helping kids with transitions

5 Tips for Helping Kids with Transitions

Many children, with and without disabilities, have difficulty managing transitions. This is especially true when you’re moving from a more preferred activity to a less-preferred activity. Who hasn’t had the battle of bedtime, especially when kids are involved with a fun project, watching tv, or playing right before? Here are some practical tips to help with transitions.

  1. Use a visual schedule or checklist

I live by checklists and schedules for myself, and have found that many of my clients have a reduction in stress, tantrums, and meltdowns when a schedule is provided to them. If your child can’t read yet, a combination of pictures and words (to reinforce reading!) can be really helpful. Try a wipe-off board where you write (and check off!) the list for the morning, or a folder with laminated pictures velcro-ed to it.

  1. Use a timer

Many kids have success with visual timers and 10 or 5 minute warnings. If your child can’t read an analogue clock, use a digital one, or use an analog that has a colored portion that ticks down, so they can see how much time is left.

  1. Think forward

In behavioral circles, this is known as FIRST-THEN, as in “first put your toys away, then we’ll go make lunch.” Setting it up this way helps ease anxiety about what’s coming next. You can also do this by reminding your child when they will have the opportunity to engage in the activity you’re asking them to transition away from again. “We have to put up the toys now, but after dinner, you will be able to play again.” I sometimes pair this with an IF-THEN. “If you can show me how quickly you can clean this up, then you’ll have more time to play later!”

  1. Make transitions fun

This can be especially helpful when you have to move from one extreme of activity level to another, i.e., a very active event to a very quiet one. As you transition, you can have your child pretend to be an animal or use their imagination to sneak to the next activity. If we have to go from playing outside to naptime, I build in about 10-15 minutes to pretend that we’re mice and we have to sneak past a cat, or pretend that we’re sneaking into a bank to jump in the vaults, Scrooge MacDuck style. It works similarly in reverse—pretend to be an airplane, careening down the hallway, or a T-Rex, stomping to your next destination.

  1. Provide choices

Another tip from the behavioral sphere: forced choices work well, and aren’t as horrible as they sound! Essentially, as the parent or teacher, you give two options that are equally palatable to you. “Do you want to use this pencil or that one to do your math?” “Do you want to take your shower before or after dinner?” The key is holding the child accountable for the choice that they made, and following through. We all like to feel like we have choices, and this is one way to give your children choices without letting them run the show.

  1. BONUS TIP! Teach calming skills

None of us are born knowing how to self-regulate. We all have to be taught how to calm ourselves down when we are over-stimulated, upset, angry, or sad. When children are small or have neurological challenges that make it difficult for them to follow multi-step directions, we have to co-regulate with them. Researchers Grolnick, Kurowski, McMenamy, Rivkin, and Bridges[1] identified multiple ways caregivers can co-regulate with children:

  • Prompting/helping: Caregiver physically or vocally prompts and scaffolds child (e.g., physical prompting with toy if child becomes frustrated)
  • Following the child’s lead: Caregiver is sensitive to child’s interests and follows the child to his/her desired toy/activity (e.g., Caregiver may appear to wait for child to choose a toy and then insert herself into interaction)
  • Redirection of attention: Caregiver distracts the child or directs the child’s attention away from negative stimulus (e.g., pointing out other toys in room)
  • Active ignoring: Caregiver actively ignores child during distress episodes (e.g., mom may continue to play with a toy or purposely turn away from child)
  • Reassurance: Caregiver reassures or encourages child surrounding frustrating or negative activity (e.g., It’s okay. You can do it!)
  • Emotional following: Caregiver’s reflection, extension or elaboration upon child’s distress or preoccupation (e.g., I know you want the toy)
  • Physical comfort: Caregiver initiates behaviors to comfort child (e.g., hugging, kissing, picking up the child, rocking)
  • Vocal comfort: Caregiver initiates vocalizations to comfort the child (e.g., sshhing, singing, sing-song voice)

[1] Grolnick, W. S., Kurowski, C. O., McMenamy, J. M., Rivkin, I., & Bridges, L. J. (1998). Mothers’ strategies for regulating their toddlers’ distress. Infant Behavior and Development, 21(3), 437–450. http://doi.org/10.1016/S0163-6383(98)90018-2

 

family estrangement

Things We Don’t Talk About: Family Estrangement & Cutoff

Content note: This post contains mention of childhood abuse and trauma. Please exercise discretion if this is something that may be triggering or upsetting.

This is part of a continuing series of “Things we don’t talk about,” also known as “Why people are in therapy” and “the elephant in the room.” While many therapists work with people who are estranged from family members. Not as many will acknowledge that there are times and events that make it appropriate to limit or even cut off contact with a family member. With more frequency, I am discussing and hearing about adult children who have experienced this with a parent. More often than not, the estrangement comes after years of verbal, emotional, physical, and/or sexual abuse. I often find myself asking the critical question: If you were not related to this person, would you continue to have a relationship with them?

I’m very lucky to have the parents that I have. I would still be friends with them even if I wasn’t related to them. Their parenting wasn’t perfect (no one’s is!). But they learned from their mistakes and tried to repair any tears that happened in our relationship over the years. They set appropriate limits with me and my sister, held us accountable when we broke rules, and raised us with the knowledge that we were loved and cared for.

It is appropriate to set boundaries.

Remember, boundaries are not for the other person! They are for the person setting the boundary, in order to draw the line and set a healthy limit on what is (and isn’t) acceptable. Sometimes cutting off contact is the healthiest thing to do. However, there’s a narrative in our culture that says that children should always love and be connected to their parents. When some of my clients have shared with friends that they don’t speak to their parent(s), they hear the old saying: Blood is thicker than water.

That phrase is often used to force someone to continue a relationship that not only isn’t healthy, but is actively harmful. But that’s not the whole saying. The whole saying is: The blood of the covenant is thicker than the water of the womb. Translation: the promises you make to people are more vital than a biological tie. With the help of a supportive therapist, you can start to learn your appropriate boundaries and work on setting them. When people violate those boundaries, they’re showing you who their covenant is with—and it’s not you.

vaping program

Introducing RAVE: Reduce Adolescent Vaping Education

Raising Awareness Around Vaping

Vaping, or the act of inhaling a vaporized liquid from an electronic smoking device, is becoming an epidemic across the country. Teenagers are picking up BLU cigarettes, JUULs, and other vaping devices for a multitude of reasons and ending up addicted to nicotine. Whether teenagers are interested because they see their friends vaping, enjoy the flavors, or think it looks cool, it’s detrimental to their health and wellbeing.

There is a common misperception that vaping is safer than smoking because vaporizers do not contain the hundreds of chemicals found in the tobacco leaves and filters of cigarettes. However, research is showing that this is not the case. The vapor is infused with propylene glycol, flavoring chemicals, and nicotine. A person who vapes, just like a person who smokes cigarettes, becomes dependent on the nicotine within the product.

Some vaporizer liquids do not contain nicotine, but most do. In fact, JUUL is the most popular brand of e-cigarettes and 100% of their “pods” contain nicotine. While it is marketed as a smoking cessation device to help adults kick the smelly habit of smoking traditional cigarettes, the marketing is also targeting teenagers. Until they were reprimanded by the FDA, JUUL had a highly engaging presence on Instagram, a social media platform mainly used by teenagers. And still, to this day, the design and packaging of the JUUL is sleek, “sexy”, and appealing to easily influenced teens.

More worrisome than the design and accessibility of the JUUL, and other vapes, is the discreetness of them. Unlike traditional cigarettes that come in a large pack and carry a lasting odor with them after they’re smoked, vapes are discreet in size and omit no odor. This makes it much harder for parents, teachers, and other adults to recognize when their teenager is vaping.

The RAVE Program

According to research reported in the Wall Street Journal, vaping rates among teenagers jumped 75% in 2018. Alarmed by this increase, Mark Neese, principal therapist at True North Counseling in Louisville, KY, has decided to raise awareness around the dangers associated with this behavior by introducing a special program. RAVE: Reduce Adolescent Vaping Education, is a 4 to 6-week program that combines individual, group, and family therapy with education to ensure that parents are able to act as change agents in the lives of their teenagers. Teens enrolled in RAVE will attend 4 weekly group sessions that are facilitated by two certified clinicians. True North Counseling’s certified clinicians include one behavioral specialist and one social worker who will provide up-to-date information about the dangers of vaping and smoking. Each session will feature a strong Mindfulness component as well.

In addition to the four group sessions, a family session will kick off the program and three individual sessions are also included with the goal of enlisting a commitment from the teen to stop vaping. During this process, parents are given strategies for relapse prevention including the use of Nicotine Test Kits. Nicotine can stay in your system for up to three months depending on the frequency of use. When used randomly by parents and guardians, nicotine testing proves effective in deterring teenagers from continuing to vape. Nicotine Test Kits will be provided to the parents or guardians who participate in the RAVE program, so they can test their teenagers as frequently or infrequently as they’d like.

Tips for Parents & Guardians

If you are a parent, guardian, or adult concerned that a teenager you know may be vaping, the first thing to do is talk to them. Ask them if they feel they are dependent on the device or if they feel agitated when they are not doing it. Discuss the risks of vaping including what’s known and not known about the long-term effects. Make sure that they understand vaping is just as bad for them as cigarettes, but with different effects and different results.

If you’ve already talked to them and still suspect that they are vaping, let True North Counseling in Louisville, Kentucky help. With the new RAVE program available at True North Counseling, parents or guardians can work with their teenager and True North Counseling’s certified clinicians to help teens stop vaping. As a team, everyone will come up with a strategy to quit vaping, prevent relapse, and stay mindful of the dangers associated with vaping and the benefits, both short-term and long-term, of not vaping.

To learn more about the dangers of vaping, read our past blogs on teen vaping and vaping facts. True North Counseling’s first RAVE program begins on July 11, 2019. For program costs and enrollment those interested in learning more can contact Henry L. Buckwalter, CSW, an Associate Clinician at True North Counseling, by calling 502-377-4814 today. 

Things We Don’t Talk About: Child Abuse

Content note: This post contains mention of childhood abuse and trauma. Please exercise discretion if this is something that may be triggering or upsetting.

Following on the heels of the previous post about Things We Don’t Talk About: Miscarriage and Stillbirth, I thought I’d exercise my role as “Namer of the Elephant in the Room” and talk about child abuse—specifically, childhood sexual abuse. From 2009-2013, national Child Protective Services agencies substantiated (or found strong evidence to indicate) that 63,000 children a year were victims of sexual abuse. A majority of child victims are 12-17. Of victims under the age of 18: 34% of victims of sexual assault and rape are under age 12, and 66% of victims of sexual assault and rape are age 12-17. The majority (9 out of 10) of these assaults happen to girls. Our own Kentuckiana community has seen several serial abusers in the news recently, with perpetrators who gained access to victims through schools, childcare organizations, and scouting community activities. The overwhelming response on all of these cases where children were abused has been “Where was her mother?”

The idea that sexual abuse is perpetrated by a stranger is simply false. Not only is it untrue, it’s also dangerous, because it shifts the focus from helping children be heard and feel safe to teaching children that there is nothing they can do to keep themselves safe from strangers. The vast majority of perpetrators of sexual violence against children are known adults who were trusted by the child’s parent(s). RAINN estimates that up to 93 percent of victims under the age of 18 know their abuser.

Make no mistake: the responsibility for child sexual abuse rests solely with the perpetrator. Child sexual abuse isn’t a symptom of “bad parents,” or being negligent or not caring about your kid. However, there are things that parents can do to reduce the risk of their child(ren) being sexually abused.

First, know the signs.

Physical signs:

  • Bleeding, bruises, or swelling in genital area
  • Bloody, torn, or stained underclothes
  • Difficulty walking or sitting
  • Frequent urinary or yeast infections
  • Pain, itching, or burning in genital area

Behavioral signs:

  • Changes in hygiene, such as refusing to bathe or bathing excessively
  • Develops phobias
  • Exhibits signs of depressionor post-traumatic stress disorder
  • Expresses suicidal thoughts, especially in adolescents
  • Has trouble in school, such as absences or drops in grades
  • Inappropriate sexual knowledge or behaviors
  • Nightmares or bed-wetting
  • Overly protective and concerned for siblings, or assumes a caretaker role
  • Returns to regressive behaviors, such as thumb sucking
  • Runs away from home or school
  • Self-harms
  • Shrinks away or seems threatened by physical contact

It’s never too late to have these conversations.

  • Teach your child about boundaries. Let your child know that no one has the right to touch them or make them feel uncomfortable — this includes hugs from grandparents or even tickling from mom or dad. It is important to let your child know that their body is their own. Just as importantly, remind your child that they do not have the right to touch someone else if that person does not want to be touched.
  • Teach your child how to talk about their bodies. From an early age, teach your child the names of their body parts. Teaching a child these words gives them the ability to come to you when something is wrong. Learn more about talking to children about sexual assault.
  • Be available. Set time aside to spend with your child where they have your undivided attention. Let your child know that they can come to you if they have questions or if someone is talking to them in a way that makes them feel uncomfortable. If they do come to you with questions or concerns, follow through on your word and make the time to talk.
  • Let them know they won’t get in trouble. Many perpetrators use secret-keeping or threats as a way of keeping children quiet about abuse. Remind your child frequently that they will not get in trouble for talking to you, no matter what they need to say. When they do come to you, follow through on this promise and avoid punishing them for speaking up.
  • Give them the chance to raise new topics. Sometimes asking direct questions like, “Did you have fun?” and “Was it a good time?” won’t give you the answers you need. Give your child a chance to bring up their own concerns or ideas by asking open-ended questions like “Is there anything else you wanted to talk about?”

 

 

 

Friday Waypoints

Friday Waypoints – 05/17/19

Mark Neese is back with another Friday Waypoints blog post. On this weeks Friday Waypoints, Mark discusses how drugs cause parents to abandon their children, why the internet is a dangerous place for teens, and he revisits The Parklands of Floyd Forks. Mark discusses his previous visit to The Parklands of Floyd Forks, a hidden gem in Louisville, KY, in his Friday Waypoints on 5/10.

Drugs and Parents that Abandon Their Kids

I’ve been working with families for about 25 years. My early career was working in the rural counties surrounding Louisville. The families that I worked with were struggling with poverty and at times intellectual disabilities. It was challenging and rewarding. Every now and then I run into one of the family members that I worked with and it is very gratifying to see them doing well these many years later.

Today things are different. I have never witnessed an epidemic as I have today: parents abandoning their children because of drugs. This past weekend was Mother’s Day and two of the teens that I work with wanted to call and talk with their mothers but were unable to contact them because they were both AWOL. Both mothers are semi-homeless and have serious drug problems. To compound the problem, one of the teens witnessed his father being taken away in an ambulance because of a suspected overdose, on the very same day. Not such a “Happy Mother’s Day.”

Meditating in The Parklands of Floyds Fork (Reprise)

I was back at the Parklands yesterday to visit the Moss Gibbs Woodland Gardens. It is the gem of the new park system. It’s beautiful, and quiet, and I anticipate spending many of my mornings there. I’m practicing Mindfulness and using guided meditations by Donald Seigel. For those interested in learning more you can visit his website for free meditation downloads: http://www.mindfulness-solution.com.

The meditation that I used yesterday while sitting in the midst of the garden was one that focused on self-compassion. During this meditation you focus on the phrases: “May I be happy, may I be healthy, may I live at ease,” or “May I be safe, may I be at peace, may I be free from suffering.” You can do this while driving, walking or sitting in a quiet place in your home. The Woodland Garden offers a place to sit quietly and listen to the Towhees, wrens and Cardinals. It offers a place to be part of a forest.

The Internet is a Dangerous Place for Teens

I am working with a Teen that was nearly swallowed up by Internet. Her mother saved her. It started with the website, “Wattpad.” This is a social storytelling platform. It ended with her sending pictures of herself to perfect strangers through a group on Instagram: #ddlg. She was being groomed for something dangerous and evil.

These are adult sites and 13-year olds should not be on them! She had no clue what she was getting into.

Parents, monitor your teenagers on the internet. There are predators that will take advantage of their innocence and take it from them!

Quote I’m Pondering

“Your smile and your laughter lit my whole world.”

Ranata Suzuki

Vaping FAQs

The Next Scourge (a term I never use) of Our Country: Teen Vaping

Leave it to the Tobacco Industry to figure out a way to get more people addicted to nicotine at a time when smoking in this country has been in decline.

Here is their approach: 1) Target teenagers, 2) Make the product very cool (sexy), 3) Make it in as many flavors as possible, and 4) Put nicotine in the product.

The result: Teenagers are increasingly using vape pens (e-cigarettes) and becoming addicted to nicotine and putting themselves at risk of smoking combustible cigarettes.

In case you have no idea what I’m talking about, here are some FAQs (Courtesy of Smoke Free America) about vaping:

Vaping FAQs

What is vaping?

Vaping is the act of inhaling a vaporized liquid from an electronic device. The vapor commonly contains nicotine, flavoring and other additives. It also can contain THC, the chemical in marijuana that makes the user feel “high.”

What are the different vape products?

Popular terms for vaping devices include JUULs, e-cigarettes, e-cigs, smokeless cigarettes, vaporizers, vape, vape pens, vapor pens, mods, tanks, cigalikes, e-hookah and hookah pens. These vary widely in size, shape and design. Some look like computer flash drives or highlighters, while others are bulky and box-like.

What is in a vape juice or e-liquid?

Vape juice, e-liquid, JUULpods – these are all names for the liquid that is vaporized into an aerosol cloud. Vape juice most commonly contains three ingredients: propylene glycol and/or glycerin, chemicals for flavoring, and nicotine. 

The pods for JUULs, the brand name of the most popular vaping device among teens, contains nicotine 100 percent of the time. The amount of nicotine in one JUULpod has the same amount of nicotine in an entire pack of cigarettes. Some vape pods can also contain THC, the chemical in marijuana that makes the user feel “high.” Complicating the issue, vaping doesn’t give off the telltale smell of smoking marijuana or cigarettes.

Is vaping healthier than smoking cigarettes?

Though some may claim vaping is less dangerous than traditional cigarettes, that doesn’t mean that vaping is safe. In other words, “safer” doesn’t mean safe. Studies have shown that the aerosol vapor can contain dangerous toxins, including heavy metals and chemicals known to cause cancer and other diseases. 1

Most vape devices contain nicotine, which is highly addictive. Human brain development continues far longer than was previously realized (until age 25), and nicotine use during adolescence and young adulthood has been associated with lasting brain impairments, including effects on working memory and attention. 2

There are also no standard regulations for vape manufacturers. Even with more than 450 different types of vape products, there are no universal standards for product design, ingredients and safety features. 3

More troubling, some vape products are owned by big tobacco companies, which have a history of prioritizing sales over safety.4

Some teens say they just vape flavors, without nicotine or THC. Is that possible?

While some vapes do not contain nicotine or THC, most do. In fact, 100 percent of JUULs – teens’ top choice for vaping devices – contain nicotine. And each JUUL pod contains the same amount of nicotine as a whole pack of cigarettes. Plus, studies have shown that most vaping products labeled “nicotine free” actually contain nicotine.5 For teens who don’t want to become addicted to nicotine, the safest option is not to vape at all. 

Can teens under age 18 legally vape and buy these products?

Vape devices and paraphernalia cannot legally be sold to or used by anyone under the age of 18. 

How can I tell if or what kids are vaping?

That’s part of the problem – it can be very hard to tell if a teen is vaping. Not only do manufacturers make discreet devices that resemble flash drives, highlighters and more, but they also do not have the same strong odor that is often a giveaway for parents and teachers. Vaping is so discreet, in fact, that students have been known to vape during class.

 

What is Divorce Counseling?

Divorce counseling is different from marital or couples counseling in that it takes place after the couple has decided to split up. (Incidentally, divorce counseling isn’t just for people who are legally married—it can also be helpful for people who have children or property in common.) Generally, divorce counseling can be divided into two parts: pre-divorce and post-divorce.

Pre-Divorce Counseling

  1. What: In pre-divorce counseling, you can expect to learn skills to rationally make the major decisions that have to be made when a couple is splitting assets, determining custody of their child(ren), or ironing out financial details. This is especially important for couples who have a child (or children) together. I have been known to ask parents to put the Three Tenets of Right Speech as the background to their phones: 1. Is it true? 2. Is it kind? 3. Is it necessary? (Or, as Craig Ferguson said in his standup, “Does it need to be said? Does it need to be said by me? Does it need to be said by me right now?”)
  2. Why: Often, by the time people get to deciding to divorce, there is so much animosity built up between parties that having everything becomes even more challenging. The choices that you make following your decision to proceed with splitting up can have an impact that far exceeds the length of your relationship, especially where children are involved. An important question that CoParenting International asks is, “What do you want the legacy of your divorce to be?”

Post-Divorce Counseling

  1. What: In post-divorce counseling, you can work with a neutral party to iron out the sticky situations that happen after divorce, whether that’s a financial change, a move, or a new adult in your child(ren)’s life. One of the things I teach is BIFF communication, which stands for Brief, Informative, Friendly, and Firm. An example would be a text reading, “Hi Sally. I will pick up Jeremy at 3 pm on Friday and bring him back to your house on Sunday at 5 pm. Thanks.” This is an alternative to the “nastygrams” often sent by co-parents, which may sound familiar if you’ve ever received (or sent) one: “Hey. PLEASE HAVE JEREMY READY at 3 pm Friday. I don’t want a repeat of last week, when you SAID he’d be ready, and he WASN’T. You just want to ruin our time together, don’t you?”
  2. Why: Life circumstances can change quickly, and the former spouse who was able to pay spousal support might not be able to if he or she experiences a job loss. Likewise, when new partners come into our former partners’ lives, re-negotiating can be extremely difficult.

If you need help navigating the difficulties of life after splitting up with your partner, contact us!

Teenagers and Phones

One of the most common problems we see in our practice is teenagers spending too much time on their phones. To me, this is a fairly complex problem with a simple solution. The only time your teen needs a phone is when they are not with you, in order to contact you and maintain safety. Past that point, having a phone is a privilege that you as the parent can bestow or withhold.

Before agreeing to give your child a phone, I recommend having a serious and frank discussion about expectations. Putting these expectations in writing is even better! Some things to consider before giving your child a phone:

  • Do they already “push limits”? If so, regulations that you put in place for the phone will probably not be followed.
  • Does your teen understand who the phone belongs to? As minors, they are not able to sign contracts. The phone (and the phone bill) belong to you, the parent. Your teen should never be under the illusion that the phone “belongs” to them.
  • Does your teen understand privacy? As it’s your phone, they have NO EXPECTATION of privacy. There should not be a password on the phone, nor should there be any unauthorized apps or messaging taking place. You have the ability (and responsibility) to monitor all activity taking place on your child’s phone.
  • Does your teen understand that nothing on the internet goes away? Your teen should assume that pictures, videos, and messages will be viewed by their friends, their enemies, their teachers, their future employers, their mom, and their grandparents. Before posting anything, they should assume that everything will be seen by the person whose judgement means the most in the world.

I understand that these expectations and conversations are difficult! But as the adult, you are legally responsible for anything that takes place on your devices. Our principle therapist Mark Neese often talks about the “parental trajectory,” meaning the path that a parent takes to meet their child’s needs from infancy, through childhood, in order to successfully launch them into adulthood and independence. What do you want your parental trajectory to look like?

What is Reactive Attachment Disorder?

Content note: This post contains mention of childhood abuse and trauma. Please exercise discretion if this is something that may be triggering or upsetting.

Reactive Attachment Disorder (often called RAD) is a childhood disorder characterized by:

  • A consistent pattern of emotionally withdrawn behavior toward caregivers, shown by rarely seeking or not responding to comfort when distressed
  • Persistent social and emotional problems that include minimal responsiveness to others, no positive response to interactions, or unexplained irritability, sadness or fearfulness during interactions with caregivers
  • Persistent lack of having emotional needs for comfort, stimulation and affection met by caregivers, or repeated changes of primary caregivers that limit opportunities to form stable attachments, or care in a setting that severely limits opportunities to form attachments (such as an institution)
  • No diagnosis of autism spectrum disorder

In the general population, RAD is believed to occur in 1.4% of children under the age of 5. However, this may be an under-estimate, as many families do not seek help for the symptoms, or know that help is available. Often when a child has a RAD diagnosis, they have experienced extreme neglect and/or abuse during their early childhood. The first child I saw with RAD was during my graduate training. (I will call her Sarah in this story, though both the name and any identifying details have been changed.) Both of her parents were multi-substance abusers, and were unable to attend to her needs when they were impaired. Additionally, they allowed their fellow drug abusers to cycle through their home, exposing their daughter to not only more witnessing of drug abuse, but also sexual and physical violence at the hands of her parents’ “friends.” Sarah was removed from her home at age 8, and was placed with her grandparents, where she had a stable, healthy home environment for the first time in her life.

Problem solved, right?

Unfortunately, no.

I look at RAD as a series of behavioral habits that have been learned over a period of time.

Like many children who have experienced neglect, Sarah stole and hoarded food. On the surface, this may just look like “bad” behavior, especially if viewing the behavior without the trauma lens. However, knowing Sarah’s background and understanding that, through many periods of her childhood, there was no food in her house. She had learned to save food from school and from the times when her parents were in a mental space to remember (and could afford) to buy food. Though she wasn’t in the same situation any more, the instinct to save herself from hunger was still there.

Similarly, like many kids raised in environments of abuse and neglect, Sarah had no self-regulation skills. (I’ve talked before about how important self-regulation skills are!) When parents cannot or do not attend to their children’s emotional needs, children cannot develop the skills to regulate their own emotions. So then why, in a stable situation, would Sarah have suddenly been able to connect to her caregivers emotionally? For kids with RAD, we see extremes in behavior—standoffishness that can’t be dismissed as being shy (a true unwillingness to allow people to get close to them), or immediate hyper-connectiveness that often puts the child at risk of future sexual or emotional abuse.

Not being able to self-regulate can look like age-inappropriate tantrums too. I’ve seen kids with RAD diagnoses scream like infants when they’re suffering. Those needs weren’t met when they were at the developmental stage of infancy, so when they feel those same needs aren’t being met, they return to the behavior that they engaged in at the time.

So what’s to be done?

People with RAD aren’t hopeless. (One of my personal biases is that people have an immense capacity for change, and are remarkably resilient.) However, change has to be precipitated by safety in the home environment and community. I can’t teach you that you’re safe if you’re not in fact safe. (In fact, that’s incredibly unethical and dangerous.) Studies have been done recently that show that therapy, even with “temporary” parents (i.e., foster parents), can be healing and bring about lasting change and progress. The key to making lasting, positive behavioral change is “providing a stable environment and taking a calm, sensitive, non-intrusive, nonthreatening, patient, predictable, and nurturing approach toward children” (Haugaard; Nichols, Lacher, & May). Fortunately, that’s something that specially-trained therapists can help you with! Contact True North Counseling for your first appointment.

 

Top 10 Tips for Caregivers of Students with IEPs

When your child has an Individualized Education Plan (IEP), each new school year brings a unique set of challenges. While this post is primarily for caregivers who are new to the IEP process, it never hurts to review some of the basics. I will refer to guardians in this post, as it encompasses anyone who has a legal relationship with a child. (I may do a separate post about IEPs for children in state’s care.) Please note that I am not a lawyer, and this post is primarily for students in public school in Kentucky. (I may also do a post about children with IEPs in private schools, but I will have to do my research first!)

Top Ten Tips for Caregivers of Students with IEPs

1. As the guardian, you can call an ARC meeting any time you want.

This is the “big meeting,” and involves not only the parent and teacher, but the school counselor, occupational therapist, speech therapist, physical therapist, behavior coach and anyone else who might be involved in your child’s school life.

2. Put things in writing, especially requests for meetings.

The school counselor (or if you’re lucky an ECE clerk) is usually responsible for coordinating the meeting. This helps get all the players together, but ultimately, it is the school principal who is on the line if there’s a legal dispute.

3. You can bring anyone you want to the meetings.

If you request district personnel to attend, do so in writing. (I once heard about a parent bringing their pastor with them for support. The school assumed that he was their attorney, and (not coincidentally!) were very cooperative that meeting!)

4. You don’t have to sign ANYTHING at the meeting.

You can request a copy to take home and look over. These meetings can be really overwhelming!

5. An IEP is a living (meaning it has to be updated), legally binding document.

No matter the school or classroom, the IEP dictates the services your child is legally entitled to under IDEA and FAPE.

6. If your child needs to be reassigned, you have the right to refuse the reassignment.

However, you need to be aware that refusing an assignment may make your life (and by extension your child’s life) more difficult. Your best bet is to learn why your child is being assigned to another classroom or school. Ideally, any reassignment would be to better meet a child’s needs.

7. Request a Functional Behavior Assessment

If the school or district is telling you that your child needs a different school or classroom assignment due to his or her behavior, you need to request a Functional Behavior Assessment or FBA. Now, this is my bias as someone who works with kids and their behavior for a living, but if behavior is keeping someone from participating in the environment, it doesn’t necessarily matter how many times we change the environment–the behaviors will still exist. The last thing you want to do is to change teachers, schools, etc. every time a challenging behavior pops up!

8. Remember that you ultimately know your child better than anyone else will.

Your job is to support and advocate for your child.

9. Some parents find it helpful to have a binder with their child’s picture on it.

This can be helpful to remind everyone at the meeting of who they’re talking about, and that the data is attached to an actual human being. This binder should have sections for past IEPs. A big red flag to me is when a goal has not changed, no progress has been made, nor has the goal been modified for at least six months. Look over your past IEPs before you go in for your annual meeting. This binder should also include assessments and your notes. This is where you can write down your questions for the meeting ahead of time, to ensure that you’re getting all your questions answered.

10. Above all else, remember that there are many teachers and other professionals who care about your kids, want them to succeed, and are on your side! Don’t be afraid to reach out and ask questions.