Hangry

This little infographic shows the typical process we experience when we’re hungry:

And this little infographic shows how hunger turns to hanger and how easily the state of hungriness can lead to escalation in our house (and I suspect we’re not alone):

I love hangryness, its a real joy.

I’ve previously written about Interoception  and Adopted Children & Eating Issues and Demand Avoidance if you’d like more info than the little bits here that you will no doubt need to squint at (it does look pretty though).

I’m assuming that time and working on interoception are going to help with this. I also need to remember to leave Little Bear a tray of healthy snacks outside of his bedroom door for when he wakes up at the crack of sparrows and none of us are ready to leap out of bed and make him some breakfast. On the occasions when I’ve remembered, it seems to have worked well in terms of pre-empting some of the issues above. Anticipating hunger and regular snacking and routine mealtimes do seem to keep things as calm and even as possible (though don’t actually take away the underlying issues). If anybody else has any clever tricks, I’d love to hear them.

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Demand Avoidance

I have been pondering this blog for a while and, ironically, avoiding it. There are a few reasons why: it requires research which takes time; I may have had more than my fill, of late, of demand avoidance and I’m not sure how kind it is to myself to spend even more time thinking and writing about it. But hey ho, here I am writing about it because there’s no time like the present and it will, at least, feel current and relevant.

I thought this would end up as a compare and contrast between PDA – Pathological Demand Avoidance – and demand avoidance as part of an attachment profile and potentially some mention of ODD (Oppositional Defiance Disorder), with me arguing that although Little Bear is pretty demand avoidant, I don’t believe he has PDA. However, after reviewing the literature, I feel comfortable to say that PDA and demand avoidance with a trauma history are different conditions and I do think this is acknowledged by some knowledgeable professionals, even if not widely (See this piece of research PDA and differential diagnosis ). I should point out that PDA is not officially recognised as a condition in the DSM or ICD diagnostic manuals but there is a growing belief that it does accurately describe the needs of a specific group of individuals (See PDA Society for more info).

Assuming it does exist, I think what would be really useful would be a Coventry Grid type document (comes up on Google if you are interested)  that drew out the differences between demand avoidance in PDA versus demand avoidance in a trauma background. The difficulty is that this is extremely difficult to draw out. One key factors seem to be the case history – are there trauma/neglect/attachment issues in a child’s background or not? Parents of children who match the diagnosis of PDA are rightly worried about it being branded an attachment disorder because there is a direct insinuation that they have neglected or abused their children. I can see how this could be problematic. However, I do think that where there is identified trauma in a child’s background, such as in Little Bear’s, this should immediately bring into question a diagnosis of PDA. Similarly, I would also say that trauma in a child’s background should bring into question an Autism diagnosis. I’m not saying that an adopted child couldn’t have PDA or Autism: a small percentage could. However, I am saying that where there is trauma in a child’s background, the impact of this should be considered first and foremost.

The second key factor appears to be whether a child who is demand avoidant matches the criteria for Autism. If they do, they are more likely to fit the PDA profile. However, there is also literature out there to contradict this – see Gillberg Research .

I can’t really work out where ODD fits in, because Little Bear appears to fit the profile for that too (ODD is recognised and does have DSM & ICD criteria) but my hunch, again, is that it wouldn’t be right to diagnose him with it.

The group I am interested in are those such as Little Bear, who do not meet the criteria for Autism and do have trauma in their background and are markedly demand avoidant. What is going on with their demand avoidance and how should it best be managed?

A useful place to start seems to be the Extreme Demand Avoidance Questionnaire (EDA-Q) – a questionnaire which has been designed for research purposes and is not diagnostic, but could be useful in picking apart the nature of behaviours we experience. You can find it here: EDA-Q

I have filled it in for Little Bear. As you can see, he scores 38 points which doesn’t reach the threshold for a PDA diagnosis (the threshold is 50 or over) , though it does say that those scoring lower may still meet the criteria as individuals can be impacted differently. I’m a little unclear as to how this type of decision would be informed. Either way, I don’t think he has PDA, yet he certainly does have a higher than average propensity towards demand avoidance. For context, Big Bear scored 6 on the same questionnaire.

These are the descriptors in which he scored the most highly:

• Is driven by the need to be in charge
• If pressurised to do something, s/he may have a ‘meltdown’ (e.g. scream, tantrum, hit or kick).
• Has difficulty complying with demands unless they are carefully presented.
• Has bouts of extreme emotional responses to small events (e.g. crying/giggling, becoming furious).

I have previously written about his need for Control which fits in with the first and second point. In reference to the third bullet point, sometimes demands that are made in a reverse psychology kind of way (‘I bet you can’t do x or y’ or ‘I really hope you aren’t going to eat my apple’), or a challenge kind of way (‘I’ll time you to do x’) go better than a straight forward ‘do it, or else’ kind of way. The fact that I have thought of alternative ways to phrase demands suggests this is something we have to do quite often. In reference to the fourth point, at the moment, something as small as asking Little Bear to go to the toilet and then, God forbid, actually wash his hands afterwards, is enough to unleash fury.

It is also interesting which statements he didn’t score on. I am assuming that in order to gain a high enough score to meet diagnostic levels for PDA, a child would generally score highly across all descriptors. Could it be the areas where children without PDA don’t score that are important diagnostic indicators for differential diagnosis?

Little Bear didn’t score on the following:

• Finds everyday pressures (e.g. having to go on a school trip/ visit dentist) intolerably stressful.
• Takes on roles or characters (from TV/real life) and ‘acts them out’.
• Makes an effort to maintain his/her reputation with peers.
• Prefers to interact with others in an adopted role, or communicate through props/toys.
• S/he was passive and difficult to engage as an infant.

I’m not sure if it’s just the examples used in the point about finding everyday pressures intolerable, but Little Bear loves a school trip and his behaviour was exemplary the last time we went to the dentist so I’ve scored it as zero. I would say that he can find new situations or places anxiety provoking and that might lead to more dyregulation. However, I wouldn’t say that necessarily correlates with greater demand avoidance in those situations. It might, or it might not – I suspect it is more complex than just where we are at the time.

If the descriptor were to mean every day, seemingly inconsequential demands, such as eating, toileting or getting dressed, I would have scored it much higher.

The bits about taking on a role or communicating through props don’t resonate here. Little Bear has good imaginative skills and sometimes there are difficulties separating Fantasy versus Reality but I wouldn’t say he uses them as a means of communication or specifically to avoid demands. I think this is where social mimicry as part of an Autism diagnosis comes into play.

In terms of how Little Bear presents himself to his peers, he certainly doesn’t try to comply with them but not us. I would say he takes a blanket approach to demand avoidance and if anything, there is a slight bias towards doing what familiar adults say. The less attached he is to a person, the less likely he is to co-operate with them, be they child or adult.

In all honesty, I don’t know if he was passive as an infant, as we didn’t know him then, but I cannot for one minute believe that he was!

The other items on the questionnaire that I have scored as ‘somewhat true’ or ‘mostly true’ are mainly not scored more highly because the behaviours come and go or because they used to be a problem but we have seen improvements. I have read that children with PDA can fluctuate in their demand avoidance – becoming much more co-operative when they are comfortable and relaxed. I would say this is true for Little Bear too. If he’s struggling in general, the demand avoidance will be much more pronounced. It is to the point where we have had months of co-operation – where I could just say, “Please put your shoes on”, as I would to any other child and Little Bear would do it with a smile – and then times like we are currently experiencing where every tiny request feels like a battle and can all too easily lead to escalation.

I have gone on the hunt for information about demand avoidance in developmental trauma to explain why this would happen but it’s thin on the ground. The Beacon House information about trauma does say this:

• Boundary setting can trigger a big reaction or noncompliance in child (where there are Attachment insecurities)
• Prolonged meltdowns over small things (as a part of difficulties with Emotional Regulation)
• Rule breaking at school
• Unresponsive to day to day requests (often seen as non-compliance) (as a part of Behavioural Dysregulation)

I guess those things sort of add up to the levels of demand avoidance that we see but I’d be really interested in knowing how other children who have experienced developmental trauma score on the EDA-Q and how their scores are distributed across the descriptors. I can’t help feeling we don’t have enough information about this and at the moment and it would be difficult for clinicians to make informed differential diagnoses between PDA or ODD and demand avoidance caused by developmental trauma.

If anyone knows of any other sources of information I’ve missed, please get in touch.

The one thing that I can unequivocally say is that parenting a child with demand avoidance is a little tricky (I’m totally under-egging it) and that finding ways to manage and manage it, has us scratching our heads. I am very much still working on it but here are some things that sometimes work at our house:

• Know your own triggers. It is very, very difficult to be calm when a child won’t do anything you say. I having to be conscious of the fact that this could cause me to snap and that I need to very deliberately react in a different way. I find this is much easier to do if you plan your response in advance, rather than just reacting when you are taken by surprise.
• At the moment, the plan which feels most effective is not shouting and moving away from, not towards Little Bear. He needs the space and I am less likely to react negatively a bit further back, busying myself with something else. This more casual approach seems to help things simmer down. Little Bear tried to saw the table with a dinner knife the other day, in a bid to avoid eating his tea, but I barely turned around. I did calmly tell him that it was his choice whether he carried on doing it or not, but if he did, I would take the money from his pocket money to fix it. It wasn’t in a threat way – just a pointing out a logical consequence way to help him with his decision.
• Self-care. I know people mock the concept but maintaining patience and calm in the face of zero co-operation is exhausting. We must look after ourselves (I’m talking to myself as much as anyone after a friend gave me a stern telling off!)
• Allow much longer to get ready to go somewhere than you’d think necessary. This allows your small person to spend time avoiding and doing everything but getting ready while you gently steer them through the necessary tasks. Time pressure won’t help anyone.
• Reduce the demands. There are certain tasks that have to be done but can you help by dressing or feeding or helping in another way? Other tasks, which are not essential, could be omitted for that day.
• Often it is verbal demands that Little Bear can’t tolerate. Sometimes we manage to acknowledge this in advance of what is likely to be a tricky situation for him e.g. bedtime and are able to collaborate on a solution. We’ve found that things like having all the equipment Little Bear needs for a task laid out for him e.g. toothpaste already on the brush, pyjamas laid on the floor etc. means he can complete the whole routine himself without us needing to make any verbal demands. Visual supports like a tick chart or timetable can also work.
• As mentioned above, careful wording of a command can help e.g. reverse psychology or a challenge. Unfortunately two good choices no longer works for us, because Little Bear has figured out he can just agree to neither.

 

I should point out that underlying the demand avoidance is likely to be anxiety of some kind – whether it be a fear of losing control or some other internal precipitant – so we should be mindful of this and manage the behaviour as kindly as we can.

I have to be honest and say that I am a little torn over demand avoidant behaviour. Half of me is extremely therapeutic about it and willing to be patient and accommodating. The other half of me thinks that one cannot successfully navigate life never doing what one is asked (employers and the Police certainly aren’t too keen on it) so perhaps there is some mileage in being encouraged to push through the difficulty barrier of wanting to avoid demands. I insisted, the other day, that Little Bear did carry out his reading before he went on an exciting day out. I insisted very quietly and patiently and had been specific on how many pages I expected (hardly any) but such was the strength of his need to avoid the demand that he would have given up his day out just to avoid the reading. We persevered and when he finally did the reading, we were able to praise him and make a big fuss for pushing through something we knew he was finding difficult. He was pleased with himself and had a lovely day out.

Isn’t this how resilience is built? By people believing you can do things you think you can’t and supporting you to achieve them anyway? Life for Little Bear is going to be extremely difficult if he can’t cope with the smallest of demands so I don’t see that lowering our expectations to zero will be of much long term use to him. I suppose, like everything, it’s a fine balance between being therapeutic and building life skills and we continue to hobble along the line.

 

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?

Control

I have to admit that I have been dithering this morning. I knew I needed to blog but it’s dark, rain is pounding the window as though the world is weeping and I feel like getting wrapped in a blanket and hibernating. Part of the problem is that I haven’t been particularly kind to myself with my choice of topic this week. I have decided to write about control and controlling behaviour but it’s quite meaty and I’ve needed to hit the books first. It is always easier to write the kind of post that just flows out of my head but sometimes a topic comes to mind because I don’t understand it enough and because I need to use the blog as an opportunity to learn a bit more. So, mind over matter, here I am, semi-researched and ready to type.

Controlling behaviour is certainly apparent in our house and it always has been, ever since Little Bear arrived. Admittedly, it isn’t as present as it used to be but there are certainly times when it is and it can be pretty tricky to manage. Initially, Little Bear sought control in every interaction. If we said ‘do this’ he said, ‘no’. If we said, ‘don’t do that’, he would say, “I certainly will.” He went further than that. If somebody sat somewhere he didn’t like, he would threaten them until they moved. If we gave him food, he wouldn’t eat it. If we didn’t want him to eat something, he’d eat it. His need for control made him contrary and oppositional in pretty much every interaction.

It can be extremely difficult, when faced with this type of behaviour, not to go head to head with it; not to threaten and shout and vie to be in control yourself. As a parent of a non-traumatised child, we were used to being in charge; to him pretty much always doing what we asked of him so this new world where a three year was attempting to rule the roost was shocking to say the least.

In order to properly explain why he was behaving like this, I’ve done a bit of reading. Bruce Perry (my favourite guru), says, “Because youth who have been through trauma often come from homes in which chaos and unpredictability appear ‘normal’ to them, they may respond with fear to what is actually a calm and safe situation. Attempting to take control of what they believe is the inevitable return of chaos, they appear to “provoke” it in order to make things feel more comfortable and predictable”. This rings true. From what we know of Little Bear’s birth family, life was chaotic. There was little or perhaps sporadic adult supervision. There were older siblings who may or may not have tried to exercise control over the younger ones but in general I suspect everyone ran wild and free. Unfortunately, this pattern continued in foster care, where Little Bear also received little supervision and seemed to spend his days entertaining himself in dangerous and risky ways.

This isn’t okay. However, for Little Bear, it was all he had known. To him, chaos and lack of supervision was normal. When he arrived here, to an environment of constant supervision (we literally didn’t take our eyes off him for the first months because we didn’t know what he might do) things must have seemed totally upside down. I suppose it might have felt smothering and claustrophobic. To him, this was chaos. This was abnormal. It must have felt very unsafe, hence his need to regain control by refusing to comply etc.

This is where things get a little tricky. Obviously, I wouldn’t want my son to feel unsafe at home. However, it isn’t healthy to allow a three year to control everything. That could only lay down the foundations for far larger problems later. As scary as this was for him, Little Bear was going to have to get used to environments where adults are in charge and where demands are made of him because otherwise school and work were going to be impossible. Hopefully, over time, he would learn a new type of safety, where grown-ups, not children, are in charge.

It is hard to pick apart how we succeeded in that because we did a lot of things that tackled a lot of different issues. Sometimes we got it right and sometimes we got it wrong. Vera Fahlberg tells us about how it should work: “The supportive approach to control issues is twofold. First, the adult demonstrates to the child that the child does not lose when he complies with reasonable demands, but instead everyone wins. Second, the adult provides as many opportunities for the child to be autonomous as is appropriate, given the child’s age.”

I think we were lucky that Little Bear could tolerate praise and in fact lapped it up. It meant that we could praise good decision making and co-operation. We were careful to praise every single tiny step of positivity. We didn’t just assume that he should put his shoes on when we asked. If he did co-operate, we made a big fuss (in a good way). If he didn’t co-operate we got pretty practised at ignoring a lot of the less positive behaviour (throwing etc.) and waiting, silently, for him to co-operate. We would always praise the part where he did do what was asked and try not to comment too much on the more negative bits that had happened first. We tried not to feed the control monster.

I can’t, hand on heart, say that we handled all situations as well as this. There certainly were times we went head to head with him and we learned the hard way that it is ineffective, as I suspect most new parents of traumatised children do. I can’t, hand on heart, say that there aren’t still occasions when I just want him to ‘do what he’s bloody asked’ and handle it less than therapeutically. We are human.

A lot of this is about relationships. As time went on and we were still there and we said sorry when we were out of order and we repaired things when it had gone awry and we talked and we wondered, Little Bear’s need for control itself gradually subsided.

Interestingly, Vera (I hope she doesn’t mind first name terms) also says, “Parents who know they can take charge whenever the situation warrants are not threatened when their children make decisions that don’t work out well. If a parent doesn’t know how to take charge when a child is out of control, the young person senses this and becomes frightened.” She goes on, “If the parent continues to be unable or unwilling to control the child in such a situation, the child’s inappropriate behaviours usually escalate.”

From the first day I met Little Bear, as well as being shocked by his behaviour (not mentioned in any paperwork, anywhere), I knew I should never show his behaviour any fear. I had met many families of children with complex needs through my work and many times seen parents so frightened of their children’s behaviour that their lives were ruled by it and it paralysed them from making changes which might ultimately help. From the onset, we reminded ourselves that Little Bear was a small child and we didn’t need to fear him. It did help us to remain calm when he was losing control. There were many times I held him and said, “I’m not going to let you hurt me” when he was lashing out. We did take control when he was losing control. We removed items he was too overstimulated to use. We stayed with him no matter what he did.

Again, I can’t pretend we always handled these situations appropriately. Tiredness, illness, hormones all impact your ability to stay calm no matter what. I know that sometimes it did feel like a battle for control and that Little Bear was trying to push and push to get a reaction because he felt out of control and he needed to check whether we were reliably in charge or not. Dealing with control issues is certainly not easy. I like to think we got it right enough of the time to make a difference.

In general, these days, I’d say we walk a line between encouraging Little Bear to co-operate (with reasonable demands) and giving him the autonomy Vera talks about. Depending on what else is going on, we make adjustments to keep us on the line. For example, if Little Bear is finding life a bit tricky, we reduce the demands we make of him. We might feed him his tea or help him get dressed so that he can manage the rest of the demands of his day.

Giving him autonomy is tricky because he may still exploit it. If we say he is in charge of a task, he would then think he was in charge of that task forever. He might also think that ‘being in charge’ of something means he can speak to people involved in a very bossy way. It can be hard to give him manageable autonomy that doesn’t lead to a spiralling need for more control. It tends to help if we give autonomy with very clear parameters. As an aside, we have always felt it important to put him in challenging situations with a high likelihood of success e.g. helping Grizzly with a job involving power tools or going canoeing or helping with cooking. They are often situations he can’t believe he’s been let into and in which he rises to the challenge. Being able to succeed in these highly supported but risky activities has many benefits, one of which is feeding his need for control safely.

We have noticed that Little Bear’s control issues come to the fore when he is anxious, frequently in the car. He makes irrational demands such as ‘take over that car’ or ‘drive into that field’ or he tries to control the songs we have on or which windows are open. I increasingly wonder whether journeys scare him and throw him back to a place where chaos ruled. I suppose that as a child, being put into a car and taken somewhere is totally beyond your control, especially if that place is a contact centre or a new home. As I write this I think there is more we could do to calm him at these points (visuals of where we are going, though we always tell him verbally, perhaps a task to be in charge of) but I have to admit this is a time we are firmly in charge and don’t tolerate his spiralling demands.

Another big challenge has been getting school – a place that is institutionally controlling – to understand and manage Little Bear’s controlling behaviour appropriately. There have definitely been times when they haven’t listened and they have tried to use a very authoritarian approach which has backfired spectacularly. Earlier this term, I noticed that Little Bear’s behaviour was spiralling at home and school. He was less co-operative and getting him to comply with any requests was becoming a battle ground again. Sometimes, when you’ve had a good period, a period of relative compliance, a change can put you on the back foot and you forget for a while that you have much better strategies up your sleeve than the ones you are reflexively using. Guilty of slipping into traditional parenting ways, I tried to step back and think. Why was Little Bear seeking control left, right and centre again? There was only one logical explanation: he felt out of control somewhere in his life. Coupled with school refusal I could only assume that place was school.

I continued to speak with school but wondered whether there was anything that could be done at home to keep us on the line I talked about. Little Bear’s bedtime routine had become difficult again, with refusal to comply with each part of the now very familiar routine. To try to reduce the demands, I tried a visual timetable. I explained to him that as he finds us asking him to do things difficult, he could be in charge of the tick list and hence the whole of getting ready for bed. In theory, it would be possible for him to do all the stages without me making any verbal demands at all (i.e. autonomously). I should really have anticipated that his need for control is such that he would have to test the parameters of the new system, rather than just using it. So far, he has tried adding more boxes, demanding things that are not on the list, rubbing out all the ticks half way through, using crosses instead, refusing to give the list back and writing on himself with the felt pen. This is a good example of him seeing what the parameters are. Rather than ditching the timetable, I am trying to be very clear about what is and is not part of the timetable process. If he can’t manage to stick within it, I guess it will show me he isn’t ready for this level of autonomy. However, I think he is. The other night, he had a wee, washed his hands, brushed his teeth, put his night things on, added a box which was ‘put clothes in the washing basket’, actioned that box and got his reading book all without me speaking. I was there though – I don’t want him to think he gets less attention for being independent – and gave lots of praise at the end.

Similarly, in the mornings, I used to give out commands, one at a time, until the routine was done. It worked for a while but then we started falling at the final hurdle. We’d get to going out the door and Little Bear would refuse to put his shoes on. I’m not quite sure how it happened, but somehow Little Bear figured out (maybe with some help) that if he just did all the jobs that needed doing, one after the other, I wouldn’t need to ask him to do anything and he would get a longer period of uninterrupted I pad time (“the child does not lose when he complies with reasonable demands, instead everyone wins”). By some miracle he now does that and is fully ready, by 8:10am or so, teeth brushed, shoes on and can go on his iPad for 20 whole minutes without interruption.

At the moment, I make very few verbal demands of Little Bear at home but the expectations are the same. I’m still in charge but he has autonomy in how he meets the expectations. I suspect this could be the key to managing his need for control going forwards.

Right, sorry for that massive thought-vomit. Better out than in as they say. I’m off to ponder managing car journeys…

 

 

School Worries

Last week in Adoptive Parent: Behaviour Detective, I wrote about my growing concern for Little Bear. Although I was struggling to narrow down the possible reasons for the changes in his behaviour, I was seeing warning signs that school could be at the root of it.

I was pinning my hopes of resolving the whole thing on a meeting with them which we had scheduled in for Tuesday. Hopefully a good chat and picking through the issues together would help us get back on track.

On Monday I got called in again. Would it be ok if we cancelled the meeting? They just felt that the things they have recently put in place (a timetable) need more time to bed in and they don’t have any updates for us.

I wasn’t really ok with this because Grizzly had re-jigged his ridiculously busy work diary so that he could attend. Although school don’t feel they have any information to share with us, we certainly feel we have many unanswered questions and do not yet have a clear picture of what is actually happening in the classroom.

We feel in need of a meeting.

However, I have always liked Little Bear’s teacher and feel I have to try to trust her. Although I tried to suggest the meeting would still be beneficial she was immovable. Mrs C, the TA, had already been told it was cancelled. She really felt it would be better to wait – its parents evening next week anyway. This didn’t reassure me much as Grizzly will be in America then and I’ll only have a ten minute slot…

It would be useful if Grizzly could be there because I’m pretty sure school have me down as a neurotic mother.

Not wanting to be completely fobbed off I asked about Little Bear’s behaviour as I stood there in the classroom door. It isn’t good. He is frequently refusing to do any work or anything he is told. In the whole class group he is silly and disruptive. He keeps getting himself sent out of class.

It sounds as though the TA has a lot of training needs. She is currently vacillating between getting cross with Little Bear and letting him do whatever he wants. Her management of him sounds inconsistent.

Evidently Little Bear doesn’t know where he is at with her. Unsurprisingly this is leading to a spike in his anxiety. He is pushing the boundaries because he needs to feel them there, sure and sturdy. Without clear boundaries Little Bear is anxious and out of control. He tries to claw control back in other ways like refusing to comply. When he pushes against a boundary it is because he needs it to stand firm. Predictable, consistent boundaries make him feel safe. If the boundary keeps moving or is there sometimes but at others not life is very confusing and unsafe. Life is how it used to be before he was truly parented: when he was in charge of his own survival.

We know this because we have lived with and parented Little Bear for 2 years now. We have introduced boundaries into his life (because we had to for everyone’s safety) and we have stood firm and united against the full onslaught of his behaviour, day in, day out, until he began to trust us and feel safe. Consequently he is unrecognisable from the out of control firework of a child who first swept us, quite literally, off our feet. At home he is now usually co-operative, able to listen and to engage appropriately in family life.

I don’t mean to sound full of my own self-importance when I say this but we are the experts at managing Little Bear. No one else understands his challenges or has as many strategies that work as we do.

I don’t think school know this or believe this.

I haven’t spelled it out in as many words but I have offered countless times to help. Perhaps we could meet? Perhaps we could problem solve together? Perhaps we could share ideas and agree a common strategy?

It is essential in my eyes that we work as a team – the consistency shouldn’t just be within our home or within school but across both settings too. This will undoubtedly help Little Bear to feel safer and less confused about what is expected of him.

School do not seem to want us to engage with Mrs C in this way though. In fact I feel they are actively keeping us apart. I’m quite confused as to why. Yes, I ask a lot of questions and I e-mail and I pop my head in. I guess I take up their time but I have never been cross or anything less than pleasant.

I can’t help feeling that they don’t value the contribution we could make. Perhaps they’d rather do things their way.

I reassured Little Bear’s teacher that no matter how well Mrs C is or isn’t coping with Little Bear, we appreciate that she is keen and willing and we completely empathise with the challenge he is providing her with and how this might be making her feel. Because we have lived this and we have felt those feelings. We get it.

We could help her.

In the meantime we are becoming increasingly frustrated and concerned. Each week that passes is another week of Little Bear being the class clown or naughty boy. It is another week of wasted potential.

I wish I could say with confidence that it is one week closer to a breakthrough but what if it isn’t? What if it is one week closer to not coping with mainstream education?

Sometimes it doesn’t do to have too much knowledge. Sometimes knowledge feeds fear. I keep abreast of adoption in the media. It hasn’t pass me by that one of the biggest stressors for adopters where things have gone wrong is navigating the education system for their child.

Ironically this week I’ve also visited a new school in my professional capacity. It is billing itself as a last chance saloon for children who haven’t coped in any other school. It is going to be the one place that won’t give up and that provides children with all the therapeutic input they need as part and parcel of their education. It sounds brilliant. I don’t think I can work there though because every time I drove up to the building a deep seated fear would be awoken: would this be Little Bear’s future? Is he going to become one of these children who is misunderstood, mismanaged and ultimately failed by our mainstream school system?

I told Little Bear’s teacher that I am worried, that the situation is worrying. Yes, she confirmed, it is worrying. Even Grizzly is worried and he usually says everything will be fine.

The worrying is tiring. I have a virus I can’t get rid of and two cold sores. It is not surprising.

The not knowing and the not being given updates and the being kept in the dark about what is happening day to day is only fuelling my anxiety. I would feel much better if had more information. I have mentioned several times that unless the teacher or TA tells me about things that have happened I won’t know about them. Little Bear does not come home and tell me. I am not psychic. We can’t talk things through with Little Bear and help with understanding what might be going wrong or what strategies could be put in place if we don’t know what the problems are.

Neither Grizzly nor I are any good at sitting around and just waiting to see what happens. We are both naturally pro-active. Just waiting and seeing does not seem a good plan when things are evidently going tits up.

I worry.

Post script:

Since I drafted the above, there has been a development: I got a phone call from the Head Teacher. He informed me that, on Tuesday, instead of the meeting we had asked for, they had had an internal meeting about Little Bear. Yes, a meeting without us. They had concluded that things were not going well and they would require some external support to help them.

He sounded very pleased with himself as he announced that he had done some research and found a great organisation that would be able to help us, had I heard of them? Err, well, yes, as a matter of fact I had because they are our post-adoption support service and I work for them sometimes! He went on to apologise that it had taken them a while to sort this: they needed to figure out what the right sources of support where.

It took me all my strength not to scream “why didn’t you just ask me?!” It’s so incredibly frustrating because once again we have been passed over and dismissed. I could give him a detailed account of the organisation in question and their offering. I provide part of their offering. We could have had a free consultation from the service, which I had mentioned several times but evidently this fell on deaf ears as a referral has now been made for costly assessment/training instead.

The Head also mentioned that they feel Little Bear is presenting with ADHD and that his behaviour in Year 1 “has taken them by surprise”. I’m baffled about how they are surprised. We are not surprised. We have described several times his behaviour at home and how his behaviour has changed over time. What they are now seeing is probably about a tenth of the behaviour we dealt with for the first 6 months or so of having Little Bear. We warned them before he started school what they might encounter.

In fairness, Little Bear surprised us all in Reception by taking the start of school pretty much in his stride. Looking back, I suspect very few demands were made of him in Reception whereas now the demands are constant throughout the day. It is obvious (to those of us who know him well) that this would lead to increased challenges.

Whilst I had to rant quite a lot yesterday and steam was coming from my ears, I have to focus on the salient points. An organisation which I have deep faith and trust in is now in Little Bear’s corner. I know they will help us. I am confident they will help school to see that we do know actually rather a lot about our son.

I was direct with the Head Teacher about some of our concerns: crucially that we need them to recognise us as part of the team. He was placatory but I fear still dismissive.

I am quite disappointed in myself that I have somehow come across as irrelevant. As a professional person working in the field of adoption and being an adopter, you’d think I might have a voice. I dread to think how other parents are made to feel.

I still worry.

 

A bad bedtime

Last night’s bedtime for Little Bear was like stepping back a year in time. It took me completely by surprise. In fact, it’s funny how quickly I have forgotten the full extent of the challenge we used to face every single day. Last night was certainly a challenge though and if the truth be told I was quite unsure how to handle it. Even now, having reflected about it on my drive back and to work this morning, I am still none the wiser about what a better way of handling it might have been.

The thing is that we are quite familiar with dysregulation. I wrote about it in my last post as it tends to pay us a visit on Saturdays. Little Bear’s usual dysregulation is reactive: it doesn’t come out unless we make a demand of him like asking him to go to the toilet or eat a meal. Left to his own devices in an imaginary demand-free zone I think his behaviour at these points would probably seem quite calm and nothing out of the ordinary. When a demand is made, he will resist and refuse and might lash out. However, if we left him alone he would not come looking for trouble.

Last night’s uber-dysregulation (I’m clearly making up terms to suit myself here), however, was on a whole other scale. Last night’s dysregulation was combative and purposefully provocative and very difficult to manage.

Things seemed like they were going awry when Grizzly picked Little Bear up from school. He was scowling and grumpy: not his usual default demeanour any more. The teacher didn’t need a word though and although we had a bit of resistance on his arrival home, Little Bear settled quickly. We spotted the signs so fed him and let him rest in front of the tele. Tea and in fact the whole evening went without the need for remark. It was only when I said it was bedtime and insisted after some refusal that Little Bear did need to turn his I Pad off that I knew I was in for it. It’s hard to describe but there is a visible change in him at these points. His body language, facial expression and whole comportment were different. He does not seem like the same child when this happens.

I persevered with bedtime, keeping everything the same as usual. I asked him to go for his “night night wee”. He went into his bedroom. I asked him again. He rolled around on the floor. I began to count as I always do. I got to 3 and he looked me directly in the eye and didn’t move. I said “ok, that’s one story gone”. He usually has 3 books and we regularly use their removal as a consequence if needs be. This upset him and he began to cry but did go to the toilet. I could see the way this was going and tried to reason. I explained that he had made a bad decision so lost one story but if he made some good decisions now, he could still have 2. He called me an idiot. I removed another story. He started chanting “mummy is stupid” so I removed the third. It’s hard because I knew he was dysregulated but it isn’t ok to call me names every time I do something he doesn’t like. Perhaps I should have tried to ignore it instead.

As he was now quite miserable and grumpy, I tried to cajole him. “If you get ready super quick and are really sensible, you can win 2 of your stories back”. I felt this was fair. I was giving him a way out and most children would have seen that 2 stories was good, it was what they wanted and I think they would have tried to buck themselves along to get them. In fairness, I think Little Bear would have on a usual day. In fact most of the time when he loses stories I don’t give them back and he usually accepts that. Not last night though. No. Last night he began getting his knickers in a twist because he thought I should let him win 3 stories back. Perhaps I should have just let him but clearly I can match him in a battle of who is most stubborn (oh dear) and I felt it was the wrong message.

I was able to distract him though and we jumbled our way through getting into pyjamas and doing teeth well enough that I did let him have his stories. He listened well and enjoyed them. We had a nice 10 minutes of quality time together. Little Bear seemed his usual self. That is, until the second I put the books back onto the shelf. At that exact instant, Dysregulated Little Bear was back. It was literally as though someone had flipped a switch.

Me: “okey doke, lie down in your bed then”. Little Bear does not. Me: “come on, Mummy let you win your stories back and we’ve had a lovely time. Let’s be sensible now”. Little Bear: “no”. Me (probably sounding exasperated) “Little Bear, you’ve got some choices now. You can either lay down and be sensible or not. But if you don’t, you know there will be a consequence. It’s your choice but I think you’re really tired and a big sleep would make you feel better”. Little Bear (continuing to hang his legs over the side of the bed): “no”. Me: “ok”. At this point I left the room and sat on the landing so I could still keep an ear out for him.

I was swiftly followed by something (probably a dummy) being pelted at the door then various other items. I could hear a range of crashing and bashing, wall kicking, bed-rocking etc. Little Bear then started shouting and hurling insults. I chose at this stage to ignore him because I knew all this behaviour was designed to attract my attention. However, being stubborn as I am, I have previously sat outside his door and ignored him for a very long time in the hope he would run out of steam but he didn’t. I wasn’t entirely sure that ignoring would work this time either. I pondered my options.

It is difficult in these situations because there are not many options and of all the options not many are favourable ones. I feel that at these times Little Bears WANTS me to lose the plot with him. He wants me to shout and ball. Sometimes I think he wants me to hit him. Sometimes I really feel like it. I think this has something to do with Mirror Neurons though it is odd because to my knowledge Little Bear has not been in a domestic violence situation and has not been physically abused. Nevertheless, he is sparring for a fight and it sometimes feels as though nothing will work until he has managed to escalate the situation and got whatever it is out of his system. Obviously I never do hit him (and don’t think hitting is ever an actual option) so need to have a better strategy.

When he had been shouting for a while, he started saying “why aren’t you speaking to me mummy?”. I said that he wasn’t behaving very well at the moment but I would speak to him if he spoke to me nicely. I asked if he was ready to speak to me nicely. He said he wasn’t and went back to shaking his bed about.

At the point when I felt his bed might actually fall down I decided I had to try something different so I went in to speak with him. I gave him another chance to make a different choice and lie properly in the bed. He did not take it and probably called me something inappropriate so I decided to get him out of the bed and try a ‘time in’. I sat him a couple of feet from me on the landing, making sure there was nothing within his reach that could become a missile. I could see him from the corner of my eye. His behaviour continued to be provocative – moving from the spot I had told him to sit on, trying to turn around, trying to move behind me. It felt like a battle for control.

I distinctly remember sitting in Prep Groups talking about managing behaviour. We were talking about distraction and why that is so much better than a consequence and one lady piped up saying “but then you’ve let them win” and we all inwardly groaned because we knew the whole lesson was about not making it a battlefield or about winning or losing. As a parent you have to be the bigger person. You have to let some things go purposefully unnoticed. You have to pick your battles. You are meant to be therapeutic.

However, how do you distract a child at bedtime? I don’t want to distract him, I want him to go to sleep. I also have to be very careful with Little Bear because the rules need to be the rules. He knows where he’s at then, without any uncertainty. Consistent rules make him feel safe. I can’t have a rule where you aren’t allowed to bounce on your bed except when you’re feeling rubbish and then you can. That doesn’t work. The rule is that you can’t bounce on your bed. If I made an exception one day, the next day, Little Bear would think he could do it again. Last night, he was checking all the rules and I felt I had to make sure they were still there.

I also felt that he was spiralling out of control and on some level he needed me to make sure things stayed under control so that he felt safe. He needed me to keep him under control. In that way it WAS a battle for control.

Needless to say that having all these thoughts and insights is all well and good but you still have a spiralling child who you have now been trying to get to sleep for 2 hours. I did eventually lose my temper and shouted at him and it was a shame because although when he first arrived you could practically explode and he wouldn’t bat an eyelid, he does now look pretty frightened if one of us shouts. It took holding him for a while and some more discussion and wondering to get him to calm down. Even then he still said he wasn’t ready to go to sleep sensibly.

I left the room again and after a minute or so, he said “mum, I happy now” and when I went back in it was as though the switch had been flicked back again. Whatever “It” had been was over. We had kisses and cuddles and he settled down.

I didn’t feel good about my handling of it. I wished I hadn’t shouted at him in an angry way. We have found before that unless he has a good cry and gets everything out of his system he won’t settle and somehow you have to make the escalation stop. I’m open to suggestions if anybody has any wise words.

The saving grace is that he could have been having that meltdown at the school disco which would have been MUCH worse.

I don’t know what was behind it but I’m hoping that the Easter Holidays are going to be just what we all need.