adoption, it doesn’t matter. I really do think much more value is placed on genetics than is necessary or relevant. Three years have sealed the bonds, strengthened the attachments and mercifully, made everything feel really normal.

 

 

 

Reflections on Adoption Three Years In

Play

The other day I noticed both Bears playing together in a way I hadn’t observed before. Little Bear had built a new Lego set, an air ambulance, and had somehow managed to convince his brother to play with him. Not only that but he had convinced him to include his new Lego set, a superhero ship with Ant Man in it, and the two of them were caught up in some sort of imaginary world that involved Lego men living in an Egyptian sarcophagus, daring rescues and the occasional mention of a ninja. The game moved around the house, obviously, because helicopters and spaceships do fly and baddies will insist upon moving their lairs.

It felt noteworthy for a couple of reasons. Big Bear has hitherto been very cautious about his possessions around Little Bear, generally keeping new or precious things safely stowed in his bedroom with its securely lockable door. There are now days when he leaves the door open (a MUCH bigger deal than you would imagine and one we are pretending not to have noticed for fear he will shut it again) and days when he is more relaxed about his stuff. The fact that he had just built something new and was willing to play with it in the same game as Little Bear really showed how far the Bears have come in terms of trust and respect for one another.

I wondered why they hadn’t played similar games before with Little Bear’s toys (he’s only too happy to share with his brother) but realised it was because until very recently, this year anyway, Little Bear couldn’t have played those games. He wouldn’t have been able to follow the storyline or formulate appropriate dialogue to be able to join in, however much he might have wanted to. The leaps he has made (and continues to make) with his language development have unlocked a whole new world for him in terms of imaginary play. Not only that, but his ability to concentrate and to engage in more complex games has really developed too.

It has got me reflecting about play in general and the changes we have seen over the nearly three years Little Bear has been with us. I’m going to talk about play in developmental stages. There are various ways play development can be categorised but I’m thinking mainly about symbolic play/ imaginative play rather than social play. There are several different terms for each of the stages that can be found in literature on the subject but this is the version I personally find the most useful.

Exploratory play

This is the first stage of play to develop (in typical development) when infants pick things up, drop them, chew on them, throw them, bang them together. Children are exploring tastes, textures, weights, sounds, wetness/dryness etc. They tend to be fascinated by anything and everything, not necessarily things you traditionally consider to be toys. It’s their first attempts at engaging with the world around them and they want to experience everything.

I suspect that many children who have adverse starts in life don’t have enough experience at this stage. If you spend too long in a cot or pushchair or highchair without any stimuli, you won’t be able to explore the world around you in the way you should. Being neglected at this stage robs a child of the experience they need to assimilate their senses. It is hard to learn to differentiate between hard/soft, wet/dry, hot/cold, rough/gentle if you don’t have any experience of feeling/touching things. I suspect that many sensory integration needs have their root in neglect at this stage.

When we met Little Bear, aged 3 and a half, much of his free play happened at this level. We spent a lot of time splashing in water and digging in sand. I also spent a lot of time telling him not to throw things or touch things that I would have expected him to know not to touch. There is the time he tried to lick a snake, the time he played in the toilet water and the time he smashed all the hens’ newly laid eggs. I genuinely believe Little Bear was still trying to assimilate all the sensory information he was getting from his environment and can only assume he hadn’t had enough time exploring (safely) when he was younger.

I had to make conscious efforts to offer him plenty of opportunities to engage in tactile sensory activities whilst teaching him some boundaries to keep him safe.

Water, the sand pit, kinetic sand, play doh, baking, not concerning ourselves with cutlery and turning a blind eye to him laying down prostrate and ‘swimming’ in gravel were the key, alongside exposing Little Bear to a wide range of ‘normal’ play experiences.

Pretend play with real objects/ oneself

The next stage of play is when children begin to show an understanding of what everyday objects are used for e.g. they might pretend to drink from an empty cup or babble into a pretend phone.

The thing about children who have been neglected is that their development is pretty patchy and though Little Bear had gaps at the exploratory stage, he did know what everyday objects were for and could pretend in this way already. He was certainly partial to a phone, even though his language skills wouldn’t allow him to have much of a conversation.

Large doll play

It isn’t usually long before children begin to relate everyday objects to each other and to their other toys. This is when they start to ‘feed’ their teddies or get them dressed.

We are pretty partial to a teddies tea party in our house and I can remember Little Bear being a bit bewildered the first time we got plates and food out for his cuddly animals. He soon picked up the idea though, often dolling out real biscuits for the animals and taking the opportunity to have some himself.

I found this stage useful for modelling behaviours and exploring some of Little Bear’s behaviours in a less direct way. Sometimes I would make the animals do things he had done or that we were finding tricky and it was interesting to observe how he dealt with them (he often took the role of parent). We also did it in a way that took the heat off Little Bear. Sometimes it was his rabbit who had been shouting or throwing things or saying rude words and we would ask Little Bear to have a word with them and teach them how to be sensible. He loved this responsibility and getting the rabbit to behave often mysteriously led to improvements in Little Bear’s own behaviour.

I’m not sure whether the last paragraph is more about developing play or exploiting the stages of play but still. Occasionally it worked the other way and Little Bear would express a fear or a worry through the voice of his animals, which was useful too.

Sequences of pretend play

Over time children begin to put several bits of play together so they might play with their toy kitchen and act out making dinner, feeding it to their doll then washing up.

I would say we were working at this stage alongside the previous one and exploratory play when we first met Little Bear and for the first months afterwards. That is the thing with child development; it is often not neat and linear, but skills overlap and appear at different rates. I think that children who have had difficult starts are more likely to have a muddled developmental profile and I can honestly say we could go from working at a 6-12 month level in the morning to approx. a 3 year level in the afternoon then back to an 18 month level again. It was hard to keep up with but imperative to match Little Bear’s level as best we could. There is no point trying to work to chronological levels when your child needs something much different. Little Bear would not have been able to reach the places he has reached had we not filled in the gaps.

The main sequences of play we engaged in a lot involved Little Bear pretending to be a superhero. We did a lot of dressing up, building dens and pretending we were in peril. He seemed to love it and it was great for extending his world knowledge and vocabulary.

Small World Play

At this stage children transfer their play skills into miniature representatives of the types of games they have already been playing. They might start playing with a farm or Duplo or Playmobil and doing some basic pretending.

I know we weren’t ready to play at this level when Little Bear first arrived. I distinctly remember trying to introduce him to Duplo but he lost his temper within the first nanosecond because he couldn’t get the man to sit in the bus as he wanted. You would certainly expect a typically developing three year old to be able to play at this level but it would take months of exploratory play, building resilience and bigger, more physical play for us to be ready to try again.

I think it has been the development of Little Bear’s attention span and his resilience to persevere through knockbacks and failed attempts that has allowed him to engage in small world play and crucially, enjoy it. I find it uniquely pleasing to observe.

Little Bear has always had a good imagination, that was clear from day 1, but it is only at some point in this past year (he’s 6 now) that everything has come together to allow him to explore it in his play. Play stages and language development are very much aligned so it shouldn’t really be a surprise that it is the point at which he has gained linguistic competence that he has also developed complex play abilities.

Play develops from here on in, becoming more complex, with longer, more detailed scenarios panning out. The Lego game that I observed the boys playing at the start of this post epitomised the progress Little Bear has made – playing a small world game, with tiny fiddly pieces that require a heap of resilience, making up an imagined scenario, adding appropriate dialogue and crucially negotiating and listening to his brother so that they could both be in the same imagined place, at the same time, contributing to the same scenario. It is standard kid stuff on face value but it is so complex and requires so many pre-requisite skills that it really is a feat of development.

I should really give Lego its own special mention before I finish because we love Lego in our house and also because it alone is a good indicator of how Little Bear is doing.

Big Bear had a premature love for Lego, getting into it from age 2.5 and loving it ever since. Given Little Bear’s disordered/ delayed development he wasn’t going to get into it anywhere near as young. I think he was about 5 when he could first start to tolerate building a simple model with a high level of adult support. I remember worrying because he really struggled to scan the tray to find pieces he needed let alone being able to follow the instructions. As with everything, we have practised and persevered and Little Bear has developed his skills quickly (once he overcame the initially difficulty). This week he chose to spend his holiday money on a sizeable Lego model of a dragon. It has an 8-14 age recommendation and he has done brilliantly, followed the instructions well and built the majority of it himself with just a little adult support.

What are my conclusions? Well, Little Bear is something of a legend but that is often my conclusion. Play has played a crucial role in his development and is very much intertwined with language development. Play has to happen in developmental order. You can’t skip bits willy-nilly; whichever stage a child is at, that is where you need to meet them. Development doesn’t happen overnight; stages take as long as they take. Developmental delay is never hopeless. Progress can and does happen and we should be aspirational for our children, no matter their start in life.

 

 

 

 

 

 

Play

Talking is Crucial

We’ve had a flurry of activity here over the past week or so, with various people visiting us and several sleeping over at different points. Each person has come with their own story, most of which have made our day to day challenges pale into insignificance. Their stories are not mine to share of course, so I won’t, but reflecting on it all has left a few thoughts whirling about.

Firstly, talking is crucial. It is crucial in a very basic form: the form where it allows you to have your needs met. We know this as a family, having adopted Little Bear at a point when he couldn’t communicate well and there was more he couldn’t tell us than he could. We know it but sometimes a situation arises that reminds you. One of our guests was a family friend who happens to have learning difficulties. Her speech and language skills are very limited and even in the short time she stayed, we could see a snapshot of the challenges she faces every day. She couldn’t always tell us what she wanted to eat; she couldn’t tell us what she wanted to watch on TV; she couldn’t tell us why she did or didn’t want to do certain things. It must be incredibly frustrating, especially as she can understand much more than she can express (you can’t help but notice these things as a speech and language therapist and incidentally, be a little desperate to solve them).

I certainly feel as though life would be different for her were she able to say everything she is capable of, whether that was verbally or in another way. I also felt it must have been really scary for her, to come and stay somewhere she hadn’t stayed before, knowing she might not be able to get all her needs/ wants met. Imagine how vulnerable that would make you feel. I suppose some people might think that due to her learning difficulties she doesn’t think about these things but I know she knows her communication is different. I think she’s embarrassed about it and is certainly more reticent if there are a lot of people around or people she doesn’t know well. More words began to sneak out as she settled but there was still a huge disparity between the ones she comprehended and those she was able to verbalise at the point she wanted to say them.

I can’t help but think of the what-ifs. What if she’d had more/better speech and language therapy when she was younger? What if she did now? Is it too late? Is it ever too late? Should something alternative have been put in place? What should it be? Why wasn’t more offered? Did people think it was ok because of her learning needs? What if a young child presenting as she did when she was young was under speech and language therapy now? What potential would be seen in them? Would outcomes be different? I like to think so but given what we know of speech and language therapy services since Bercow10 (see Ensuring Children’s Speech and Language Needs Are Met: A Call to Action) I wonder…

Surely we should be striving for the most a person can do, whoever they are, instead of settling for the least we can get away with.

On another note, it was interesting to observe Little Bear with this person. Firstly it really highlighted the progress he has made with his communication. He is a competent communicator now; he can say everything he wants to say and mostly with clarity. It’s not to say that his speech and language skills are perfect, because they are not, but in general, if you popped him into a group of people he didn’t know well, he’d be ok communication-wise. I don’t mean to draw a comparison, because that’s wholly inappropriate, but the realisation that Little Bear has reached that point was a bit of a surprise. I worried for so long that he wouldn’t reach it that this little revelation is very welcome.

Along with this revelation came an uncomfortable truth. Little Bear is now able to use his communication skills for both positive and negative purposes and though he was mostly great with the lady I’m talking about, there was one point when he was tired and cottoned on to the fact that he was verbally wilier and could use his words to wind her up. It was weird to observe because I have seen it so many times directed towards Little Bear, from wilier peers. I tried to intervene to stop him as I could tell he was upsetting her but as he was on that trajectory where he couldn’t stop himself he carried on regardless and I decided to take him out of the situation and up to bed.

The incident had a weird, double-edged irony: I was sad to observe it and sad for the lady’s communicative limitations whilst being simultaneously disappointed that Little Bear would do it yet also noting it was indicative of his developmental progression. We talked afterwards about it and Little Bear could remember times when he wasn’t able to say what he wanted and times when he had to resort to other methods of getting his messages across, such as hitting out and I think he understood why he shouldn’t have exploited her communication difficulties as he had. He was sorry afterwards.

Although it feels like an important moment to reflect on, I don’t want to make it more significant than it was. Overall both boys were fabulous and just took all the issues of the past week in their stride. They are both very empathetic and I’m extremely proud of the kind, understanding, non-judgemental young men they are becoming.

At one point the lady I keep talking about gave Little Bear a bear hug that was a little squeezier than he might have liked. Initially he got a bit upset and took himself out of the room. When I went to him he started with the usual “I hate said person/ she hurt me/ she did it on purpose/ I hate her now” rhetoric but we had a little chat and I left him to calm down. The next thing I knew he was coming over to her, offering another hug but asking her to be more gentle. Again, I could see the progress he had made. Previously he wouldn’t have been able to put his communication skills to such good effect, would not have calmed so quickly and would have given said person a wide birth/cold shoulder for a lengthy period. I think the approach he took showed real maturity and I felt a glow of pride.

Our week also taught me that it is not just talking at the fundamental level of getting our most basic needs met that is crucial. Talking is also crucial to keeping us mentally well. Other guests we had were carrying other issues and when I say carrying them, I mean lugging about a massive sack of stress, hurt and grief wherever they go. The difference, I think, between that massive sack dragging you further down or you being able to get on with your life despite it, seems to be your ability to talk about it. The person who internalises or who does not have an available/ safe outlet for their worries and feelings is in danger. I know that sounds a little dramatic but I genuinely believe it’s true. There is a lot on social media at the moment about suicide prevention and all the statistics around the issue. It’s worrying.

Talking helps people take things out of their massive sack. Issues can become less, opinions can be sought, advice given, soothing words or hugs dispensed. Talking doesn’t make things go away but sometimes it can give perspective, space or a fresh view point. Things tend to multiply or expand or metastasise when left in the sack. Talking can curb things, keep them in check, prevent them taking on a life of their own.

On face value, one of our guests maybe seemed to have a lot of issues. They told me a lot of things. They seem to have a lot to worry about. However, I know that another of our guests, who said nothing, also has a huge sack of issues. It’s the one who said nothing that worries me. The one who talks spills the contents of their sack at regular opportunities and I’m glad they do. They have hard things to cope with but they’ll be ok. The other one, the one who doesn’t talk, I worry about them. I don’t know if they have that safe outlet, that trusted person, that someone who will just listen. I don’t know and I think their lack of being able to talk, even though they have the communication skills they need, is a red flag. I suspect it is not being viewed as such by people around them – they do not appear upset, they aren’t saying upset things ergo they must be fine.

Whilst talking is crucial, so is listening and both are required for mental wellness. I know many people who think they are good at listening but few who genuinely are. The best kind of listening is not just done with the ears; it is about observation, reading between the lines, hearing the unsaid. It is the ability, or maybe the willingness, to see beyond what is presented. I suppose it is about connection. I suspect not everyone thinks they have the time.

I also suspect that people don’t always think the same level of observation and alertness to emotional wellbeing is required for children; that somehow children are just fine. They aren’t and the ways they manage, or don’t manage, their feelings and worries and grief will follow them into adulthood and shape their future selves. This whole talking thing needs to start as soon as possible.

Sometimes I wonder if I’ve got too wrapped up in adoption and the issues it brings. None of the people who have been here this week are care-experienced. They are not adopted yet they have experienced trauma. I guess I’ve been reminded that we don’t know what sacks people might be lugging with them; these cumbersome burdens are often invisible. The emphasis is on us, as fellow human beings, to be alert, to look beyond appearances, to actively observe and skip the snap- judgements. Talking is crucial but so is hearing the unspoken.

It has been a funny old week.

 

 

 

Talking is Crucial