Heal thy self

15 01 2012

As always happens after an LML related appointment, CD and GM have a bit of a de-brief.

Earlier in the week it followed a their second CAMHS appointment, which they attended without LML.

“I don’t feel like we got very far” says CD, “we didn’t get any further than the last session.”

“No” agrees GM, “we can only hope they actually read LML’s CPR before the next appointment. They have had it fir over a month.”

“I can’t believe that they asked us what we should do in the next session – who are the flippin therapists for goodness sake, us or them!!??”



29 10 2011

“Mummy” says LML,

“I” she points to her chest,

“Love” she spreads her hands over her chest,

“You” she points to GM and ends with a dazzling smile.

Changing of the Guard

6 07 2011

You’ll be seeing a different doctor today, the old one has moved on to pastures new” the administrator informs the Mostly Functional parents as they begin the routine that is the six monthly child development appointment.

The new doctor seems friendly enough, she soon starts to examine Lolly. She questions the Mostly Functional parents about Lolly’s health and behaviour. “I think she needs additional support. I’ll contact the nursery SENCO to make a referral for early years funding.”

The kids are bouncing around the consultation room, in to everything. GM and CD spend a lot of time stopping them from playing with the medical equipment that is all over the room, the sink, the giant paper rolls, the surgical gloves, the curtain. They tag team it, without any need for discussion or agreement.

It’s soon LML’s turn. After a number of routine questions the paediatrician focusses in on LML’s behaviour. “Is she always like this?” she enquires as LML flits from one prohibited activity to another.

I would like to refer her to the Child & Adolecent Mental Health Service (CAMHS), it’s difficult because many of the behaviours for Attachment Disorder are also seen in ADHD. I think we should assess her for ADHD, medication may help slow her down and focus more, making it easier for her to access education.”

Grumpy Mum is quick to say, “When we adopted LML we knew her behaviour might be challenging, we accepted that that’s who she is. I’m not sure either of us would want to manage her behaviour with drugs.”

The parents accept that this is a route in to CAHMS though; something they have been talking about how to achieve for some time. The Mostly Functional parents agree to complete a Connor’s Parent Rating Scale. Not convinced that the paediatrician, after less than an hours consultation, has made a correct ‘diagnosis’, they still see the benefits of the route she is proposing as it’s likely to open up new opportunities for support for the family and LML.

Good things come to those who wait

13 11 2010

Crap Dad had waited for this moment for over three years. He didn’t want to move. He wanted to extend the moment for as long as he could.

He’d read the books and endlessly discussed attachment disorder with everyone from social workers, clinical psychologists, teachers, other adopters to family members. He’d discussed what this meant on a day to day basis, how LML was always alert, rarely relaxed and a little… distant, unwilling to share moments of intimacy . But at this moment all of the hard work, the strategies and tools, the patience and practice had started to pay off.

“Three years”, he thinks, “Three years, I’ve waited for this.”

When he’d put the Iron Giant on the DVD player, he’d done so at Lolly’s request. It was 7.00am, they’d already been up an hour and a half and he’d had enough of kids TV.

Lolly had almost immediately come to sit next to him on the sofa. Shortly afterwards LML joined them. She curled up on the settee, laying across Crap Dad with her head resting on his lap, totally relaxed, watching the film.

Three years he had waited for this moment and he relished every second of it.

He gently patted her back and stroked her head, internally celebrating these simple actions.

“Three years…”

Absent Parent

10 07 2010

The screaming is intense, much more intense than usual. Crap Dad rinses the flannel he’d gone to get and returns to the dinning room. Lolly is very distressed, her face is various shades of purple, he mouth wide open and the tears are starting to form and roll down her cheeks. She continues to scream.

Crap Dad tries to comfort her. He asks LML what has happened, she looks at him blankly. He scans Lolly but can’t see anything. He continues to try and sooth her but the screaming just gets louder. “Has LML hit you? Show me where it hurts, baby.” More screaming, her face changing colours like an over excited chameleon.

He checks again, asking, “Does it hurt here?” Then he sees the marks start to appear. Millimetres to the the side of her right eye four very small welts start to appear. Evenly spaced they can only mean one thing, he scours the table and floor, “Where is that fork?”

“…I’m afraid that how it is.”

25 06 2010

The mostly functional parents sat on one sofa in their living room whilst the clinical psychologist sat on the other.

“So how are things?” She asks.

The mostly functional parents start with the positives, LML’s improved language development, improved behaviour when out walking and an improving relationship with Lolly.

They then move on to the challenges. The anxiety when going somewhere unfamiliar or when her routine changes; when having her nappy changed, particularly when its soiled; when someone new comes into the group, for example when the parent fortunate enough not to have to get up early comes down stairs.

That even though the relationship with Lolly is improving LML regularly pokes, slaps, kicks and hits her little sister (often hitting her with any hard object she has to hand).

They talk about how difficult it is when LML has reduced Lolly to tears and then whilst one of the mostly functional parents comforts her LML will take the opportunity to do a ‘naughty’ act.

The pychologist nods her head and says, “Yes, that must be difficult. I think you need to ignore the ‘naughty’ act and just focus and Lolly. You can sort the mess out later.”

The mostly functional parents talk about how it doesn’t matter how much time they spend playing and focussing on LML as soon as they stop, even for the shortest of periods, LML will be doing something ‘naughty’. She’ll be either hitting her sister or maybe climbing into a draw to get paints, glue, pens out.

The psychologist says, “Hmm, that’s a difficult one. It’s typical attachment disorder behaviour. I would suggest that she’s trying to remain the centre of your focus, that she feels that you won’t come back if you aren’t there with her giving her your attention, and if what she can get is negative attention then that will do for her. With older children we would normally suggest using something like an egg timer so that you can say to the child I’m going to make a cup of tea, you continue playing / watching TV and I’ll be back when the bell rings in two minutes. But because of LML’s development delay I would guess that she wouldn’t be able to manage that. I think you’re just going to have to work hard and keep on top of things. I can’t really offer you anything more than that. At this point I think I’m afraid that’s how it is.”

They finish by talking about the various ways LML seeks to gain control of most situations and how they choose their battles allowing LML to feel in control but when it matters asserting their authority.

repetative beats

17 06 2010

GM and LML ‘chat’ as they walk to the park …

“where daddy?”

“he’s gone into town LML”

“where daddy?”

“he’s gone to town sweetheart”

“where daddy?”

“where is daddy?”

“town .. where lolly?”

“nursery darling”

“where daddy?”

“daddy went to town”

“where lolly?”

“lolly is at nursery today”

“where going?”

“we’re going to the park love”

“where …”

This continues, on an anxious cycle, for the entire 20 minute walk.

Good friday, uneasy Saturday and exhausted Sunday

5 04 2010

Worn out, that’s how Crap Dad feels. A virus which has the symptoms of a sore throat, headache, congestion and tiredness hasn’t helped. But it’s the constant, incessant, relentless, interminable, unceasing and unremitting struggle with LML that has him feeling down. There are moments every day where her beauty, humour and exuberance shine brightly but these are generally interspersed with hours of challenging behaviour. This can range from the now mundane physical attacks on Lolly, the ever shifting attention which makes it impossible to complete a task, the lightening quick. octopus like, grabbing of objects, which make her being in the kitchen both stressful and scary and then there is the need for constant supervision without which she soon descends into behaviour or activities which end in destruction or a mess. All of which means that doing anything else other than focussing on LML whilst she is awake is almost impossible. It’s wearing and hard work, especially when you’ve been hit in the face for the umpteenth time that day!

Of course, all of this is done with the most endearing and beautiful smile. She is both delightful and disagreeable, kind and constantly infuriating, charming and challenging. She is our daughter.

When the problem parents sat down with their social worker and discussed the potential match, when they initially met the paediatrician to discuss the issues LML may face in the future, when they talked to the foster carers about LML nothing could have prepared them for where they are now. That’s not a bad thing, that’s just they way it is. Lately, a constant phrase that has been running through Crap Dad’s head is, “it ain’t where you’re from, it’s where you at”. When the problem parents made the decision to adopt they new that any child placed with them would, in all likeliness, have significant issues that they would have to work through. Developmental delay, learning difficulties, attachment disorder and behavioural issues are now what we are working with.

LML is going to need all our love and energy to achieve her full potential, she is our daughter and Crap Dad loves her with all his heart. He knows that tomorrow is another day and that he’ll feel different than he does now. He knows he needs to look after himself, so that he has the energy and enthusiasm to parent in the manner he wants to. He knows that he loves LML and that she is our daughter.

As easy as ABC…

17 03 2010

“It’s pleasing to meet with parents who don’t use their child’s issues to excuse their behaviour” said the educational psychologist.

The mostly functional parents were attending an informal meeting with the educational psychologist which included the clinical psychologist and speech therapist who work with LML. The meeting’s aim was to share information about LML and to enable the education psychologist to start to think about her transition from nursery to school in September. The mostly functional parents share their experience and are open and honest about LML and her needs.  They understand that the ed psych is NOT referring to ‘bad’ behaviour, but just how LML is, and also that she is pleased because the parents have aspirations for their daughter that are realistic.

At the end of the meeting it is agreed that the Ed Psych will write a report which will be used as a baseline of where LML is at, that she’ll undertake an ‘observation’ and this will be used to access increased funding to support LML in school.  The staff at the school will be encouraged to attend training on supporting LML’s communication development and on issues around attachment.  The ‘transition planning’ will begin as soon as possible.

At the end of the meeting the mostly functional parents feel that although it was a bit wishy-washy there was some progress made and that it’s the first step to managing the transition to school.

Nursery blues

11 03 2010

Lolly is starting to attend nursery, and she is currently doing short(ish) visits building to 2 days a week.  She will be joining the ‘baby room’ at the nursery that LML attends, so she is familiar with the general environment (if not that particular room) and many of the staff.  Last week she was left for half an hour one day, then for about 5o minutes a couple of days later.  There were no tears, and she seemed to be taking it all in her stride.

Today was the first day that she went to stay whilst LML was at nursery.  LML spotted GM and Lolly making their way through the nursery room to the baby room almost right away.  They all said hello, exchanged kisses and hugs and GM explained that Lolly was going to spend some time in the baby room today and mum and dad would be back later to collect them both.

As soon as the pair went into the baby room, LML became utterly and completely distressed, throwing herself out of the arms of her carer; inconsolable.  This is a familiar experience for GM, but it was clear that she does not often behave like this at nursery.  Lolly was oblivious to the grieving sibling in the next room, desperately trying to claw her way into the room, though the door and the round window that the children can see through.  As soon as she was allowed into the baby room LML miraculously cheered up and she was soon exploring the space and playing with her sister.

When it was time for GM to leave the children it was agreed that LML would be allowed to choose whether she remained in the room with her sister or would go back into the main room of the nursery.  She opted to stay in the baby room.  GM gave them both a kiss goodbye, told them that she and daddy would return later and left the two children happily playing.

An hour and 50 minutes later the mostly functioning parents arrived back at the nursery and were greeted by LML’s shrieks of delight.  “Mummeee!  Daddeee!” resounded across the main room as soon as they entered.  They were told that after a little while LML was persuaded out of the baby room and happily played in the main room for the remainder of the day.

As CD and GM entered the baby room it rapidly became apparent that all was not well there.  CD immediately took the distraught Lolly from her key worker but as soon as she saw GM her wails of distress increased.  GM took her in her arms “We’re here Lolly, we’re here” she chanted as she tried to listen to the clearly frazzled key worker.  Lolly was inconsolable, hiccuping and sobbing her distress.  Eventually GM maneuvered around the key worker and found a sofa to sit on, and settling face to face with Lolly she rocked and soothed, cuddled and reassured the child until she began to calm.  As soon as the key worker began to talk to GM again, Lolly burst into fresh floods of tears, but GM could see that she had regained enough equilibrium to be soothed with rocking and cuddles and did not immediately need her full attention.

GM began to listen properly to what the key worker was saying

“She was ok to start with, just a few little moments of unhappiness, but lots of playing and fun in between;  I took her outside when she got upset and that seemed to do the trick.” she said as GM stroked Lolly, and rocked her back and forth,

“But she wouldn’t eat much of her tea and really started to get upset then.”  the key worker continued.  GM listened, looking from the key worker, to show she was attending, and back to Lolly to gain eye-contact and reassure her that she was there for her.

“As I said, she was ok at first and has only really been crying for this last bit, since tea-time.” the key worker shrugged and half smiled “it has to be done” she said, “to settle her in.  She’ll get there”.  Lolly’s little body was still shuddering a bit, but she was calmer, just hiccuping a little.

“It’s been about a third of the time she was here, that she’s been upset” the key worker explains “mostly just since tea-time..”

A little part of GM froze .. mostly since tea time .. her little girl has been crying for 30 or 40 minutes?  Inconsolably crying?

Internally she is has to steel herself, but it does not feel right …  It does ‘have to be done’, as GM will be returning to work within a couples of months, but she doesn’t want it to be so hard for her little girl.

It occurs to GM later, as she discussed it all with CD, that although they have been educating ‘the nursery’ about some of the issues that can arise for adopted and looked after children, this has not been directed at the baby room.  She had assumed some basic level of understanding of attachment, trauma and loss that actually should not be assumed.

GM knows that Lolly is not going to be less upset at being left, if the nursery staff in that room have a better understanding of what the 2 year old might be experiencing or feeling.  But some understanding has clearly helped other staff feel more empathy for LML, and Lolly needs that same chance.

Let the process of education begin … again.

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