Reflections on Adoption 4 Years In

Every year since LB came home, I have written a reflective blog post to mark the anniversary of his arrival in our lives:

Reflections on Adoption One Year In

Reflections on Adoption 2 Years In

Reflections on Adoption Three Years In

It’s time for this year’s so I have just looked back at the previous three. In year 1, I reckon I played down the true horror of our experience. I probably wasn’t that comfortable sharing on social media yet and still very conscious of what others might have thought.

In year 2, I was analytical. It’s clear I had already come on quite a journey in terms of my knowledge of attachment, trauma, ACE’s etc., how it all fitted together and what it meant for LB. I was well into my constant quest to fathom his behaviour.

I don’t know what happened to me in year 3. I’ve just read it back and sneered to myself – and not in a good way. It’s lovely that I was so positive and all glowing about how ‘normal’ our life was but had I lost touch with reality?

I do think year 3 was a good year for us. I do remember struggling for blog-fodder because everything was ticking along and being quite unremarkable. Ha. What a fool. I should never have tempted fate with my glib positivity because in contrast, year 4 has been significantly more difficult. Last year, I seemed to have lulled myself into a weird false sense of security that we were following an upward trajectory and the only way to go was further up.

That was not the case. It’s not that things have been awful – they haven’t – but they’ve been hard enough that I know without a shadow of a doubt that our ‘normal’ is not normal.

I suppose in our third year as a family, LB was settled in his second year with his very favourite, gentle-natured teacher. Once he had formed bonds with his TA, there were no significant upheavals for him. Our fourth year has seen him have a difficult transition into year 2 and we’ve had the most trying time yet attempting to get his teacher on-board. Though we did eventually achieve significant progress and breakthroughs, it felt as though the entirety of the academic year was punctuated by mini-crises, every few weeks or so. This was exhausting, stressful and highly frustrating. I think I came the nearest I have come to having some type of school-based meltdown.

It follows that a tricky school year would equate to a tricky behaviour year and boy, have we known about that. I think the most concerning thing is that behaviours we hoped were long gone, such as Childhood Challenging, Violent & Aggressive Behaviour (CCVAB)  have returned. I don’t know if I would say they are worse than before but the experience now that LB is 7, instead of 3 or 4, certainly feels different. Thankfully he still can’t really hurt me but where I used to dither over whether his lashing out really could be classed as CCVAB when he was smaller, I know it would be now. He’s bigger, he tries to be intimidating and we have to work hard to de-escalate situations at times. Thankfully, CCVAB is not our everyday experience but it has become more frequent of late, making us feel as though we are regressing and as though we are re-living that challenging first year when we should be forging forwards with confidence into our fifth.

We are finding this an emotionally challenging parenting situation – one that is almost impossible to navigate without anxiety taking hold. How is it possible to be back here? If we are back here and we stay here, what on earth does the future hold?

Over recent weeks and months we have worked harder than perhaps ever to maintain equilibrium in our little family. Grizzly and I have had many despairing chats. We know our world has got smaller – we have said ‘no’ to more things because we know LB won’t cope, or, sometimes, that there is a high likelihood that LB will kick off which will make a situation a nightmare and we won’t cope. We are acutely aware that there are times when four people are ruled by one person and he’s the smallest.

I think one of our strengths as a couple has always been our ability to keep on keeping on – to brush off incidents quickly, to move on, to not let them mar our days or hang over into our tomorrows. Grizzly, in particular, has never stopped doing things because of fearing what LB might do – he’d pretty much do anything with him and if an incident occurred he’d deal with it. I’m naturally less like that but once that first year was over, I have never gone to bed worried about the next day. I might pick and choose activities carefully but I’d never overly concern myself with what LB might do somewhere or how I might cope with it. I suppose we have, in the main part, been pretty confident in our ability to parent him.

That sort of sounds like a happy accident but I think it has been a lot more actively cultivated than that – it has been born out of us being well-read and researched, having a clear priority list (think NVR baskets though we had actually not heard of them when we started doing it) and purposefully using a highly joined up approach. We have actively refused to fear the more challenging aspects of LB’s behaviour from the outset and always made sure we’ve had plenty of tools in our parenting toolbox. We have had a clear vision of how to handle things so it has almost been like we’ve had a set of pre-planned instructions we could just follow in any given scenario.

I have to be honest and say that confidence has taken a knock in both of us of late. I think it’s because of the aggression and LB’s increased size and his increased ability to cook up a major scene. I think it’s because we have found ourselves in parenting situations that have been, frankly, pretty scary and in which we’ve had no Scooby of what to do. I mean what exactly are you supposed to do when your 7 year old spits on you in public or threatens to punch you if don’t do x or y and then does punch you when you stand firm? Even when you read a book about Non-Violent Resistance you don’t really get an answer.

This last year has seen us have to re-think our strategies and employ different approaches. I think when children are smaller, it is an accepted part of parenting that occasionally your child might have a meltdown or refuse to leave somewhere and you can simply bundle them up like a sack of spuds and transport them out of there. Although we still see that type of behaviour, that response is no longer appropriate now that LB is large and extra-specially fighty. Verbal ways of managing such situations are tricky when your child is hyper-aroused and anything that comes out of your mouth will be seen by them as provocation. We have had to further hone our skills of staying calm, literally in the face of flailing fist and attempts to damage things. I very rarely raise my voice because there is now a clear correlation between that and escalation. Where once we would have stayed with LB no matter what he was doing (for the relationship and so as to show the behaviour no fear), we now sometimes find ourselves in situations where he appears purposefully provocative and ignoring or walking away are far more effective (and safer) strategies. One day, he seemed intent on damaging the house but when he realised no one was even there to see, he got bored and switched on the TV. Had we have followed him around, trying to coach him out of it, or even worse, used a traditional telling-off method, I know someone would have been hit or kicked. It was far wiser to make ourselves scarce.

I’m finding that a chameleon-like parenting ability is required so we can alter our approaches to match the ever-changing circumstances we find ourselves in. I have also reflected a lot on this, as I’m sure you have come to expect, and a controversial part of me is whispering that since we’ve upped our therapeutic approach to parenting, LB has potentially started to view us as weaker and easier to dominate. I’m a huge believer in the power of relationships and I’m sure that is the way to lasting change but I need him to get the message that threatening people is not the way to get what you want. And that violence is never ok. Though we will of course be persevering with all things therapeutic, I am increasingly of the point of view that LB also needs logical consequences to really underline serious messages.

Anyway, since we’ve agreed on this plan, I feel stronger in my interactions with LB. This sort of parenting certainly requires a plan, in a way which ordinary parenting doesn’t. Once you have a plan, you are much less likely to find yourself off balance, flailing for a solution in a challenging situation. You still find yourself in that situation but you have half a clue how to handle it.

This sort of out of the ordinary parenting (I prefer this term to ‘extraordinary’ because that sounds like we’re fabulous at this and as you can see, we’re just feeling our way through the swamp) requires an incredible amount of strength – to get up again; to do it again; to go there again; to get in the line of fire again; to do it cheerfully; to not let that incident haunt the next minute, next hour, next day; to not be quaked by it; to love unconditionally. Unconditionally: despite it all; including it all.

Sometimes I don’t know how we’ve got this far. Sometimes it’s easy. Sometimes it really isn’t.

I suspect this is another trough in the typical peak and trough pattern of life with a trauma-experienced child. I talked last year about higher peaks and shallower troughs. Year 4 has involved many more oscillations and a more frequent swinging from peak to trough. Some troughs have been pretty deep but we haven’t languished in them for long. The weeks, and even months of relative calm I talked about last year have all but vanished. I don’t think we’ve managed more than a calm (ish) week or two before something has happened. And it has been harder than ever to pinpoint triggers. There have been some obvious things like a school residential, specific incidents in school, moments of poorly thought-through parenting etc. but at other times it has felt like a general malaise. LB certainly continues to struggle with his Interoception skills and feeling under the weather is generally expressed through increased fightiness only – he still doesn’t know he’s ill and we often don’t until several days later when someone else catches it. He has grown a lot too – I don’t know whether that could impact.

There is always a trigger. I know that. It is tricky when you are a person who over-thinks a lot yet you still can’t figure out what it is. I feel quite sure that LB rarely knows what’s behind his own behaviour at the moment – not in a way he can express in words anyway.

In the process of writing this, I’ve thought and re-thought and scrolled back through my Twitter feed looking for clues. I think I can trace the latest regression back to the blasted school residential. It wasn’t even two months ago yet LB has had three different bugs since then and just hasn’t been himself. As I say, at times it has been like stepping back three years. I wonder whether it has essentially re-traumatised him, re-awakening all those feelings he felt when he was uprooted and brought here. I think he had a taste of the wild abandon he used to experience in foster care (due to being in a large dormitory full of boys without constant supervision) and that has re-awoken his need to be in charge of his own survival. Certainly we have been able to soothe him by staying around the house, with a high level of nurture – the kind of thing we would have done when he first arrived – but as soon as we try to spread our wings a little, we are rapidly back to a tricky place. My conclusion, now I have some possible insight, is that he needs more of his world being kept small and the close nurture and the bonding. I don’t think there’s going to be much excitement for the remainder of the holidays. I hope it’s going to be enough because LB in school, trying to learn, when he’s in this survival state isn’t going to be pretty.

*

I’m sorry that I have been more negative than usual this year. I have always been mindful of frightening people but the further into this we get the more important it feels to tell the truth. In some ways it has got harder to do that – this year has also seen a rise in people questioning the very concept of modern adoption. There are many who see deep flaws in the current system – who view the permanent separation of children from their birth families as morally corrupt; who see all adopters as wrong-doers. There is a very strange juxtaposition between having an awareness of that and living this. I suspect a hard year has felt harder within a hostile climate.

All of that said there have of course been positives. Yesterday was lovely and it has never been more important to stop and acknowledge and enjoy these moments.

I am hopeful of a better school year. I was wondering aloud the other day whether the next teacher would heed any of the plans we made in our transition meetings when lo and behold we arrived home yesterday to a package she had hand-dropped off with a post card for both boys and a book for LB and an offer to meet in the holidays if it would help him. I’m so grateful and feel she understands things on an instinctive level Mr. Previous Teacher, though he was lovely in the end, just didn’t have.

Despite our wobbles, we remain positive and resolute. I remain optimistic. Here’s to some of that mystical normality I once knew making a re-appearance in year 5.

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Promises, Promises

Here’s a little scenario that happened in our house this week:

Me: It’s bedtime, Little Bear

LB: Aw, can’t I have a bath?

Me: I think we’ve left it a bit late for a bath – you’ve been busy eating your pudding, haven’t you?

LB: Yeah, but I reaaallly want a bath (Hangs off me, bats his big brown eyes at me, pulls his best super cute puppy dog face)

Me: I’m just a bit worried that because it’s late, you’ll find it hard to get out the bath when I ask you to…

LB: I won’t! I PROMISE. I’ll get out straightaway, when you ask me.

Me: Are you sure?

LB: Yes, I PROMISE. Straightaway.

Me: Hmm. Ok then, as long as you’re sure you can do that…

Did he get out the bath, folks, when I asked him to? No. No, he did not. He went under the water to pretend he couldn’t hear me. I gave a countdown (‘we’ll need to get out in 5’ etc.), I reminded him of his promise just before the moment it would be needed, just in case he’d conveniently forgotten. So, he could hear me and he hadn’t forgotten, yet neither did he exit the bath. Once I’d let all the water out and he finally decided he was out of options, he did get out and began calling me names/ telling me he hated me and that I was making him annoyed. It was all rather ironic really, given I had stretched his bedtime for him, made a concession for him and he had reneged on his promise. I mean, yeah, he was totally justified in getting annoyed with me (can you hear me rolling my eyes?!).

Anyway, more fool me, because I should know by now that Little Bear can’t keep his promises. I’ve been pondering on this since and have had a few chats on Twitter about it, as I do (it’s such a good barometer of what is adoption shenanigans and what is just plain shenanigans). There are two things in my mind: why can’t he keep promises and why do I keep giving him the chance to make them in the first place?

My immediate thought about why he can’t stick to them is because at the point of making them, he is fully present and intent on doing what he says he will (I don’t believe he ever sets out to purposefully dupe me) but as he struggles with regulation, when it comes to the point of following through, he isn’t able to control himself enough yet to do so. I imagine there are times he knows he’s letting himself down but can’t help but do it anyway.

Then there is the theory that perhaps it’s an act of self-sabotage. Perhaps he doesn’t feel he deserves a nice bath or a peaceful bedtime and kind of deliberately puts a spanner in the works. This is a sad state of affairs if it’s true. I have tried wondering aloud along similar lines but I can’t tell whether it resonates or not – I suspect it doesn’t because he usually gets quite tearful if we get our wondering right and he certainly wasn’t tearful on this occasion – just combative.

I suppose another theory is that it could be an anxiety-based behaviour. Perhaps the end of the bath triggers something in his mind about the beginning of bedtime and the fact that sleep is soon and sometimes he has bad dreams. Perhaps he is attempting to stave that off by causing an escalation.

Another feeling of mine is that sometimes Little Bear remembers a situation similar to the one he is in and recalls a situation or behaviour that has happened before and for whatever reason is moved to recreate it. We’d certainly had a similarly difficult bath time a week or so before and the following evening from the incident described above also featured a sudden switching and similar behaviour. I can’t really explain why this would happen but there are certainly times when I feel it does.

There could also be an argument for saying that because I had voiced my concern about what could happen in the situation (me trying to be open and honest etc.) I had somehow created a self-fulfilling prophecy. There is certainly a truth in the more Little Bear knows you want him to do something, the less able he seems to do it. He’s pretty oppositional like that.

As if I hadn’t already muddied the waters with enough theories, I have more. Could this behaviour be linked to poor situational understanding/ poor cause and effect? I feel as though I don’t have many of these challenges with Big Bear because it is obvious to him that if he messes me around in this way, I won’t give him similar concessions in the future. However, this type of A + B = C thinking seems challenging for many adopted children. Perhaps Little Bear doesn’t realise he is cutting off his nose to spite his face, as it were? I have started asking him what he thinks might happen if he does such and such, at times. The confounding this is that he is often able to tell me what a logical consequence might be. I can’t tell whether he isn’t bothered so just does the thing anyway or whether there is a disconnect between knowing in theory and changing his behaviour in practise.

A final theory is that demands of any kind make him anxious because they feel as though they are clawing at his need for control (see Control where I’ve written all about that). Someone on Twitter mentioned Pathological Demand Avoidance to me (PDA for short, a sub-diagnosis of Autism) and it is something I’ve turned over in my mind before because Little Bear is undeniably demand avoidant. However, whenever I check out the diagnostic criteria I don’t feel he meets them. There are elements that ring true but I don’t believe Little Bear lies anywhere on the Autistic Spectrum. As with any child who has experienced developmental trauma, I always think it’s essential to consider the impact of that first and foremost. I would love to see a document like the Coventry Grid though, which instead of drawing out the similarities and differences between ASD and attachment, drew out the similarities and differences between PDA and demand avoidance within an attachment/trauma presentation. I think I might e-mail Heather Moran and see what she thinks (why not?).

One of the reasons I don’t feel Little Bear has PDA is because his ability to manage demands fluctuates enormously. Sometimes he can do everything you ask without difficulty. At other times every tiny request is difficult for him. I think a child with true PDA would be much more consistent in their demand avoidance. Little Bear’s behaviour tends to be pretty unpredictable. I know there would be other days when we could have had exactly the same bath time scenario and he would have got out of the bath the second I asked him, like an angel. What is difficult is predicting which days would be like that. If Little Bear is having a day where every demand is a battle, I would never have even considered entering into a promise-based scenario. I would have made sure the rules were really firm and clear and it would have been an early bed.

However, on the particular day in question, everything had been going well. Little Bear had done well at school, eaten his tea, come off his I pad and come upstairs as requested. The stars appeared in alignment so I was sucked in by the promise of a promise. The switch from co-operative to oppositional happened in a nano-second. I have to say that I find this type of scenario difficult. Because I don’t see it coming and because I have already given ground, it is extremely difficult not to feel taken advantage of and really rather annoyed. I coped much better the second night when I was able to anticipate the behaviour I might be confronted with in advance.

So why do I do it? Why do I allow him to get into a making promises situation if I know he might not be able to stick to it? I’ve asked myself this question a lot. Part of it is because I find myself keeping the rules much stricter for Little Bear than for Big Bear and that can feel mean. I let Big Bear stay up late sometimes or negotiate on what order he’s going to do certain tasks in because he has proved over and over that I can trust him to do that. I’d be quick to reign things back in again if I thought he was exploiting me but I have very little need to. However, because Little Bear has more difficulty sticking to promises and has reneged on many, I am less inclined in the first place to give him a chance. I suspect that is with good reason and that with firm, immovable boundaries and rules, he feels safer and happier. I also don’t like putting him in situations with a high risk of failure because in general, that doesn’t do anything helpful for his self-esteem.

There is something about me not trusting him to have a go though: I don’t want him to think I don’t trust him and don’t believe he’s capable of keeping promises. I know that he can (given the right set of circumstances) and I would like him to have a go from time to time and feel successful at it because otherwise he will surely grow up thinking he is a person who can’t stick to their word. He certainly finds it harder, given the myriad possible reasons I’ve cited above, but I don’t believe it’s impossible, and like anything else, I’m sure he’ll get there in the end.

 

 

*Also, how complicated is this adoptive parenting lark? One tiny scenario, a gazillion possible explanations. Maybe he just didn’t feel like getting out the bath?

A Thursday with Little Bear (aged 6 and a half)

Back in May of 2016, when Little Bear was just over 4, I wrote an account of a day we had spent together (you can read it here: A Friday with Little Bear ). Today I was struck by the idea that it might be interesting to do it again – to reflect the progress he has made as well as the types of challenges we experience now he’s a bit older. I’m not 100% sure of the wisdom of this but here we go:

I was woken at about 8am by Grizzly’s alarm and a throbbing headache. The rest of the house was silent. When Grizzly got up (he was working at home) I could hear him speaking to Little Bear who had been up a while but had entertained himself with his I pad. We had a slow start because its half term.

When the boys had had quite enough screen time, I attempted to complete Little Bear’s holiday homework with him. Apparently he is supposed to write a whole side of A4 about what he’s been up to in the break, being sure to include conjunctions, adverbs and expanded noun phrases. In order to make the task slightly less ridiculous for him, I first read him his new social story about making mistakes and then we had a chat and I drew some pictures/ wrote some key words to make the task more visual. It looked like this:

 We began the writing task using the visual to support us. Little Bear did well for the first sentence then quickly lost concentration during the second. He wasn’t keen to say the sentences out loud first which meant he wrote things that didn’t make sense. He quickly became annoyed and threw his pencil across the room. He was able to using a breathing technique when I pointed at his social story and we did manage to complete the second sentence. After that, it seemed wise to take a break.

Little Bear got himself a snack and lay down on the sofa and put the TV on. He stayed there quite a long time while I got ready and did a few jobs. I explained we were going out soon and gave a ten minute then five minute then every minute for about five minutes warnings. When it was time to go, Little Bear refused to turn off the TV or get off the sofa. After some persuasion/ negotiation he switched it off but refused to go for a wee or put on his shoes. I helped him with the shoe part so that we might actually leave the house today.

When he finally got outside, he didn’t want to get into the car.

In the car, Little Bear tried to tell us which songs we were and were not allowed to listen to. I made sure we took turns to choose a song.

When we arrived in town, we met my parents. Little Bear ran over to greet them and measured himself against my mum who has not been blessed with tallness. “I’m bigger than your mum’s boobs now!” he yelled, loud enough for half the town to hear. I don’t even bother to blush or check if anyone is looking any more.

We went into a clothes shop because the boys needed some tracky bottoms and they quite like looking at clothes for themselves sometimes. Little Bear chose some tops with those sequin designs that brush forwards and backwards which kept him busy for a couple of minutes. He was soon running around the store and trying to engage one of us in hide and seek. My Dad took him to the toilet while we paid. We met them at a restaurant but Little Bear had found a piano and my Dad was having some difficulty getting him to come away from it. When he did manage to extricate him, Little Bear found a triangle of landscaping to run up and down and round and round. I said he could have one more circuit then we’d go into the restaurant. He had one more then tried to negotiate for 5 more. He would only come when I started to go into the restaurant.

I had brought an activity book which kept Little Bear fairly busy while we waited for food though he mainly stuck stickers to himself, not the pages. He sat and ate surprisingly well but as soon as the last bite was in his mouth he was up out of his seat and heading for the door. He wasn’t pleased when I asked him to come back and explained not everyone had finished yet. Little Bear began hanging on the back of his chair and jumping around. I took him to the loo for a change of scenery and little walk. On the way back to the table he tried to push me then tried to jump onto me while we were close to people’s tables. I had to crouch down and explain to him (again) how we should/shouldn’t behave in a restaurant. He told me he hated me rather loudly. He sat on me while I was crouching which nearly knocked us both over backwards. I managed to persuade him to wait until we got to the table and then he could sit on my knee. He did and I asked him if he wanted a squeeze. He did and this calmed him a little. We also did some pushing with his hands pushing down on mine. I do try to use a bit of calming sensory input when we’re out and about – sometimes it works, sometimes it doesn’t. This time it bought us a few more minutes for the others to finish their drinks/ pay the bill.

Little Bear didn’t want to put on his coat and shouted at me again. When we got outside, he ran around his triangle again and seemed much happier.

Next stop was the shoe shop. Little Bear loves going there, but only if it ends in new shoes. I kept explaining that it would depend what the lady said and his feet might not have grown –forewarned is sort of forearmed but I rather suspected there would be some fallout if shoes were not needed. Thankfully, they were. Little Bear told the lady he is a year older than his is (purposefully) and did try to control the situation by taking hold of her tablet/moving her seat around/ not letting her put the shoes on his feet. I had to remind him that it was her shop and she was in charge. He tolerated this and did say please and thank you. There was a time when he wouldn’t have spoken to her at all so overall, I was pleased with how it had gone.

We went in two more shops. Little Bear wanted something in each one. He didn’t tolerate me saying ‘no’ too well and told me he hated me a few more times. Outside he saw a balloon on a stick someone had stuck into a flower bed. I asked him not to touch it. He pulled it out of the soil and waved it about. I explained it was dirty and not to touch it. He waved it about some more. I told him to put it back. He waved it about. I got a bit cross and told him off. Little Bear tried to run off. As I took hold of his hand to stop him, he hit me then pressed his nails into my hand as hard as he could.

We went into the library because there was supposed to be an activity on. There wasn’t. Little Bear found a lion statue and sat on it. I explained it wasn’t for sitting on and asked him to get off. He did but shortly got back on. I asked him to get off. He said, “But that baby over there is sitting on one.” I explained the baby was small and he was big and needed to get off. He got off then three seconds later got back on again. I re-iterated the need for good listening and asked him to get off. He did but the next thing I knew he was sitting on it again and a librarian was telling him off.

I told him we were going because the activity wasn’t on so we’d go for some pudding instead. Little Bear didn’t want to leave. There were negotiations. When we were finally going in the right direction, Little Bear saw the security barrier and began climbing it. Every time we are there he does that and every time I explain why I don’t want him to do that. I got a bit stern. Little Bear hit me.

We went past the pet shop and I had to stop Little Bear getting inside a rabbit hutch. Then he fell into step with Big Bear and suddenly hollered, “King Kong’s got massive balls” at the top of his lungs. My patience was really beginning to wear thin at this point.

We went for a drink in a café that has toys. Little Bear was entertained for a while and the grown-ups managed some civilised conversation. After a while, Little Bear announced he wanted to play the piano again. I told him the piano was finished and we were going home. He didn’t want to go home. He began jumping and swinging on the back of his chair. I suggested we go for a wee then home. Little Bear hit me and ran off. When I found him he wouldn’t come. He told me he hated me and it was the worst day ever and I was the worst mum in the whole world. I took him to the loo then when I got back from going myself, my Dad was having a word with him about not kicking the café wall. There were issues leaving the café/ getting his coat on etc.

We finally got into the car. My parents decided they would come to our house for a short time so we both left the same car park to go to the same place but they were slightly ahead of us. “Take over them,” Little Bear demanded. “I can’t,” I said, explaining it wasn’t the right kind of road. He continued asking me to do this and when I wouldn’t got quite upset. “But they will get there before us,” he said, “if you don’t want me to be upset, take over them!” The tears were coming now so I had to calmly explain that it didn’t matter who got there first and that it was my main job as the driver to keep us safe, which meant no overtaking on little roads. I tried to distract him with some singing. Little Bear evidently began to reflect on his behaviour in town and started saying I shouldn’t have bought him any shoes. I tried to empathise that it must be hard if he felt he didn’t deserve them but that even though he hadn’t been totally sensible in town, that could have been because he was tired and despite any behaviour, I still felt he deserved to have new shoes which fitted his feet and I was glad I had bought them for him.

“I bet Grandpa doesn’t even know the way to our house anyway!” he said.

At home, Little Bear asked me if he was allowed to go on his I pad. “Yes”, I said. “Phew,” he said, “That was close, I think I nearly wasn’t.” He sat down with his brother and peace was restored.

At tea time he couldn’t sit still and did everything other than eat.

After tea he played Lego at the table, a game with his Dad and brother and then we played a game altogether. It was lovely. Little Bear understood all the rules and was really sensible. He didn’t mind when he didn’t win.

Little Bear was not especially co-operative for bedtime – I could hear Grizzly having to repeat instructions and giving warnings but when he finally got into bed, he read the whole of his school book because he wanted to, all 20 pages. He shouted for Big Bear and I and we made a big fuss.

Grizzly settled him and came down. We could hear kicking the bed noises and intermittent shouting noises but then he quietened down.

*

In the two years since I last wrote out a day, everything has changed yet nothing has changed. Being out is still harder than being in (in some ways). There are still times when my patience is sorely tested (and surely anybody’s would be?). We are still more visible/ louder/ more inappropriately behaved than other families. There is progress though: regulation is better on the whole and self-regulation is creeping in. There is heaps more verbal communication. Little Bear’s interaction with strangers is more appropriate and his situational understanding is generally good now. He does know what the expectations are, even if he can’t quite manage to stick to them. Little Bear’s anxiety is more obvious because he can express it verbally now – it is less likely to get misinterpreted as bad behaviour. Little Bear can reflect on situations afterwards and can feel very remorseful, in a way that he didn’t used to.

There are good bits and there are bad bits. I don’t worry too much about the less than good bits – they’re par for the course and we’ve got pretty good at taking most things in our stride.*

No matter the behaviour, he’s still gorgeous, just as he is.

 

 

 

*Just off to lie in a darkened room

 

 

 

 

 

New Teacher

You may have gathered, from my last few posts, that Transition has been the theme of the summer season here. See This Year, Last Year  & Fear of Loss if you don’t quite know what I mean.

Little Bear’s angst has been building for several months in anticipation of moving to Year 2 and getting a new teacher, reaching its zenith this week when the Big Move actually happened.

The first we knew about Little Bear’s sense of impending doom was in April-time when he announced he was scared of the Year 2 teacher. I’m going to call him Mr Jones for ease because Mr New Teacher is already feeling unwieldy. Mr. Jones seemed, from what little I knew of him, to be perfectly nice. He does, however, cut a substantial figure. I don’t mean he’s overweight but he is certainly taller than average. Grizzly is also a taller man so I wouldn’t have thought it would have been particularly noteworthy for Little Bear but evidently the broader build, deep voice and towering height were creating some level of fear for Little Bear. I suppose he must seem giant-like to a 6 year old.

We tackled this by chatting with Little Bear’s Year 1 teacher (whom I have never gifted with a pseudonym but I am feeling sufficiently guilty as to rectify that right now. She can be Mrs Potter henceforth.) Anyhow, we made the teaching staff aware and they made sure that Little Bear spent more time with Mr Jones in a non-threatening way. Mr Jones is a bit of a joker and told Little Bear that he doesn’t bite; not hard anyway. Little Bear found this pretty funny and it was one of the rare snippets of school he actually shared with me. Over time Little Bear got more used to Mr Jones until one day he announced he wasn’t scared of him anymore.

This was great but such was the state of Little Bear’s anxiety that where one fear was allayed, another immediately crept in. Now that Little Bear had allowed himself to accept he really would be going to Mr Jones’ class, the realisation hit that he would consequently be leaving Mrs Potter behind.

As for any child who has experienced severed relationships and developmental trauma, the loss of another key person is very triggering – it drags up the emotions of previous losses, wobbles the present and makes you question the certainty of the future.

I don’t think I’m over stating the situation when I say that Little Bear loves Mrs Potter. She has played a big role in his life so far. She visited him in pre-school and was a key person in his transition from pre-school to Reception class. She set him on course for his whole formal education. She has been responsible for him learning to read, write, do Maths. She has stayed with him for two full school years and in that time has been a safe, trusted adult who has stuck with him through some pretty testing times and challenging behaviour. Little Bear adores her and Mrs Potter makes it clear to him that the feeling is mutual. No matter what.

It was completely understandable that Little Bear would be bereft to leave her. To be quite honest, I was also a little bereft. It’s no secret that navigating the education system as the parent of an adoptee is tricky. It can be extremely difficult to get the system to understand your child rather than wanting to constantly change them. As a parent of a child with additional needs, it can be hard to get your voice heard and to be recognised as an expert in your child and seen as a valuable member of the team. At times in Little Bear’s education so far, I have struggled with all of these things. I have also had moments of utter panic at the level of Little Bear’s delay and how on earth he will ever manage to catch up (see LINK). Throughout these challenges, Mrs Potter has always been there. We have somehow managed to develop a really honest and mutually respectful relationship, something which I know is difficult to achieve. I also felt the fear of leaving that safety behind and taking a large leap into the unknown. I felt the fear of having to work really hard to create that relationship again, with another teacher, as well as instilling in them the same level of understanding of Little Bear as Mrs Potter now has.

This transition was a Big deal for all of us.

We tried to allay Little Bear’s fears by reassuring him that Mrs Potter was not disappearing from his life. She would just be next door, in her classroom. He could go to see her whenever he needed to. We (Mrs Potter was very involved in this) reassured him that she would not forget him and that she would still love him, even when he was in Mr Jones’ class. Little Bear and I made a present for Mrs Potter. I made a big deal of how she would think about him every time she looked at it and Little Bear really did pour his love and a few of his other feelings into the picture.

Little Bear started to feel better about moving on from Mrs Potters’ class but such was the state of his anxiety that where that fear was allayed, another crept in.

When we were getting organised with teacher gifts, I made sure to get one for Mrs C, Little Bear’s TA. Although she was going with Little Bear to Year 2, I wanted to thank her for everything she had done for him so far. Of all the teachers in Little Bear’s life, Mrs C has been on the biggest journey. I feel okay to say now that when they first met it was something of a personality clash. It was a disaster and I genuinely believed the wrong appointment had been made. I suspect Mrs C was pretty confident in thinking she’d easily sort Little Bear out with a bit of firm discipline. However, it was more like a head to head stand off and the harder she went in, the more he resisted and the more creative he became in testing her boundaries. I’m pretty sure he gave her the full works, including a few kicks and scratches and caused her to go home in despair on a daily basis, wondering why on earth she had taken the job.

However, I have to credit Mrs C with a very important trait: she has been willing to listen and to try something different. She was prepared to persevere and she stuck with Little Bear where others would certainly have thrown in the towel. She changed her approach, she read what we gave her, she listened and she has now become another trusted and consistent adult in Little Bear’s life, who understands him and is able to effectively support his learning. I would now be absolutely gutted if she left and feel as though she is the crutch that will bear the weight of this transition for Little Bear.

As such, I felt it was important I expressed my thanks. When I mentioned I had got her a gift, a flash of panic darkened Little Bear’s face. “Mrs C is going with me to Year 2 isn’t she?” he asked, evidently fearful she wasn’t. Yes, we reassured, she is. However, over the course of a few days, Little Bear made more comments indicating he thought she wasn’t really. I suppose it is hard to fully trust even your trusted adults when you have been so let down before.

On the last day of year 1, I didn’t really know how Little Bear would be but taking his gifts in seemed to be a handy distraction. Mrs Potter cried over him several times and both she and Mrs C gave him a cuddle in exchange for their gift. Little Bear was absolutely made up that they loved their gifts and evidently Mrs Potter let him believe that his gift was her favourite.

Surprisingly, the day ended much more positively than I had anticipated and much more positively than the end of Reception class which had involved a lot of throwing and screaming. I couldn’t even see Little Bear when I went to pick him up and it turned out he was so nonchalant about the whole thing he was busy sharpening his new pencil instead of being upset. Mrs Potter had bought each child a notepad, pen and pencil and Little Bear was so delighted that he came home and immediately started writing?!

Then, that Friday night, at 5pm, Mrs Potter and Mr Jones both came to visit Little Bear at home. This was absolutely above and beyond the call of duty and not something they usually do. However, because they understood Little Bear’s anxieties and are prepared to do things differently to help him, they wanted to. Little Bear loved the visit and I really feel it assuaged his worries. We had the calmest weekend we’d had in several weeks. It felt particularly poignant because it reminded me of when the foster carers came here to visibly give Little Bear their permission to be happy with us. I felt Mrs Potter was visibly saying “Mr Jones is taking over now and he’s a safe person too. I am ok with you being happy in his class” and that was so much more powerful happening in our home.

The preparation had gone as well as possible but we were in no way complacent. We had no idea what Monday morning would bring.

It actually brought a very happy Little Bear who was excited to be in Year 2. He skipped straight in without a backward glance.

My anxieties rose a little after school because Little Bear did his usual trick of not telling us anything that had happened/ telling us a clearly fictitious version. Later in the week I made sure to have a quick catch-up chat with Mr Jones – both to set the expectation that we need to be in regular touch and also to put our minds at rest.

Obviously I am far from having the relationship with him (yet) that I had with Mrs Potter but the chat felt positive. Mr Jones doesn’t feel Little Bear is testing him which is a good indicator that Little Bear feels safe and settled. Mr Jones has been laying out his boundaries but has not removed Little Bear from class or used any cards. He told me that Little Bear had not engaged well with a particular task but he had evidently gone away and pondered why that might have been and then asked Mrs C’s thoughts, knowing she has more expertise when it comes to Little Bear. I feel these are good signs of willingness to listen and look beyond behaviour and hopefully bode well…

I don’t want to count my chickens (especially after our recent fox-induced henmageddon) but at the moment it looks as though the anticipation of the transition was the biggest problem for Little Bear and that the measures everybody put in place to support him helped a lot. I have been really touched by the level of support we have recently received from school – it has come from a place of genuine care. As well as thanking the individual teachers, I have now e-mailed the Head Teacher to make sure he knows how hard members of his staff have worked and what a difference their commitment and support has made to us. I would be quick to speak up if the right support wasn’t in place for Little Bear so I feel it’s imperative that I am also willing to speak up when things are done well.

I am under no illusion that year 2 will be plain-sailing. Mr Jones has already discussed his aim of taking Little Bear from working towards Year 1 levels to achieving expected levels for year 2 in a year’s time. This is no mean feat and I don’t honestly know if it’s achievable. We also have the spectre of SATS on the horizon and a school residential. But for now, on the wind-down to the summer holidays, I am grateful for having got this far. The new teacher, myself and of course Little Bear are all taking our first tentative steps into this new situation. I just hope that we find a way to walk together.

 

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.

Recent Events

There have been many conversations in our house recently that I wish I didn’t have to have; most of them relating to death in some way.

It was initially due to the loss of Supergran and the boys consequently experiencing their first bereavement.

Little Bear’s anxiety around the subject comes out as an apparent Death Obsession. He talks about it all the time. Everything is dead according to him or he might want to kill something or he might wonder when someone is going to be dead. He has been this way for some time, to the point where I have to admit I mainly ignore the death overtures and I don’t let it concern me. We have all become somewhat complacent about it.

Recently he has evidently been pondering it a bit more though, asking questions such as “when you go to heaven, does a big hand come down to get you?” and “is Bob dead?” (Mr Foster Carer). He has checked a couple of times whether he is going to die soon. The questions appear at random points and are not necessarily related to things that are happening at the time, suggesting they are playing on his mind. In fact, at tea time this evening he randomly said “I hate Supergran now”. On further probing it turned out it was because she has died and essentially left him forever; something one assumes is quite triggering for a Care-experienced child.

I explained to him that it wasn’t her fault and that she was poorly and wouldn’t have wanted to leave him. He then said “she doesn’t love me any more does she?”. I tried to explain that Supergran will always love him, even though she isn’t here anymore and even though he cannot see her, she is still with him in his heart. This seemed to soothe him a little and then he confessed that he is worried that Grizzly or I might die.

Little Bear is sleeping really badly at the moment. It is hard to say why but as I’m writing this I’m wondering whether he is anxious. It is incredibly difficult to reassure children about death seeing as though it is inevitable. I tend to go with the usual platitudes about it only happening when you are really old etc. However, when they go to school one day and find out that somebody exploded a bomb in Manchester, purposefully trying to kill people, it becomes even more difficult to believe the reassurances. This time it isn’t some random place they haven’t heard of but a place they have visited and are aware is not too far away. Like children (and grown ups) up and down the country, my Bears are somewhat freaked out.

I don’t think that Little Bear fully understands the severity of what has happened, which is good, but I also feel he struggles to verbalise any questions or wonderings he might have, potentially leading to a far scarier narrative going on in his brain. He was the first to figure out though that Grizzly could have been there as he often works in Manchester and other potentially dangerous big cities, which has no doubt compounded his previous anxieties.

Big Bear, on the other hand, knows far too much about everything and has asked me many a question. Last night’s conversation began with me having to explain what will happen at Supergran’s funeral. Due to his constant earwigging of the hard to have grown up conversations that have been happening, I also had to explain what a “Chapel of Rest” is and that Supergran will know that people are going through her belongings and that it is ok that some of them are going to the charity shop because she doesn’t need them any more (he was concerned that it might be disrespectful). He also wanted to know how she got Cancer in the first place.

Somehow this conversation led on to “Mum, what is a Suicide Bomber?” – words that you would never wish to hear leaving the mouth of a 7 year old. Admittedly he was saying “suicide robber” but I knew what he meant. He had also heard the term “terrorist” and wanted to know what it all meant. I don’t believe in lying to children (though being able to shield them from the truth would be preferable) and feel I should give them as much information as they want/ are capable of processing. Once I nearly caused my Mum in Law’s friend to choke on her tea as Big Bear happened to ask me how babies come out of their mummy’s tummies when she was there and I think my answer of “they have to push them out of their lady bits” was a bit too honest and graphic for her!

Unfortunately this topic wasn’t as pleasant as I tried to navigate why someone would want to kill themselves/ others, whether it would happen again, whether the bomber had any “friends” we should be concerned about and if they would start bombing our houses. Now he has added ISIS, IRA and counterterrorism to his vocabulary too.

It is a truly terrifying world that we are raising our children in.

I wish that it wasn’t necessary for me to have had all these hard conversations with my children this week. I wish they could grow up freer and with more innocence. I wish I didn’t have to consider carefully each place that we might go to and wonder how likely it is to be a terrorist target. I wish parents up and down the country didn’t have to either.

I wish they didn’t need to know what cancer is or wonder about who will get it next.

It is hard with the current state of affairs not to become an anxious hermit who is scared of the world.

I guess everyone will find different ways of moving forwards and getting on with it. For me I think I want to be outside as much as possible. The world is actually full of beauty and our little corner is not scary at all.

I have spent today in my garden, taking some feelings out on the weeds. I enjoyed the peace and the sun. In one flower bed I found some Crocosmia which were not part of my colour scheme when I planted it and that I have been trying to pull out for a few years. Somehow, despite my best efforts, they are still there. It struck me that they are a metaphor for life right now: I’ve tried and tried to destroy them but they refuse to be destroyed. It doesn’t matter what I throw at them they are strong. I have given up on my colour scheme: who wouldn’t want some bright orange flowers to look at anyway? We need to be like the Crocosmia; we need to keep bouncing back no matter what life throws at us.

Life is still good and we need to live it to the full. This weekend I will be wearing my favourite dresses (not saving things for special occasions), spending quality time with my boys, letting them have that ice cream or stay up for 10 extra minutes. We will be doing nice things, eating nice food and having as many cuddles as possible. I will be telling them I love them frequently. #cherishthegood

 

A bit of a rant

Beware lovely readers this post is going to get ranty. I apologise in advance because I pride myself on being a blogger with a positive outlook and can usually find something that I’m proud of/ happy about/ amused by that I can share, even when things get challenging. However, even if I dredge the silty bottom of today’s subject matter I cannot think of even one half positive to balance things out. So for one day only I’m just going to vent.

The thing is that our local Speech and Language Therapy (SaLT) Service is turning out to be completely and utterly useless and for the first time in my career I am embarrassed by association.

Little Bear was referred last February. As most of you will know he was experiencing developmental delay caused by neglect with more specific and significant speech and language difficulties on top. His communication difficulties impacted on every area of his life, from his learning to making friends to his behaviour. I felt he had a high requirement for therapy, not least because he had had such poor stimulation for the first 3 years of his life.

We were offered an initial assessment appointment on 4 separate occasions and each time the appointment was cancelled by the SaLT Service. Apparently the therapist had experienced a string of personal problems. I was empathetic, things happen, it can’t always be helped. It wouldn’t have happened where I used to work though: somebody else would have covered for the therapist after the first or second cancellation.

Eventually Little Bear was seen on our 5^th attempt, after 8 months of waiting, back in October.

I don’t think I was ever going to particularly enjoy taking him to his appointment: I’ve been doing Speech Therapy my way for a long time and obviously you do things a certain way because you think that is the best way. I knew a different therapist would do things differently and I would need to sit on my hands and try to distance myself as best I could. I have worked with lots of other therapists though and I know that my way is pretty similar to most other people’s way and I would have been very happy for any of my colleagues to see Little Bear.

I wasn’t totally convinced that the differences I saw in how the therapist ran Little Bear’s initial assessment could be passed off as style differences but I gave her the benefit of the doubt. I noticed that she didn’t take any time to get to know Little Bear or build up any rapport with him. There wasn’t any chat about what he likes or how old he is or where he goes to school, she just spoke with me to do a case history then assessed him very clinically. His behaviour during the session was off the scale compared with what was typical for him at the time.

During the assessment she didn’t transcribe his speech, just making some basic notes. I concluded her memory must be a lot more detailed than mine. She didn’t ask me anything about his social communication or memory skills.

At the end of the initial assessment, the therapist concluded that Little Bear’s expressive language skills were pretty much in line with his age (??!) and that his needs were not that severe. She agreed to put him on the waiting list for therapy though and said an appointment might come through before Christmas if we were lucky. I somehow came away feeling like a neurotic parent who had completely exaggerated my child’s needs.

Little Bear had a huge meltdown on our arrival home and flatly refused to go to school afterwards. He has never done that before or since and I had to carry him there with his dummy and blanket.

Then we waited. And waited some more.

We recently received a letter inviting us for a “follow up” appointment. It was at 8:45 am on the Friday of half term. I certainly wouldn’t have chosen to get both boys out of the house earlier than on a typical school day during their holiday but beggars can’t be choosers. We’d waited a year by now, I was damned if I was going to try to change it.

We arrived 5 minutes early and checked in at Reception. “Do you know which therapist it is?” the receptionist enquired. I didn’t. “It’s just that there are 2 and one is currently stuck in traffic” she explained. I really hoped it wasn’t our one.

It was our one. We duly took a seat and waited. This could have gone either way and we were just lucky that Little Bear was able to tolerate a wait today. I think it helped him that Big Bear was there too.

Little Bear did try to tell me that he was nervous this morning though. Previously you could just spring things on him and he would either go with it or not, depending on what sort of day we were having. He is getting a lot more aware of what’s going on now though and he knew that the ‘talking lady’ would expect something from him. Although he wasn’t able to say “I’m nervous” or “I’m worried”, he tried his best to get the idea across to me without a meltdown. He said “I think I take Phoebe to see the talking lady and he sit on my knee”. Phoebe is his cuddly dog who barks and wags her tail. Ok, I said. “Why? Does Phoebe want to come?”. “Yes, cos it might be scary”. “Might it? I don’t think the talking lady is scary” I tried to reassure. “Yes” he said “speaking might be scary for Phoebe”. Aha. I think perhaps he knows his speech isn’t quite how it should be and he knew that it would be under the spotlight today. We decided that noisy Phoebe might be best left at home but he brought 3 cuddly puppies to sit on his knee because they are “more sensible”!

What a shame to make an anxious child with attention difficulties (who finds sitting still difficult at the best of times) wait in this manner. Why arrange an early appointment if you couldn’t be sure of being there? I was getting cross but again tried to be reasonable. It wasn’t her fault the traffic was bad.

Eventually, the other therapist who was there came out to us. She was starting her own clinic at 9:30am but could squeeze us in. Apparently her colleague lived a fair distance away and was never going to make it.

We walked into the clinic room to find another person in there. She was later introduced as a student though I was not asked to consent to her being there which I know is the standard procedure.

The lady who had stepped in was obviously trying to do us a favour but was clearly flustered and had not read the notes. She started reading them while I was there and began firing questions at me: “how are his vowels?” “Have they improved?” “What about his word retrieval difficulties? Are you still concerned about those?”. As she was using technical language I assumed she knew I was a SaLT. “What is he working on at the moment?” she asked. “Well, we have started doing some work on ‘pl’ and ‘bl’ sounds” I explained. “Why?” she demanded. “Err well, because he was reducing those clusters and it was affecting his intelligibility” I replied. “Oh” she said “seems odd, those sounds are very complicated”. “And because I’m a Speech and Language Therapist” I retorted before I’d really considered whether that was a wise thing to say. I did well and kept the swearing inside my head though.

She proceeded to attempt an assessment with Little Bear. She was clearly in a rush and didn’t bother with any rapport building either. I could have told her, had she asked me anything about his behaviour and how best to manage him, that sitting him next to a big stack of toys would impact negatively on his ability to concentrate.

Once the assessment was over, she said “yes, he does have some speech difficulties I’ll put him on the waiting list for a block of therapy. Is that ok?”. Well no, after a year of waiting and thinking that therapy was starting today, no, that isn’t really ok. On querying whether today was meant to be the start of input, she explained that they have a lot of children waiting and some for quite lengthy periods so they are just seeing everyone to “check in” so “everybody has had something”. I can only think that that terrible piece of clinical decision making is due to having to meet some sort of waiting time target. It makes literally no sense because we still haven’t had anything. We haven’t had one piece of advice or even a strategy to use. Time is being wasted reviewing everyone who is waiting and doing NOTHING with them when they could have used that time more productively to start several children’s therapy. Although assessment is essential from a clinician’s point of view, on its own it does nothing to improve outcomes for children.

The whole experience was painful. We were very quickly dismissed, with minimal attention paid to Little Bear. I think it is just common courtesy to praise a child and let them know that they co-operated well at the end of a session.

I have been quite unsure about writing this post as it feels so wrong criticising fellow professionals. However, the whole experience to date has made me feel like an old person who says “it wasn’t like this in my day” as if things have changed beyond recognition over the past 50 years or so. Yet I am not elderly and I only left the NHS last year. Nevertheless I do not recognise this as the Speech and Language Therapy that I know. Where is the quality? The bit where you care about the children and families you are trying to help? The bit where you are thorough and try to consider all aspects of a child? The bit where you look beyond the snapshot provided by one rushed assessment? The bit where you think about a child’s background and the impact that their communication difficulties are having on their life? The bit where you don’t keep patients waiting, where you manage your diary in a realistic way and you prioritise the children who need you most?

If this is what people’s experience of SaLT is, I’m not surprised that nobody really knows the breadth of what we do and that as a profession we have a bit of an image crisis. I am ashamed to be associated with the type of service that has been provided to us. I know that each individual failure in our case has had a fairly reasonable personal excuse behind it but overall the quality of the service Little Bear has experienced is not excusable.

We have experienced the Audiology Service, Educational Psychology, School, Health Visiting and other medical professionals and I have felt well supported by them all. It does upset me that it is SaLT in particular that is letting us down.

And so we wait again.

 

*Rant over. I promise some positive sentiments next week.