A Therapeutic Week

It’s funny how you can have periods of time where everything feels difficult or like you aren’t making headway, then several positive things happen at once, making you feel as though you are taking a bigger than average leap forward.

A big positive last week, came in the form of a meeting I had with Little Bear’s teacher. We needed to update his SEN targets, both because they were due but also as part of our funding application. The teacher could have just written them by himself and wafted them under my nose to sign. However, he didn’t, inviting me to meet with him and write the targets together. We pored over the recent psychology report (see The Right Eyes ), agreeing how to group the advice into targets and how to apply the advice, in real terms, in the classroom. It felt truly collaborative, as though my knowledge as a parent was respected and even, dare I say it, valued.

Part of the reason I sound a bit disbelieving about this is not only because this level of collaboration is so tricky to attain but also because this is the same teacher I wrote Dear Teacher about, earlier in the year. I put our improved relationship down to perseverance on my part, an open mind and willingness to listen on his and probably a few of the things I wrote about in Stop. Collaborate & Listen.  It’s reassuring that these things do (can?) pay off in the end.

Irrespective of what has gone into achieving it, the outcome for Little Bear is surely more favourable, now that we are all working to the same advice? As most of the advice is around emotional, behavioural and sensory supports, the final targets did have a very therapeutic feel about them. And it’s reassuring that he’s getting a lot of that sort of support all day at school as well as at home.

The meeting also led to a second therapeutic development: a sensory/calm box. It was one of the recommendations from the psychologist, although she said ‘sensory box’ and I slightly took it in my own direction. I maintain that Little Bear’s sensory presentation is complex and often when he appears to need more movement, he actually needs help to calm. So far, this is something we have struggled with and I have found difficult to get right for him. Little Bear’s TA is very good at knowing when he needs a movement break and taking him outside to bounce a basketball or have a little kick about. However, it’s the times when he needs some comfort/ soothing to calm that we all struggle with. This is where I saw the sensory box coming in and half-inched it as more of a ‘soothing box’. We have managed to establish, after longer than you might think, that Little Bear finds fluffy things soothing so I mainly went for tactile items in the box – things to squeeze, stroke etc. I did add a kaleidoscope for a bit of calm visual distraction and also some photos of us in case he needed the reassurance of seeing us during the school day. Here’s the box before Little Bear decorated it and we added the personal bits:

 

I found that The Works was a great shop to go to for little squeezy things and much cheaper than if you look for ‘sensory toys’ on Amazon. I also got the wooden box from there, which is the ideal size and personalise-able – something Little Bear really enjoyed.

Early feedback suggests the box does offer him comfort at school, which I’m really pleased about – could that be another sensory hole plugged? There have been some issues with him not wanting his access to it to end, but hopefully they will be solved with a bit more structure and a sand timer.

A fluffy beanbag, a fluffy blanket and jackets/zippers with fluffy linings inside have all brought comfort at home over recent months so maybe we have finally hit on the right modality for soothing? I hope so. It certainly feels more effective than letting him run wild and over-stimulating himself.

The third and final therapeutic development has come in the form of massage. I’m not too sure how this came about, although I know someone has mentioned it to me previously as a good approach but I can’t exactly remember who. Somehow, Little Bear has started asking for a massage at bedtime. It has felt like an exercise in trust, communication and consent, as well as an intrinsically soothing exercise. I’m careful to ensure Little Bear is in control of the massage and that I listen carefully to him and heed his requests. He has got quite specific in expressing what he wants e.g. ‘rub my leg but not the back of my knee’, ‘more firmly please – not as hard as this but harder than this,’ (while poking my arm to show me). It feels imperative that I adhere to his boundaries in this way – not just because I clearly should respect anybody in that way, but to strengthen our bond, and as a reference point for his own behaviour e.g. when he’s holding onto my hair and refusing to let go, I can say, ‘when I give you a massage and you say, that’s enough, or not my toes, I always stop. When I ask you to let go of my hair, you should listen to me, like I listen to you’. It has also given the opportunity for me to clarify the rules on ‘private places’ i.e. ‘no, I won’t massage there, it’s a private place, nobody is allowed to touch you there’.

And even more than all that, it feels like we’re doing something fundamental: repairing gaps in Little Bear’s development.

Although Little Bear has always been affectionate, this feels different – as though he is allowing himself to be vulnerable. It has made me think about the early months when he pushed us away at bedtime, not wanting goodnight cuddles or kisses. I remember trying to respond playfully – pretending I had lost him in the bed, patting the bedsheets to try to find him. I’d mainly pat the bed but occasionally get his feet and pretend I thought they were his head. He found this funny and over time, would ask me to play the game until we eventually, after a long time, got to the point of me patting his head or chest and eventually planting a sneaky kiss. The contrast between that – me earning his trust one baby step at a time – and him asking for a massage, feels vast.

I’m reminded that we’ve come a long way – we really have.

Advertisement

The Right Eyes

Today, Little Bear has been seen by another psychologist. This came about because the last time we saw an Educational Psychologist, I became very irate and had to resist the strong urge to tell him he didn’t know his arse from his elbow. You may remember this ranty post which tells you all about it: Conversations

Thankfully, the Bear’s school were none too impressed either and volunteered to pay for a private psychologist to ensure a non-biased, useful report. I know that I have moaned at times, about the school, but things have come a long way. I feel a real gratitude towards them that they genuinely care, about Little Bear and us, and that they are willing to be creative and do things differently if that’s what’s required. In these times of dwindling budgets, I’m well aware that many schools wouldn’t have funded such an assessment.

It isn’t just that, but by inviting a knowledgeable stranger into the school, they were laying themselves bare to observation and potential criticism. They took that risk because they want to do the best they can for our son and they are willing to make changes to their practice if advised. There is something about us having these shared vulnerabilities and this shared desire to ensure he reaches his full potential and is as happy as he can be, that makes me a little emotional. I think (I hope) that we have reached that much longed for status of Having A Good Working Relationship. And also Mutual Respect. I hope so, because I do feel like giving them a collective hug.

So, having got the right professional across the threshold, how was it?

Other than the times someone from our post-adoption support service has come into school meetings, this was the first time that somebody with an evident knowledge of trauma and attachment has observed Little Bear and seen what I see. There is a palpable relief in that. It isn’t in my mind; I haven’t concocted his needs; I’m not exaggerating. A knowledgeable stranger has come in and is sitting at the table I have sat at many times before and is observing things and recommending things that I have previously talked about, at that very table. She’s more convincing than me because she’s a psychologist and she certainly couldn’t be accused of being a neurotic mother, but even so, it makes me feel a little vindicated.

It’s refreshing. It’s also reassuring and hopeful. It means that instead of things being okay for Little Bear, maybe there is hope of them being the best they could be. I probably haven’t aimed that high for a while – just hoping we could avoid abject failure. School are willing and keen and they like the Psychologist and she is passionate and full of useful ideas. Surely this is the most hopeful our status has been so far?

I complained in my blog about the incompetent Ed Psych, that I knew more about trauma than he did and I’m sure that’s true. (Incidentally, today’s Psychologist said almost the polar opposite of everything he said. One has to laugh). I’ve written about  Being an Expert Parent and how our children necessitate us being so. I have always been a little reluctant about it though, so when a professional appears who is undoubtedly more knowledgeable than me and more experienced than me and I can learn from them, it’s brilliant. There is a surprising relief in it, that allows me to relax a bit, so I can attend the meeting as a Mum, not some sort of parent/professional hybrid trying to do several things at once. It makes me realise how exhausting navigating such meetings can be and how much of my emotional energy is eaten up week to week, trying to make sure Little Bear has what he needs in every area of his life, unwittingly filling the gaps left by others lacking in knowledge. Perhaps I can relax a little about his education now because between the psychologist and the school, I think they’ve got this.

It also highlights how rarely I’m in a situation with a professional who is knowledgeable enough to give advice about Little Bear’s needs. This shouldn’t be the case – that a professional who is trauma-informed is a rarity. Any professional coming to advise on children with developmental trauma should be suitably trained and aware. It is wrong that we find ourselves in a situation where the only way of getting that expertise is to pay for it, especially as childhood trauma is so prevalent.

Anyhow, with the right eyes on Little Bear, what did we learn?

There are some real positives about how things are currently being done. The Psychologist commented how lovely it was that Little Bear’s teacher and his TA are both willing to be physically affectionate with him and allow him to snuggle close to them. His teacher (a man), calls him ‘mate’ a lot and gives him reassuring pats on the back or arm. In this day and age where figures of authority have to be so careful about touching children, and some establishments have become so wary that they don’t touch children at all instead keeping some kind of unnatural and cold distance, it is heartening that the Bear’s school feel able to react to him naturally and to provide him with the physical comfort/connection he needs.

There are also real positives in terms of a multi-sensory curriculum and learning being fun. Little Bear is largely happy in the classroom and his trusting relationship with both members of staff is evident to a new onlooker. These things are reassuring.

What is more concerning is that Little Bear was not observed to be regulated at any point during the morning-long observation. I’m not surprised though. We achieve periods of regulation at home but that’s because we work really hard at it and we have spent three and half years getting tuned in and figuring out what works. I can see that without a trained eye, it would be difficult to figure out the underlying causes (often linked to Interoception in my opinion). I am still very much trying to untangle Little Bear’s sensory needs and that is with Sensory Integration training under my belt and a lot of time to puzzle. I can fully understand how, without the training or the experience, school would struggle to interpret and manage these aspects of Little Bear’s needs. The good thing is that today’s visit has brought them better understanding and the report will bring many practical suggestions for ‘sensory snacks’ to hopefully improve regulation across the day. I’m excited to read the ideas and maybe steal some for home too.

Little Bear was also observed to be anxious, hyper-vigilant and attachment-seeking in the classroom. Staff were observed to be inconsistent in making Little Bear adhere to the rules and at times punished possible self-regulatory behaviour. The big take home message for school was to ask themselves, ‘what is Little Bear showing us with this behaviour?’ ‘What is he showing us he needs?’ ‘What can we do to make him more comfortable/reduce his anxiety?’ instead of saying, ‘how can we stamp out this unwanted behaviour?’

The take home messages for me were more questions to ask of myself: ‘Are we doing enough to meet Little Bear’s sensory needs?’; ‘Should I get somebody else to assess him in this area?’; ‘Do we make appropriate accommodations for his sensory needs, particularly at mealtimes?’ I do find myself saying “sit down properly” a lot more than I probably should.

We talked a lot about difficulties with executive function and employing strategies to support that, such as visual supports, timers and short sharp bursts of learning, interspersed with sensory snacks. We talked about positive feedback, a proper meet and greet, a better transition for the end of lunchtime and closer supervision if unstructured play is leading to difficulties.

One of the main reasons we initially sought psychological input was due to the upcoming need to re-apply for funding for Little Bear. Today’s Psychologist was strongly of the opinion that Little Bear’s supportive adult should not be removed from him – he needs her support to get going with tasks and frequent check-ins to help him complete them. He cannot learn without adult support currently – an opinion we also hold strongly and one of the key reasons I got so frustrated with the LA Ed Psych who thought we should be working towards independence. The fact that today’s Psychologist independently and without any vested interest, drew this opinion is a great outcome and will hopefully add significant weight to our case for funding. I would love to say I’m not worried about that but I am because there are a few wider things also happening, relating to staffing at school and some problems with our back-up plan, should the funding application be rejected. There is always something to worry about it seems, but, today, I’m going to bed hopeful that now Little Bear has been seen through the right eyes, we might be on the right track to him getting the right support.