In September, Vivian had a neuropsychological evaluation. Basically, Jason and I had seen some unexpected changes in Vivian since her epilepsy diagnosis in January.
The differences were slight, except for the obvious change in energy/tiredness. She stopped reading long novels, and wasn't working on independent projects like she used to--projects that could last over a few days. Sometimes they were construction projects, sometimes painting, sometimes stories. They just seemed to vanish.
We weren't sure if it was a lull, or a real change, or if it was or was not related to epilepsy. I found out her condition qualified her for a visit to the neuropsychologist.
Vivian was evaluated over the course of two days. The eval consisted of a few questionnaires for me on her behalf, and a series of IQ/problem solving tasks. In short, Vivian is very intelligent, a good problem solver, highly motivated and enjoys being challenged. What was surprising was sometimes she misses "the big picture" type of question. While we'll never know whether or not this was always how Vivian was, or was going to be, Jason and I believe our observations of Vivian (types of books, projects, etc.) are different than they used to be. We've also seen her reading comprehension scores slide, even though she's on the higher level of scores related to her peers.
The neuropsych eval strongly hinted that this has been seen in epileptic patients. Normally this is not a side effect of medication, and was my suspicion, but rather a function of seizure effect/brain damage. Vivian's MRI shows no abnormalities. The evaluation gave us strategies to help Vivian as she grows older with things like reading comprehension, should we need them. In essence, this is a "baseline" for us, in case Vivian starts behaving differently or starts having trouble in school.
I'm glad Vivian was evaluated. I was disappointed that this was never recommended for Elena, so I asked the doctor about it. We had a good, long talk; basically, I noticed that when filling out the questionnaires for Vivian, I would have essentially recorded the opposite for Elena (self-sufficiency, social behavior, responsibilities, etc.).
She told me that currently, if a baby is born and determined to have a brain injury (as Elena was), their record is immediately flagged for a neuropsychology evaluation during her elementary school years. This can help a child who struggles with independence, personal responsibility, executive function, and social interaction--basically, all fields Elena (and many other kids) require assistance/help. It can provide strategies for her, and our family, to help achieve goals, manage expectations, and improve self-sufficiency. I wish I had known about this sooner.
I had Elena evaluated in November.
Our main question for the neuropsychologist was regarding our expectations for Elena, and if they were reasonable. They are not outrageous. She is intelligent, even though she struggles with some concepts, and is verbally talented. There is more to her stubbornness and lack of progress (in self-care) than just "being a teenager". It's a mix of "other', teenage angst, learned helplessness, and unwillingness to change (she is happy how things are, doesn't want to do more for herself--other people doing things for her suits her just fine, etc.).
The biggest message we got from the evaluation was that Elena is exhausted. Mentally and physically--the day exhausts her. She feels overwhelmed. By everything. She does not get excited about learning something new, it does not motivate her to do more with it--it just exhausts her. (She is not depressed.)
I thought that was how someone feels if the subject matter isn't interesting to them. I get that; if you don't like what's being taught at school or at home, it's a drag. To me, this would indicate nothing at school interests her--which I know isn't the case. And even though it's exhausting to her, she is doing much less than your average teenager--she has to be able to handle more, if she's ever to be a functional adult. Or functional teenager, for that matter.
The psychologist and I were a bit at odds, mostly b/c she was talking about how to encourage Elena through constant praise, very Kazdin-method type of lifestyle. I am convinced this doesn't work on a smart teenager--she can see right through shallow praise, and it backfires on us.
So, in short, we've been trying to encourage good behavior and try to be more patient. It basically just gave us more responsibilities than ever, and didn't help our home life much.
But, we eventually had a breakthrough. And that's where we are now.
Showing posts with label psychologist. Show all posts
Showing posts with label psychologist. Show all posts
Friday, December 7, 2018
Friday, December 19, 2014
New Waiver Business
I decided to apply for a new Medicaid waiver. I love our current one (ECDC waiver); last year I called a UCP branch (not the one in town, one in a major city--Richmond) and asked if there was anything I should be thinking about for the future, as E grows older. The answer was yes, the Developmental Disability (DD) waiver. Basically, it's like ECDC on steroids.
You have to qualify in at least two different categories to apply for the waiver. I could think of four. So, I called up the office and asked what I needed to do. The first thing was to get a psychological evaluation to prove Elena isn't intellectually disabled. No problem, right?
WRONG. First of all, I only had 45 calendar days to get the report in. I needed the report before I could get a screening. I called the school psychologist--she took 5 days to get back to me, and then said they didn't do that (they don't--unless you already have a psych eval on file as a part of your kids' IEP, they won't do it). I called twenty psychologists in town; most of them didn't do this. Oh, and by the way, psychological evaluations for exclusion are never covered by insurance. For the psychologists that would do the screening, prices were $350 and up.
Well, I got one--but I couldn't get one before the screening appointment, which I had made at the Richmond office on the same day as two other appointments for E (I didn't want to pull E out of school more than once). I was allowed to do the screening in good faith that E wouldn't be labeled intellectually disabled (excludes from the DD waiver).
The screening went well--E actually qualified in five out of six categories for the waiver.
We had E's psych eval--it's basically the WISC IQ test and a report. I faxed it over, and now we're just going through the hoops to get on the DD waiver wait list. Which is about 5 years long. I figure that's okay, maybe we'll have it when she gets to middle/high school.
I got a call from the psychologist, Dr. Patrick. He said if I was willing, would I be interested in coming in and talking about Elena's test results; he said he might have some tricks that would help us deal with frustrations as E gets older. ARE YOU KIDDING? Who wouldn't?
That appointment was this week. In a nutshell, they said that Elena is basically a verbal genius. And that given her language skills are so strong, one would assume that other skills are strong (true assumption). UNTRUE in real life. Her other scores--particularly spatial relations, problem solving, ordering--are on the low end of average. (I'll write the official psych categories once I find the report again). This IQ score spread between her verbal and other categories--is seen in less than a half of a percent in her peer population.
But it's relatively common in spastic diplegics.
The difference in these skills indicates Elena has a non verbal learning disability. I don't know much about this, but schools do; I'll be giving them this report addendum once I get it. The psychologists believe that once a few NVLD tricks are employed, E will make rapid progress in her deficient areas.
I said that was great…but what can I do at home? I gave some examples, such as:
1) Brushing teeth. For a very long while, she would fight us all the time b/c she insisted on squeezing the tube from the middle instead from the bottom. I showed her tons of time, she just would go back to her way and scream that there wasn't any toothpaste. For MONTHS.
Answer: Are you normally trying to get somewhere during this teeth brushing event? Yes (school). They said I can't be a teacher and a time manager. I have to pick one. If I'm teaching her, time doesn't matter, and we do it calmly and work it out. If I'm a time manager--just help her with the toothpaste, b/c she won't get the lesson.
2) Brushing hair. Elena loves her long blond hair, but she can't brush it well. I've taught her how to start at the bottom, move up, and then brush down from the top, as well as from the back, where you hold the brush behind you and go down from there. Both psychologists said at the same time "she doesn't know where the brush is" in relation to her head. Makes sense, b/c she basically tangles everything up in the back. Again, the solution (besides cutting her hair) is to sit down, teach her, mirror each other, etc. so she can learn a different way.
3) Time management. I tell her she has 40 minutes to do four things (get dressed, brush teeth, come downstairs, brush hair). We are always running late, we are always waiting for her. She knows how to do these things (minus the hair), she knows how to tell time, she knows she takes longer but still won't get started and it's always a struggle. Again, the psychs say in unison, "tell her to do one thing. Then when that's done, tell her to do another one thing."
This is all pretty new around here, so I'm reading up on NVLD and dividing my time between teacher and time manager. That was a good piece of advice, as I have seen the frustration level decrease since that change.
Hopefully school will help…and there's a chance that she'll receive OT, which would be great. If not, we may need to seek OT privately.
You have to qualify in at least two different categories to apply for the waiver. I could think of four. So, I called up the office and asked what I needed to do. The first thing was to get a psychological evaluation to prove Elena isn't intellectually disabled. No problem, right?
WRONG. First of all, I only had 45 calendar days to get the report in. I needed the report before I could get a screening. I called the school psychologist--she took 5 days to get back to me, and then said they didn't do that (they don't--unless you already have a psych eval on file as a part of your kids' IEP, they won't do it). I called twenty psychologists in town; most of them didn't do this. Oh, and by the way, psychological evaluations for exclusion are never covered by insurance. For the psychologists that would do the screening, prices were $350 and up.
Well, I got one--but I couldn't get one before the screening appointment, which I had made at the Richmond office on the same day as two other appointments for E (I didn't want to pull E out of school more than once). I was allowed to do the screening in good faith that E wouldn't be labeled intellectually disabled (excludes from the DD waiver).
The screening went well--E actually qualified in five out of six categories for the waiver.
We had E's psych eval--it's basically the WISC IQ test and a report. I faxed it over, and now we're just going through the hoops to get on the DD waiver wait list. Which is about 5 years long. I figure that's okay, maybe we'll have it when she gets to middle/high school.
I got a call from the psychologist, Dr. Patrick. He said if I was willing, would I be interested in coming in and talking about Elena's test results; he said he might have some tricks that would help us deal with frustrations as E gets older. ARE YOU KIDDING? Who wouldn't?
That appointment was this week. In a nutshell, they said that Elena is basically a verbal genius. And that given her language skills are so strong, one would assume that other skills are strong (true assumption). UNTRUE in real life. Her other scores--particularly spatial relations, problem solving, ordering--are on the low end of average. (I'll write the official psych categories once I find the report again). This IQ score spread between her verbal and other categories--is seen in less than a half of a percent in her peer population.
But it's relatively common in spastic diplegics.
The difference in these skills indicates Elena has a non verbal learning disability. I don't know much about this, but schools do; I'll be giving them this report addendum once I get it. The psychologists believe that once a few NVLD tricks are employed, E will make rapid progress in her deficient areas.
I said that was great…but what can I do at home? I gave some examples, such as:
1) Brushing teeth. For a very long while, she would fight us all the time b/c she insisted on squeezing the tube from the middle instead from the bottom. I showed her tons of time, she just would go back to her way and scream that there wasn't any toothpaste. For MONTHS.
Answer: Are you normally trying to get somewhere during this teeth brushing event? Yes (school). They said I can't be a teacher and a time manager. I have to pick one. If I'm teaching her, time doesn't matter, and we do it calmly and work it out. If I'm a time manager--just help her with the toothpaste, b/c she won't get the lesson.
2) Brushing hair. Elena loves her long blond hair, but she can't brush it well. I've taught her how to start at the bottom, move up, and then brush down from the top, as well as from the back, where you hold the brush behind you and go down from there. Both psychologists said at the same time "she doesn't know where the brush is" in relation to her head. Makes sense, b/c she basically tangles everything up in the back. Again, the solution (besides cutting her hair) is to sit down, teach her, mirror each other, etc. so she can learn a different way.
3) Time management. I tell her she has 40 minutes to do four things (get dressed, brush teeth, come downstairs, brush hair). We are always running late, we are always waiting for her. She knows how to do these things (minus the hair), she knows how to tell time, she knows she takes longer but still won't get started and it's always a struggle. Again, the psychs say in unison, "tell her to do one thing. Then when that's done, tell her to do another one thing."
This is all pretty new around here, so I'm reading up on NVLD and dividing my time between teacher and time manager. That was a good piece of advice, as I have seen the frustration level decrease since that change.
Hopefully school will help…and there's a chance that she'll receive OT, which would be great. If not, we may need to seek OT privately.
Tuesday, September 6, 2011
Bedtime Disappointment
Well, here I am again.
Elena is acting out at bedtime again. I have no idea what set it off...we were doing so well over the summer. We spent the night at my parent's house one time, and E was TERRIBLE--screaming, shouting, just...awful.
Her outbursts have been sporadic since then, but seem to be approaching regularity. I am convinced it is not because of school (well, it's been happening through the summer too, anyway...whatever that means). She is seriously FINE throughout the day--happy, smiley, occasionally contrary (she's 6, after all) but when it comes to night time--as soon as she gets tucked in, she picks something to obsess about.
Is her blanket on right? (For the 5th time, YES)
Will I come and check her? (I DO THIS EVERY NIGHT, once she is asleep--I shut her door almost all the way, so she knows I've been there)
Does she have a tissue if she starts crying? (YES. I do remind her if she loses it, or needs another one, she's perfectly capable of going to the bathroom to get one herself if she thinks she needs one that badly.)
She will ask these questions in different (or same) ways at least 5 times. She KNOWS the answer, but will start screaming if we don't answer her. Then she'll say she "misses [fill in the blank]" (family, friends, a stuffed animal downstairs) or that she's "afraid of [fill in the blank]". She NEVER SAYS THESE THINGS until she is under the covers at bedtime. Then she's upset b/c she "can't fall asleep" or I "won't let her fall asleep", screaming about it for 20 minutes or more. Then she tries to switch the parent in charge.
It's almost like she needs 20 minutes of crying in order to rest.
It's INFURIATING. I am so disappointed. I am angry with her. I try not to show it, try to make bedtime as normal and unanxious as possible, but this makes my mouth and head hurt b/c I am gritting my teeth so much. Jason and I are dreading bedtime again. Elena is robbing any couple time we might have with her behavior--because once she is actually asleep, we are too drained to bother trying to talk to each other. Some nights we rebound, but normally I am completely tapped out.
So, today I'm calling back our psychologist. The one we graduated from this Spring. I told myself I wouldn't feel like a failure if I had to call back...but that's simply not true.
Elena is acting out at bedtime again. I have no idea what set it off...we were doing so well over the summer. We spent the night at my parent's house one time, and E was TERRIBLE--screaming, shouting, just...awful.
Her outbursts have been sporadic since then, but seem to be approaching regularity. I am convinced it is not because of school (well, it's been happening through the summer too, anyway...whatever that means). She is seriously FINE throughout the day--happy, smiley, occasionally contrary (she's 6, after all) but when it comes to night time--as soon as she gets tucked in, she picks something to obsess about.
Is her blanket on right? (For the 5th time, YES)
Will I come and check her? (I DO THIS EVERY NIGHT, once she is asleep--I shut her door almost all the way, so she knows I've been there)
Does she have a tissue if she starts crying? (YES. I do remind her if she loses it, or needs another one, she's perfectly capable of going to the bathroom to get one herself if she thinks she needs one that badly.)
She will ask these questions in different (or same) ways at least 5 times. She KNOWS the answer, but will start screaming if we don't answer her. Then she'll say she "misses [fill in the blank]" (family, friends, a stuffed animal downstairs) or that she's "afraid of [fill in the blank]". She NEVER SAYS THESE THINGS until she is under the covers at bedtime. Then she's upset b/c she "can't fall asleep" or I "won't let her fall asleep", screaming about it for 20 minutes or more. Then she tries to switch the parent in charge.
It's almost like she needs 20 minutes of crying in order to rest.
It's INFURIATING. I am so disappointed. I am angry with her. I try not to show it, try to make bedtime as normal and unanxious as possible, but this makes my mouth and head hurt b/c I am gritting my teeth so much. Jason and I are dreading bedtime again. Elena is robbing any couple time we might have with her behavior--because once she is actually asleep, we are too drained to bother trying to talk to each other. Some nights we rebound, but normally I am completely tapped out.
So, today I'm calling back our psychologist. The one we graduated from this Spring. I told myself I wouldn't feel like a failure if I had to call back...but that's simply not true.
Thursday, February 10, 2011
Psych Graduation
The Handy Family has Left the (Psych) building!
We graduated! We've been seeing a (student) psychologist since about August 2010, specifically about Elena's nighttime issues (which aren't a problem now, by the way). We have come a long, long way.
Here's the recap.
Sometime between Elena starting to talk (2.5 years) and 4 years of age, she started freaking out at bedtime. I don't know what caused it--but it didn't take long before it was hours of straight-up screaming before bedtime, and an average of 2 hours screaming during the night. IT. WAS. AWFUL. Jason and I fought about what was going on--he thought it was due to brain damage, and may need medication; he wanted a sleep specialist. I thought it was a parenting problem--but we didn't know what we were doing wrong, and didn't know how to fix it. E's pediatrician (and other main docs) agreed with me. I didn't want to medicate Elena. After one last very very bad night, where just about all of us were crying, losing our minds, I called professionals the next day. Eight of them, hoping just one would call me back.
Two did. I chose the UVA school of education, where we'd be seeing a student psychologist and be observed by an invisible team via camera. I chose them for two reasons--one, they were cheap; two, they were close to work. We saw them weekly, or once every two weeks. Sometimes it was all of us; sometimes it was just a parent+Elena, and then sometimes just me.
We saw results, literally, after one month. I couldn't believe it. We had spent close to two years dreading every nightfall.
What took me so long? I mean, I accept--and seek--a LOT of help raising my kids. I guess a lot of that help revolved around things I wasn't trained for--like physical therapy, modern medicine, sign language, nursing, orthoses, assistive devices, etc. But for some reason, getting help with "the basics of parenting"--putting your child to bed--took forever. I felt like I was admitting I was a failure.
Well, in case my experience can help any of you, here's what I've learned. Keep in mind that during this nighttime troublefest/rehabilitation, Elena had 2 rounds of Botox, three surgeries (eyes, SDR, and PERCS), countless hours of therapy, public school, and birth of a sibling. In no particular order, here is what helped us:
1. If you have a family problem, try to make a family solution. Have a Family Meeting, where you all address the problem, and everyone has input to create a Family Plan. You stick to the plan, and refer to it often.
2. Elena's a smart girl; I need to ask her opinion on family matters.
3. Elena is a big sister and I should treat her like one. I was trying to include her in family activities, but in doing so, I wasn't making special "Elena time". We have "Big Girl Time" after Vivian goes to bed; it makes E feel special, and differentiates the two kids.
4. Having a third party (psychologist) really took the pressure off us parents. It made us all listen to someone else; if E had a problem with the plan, it was with the plan or the psychologist, NOT ME.
5. We used the Ferber Method. We tried this before, and failed miserably. Here's what we did--starting this regimen during the middle of the night wake-ups (this was all part of our family plan):
--if E wakes up, we walk in and ask what's going on. If she's not sick/needing to use the bathroom/(insert good reason for being up here), we tell her our comfort phrase "I love you. I know you can do this, I know you can go back to sleep." LEAVE. Don't tell them you'll be back.
--wait 3 minutes. If she's crying, repeat.
--wait 5 minutes. If she's crying, repeat.
--wait 10 minutes. If she's crying, repeat.
--repeat every 10 minutes until she's asleep.
Some nights, E would crawl out of bed repeatedly (she can't get back in). I'd calmly carry her back to bed, and say the phrase, and keep going.
Literally, this never took more than 40 minutes. After dealing with screaming/tantrums literally for hours EVERY NIGHT for two years, 40 minutes was NOTHING. It didn't take long until the night wakings stopped; then we tackled the actual going to bed part in the same way.
Today, I put her in bed, tuck her in, say goodnight and leave. I get ready for bed myself, and by the time I come back to read her a book, she's asleep.
I am really proud of us. Elena is proud of herself, and of me. Karen and UVA Curry School--I can't thank you enough.
We graduated! We've been seeing a (student) psychologist since about August 2010, specifically about Elena's nighttime issues (which aren't a problem now, by the way). We have come a long, long way.
Here's the recap.
Sometime between Elena starting to talk (2.5 years) and 4 years of age, she started freaking out at bedtime. I don't know what caused it--but it didn't take long before it was hours of straight-up screaming before bedtime, and an average of 2 hours screaming during the night. IT. WAS. AWFUL. Jason and I fought about what was going on--he thought it was due to brain damage, and may need medication; he wanted a sleep specialist. I thought it was a parenting problem--but we didn't know what we were doing wrong, and didn't know how to fix it. E's pediatrician (and other main docs) agreed with me. I didn't want to medicate Elena. After one last very very bad night, where just about all of us were crying, losing our minds, I called professionals the next day. Eight of them, hoping just one would call me back.
Two did. I chose the UVA school of education, where we'd be seeing a student psychologist and be observed by an invisible team via camera. I chose them for two reasons--one, they were cheap; two, they were close to work. We saw them weekly, or once every two weeks. Sometimes it was all of us; sometimes it was just a parent+Elena, and then sometimes just me.
We saw results, literally, after one month. I couldn't believe it. We had spent close to two years dreading every nightfall.
What took me so long? I mean, I accept--and seek--a LOT of help raising my kids. I guess a lot of that help revolved around things I wasn't trained for--like physical therapy, modern medicine, sign language, nursing, orthoses, assistive devices, etc. But for some reason, getting help with "the basics of parenting"--putting your child to bed--took forever. I felt like I was admitting I was a failure.
Well, in case my experience can help any of you, here's what I've learned. Keep in mind that during this nighttime troublefest/rehabilitation, Elena had 2 rounds of Botox, three surgeries (eyes, SDR, and PERCS), countless hours of therapy, public school, and birth of a sibling. In no particular order, here is what helped us:
1. If you have a family problem, try to make a family solution. Have a Family Meeting, where you all address the problem, and everyone has input to create a Family Plan. You stick to the plan, and refer to it often.
2. Elena's a smart girl; I need to ask her opinion on family matters.
3. Elena is a big sister and I should treat her like one. I was trying to include her in family activities, but in doing so, I wasn't making special "Elena time". We have "Big Girl Time" after Vivian goes to bed; it makes E feel special, and differentiates the two kids.
4. Having a third party (psychologist) really took the pressure off us parents. It made us all listen to someone else; if E had a problem with the plan, it was with the plan or the psychologist, NOT ME.
5. We used the Ferber Method. We tried this before, and failed miserably. Here's what we did--starting this regimen during the middle of the night wake-ups (this was all part of our family plan):
--if E wakes up, we walk in and ask what's going on. If she's not sick/needing to use the bathroom/(insert good reason for being up here), we tell her our comfort phrase "I love you. I know you can do this, I know you can go back to sleep." LEAVE. Don't tell them you'll be back.
--wait 3 minutes. If she's crying, repeat.
--wait 5 minutes. If she's crying, repeat.
--wait 10 minutes. If she's crying, repeat.
--repeat every 10 minutes until she's asleep.
Some nights, E would crawl out of bed repeatedly (she can't get back in). I'd calmly carry her back to bed, and say the phrase, and keep going.
Literally, this never took more than 40 minutes. After dealing with screaming/tantrums literally for hours EVERY NIGHT for two years, 40 minutes was NOTHING. It didn't take long until the night wakings stopped; then we tackled the actual going to bed part in the same way.
Today, I put her in bed, tuck her in, say goodnight and leave. I get ready for bed myself, and by the time I come back to read her a book, she's asleep.
I am really proud of us. Elena is proud of herself, and of me. Karen and UVA Curry School--I can't thank you enough.
Sunday, September 12, 2010
Taming Tantrums: Professional #2 says...
After E's last nighttime meltdown, I went crazy looking for help. One of the resources I found was at the University's School of Education, where they have child (?) psychologists. We started seeing someone as a family, primarily for E's sleep issues, and secondary for how to cope with Elena's self-realizations regarding her disability.
The family counseling is going okay. I guess I say okay, b/c things at home are going pretty smoothly. I told the therapist that my end goal was to put E to bed, no problems. Meaning, I tuck E in, smooch, goodnight, leave. Everyone rests until we wake up the next day. If E has to get up for some reason (bathroom, etc.) she takes care of it herself and then goes back to bed herself.
RIGHT NOW, we are in such a good place...E goes to bed by one parent (usually me) tucking her in, smooch, then reading books. She falls asleep during the books (she isn't looking at them while we read, she's "resting her eyes and her voice"). Since school has started, normally it's a 5-10 minute reading session and that's it. Rarely, it's a 40-minute reading session. Some nights she needs help in the bathroom, but she gets there herself, and then we help finish up and then put her back in bed and read another book to her while she falls back asleep (but this hasn't happened in a while).
Comparatively speaking, this nighttime routine is NIRVANA. It's a world away from hours of screaming every night.
Well our therapist wants us to go for the end game. Tuck in, smooch, leave. I am extremely apprehensive...we've come SO FAR. Things ARE GOOD. The therapist says we need to Ferberize her for her own good (and ours). Deep down, sure, I think it would be better for her (and us) if we could get it to work. But why rock the boat when things are SO CALM?
I don't want to be negative...but you all get me.
The family counseling is going okay. I guess I say okay, b/c things at home are going pretty smoothly. I told the therapist that my end goal was to put E to bed, no problems. Meaning, I tuck E in, smooch, goodnight, leave. Everyone rests until we wake up the next day. If E has to get up for some reason (bathroom, etc.) she takes care of it herself and then goes back to bed herself.
RIGHT NOW, we are in such a good place...E goes to bed by one parent (usually me) tucking her in, smooch, then reading books. She falls asleep during the books (she isn't looking at them while we read, she's "resting her eyes and her voice"). Since school has started, normally it's a 5-10 minute reading session and that's it. Rarely, it's a 40-minute reading session. Some nights she needs help in the bathroom, but she gets there herself, and then we help finish up and then put her back in bed and read another book to her while she falls back asleep (but this hasn't happened in a while).
Comparatively speaking, this nighttime routine is NIRVANA. It's a world away from hours of screaming every night.
Well our therapist wants us to go for the end game. Tuck in, smooch, leave. I am extremely apprehensive...we've come SO FAR. Things ARE GOOD. The therapist says we need to Ferberize her for her own good (and ours). Deep down, sure, I think it would be better for her (and us) if we could get it to work. But why rock the boat when things are SO CALM?
I don't want to be negative...but you all get me.
Tuesday, July 27, 2010
Taming Tantrums: Professional #1 says...
Earlier this week I met with someone about E and her (for lack of a better word) separation anxiety. The day before this meeting, E had screamed for FOUR HOURS--from 9 pm until after midnight. Yeah, rough night.
WELL. I know a lot of you out there have tantrum issues, or sleep issues...and while there are differences between our children, if we have any similarities PLEASE TRY THIS.
Here are the highlights:
Me: E keeps us from sleeping. I think she's mainly a normal kid with motor issues. She realizes these motor delays, and is becoming more aware of her differences. I think this has something, probably not everything, to do with her acting out.
B: E doesn't have much in her home life (with Mom and Dad there) that sets her apart from her baby sister. She needs Big Girl time/activities that make her feel special. She especially needs this as her sister eclipses her in motor function. She's a smart girl. Talk to her like one.
Me: I tried--during an episode, she just screams, there's no reasoning with her. The next day, if I bring it up, she's like "yeah, my bad."
B: This is a family issue. Make it a family discussion. Problem-solve as a family--E included, but not Vivian, b/c she's the baby.
Me: OH.
B suggested structuring the discussion like so:
When I get home, tell E after Viv goes to bed, we need to have a family discussion. Don't say anything else about it; let her "stew".
When the Family Discussion starts, begin with:
"We have a Family Problem."
"No one is getting a good night's sleep."
"This is because Elena is screaming too much".
"Let's work as a team to fix this."
Then open up the discussion, asking questions to everyone (especially E) related to why she screams, what she's thinking, what SHE thinks we should do to fix it (being reasonable, of course). Make guidelines ("E needs to stay in her room") and consequences for improper actions, letting E think of the consequences.
So we did, and put it on paper. I DID give her one child Benadryl chewable to try to tire her out, to try to ensure success (FULL DISCLOSURE). We read it over several times. Everyone agreed and signed their name.
We had Big Girl Time, including staying up 30 minutes later (B said that couldn't hurt--especially if she was crying for hours at her normal bedtime, anyway) to further accentuate the fact that she was older than Vivian. (THIS WAS A HUGE WIN--E's eyes just fired up when we mentioned Big Girl Time and Big Girl Activities that Vivian wasn't allowed to do.)
Everyone slept ALL NIGHT.
For the FIRST TIME in I have NO IDEA.
I feel like this is how most normal families must feel in the morning--reborn. I'm serious--it was a rainy muggy day, a bad hair day, a frumpy clothing day, a still-in-pain-from-wasp-sting/back crampy day, a rush-around I have work/E's PT/home life day--and I felt like I was all sunshine and rainbows, smiling like I just won the lottery on my sweltering mile walk to work.
WOW.
Now, I don't have super-high hopes that all nights will be like this. And that's okay. But to know that it can happen, and that we can be successful, if we have the right strategy (and luck?)--priceless.
Update:
2nd night in a row, everyone sleeps.
3rd night in a row, everyone sleeps--E woke up a little grumpy once, but our AC just broke. She still didn't scream, so that's in the 'win' column.
4th: some screaming. E came out of her room--but that's b/c she needed help in the bathroom. Overall, didn't last long. It's not a win, but it's still a far cry from the meltdown. (is my good fortune waning? uh oh...)
5th: good night.
6th: good night.
7th: bad night.
8th: EXTREMELY bad night.
9th: Started off badly; after 7 minutes of crying and discussion, E asked for a "do-over". Rest of the night was good!
10th-14th: fantastic.
15th--no longer updating.
WELL. I know a lot of you out there have tantrum issues, or sleep issues...and while there are differences between our children, if we have any similarities PLEASE TRY THIS.
Here are the highlights:
Me: E keeps us from sleeping. I think she's mainly a normal kid with motor issues. She realizes these motor delays, and is becoming more aware of her differences. I think this has something, probably not everything, to do with her acting out.
B: E doesn't have much in her home life (with Mom and Dad there) that sets her apart from her baby sister. She needs Big Girl time/activities that make her feel special. She especially needs this as her sister eclipses her in motor function. She's a smart girl. Talk to her like one.
Me: I tried--during an episode, she just screams, there's no reasoning with her. The next day, if I bring it up, she's like "yeah, my bad."
B: This is a family issue. Make it a family discussion. Problem-solve as a family--E included, but not Vivian, b/c she's the baby.
Me: OH.
B suggested structuring the discussion like so:
When I get home, tell E after Viv goes to bed, we need to have a family discussion. Don't say anything else about it; let her "stew".
When the Family Discussion starts, begin with:
"We have a Family Problem."
"No one is getting a good night's sleep."
"This is because Elena is screaming too much".
"Let's work as a team to fix this."
Then open up the discussion, asking questions to everyone (especially E) related to why she screams, what she's thinking, what SHE thinks we should do to fix it (being reasonable, of course). Make guidelines ("E needs to stay in her room") and consequences for improper actions, letting E think of the consequences.
So we did, and put it on paper. I DID give her one child Benadryl chewable to try to tire her out, to try to ensure success (FULL DISCLOSURE). We read it over several times. Everyone agreed and signed their name.
We had Big Girl Time, including staying up 30 minutes later (B said that couldn't hurt--especially if she was crying for hours at her normal bedtime, anyway) to further accentuate the fact that she was older than Vivian. (THIS WAS A HUGE WIN--E's eyes just fired up when we mentioned Big Girl Time and Big Girl Activities that Vivian wasn't allowed to do.)
Everyone slept ALL NIGHT.
For the FIRST TIME in I have NO IDEA.
I feel like this is how most normal families must feel in the morning--reborn. I'm serious--it was a rainy muggy day, a bad hair day, a frumpy clothing day, a still-in-pain-from-wasp-sting/back crampy day, a rush-around I have work/E's PT/home life day--and I felt like I was all sunshine and rainbows, smiling like I just won the lottery on my sweltering mile walk to work.
WOW.
Now, I don't have super-high hopes that all nights will be like this. And that's okay. But to know that it can happen, and that we can be successful, if we have the right strategy (and luck?)--priceless.
Update:
2nd night in a row, everyone sleeps.
3rd night in a row, everyone sleeps--E woke up a little grumpy once, but our AC just broke. She still didn't scream, so that's in the 'win' column.
4th: some screaming. E came out of her room--but that's b/c she needed help in the bathroom. Overall, didn't last long. It's not a win, but it's still a far cry from the meltdown. (is my good fortune waning? uh oh...)
5th: good night.
6th: good night.
7th: bad night.
8th: EXTREMELY bad night.
9th: Started off badly; after 7 minutes of crying and discussion, E asked for a "do-over". Rest of the night was good!
10th-14th: fantastic.
15th--no longer updating.
Thursday, July 22, 2010
Separation Anxiety (?) or Here We Go Again
E had Kindergarten Camp this week.
It's basically a 3-day, 2 hour/day stint to introduce rising kindergartners to their teacher, school, classroom, and potential classmates. Normally it's for kids that are new to the experience. Elena has been in public pre-K for the last two years. Last year, she was in this same school, across the hall from her new classroom. She even knew the teacher, and some of her classmates.
The first morning, it was A NIGHTMARE. It started the night before...
"Mommy, I'm going to miss you!!" and then crying/screaming/MELTDOWN ensues.
We've been through this before...each year when pre-K started, some unexplained times during the school year...for a while there, we had this at bedtime. *sigh* It doesn't get easier. I am so confused...WHY NOT?!
She even did it WORSE the second morning--that was after she admitted she had a great time the previous day at camp.
Now...you can tell me that she's nervous, or acting normal, or just isn't sure what to expect. I believe that...some if it, anyway. But E is a smart girl. SHE KNOWS. Part of her behavior is a power play. I'm not kidding.
Another part, a potentially large part, is related to her growing awareness (and vocalization regarding) being different around her able-bodied peers. And her able-bodied sister, who can now physically do everything she wants to (run, jump, snatch toys, carry large objects, climb up stairs, stand in the bathtub, etc.). This is bound to embody itself into some sort of (negative) behavior.
So I called a psychologist. Eight of them, actually, b/c I wasn't sure if anyone would get back to me (especially since no human being would answer a telephone!! ARGH!!) and I would like some advice/coping mechanism ideally before school starts at the end of August.
I think Elena is essentially a pretty normal kid in a disabled body. And that's okay. But I have a hard time believing her physical condition has zero to do with this kind of behavior. And if we end up seeing a psychologist, and they label her with some disorder--I will probably lose it. Mostly b/c I don't believe it, but also because I do NOT want another label on my kid. I mean...it's hard enough as it is. Typically, I wouldn't say that. But these past few days have been pretty tough. And honestly, today (the third and last day) it was MUCH easier. But it'll happen again...and again, probably.
It's basically a 3-day, 2 hour/day stint to introduce rising kindergartners to their teacher, school, classroom, and potential classmates. Normally it's for kids that are new to the experience. Elena has been in public pre-K for the last two years. Last year, she was in this same school, across the hall from her new classroom. She even knew the teacher, and some of her classmates.
The first morning, it was A NIGHTMARE. It started the night before...
"Mommy, I'm going to miss you!!" and then crying/screaming/MELTDOWN ensues.
We've been through this before...each year when pre-K started, some unexplained times during the school year...for a while there, we had this at bedtime. *sigh* It doesn't get easier. I am so confused...WHY NOT?!
She even did it WORSE the second morning--that was after she admitted she had a great time the previous day at camp.
Now...you can tell me that she's nervous, or acting normal, or just isn't sure what to expect. I believe that...some if it, anyway. But E is a smart girl. SHE KNOWS. Part of her behavior is a power play. I'm not kidding.
Another part, a potentially large part, is related to her growing awareness (and vocalization regarding) being different around her able-bodied peers. And her able-bodied sister, who can now physically do everything she wants to (run, jump, snatch toys, carry large objects, climb up stairs, stand in the bathtub, etc.). This is bound to embody itself into some sort of (negative) behavior.
So I called a psychologist. Eight of them, actually, b/c I wasn't sure if anyone would get back to me (especially since no human being would answer a telephone!! ARGH!!) and I would like some advice/coping mechanism ideally before school starts at the end of August.
I think Elena is essentially a pretty normal kid in a disabled body. And that's okay. But I have a hard time believing her physical condition has zero to do with this kind of behavior. And if we end up seeing a psychologist, and they label her with some disorder--I will probably lose it. Mostly b/c I don't believe it, but also because I do NOT want another label on my kid. I mean...it's hard enough as it is. Typically, I wouldn't say that. But these past few days have been pretty tough. And honestly, today (the third and last day) it was MUCH easier. But it'll happen again...and again, probably.
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