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Post by sivier on Nov 7, 2014 22:13:53 GMT
Hello
I've not been on much for a couple of months, and feel a bit out of touch and behind with everything (work, my friendships, the Boards...). I've been busy dealing with some personal (non-adoption related) issues and family illness. But I'm also having more concerns about AD and would really appreciate thoughts.
AD is 5 and a half. She had toxic in-utero conditions, and a change of FC's, plus extended time with BF in attempts at reunification, before coming to us at 18 months. She seems to have an insecure avoidant type style, though not always typically avoidant. She will show me and DH great affection and we have a lovely playful relationship much of the time.
She's in Year 1 and is bright and capable in terms of learning. However she tends to be obsessive over friendships, is 'always where the trouble is', can be excluding to other kids, is highly competitive and controlling, and her teacher says she never ever knows what AD is thinking or feeling. AD can sabotage friendships with her need to control (I know much of this will be familiar). I got called in today again about her behaviour - always being where she shouldn't be. Also her friendships seem to be with the emotionally young or those who, as the teacher puts it, 'often don't make good choices'.
Along with the things above, she is also becoming increasingly oppositional at home. I've never thought she has ODD but am beginning to wonder! But I appreciate that it might also be part of a developmental phase as many of her peers' parents report similar behaviour.
She has also for about 2 years badly wanted to be a boy, but to me it smacks of something more than the usual tomboy phase - she constantly refers to herself as a boy, says boys are better than girls, leaves girls out of play because they are not a boy, can be very dismissive about and mean to girls. She has very low self-esteem. She took longer to bond with girls/women in the family and, of course, was 'abandoned' by 3 female primary carers before coming to us. I want to get behind this a bit more. Of course I know I can't 'fix' it but I want to understand her a little better and help her accept herself more. Of course, it MIGHT just be a phase, or even be a 'wrong gender' issue, but my instinct is that it is tied up with self-esteem and accepting/liking herself. It's not because I want her to wear pink and frills and I am perfectly happy with the normal tomboy thing but I think it's deeper than that.
Her school is good generally, and is flagging up her lack of display of emotion, and controlling behaviour. They offered her some Theraplay with a trained TA in school which she did for a couple of terms and quite liked. I attended some sessions with her, and the approach that they modelled with her we've pretty much done since Day 1 - very playful, tactile, slowly building trust and closeness. I'm not saying we know it all, but I'm also not convinced this is really getting underneath the surface with AD. Do you think I should stick with this? I guess I'm unclear as to how it's going to help with the issues identified.
I've got a meeting with SENCO and AD's teacher next week. I think AD needs some kind of fuller assessment or appraisal to help her with emotional/social/control issues. What can I ask for, what would be sensible as a first step and what can I reasonably expect from the school? It may be that I need to approach PAS but I wonder whether I can get more from them if I have something more structured or formal from the school.
I am rather tired and emotional, seeing my lovely girl trying hard but struggling. Thank you for reading this long post, any thoughts much appreciated.
Sivier
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Post by flutterby on Nov 8, 2014 6:22:52 GMT
Sivier, we are not there yet, LO is only 3, but it struck me that they are doing Theraplay with her at school. Yet you only attended now and again? Correct me if I am wrong, but I thought Theraplay was supposed to help with attachment? And that would be to you and you only. After that her relationships would be widening concentric circles of close family, friends, acquaintences etc. I am not sure if doing this at school with a virtual stranger is the right thing to do. Yes, it may be a well-meaning TA, but there is never ever going to be anything but a professional relationship there. Is it possible that LO has become confused over the role of this TA? That maybe in a very subtle way she thinks she is going to be moved on again? Because why else would she have to form an attachment relationship with this person? If you are not there during the sessions to actively do the actual Theraplay yourself, then surely, might your daughter not get confused over who to attach to?
Sorry, if I have got things wrong, but it just struck me that they seem to be doing Theraplay independent of you.
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Post by Deleted on Nov 8, 2014 7:40:57 GMT
I totally agree with Flutterby on this. I have never heard of theraplay being done in school and without the parents being involved.
Was this discussed/agreed with you, or is this just something that the TA has read up on and thought would be useful to try?
To the best of my knowledge, and correct me if I'm wrong, but I always thought Theraplay was about attachment and should only be done with the parents as obviously that is who you want the child to attach to, so maybe this well meaning TA is actually doing more harm than good and is confusing DD.
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Post by poohbear on Nov 8, 2014 7:51:04 GMT
Someone I had contact with through our VA has theraplay provided at school but with a trained therapist and with the parents involved in every session.
Does seem strange doing theraplay without the parents present!
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Post by sivier on Nov 8, 2014 8:46:29 GMT
Sorry, I wasn't clear on the Theraplay. AD had a few sessions first just with the TA (who wasn't in her class but AD saw daily at the time when mixing with the other Reception class), then bought me into sessions after that to join AD and TA. I think the aim was to work on attachment to make her feel more confident and relaxed at school so that she could start to widen her friendship group a bit. But that's what I mean, I'm not quite sure how/whether it will help with that - might there be something more effective? Also the TA cancelled a few sessions due to illness etc, can't be helped but not ideal.
I think AD's attachment to me is probably pretty good, all things considered....yes she's controlling and can be very rejecting at times esp when stressed or anxious, but I think that's just her style...we'll always have those patterns. We can always build on our relationship but it probably won't change too much. Her peer relationships worry me though, as does the attraction to trouble.
I just wonder if there's a more targeted approach possible, with some kind of assessment involved.
Thanks so much for the replies.
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Post by justbserene11 on Nov 8, 2014 9:36:53 GMT
How are the school using PP? Could you ask for an assessment of sorts with an educational psychologist? Does the school have some sort of nuturing group? Also, would you consider asking post adoption to do an assessment of needs?
In regard to the theraplay, I went on a course with a trained therapist (fifial therapy) and was given guidance on how to incorporate this at home. I was told it would help build attachments and trust etc, as the child will get your unlimited focus and they are in control.
Although, they are in control they are not allowed to hurt themselves, you or the things they play with. I have a box that I store the toys in (medical kit, dolls, milk bottles, puppets, play food, cars, tea set, figurines such as emergency figures etc, dinosaurs and animals), I also alternate the messy aspect (paint, play doh, paper for cutting) and when we do this I set it up in a room she doesn't play in and we do it for 20mins (once or twice a week). When we start, I just watch her or repeat words she may say, I then wait to be invited to play and poppet will then ask that I do something like make ice cream with the play doh.
Poppet loves it and I been able to evaluate her emotional well being. For instance, one time she asked me to put on a puppet (the grandma from little red riding hood) and told me I couldn't speak....this was after an argument with my mother!
It maybe worth a try?
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Post by sivier on Nov 8, 2014 17:39:04 GMT
Thanks bserene. I do a lot of these things with AD, and use some of the techniques that the TA showed us - but you've made be wonder whether I need to rewind a bit more with some of my play with AD. I'll ask about an appointment with an educational psychologist. I am thinking of going to PAS but wondered whether it would be useful to gather some 'evidence' from teachers' observations etc first (the school SENCO taught AD when she was in nursery), so does know how she presents in class. It's really helpful to get ideas of things to explore in the meeting. x
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Post by daffin on Nov 8, 2014 20:08:34 GMT
Have you heard of Thrive? It might help. www.thriveapproach.co.ukOur Virtual School now offers it in schools to adopted kids with difficulties with attachment and/ or peer relationships or behaviour. It's based on neuroscience and sounds quite convincing. I've asked Monkey Boy's SENCO to look into it for him. |
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Post by doubletrouble on Nov 8, 2014 22:32:55 GMT
I may be on the wrong track but many of the traits your DD has are similar to these displayed by our DD. She had/has fixations about friends, always controlling and wanting to control the games, be at the front of the line, and get into trouble all the time among many other things.
We already had a referral to CAMHs for her brother so were able to talk to them about her behaviours and get a referral for her too. She has had help from O.T.s for her social problems together with speech and language and has been found to have sensory integration problems, ADHD and ASD.
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Post by milly on Nov 9, 2014 7:19:50 GMT
I'd be wary of school intervening in a supposedly therapeutic way. Dd1 was offered art therapy by her primary school and the head was so excited about it, I felt it would be churlish to refuse. Dd enjoyed it but it had no discernable impact on her. The therapist said she worked on gently challenging dd's need to control, but to me that is a fairly fixed trait dd employs when stressed, so being able to relinquish it in one situation doesn't then spread to others. Over time dd has become much less controlling, especially at home, but that seems more likely to be down to our input.(She still has big issues with peer relationships though - it's not as simple as being too controlling)
We were offered play therapy via school under pupil premium plus for Dd2, as another adoptive family wanted it for their children, but we said no. Dd2 has no real issues at present around school or friendships anyway, but I doubt the play therapist could help her with the issues she does have at home (stress management) and am skeptical of throwing therapy at children in this way without a proper assessment.
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Post by milly on Nov 9, 2014 7:27:31 GMT
To add, I don't think schools generally have much idea re dealing with complex emotional problems. And I speak as a primary teacher myself, as well as the parent of a child with such issues. You might be lucky in your senco, but you'd be better off seeking advice from other professionals - at CAMHS, or through the Ed psych service or behavioural support. Our dd has ADHD which does account for many of her issues. Her primary school got advice from someone in the LA who gave advice on behavioural issues - for a while she came to review meetings at school - she was really nice and helpful.
Now dd is at secondary she has an Ed psych who promotes the Louise Bomber approach with dd having an attachment figure in school to help her stay calm at school. That did seem to work well for a while, although she is going through a difficult phase at the moment. It's not about trying to change dd, just to support her with her anxieties etc.
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Post by corkwing on Nov 9, 2014 9:50:00 GMT
Hi, Sivier -
I love the fact that the school seem to want to help "therapeutically", as it were, but am concerned that they may be out of their depth.
I'm wondering what tone they're coming across with? For instance, with the relationships. Are they saying, "What is this showing about her? What does that show that she needs?" or "How can we stop her doing this?"
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Post by runmum on Nov 9, 2014 9:51:48 GMT
I agree it's very dangerous to allow a non-therapist to "do therapy" with our children. However I would say that they do better when all key relationships are are based on playfulness, acceptance, curiosity and empathy. So it's great that there is someone is school playing with your AD and being curious and empathic. I would just be crystal clear that if your AD starts to "process" grief or trauma in any way the parent has to take the lead in handling that and no-one at school should start dabbling. Our AS has just started doing a messy play session with a TA who has had some counselling training. I said that's great he needs messy play but there must not be any "counselling" or processing of issues and if anything comes up you need to communicate with us straight away. There is an organisation called the Caspari Foundation that trains teachers in "therapeutic teaching" it's a robust Masters level course. I don't know that much about it but always thought it seemed interesting.
I would also say that we need to be so careful with labels. Our children tick the boxes or almost tick the boxes for so many things and at the end of the day my view is that even if they have a mental health label that is appropriate for them and "right" as far as these subjective things are ever "right" intervention must ALWAYS be mindful of the complexities adopted children bring. If she is defiant what is at the root of it. Given her background can she integrate i.e. does she have psychological constancy. In other words when you say stop x or why does she actually sense that by stopping it she ceases to exist and might that be at the root of her defiance. You can "treat" constancy by using "parts" language. "I have to be saying no mummy now. I know that's hard for you. But I'm the same mum who has fun with you and can say yes when that's right for you. I'm seeing your cross part now but I know your calm fun part will be back soon" It won't make her stop in her tracks and behave but it will be building her understanding that she can be both well behaved and very difficult and you can be cross and kind and you are both one person with many parts. Over time that heals. Of course ideally she needs specialist assessment but that's so hard to get unless you pay yourself.
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Post by sockthing on Nov 9, 2014 10:40:39 GMT
Lovely to see you back Sivier, though not the difficulties of course
Lots of interesting replies. I agree that maybe the school is not the best channel for Theraplay. It's great the TA had training, but I wonder whether you need someone that is more trained specifically for adoption related Theraplay. Perhaps at school the Theraplay has been used in the past for children with less complex issues and has therefore been more of a case of building confidence. Whereas ADs issues are probably far more psychologically complex and tricky. I also think that if they were expecting a few Theraplay sessions to be enough to "fix" attachment related behaviours in the school setting that they are not understanding the long term nature of attachment issues. I'm not saying it was a completely bad idea, and I'm not saying it was a wasted effort, but just, as we know as parents, our children's issues are so deep that the long term view is needed and no expectation of fixing behaviour within a school term or two.
From what you describe, it sounds like more than just lack of confidence and a some low self-esteem - maybe there are deeper identity issues -difficulty around trusting and interpreting females, and reconciling that with being a girl herself??? I'm aware of the risk of amateur psychoanalysis! But it sounds at the very least that it needs a professional to make that enquiry.
Maybe she needs some life story work? In which case PAS presumably.
Hugs xx
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Post by sockthing on Nov 9, 2014 10:42:17 GMT
What are PAS service like in your area? Any chance they could advocate for you at school? Mine have been very helpful in coming to the school and backing me up at the start of the school year.
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Post by sivier on Nov 9, 2014 18:07:52 GMT
Thanks for great ideas and comments.
Daffin - I think it is a Thrive school, but I need to check, and find out more about how this might apply to DD.
Doubletrouble - oh my, yes she always wants to be at the front of the queue! (her Reception teacher commented on this a few times), plus all the other stuff. She doesn't seem to have sensory integration issues, as far as I've checked that out in terms of signals - but I've got an open mind about it, as with the possibility of ASD/ADHD, and appreciate diagnosis can be complex and take time.
Milly - totally agree and this is why I don't really want DD continuing with Theraplay until I have a clearer and more robust assessment of her needs. The school offered it as a way of trying to promote her attachment with me/underpin her confidence. To be fair, they are pretty good - they have a very diverse intake with experience of adopted children/children in care, or children coming from quite challenging domestic environments, They are open to discussion, welcome my ideas, all the teachers have had attachment training, the SENCO (she's also Dep Head) used to be a foster carer - so at a leadership level they get it a lot more than other schools I looked at. But DD presents as able and confident. I'm not sure her current (approachable and experienced) teacher gets it - I think she's quite perplexed by DD. We do need a proper assessment, so that we can get more targeted support.
Corkwing - good point about the tone. I genuinely don't think the school is out to simply try to 'fix her', but to help build confidence and help her feel safe at school, but I get what you say and tone is something to explore at the meeting next week.
Runmum - very sound advice, thank you, and I think the constancy issue might be relevant. I really like the 'parts' approach and think this might be useful with DD. I'm going to look into this a bit more.
Sockthing - thank you. That's totally my feeling too - that the support at school so far is well meaning but rather general. I think it's time to get more specific. I do the amateur psychoanalysis bit all the time! But yes - I need someone to offer a professional view. I don't know about the quality of PAS here - we adopted from a neighbouring LA and are now over four years in, so would need to contact my own LA of which I've no experience on adoption issues. I thought I'd start with what the school have observed/can offer, then take that to PAS. But I think I'll try for the CAMHS referral too, via my GP.
I really value everyone's advice. I'm a bit low over some things in my personal life, and not giving much back Boards-wise at the moment, so am doubly grateful for the support.
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Post by sivier on Nov 21, 2014 9:47:37 GMT
Just wanted to update on this following my meeting at the school:
The main issues with DD seem to be: continual low level oppositional behaviour, not showing any emotion at school - 'we can't ever read her', drawn towards those with poor behaviours.
Discussed how the school might deal with behaviours to avoid shaming - the school is on board with this and receptive to ideas
The SENCO felt that I hadn't given the Theraplay nearly long enough, and that DD needs time to be able to be confident enough with the adults at school and start to express her feelings. I said that I wasn't convinced that it was sufficiently targeted to her needs. But said I am open to trying this again, if it is clearly identified as being the best option
They are going to do the Boxall profile on DD to help assess needs
They didn't feel that an ED Pysch assessment was needed at this stage. They did agree that her needs can present quite subtly compared to some of the kids they are dealing with. I am not on confident ground here as I don't know typically when an Ed Psych might be called in.
They wondered whether Play Therapy might offer a better option for DD to start to understand her a bit better. They would bring in a trained professional to do this.
I mentioned the nurture group that DD had in Reception class. They said they don't run one at the moment, but her teacher might be able to find some special one-to-one time (I think they call it Bubble time) - time to play or chat with DD, the session being child led.
I've got a another meeting next week to talk through the Boxall profile results with them and hear their ideas for different options for DD.
If anyone has any other comments or views on the above I would be very grateful to hear them!
Thanks again for the advice and support.
Sivier x
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Post by doubletrouble on Nov 21, 2014 11:10:29 GMT
Interesting that they don't see the need to bring in the Ed Psych but think she needs therapy!!
I would consult your G.P. and see how you go about seeing CAMHs or peads. to look at any other underlying issues your DD might have. Some of these behaviours can be ASD or ADHD my DD and DS also have sensory problems which have been greatly helped by the CAMHs O.T. and we have also had help from their speech and language dept. We were always told they 'only' had attachment disorder but after years of struggle we discovered this wasn't the case.
Have speech and language been involved at school? as she may have a problem understanding and interpreting what they are actually asking her to do.
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Post by sivier on Nov 21, 2014 19:20:37 GMT
Thanks doubletrouble. That's what I'm a bit confused about - when and why an Ed Psych is called in, at what stage of assessing a child's needs. I'll have to do a bit more digging around that.
I'll also be making an appointment to see my GP about DD.
Speech and language are not involved. This hasn't been raised as an issue. DD has always been quick to get the sense of things and able to process a series of instructions/tasks from quite a young age. I think she's very aware of what's been asked, in fact, but feels a compulsion to things slightly differently i.e. controlling behaviour. So if for example the teacher asks them to all come to the carpet to sit down, DD will be the last, she will do it but in her own time. I know how exasperating it is (not that the school has ever used that kind of language) as this is what she does at home.
However I'm due to have a more general parents evening in 2 weeks so may find out more about her more general learning and will keep the S &L issue in mind. Thank you.
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Post by milly on Nov 21, 2014 23:36:44 GMT
As a teacher I find it very odd that the school have organised therapy yet not sought advice from the Ed psych. How on earth do they know what is required? Having said that our school got offered a play therapist (generic, not for adoptees) and decided ourselves which children might benefit. I guess emotional stuff suggests therapy while general issues ( behaviour, learning etc) suggest Ed psych involvement. My dd presented as having behavioural issues in primary (plus some learning issues) and saw two Ed psychs there - to no particular avail. Now in year 9 it's crystal clear her issues are emotional primarily (and social which give rise to the emotional problems). She now has an Ed psych involved who understands this.
Generally major concerns do lead to Ed psych involvement but their time is limited so there may be children considered more needy at present. Dd has been to schools where there are fairly few needs so I suppose that's why she has now seen four Ed psychs! (Second couldn't see much problem tho)
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Post by sivier on Nov 24, 2014 13:37:34 GMT
Thank you Milly, that's helpful.
I think that's it essentially - that the school doesn't see DD as posing major concerns in terms of her behaviour, and her learning is progressing well, but they want to help to support her emotionally.
I think the Play Therapist they use is generic rather than an adoption specialist: there are a couple of kids in care at DD's school, and possibly another who is adopted, but I'm not sure.
Hmmm - I need to ask some more specific questions, and I'll see what they say at the next meeting.
thanks!
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