Third day of ABA!

Kai started school yesterday morning, and returned home to eat lunch and launch into Day 3 of his ABA therapy.   Wow, this Applied Behavioral Analysis is some very specific and well-documented stuff!    It is helpful to see behavioral changes written in "black and white" for the purposes of looking back and tracking progress.

For example, Kai started yesterday with a 30 minute intense meltdown (yes, the "all out" kind where he yelled at the top of his lungs, stamped his feet, and wailed.)   These meltdowns are considered a "escape behaviors," and this one in particular signaled that he did not want to go into the family room to play (yes, play.).  The therapists remained consistent in their requests to come into the family room, while mom would be working in the kitchen.   As an "attachment-minded" mom of an adopted child, I am always wondering how much of his problematic behavior is triggered by trauma or loss, and how much of his behavior is triggered by autism-spectrum stuff.   All of the specialists we have seen seem to believe (and I agree) that his meltdowns are usually not trauma or attachment related.   He uses his crying and melting down to escape from situations he does not want to participate in.      At any rate, Kai's second meltdown yesterday lasted 10 minutes,  his third meltdown lasted two minutes, and the fourth meltdown lasted only 30 seconds.    Yes, the problem behavior decreased with consistency and continued expectation for him to comply. 

I spoke with the senior therapist at the end of the session, who said that they're used to kids having tantrums, and that they usually get worse before they get better.   "Riding them out" is called an extinction burst, meaning that the behaviors will subside once the child knows that we will not give into the tantrum...and the hope is that Kai begins to use more appropriate ways of communicating and relating.

I had a headache at the end of the session yesterday!   Ah yes....this is why I'm home and not out working.   We're putting in the hard work now with the hope that Kai will make these gains while he's young.

ABA....week one

This week the A-Team began coming into our home on an abbreviated schedule.   The purpose of this week is for Kai and the therapists to begin feeling comfortable with each other, in order for positive change to begin taking place.    One of the questions I had at our parent orientation was:  How long does the honeymoon period usually last?    Of course, it is different for each kid.    Well, it appears that Kai's honeymoon period lasted one day. 

You see, Kai is naturally quite endearing and cute....until something is demanded of him or he is expected to do something he does not want to do.    He has perfected his whine, whine....(okay, am I getting under their skin yet?  nope... I guess I'll up the ante to....) all out protest, (aka. tantrumville).   Most folks may have already given in by the whining stage and would definitely give in by the loud tantruming stage.    Not these folks!    This is actually a GOOD thing, as the less Kai's tantrums are reinforced by adults giving in to his rages, the less he will use his tantrums as an escape measure rather than behave in an appropriate manner.     

Today Kai flew into two meltdowns while the three therapists were playing with him in our family room.   Apparently he did not like the fact that one of the therapists had the stick to his xylophone.....    Anyhow, It took Kai maybe 15 minutes to pipe down, and no....I did not go to his rescue.   

Of course through all of this my mind is doing mental gymnastics...."Could this be attachment related?  Does he really want ME?   Is he afraid or being traumatized by this experience?  etc."   The more I thought about it, the more I realized that this kind of intervention is EXACTLY what Kai needs to be able to attach more securely to me as his mother.   Because attachment IS a two-way process, his frequent tantruming got IN THE WAY of my attaching to him.    (Ask any parent how they feel about their raging kiddo "after the fact."   Now increase the frequency of those tantrums times three or four.   I think you get the idea.)   

Seriously, Kai asked me to pick him up and hold him after today's session, nuzzling his little head into my chest and breathing deeply.    For kiddos who lean toward emotional dysregulation, breathing deeply and behaving calmly with their caregiver is a GOOD thing.  

Hay!!!

It's always good to get a candid shot of the kiddos having fun!

Our meeting with the "A-Team"

Okay, Mr. T is not part of it..... but the ABA team working with Kai through Easter Seals seems to be AWESOME!   These are the players:   Paul is the director of the Easter Seals ABA program ( http://wi-se.easterseals.com/site/PageServer?pagename=WISE_ABA)   a wealth of experience and information, and also a really nice guy.   He's the kind of guy who makes you feel like "we've got this mom, you can relax.  You've done your job now let us help you out."   Nicole is Kai's Senior Therapist on the ABA team....the one who coordinates the team and makes sure Kai is making progress with his treatment plan.   She also has a ton of experience, and has worked for over six years treating kids on the autism spectrum.   Amanda, Caela, and Karen are our Line Therapists, and all share wonderful facets of expertise with us.   Caelia has a degree in communicative disorers, Karen has a history of working with  children with traumatic brain injuries (and she herself has a repaired cleft palate, so would understand that facet of Kai's speech issues), and Amanda has been with the Easter Seals ABA program since it began.   

We are looking forward to these folks partnering with our family to help Kai starting next week.   Eventually we will work up to 25 hours of in-home therapy per week.  (This is in addition to his Early Childhood Education class  4 mornings / wk, which will be helpful for socialization, and 90 min./wk of speech therapy at school).   Whew...it has taken a long time and a lot of resource-chasing to get to this point!   We are lucky to have the Autism Mandate in the state of WI  http://oci.wi.gov/pressrel/0709autism.htm   to ensure our insurance covers these services while Kai is young enough to really benefit from them!    

It felt really good to meet with these folks yesterday, as they validated a lot of my concerns / frustrations, while praising all of the progress that we HAVE made with our little Kai-man in the last year and a half.   All I can say is Whew....it's TIME!   let's get started!  :)

Thing One and Thing Two

Today I took the Jade-ster to school.....BIG difference in her overall mood!!!   I also spoke with Jade's kindergarten teacher yesterday, and we decided that I would be able to volunteer in Jade's classroom every Monday morning (in addition to bringing her in to school rather than having her take the bus).    Jade was completely ecstatic about this.....she threw her arms around me and said "I'm so excited for you to come to my class....I can't wait for you to meet my friends!"   Whew.  One kiddo in a good space, I'll take it!

As for our little Kai-man, well....he continues to be unpredictable.   I am SO welcoming of the services he will be receiving to help wrangle in his tantrums.   Today he was a real joy (NOT) at Target, displaying a meltdown lasting from the fitting room to the checkout line and out to the car.   I must say that I am proud of myself for maintaining my calm demeanor amidst lots of those looks from other shoppers.    Thankfully, both the fitting room clerk and the woman in back of me in the checkout line issued helpful comments..."Ah, we've all been there.  Don't worry."   Those comments are gentle little showers of nurture when parenting an often unpredictable and difficult child (course, you wouldn't know he can be difficult by looking at the above photo!). 

ah, regression....

We moms have a tendency to want to believe that once we've "turned a corner" things will finally begin to fall into place.   NOT SO with traumatized and post-institutionalized kids....  it is more like enduring the bitter realization that our children have a certain vulnerability that will always be there, at times "flaring up", and at times laying dormant.

Kai's presence in our lives has certainly led us to become more vigilant in regard to obtaining services and learning about his multi-faceted issues.   During this time we have been tempted to believe that our daughter is finally "securely attached", that we can coast knowing that we did the tough work up front and can bask in the benefit of all of that.    Well....this week has been a testament to the fact that it ain't quite that easy.  Yes, just when we thought we could take a deep breath, Jade's attachment struggles have started to re-surface.

Since starting 5-K (full day), Jade has been a pistol.  We can tell that she's been agitated because she's "idling high" and being much more active than usual.  She can't sit down, can't relax, and is always moving, moving, moving.  She's been emotionally distant in that, instead of having a wonderfully expressionful (is that a word?) face and bright eyes when we say good night, her face shows no emotion and her eyes are dull and distant.  She will talk loudly and incessantly and has an anxious habit of "picking" at everything from cuticles to scabs.  There's more, but you get the idea.  We've tried our usual methods to bring her around, but she's been tough and her being distant has lasted the longest it has in over a year.   We actually thought we had a break-through in the middle of all this when she admitted to having a hard time transitioning from half-day 4K to full-day 5K and that she really missed her family.  She was genuinely sad and cried (mommy did too!), rather than being distant and angry.  While we snuggled, talked, and tried to provide consolation (as well as photos of us to take along to school with her), the rage has raged on.   Jade continues to be very, very angry......in a way that expresses some extremely visceral abandonment issues.    Sigh...

This parenting stuff is hard.   Luckily we have an appointment with our attachment therapist tomorrow.

IEP, ABA....hmmm, any more acronyms?

We've spent a lot of time gearing up for this school year.... boy, lemme tell ya!   Now that we've gotten Kai's surgery out of the way (he could take his elbow immobilizers off today....yay!), we're preparing for Kai to begin the fun stuff of ABA therapy  http://www.centerforautism.com/getting_started/aba.asp  25 hrs / wk, and Early Childhood education Monday through Thursday mornings.    We've got Kai's IEP meeting on Monday morning,  an ABA assessment on Monday afternoon, and an ABA parent workshop with Easter Seals on Thursday evening.    The following week we should be off to the races....so to speak!   

Our little Doc!

We always like to see Kai doing "pretend play".   I'm not sure if Oscar enjoys it though!!!

Day 1: "Good to Myself" day

Today was my first day of  trying to get into the swing of working out.    I think it is harder to MAKE myself get to the gym than to actually work out.   (There's always more laundry to do, phone calls to make, paperwork to fill out, parenting articles to read up on, etc. etc..... you get the idea!)

There's the good energy of just KNOWING that this is good for my body AND my brain.    When parenting tough kids it seems like the "brain energy" can get zapped out so quickly and leave me feeling depleted.   We know that research has proven that exercise wards off depression.....and with another Wisconsin winter just around the corner, gettin' into the exercise groove AIN'T a bad idea, hey?  (notice the Wisconsin accent).    So....I put the Kai-man in kid-care for a while,  got on the eliptical, and did some pumping.  Yes, I did the dreaded-but-necessary ab-work too.    :)     Now it's time to keep it up!

A Poem...

This is a poem I wrote back in the mid-90's.   I brought it out recently because it conveys a spirituality I long to aspire to on my parenting journey.     Whoa, it has been a while since I have written poetry!   Thanks for allowing me to indulge my whim!                                                                                                           

Speak of My Heart the Sunrise

Speak of my heart the sunrise

and ask no question

of the waves which thunder and hush

to the beat of their own life song.

Long not to enter the surf,

but rather, to inhale its mist

and hear its calling in your senses

echoing the mercy

of wise and ancient spirits,

reflecting nothing greater

than what is in your own heart. 

Long not in desperation

for the waves to crash more or less strongly,

or for the sun to increase or soften its boldness...

but cast your eyes on the horizon

which neither wavers nor falters,

but gently reaches to meet you underfoot.

in time, casting life's shadows

behind you.

CPM

Worth watching!

Some of you may know that we were helped to bring Kai home through a grant from an organization called the Gift of Adoption fund.    They have a new video out that is worth watching!   (You may even notice some familiar faces in it!)  Just click on the link below:

http://www.giftofadoption.org/success/deargiftofadoption.html

A Labor Day reflection...

I grew up in the 70's.... in the wake of the ERA and women having to fight for their place in the workforce.   Moms who decided to make their way into the workplace were scrutinized, and moms who decided to take a more "traditional" role were also scrutinized by those who took on a more feminist view.   Thirty-something years later I find myself still torn between these ideologies.     Nonetheless, our decision was for me to stay home with our little hoodlums.....despite the sacrifice of a few things  (income, lifestyle comfort, professional satisfaction, etc.).

Why????   Attachment needs with kiddos with histories such as ours' take a lot of time, effort and energy.   Their first two plus years of life were sub-standard at best (in Kai's case, devastating to say the least).   More importantly,  I've been saying this a LOT lately...I don't want to live my life with regrets!    

So why am I talking about parenting on Labor Day?    Because parenting kids with a history of trauma IS work!   The dividends and payoff are definitely worthwhile, but the daily effort can take its toll on one's heart and soul. 

Undersanding trama in children is something that is not well understood.   Even diagnostic criteria for children with traumatic backgrounds is in the working stages (under the term Developmental Trauma Disorder).   Kids don't fit into a typical Post-Traumatic-Stress-Disorder diagnosis, as adults who may have undergone traumatic experiences such as battle or catastrophic events.    Kiddos who have suffered years of neglect and/or abuse internalize these early experiences, which become a part of their identities.   To "bring them back" takes A LOT of hard work..... more work than I had ever imagined.  

A few examples:  

• Since returning from the hospital, Kai has awakened 2 out of 3 nights in the throes of raging night terrors, both of which lasted at least an hour to an hour and a half.   It is not uncommon for him to awaken several times in an evening and be completely inconsolable.   Not surprisingly, it is frequently hard to get a full night's sleep in our home.
• Kai has a very difficult time with emotional regulation, seemingly always bracing for "fight or flight".    He can range from contentment to extrame rage within a matter of seconds.   When this happens, he is difficult to calm down, and it is exhausting.  
•  Kai suffers from a deeply-rooted depression which reaches far into his soul.   We feel lucky to be seeing more and more spark in his little personality, and are glad that he is making more and more progress socially and in his learning.    While it is not intuitive to him, he is beginning to trust himself more.

More information about Developmental Trauma Disorder is at the following site:
http://www.dhs.wisconsin.gov/mh_bcmh/docs/confandtraining/2009/050105DevelopmentalTraumaDisorder.pdf

On this day when we pause to ponder the fruits of our labor, I can't help but think about all of us who are working through the difficulties of parenting every day.....24/7.    On Labor day, I am embracing motherhood, and honoring all moms for simply doing what we do...yes, WITHOUT a paycheck!  For the sacrifices we have made (that only we can pat our selves on the backs for), the sleepless nights we have endured, and the gut-wrenching/hand-wringing days that we feel as if we're going to lose our minds (if we haven't already lost them)..... Here's a toast!  (course, it's the kind of toast with jelly smeared all over it.  ;-)

Our brave boy!

Whoa has it been a long day! Kai's palatal elevation surgery was successful... although he sure is one hurtin' (yet brave) little dude. The surgical procedure was kind of an icky one, requiring an incision along the palate in a semi-circle in back of his teeth, while stretching and folding the tissue to lift and close Kai's entire palate (I had previously thought he was only having a small fistula repair surgery....apparently this technique is much more successful in the long-term.) Our little Kai-man is sounding quite croupy from the breathing tube that was inserted temporarily, and there's been some significant bleeding. Luckily, the practical side of me said "wear an old shirt today just in case!" (Yes...we women still worry about fashion somewhat, even with convalescing children.)

Not surprisingly, Kai's appetite bounced back quickly as he began scarfing down pureed mac and cheese, blended banana, ice cream and yogurt by eight o'clock this evening.

Kai's spirits were lifted by seeing his sister earlier tonight. Jade gave him a little "pep talk" (see above), telling him that she has been down this road also and that the "owies" will go away very soon! Course...then she proceeded to chomp down a cookie in front of him in her typical "big sister" fashion! Nope....palate surgery does NOT preclude our little guy from coveting thy sister's cookie!!!