Tuesday, November 13, 2007

I am here. No, I am there.

I had a very strange experience a few days ago. Last week, I moved my computer from my bedroom to my living room (our home office). It's a corner desk and I set it up the same way in both places, so if you are sitting there, staring at the computer, what you see (keyboard, monitor, pencil cup...) is exactly as it was. It would not be surprising that I got momentarily confused by which room I was in. What DID happen was not only surprising, but even a bit disturbing....

I was playing a computer game the other night when I noticed a light come on in my periphery. I immediately thought
that must be my wife going into the bathroom

but then a louder thought, if "louder" is the right word, responded:
No, you are in the living room. That light had to come from outside or in the dining room.

Then the two thoughts began to argue with each other.
You're in the dining room.
No, you're in the living room.

I could even see a mental picture of the floor plan of my house and mentally feel the two thoughts having a tug of war - a marker was sliding back and forth on the map between the two different locations.

This was not a fleeting experience. It lasted for four of five seconds. I sat there unmoving at my keyboard while my brain fought with itself. I started to get disoriented. I had to force myself to turn my chair and face the direction the light came from in order to determine where the hell I actually was. I looked into the dining room for a few seconds - because it took that long for my brain to decide that it was, indeed, the dining room that I was looking at. For a split second, I saw a dual image of the dining room AND the master bathroom. It was only after staring at it that I determined what it was.

We are in the living room.

I sat there for a second as if I had just woken up from a dream of some kind. Then I laughed it off and went back to playing my game.

A half an hour later, it started to happen again! I could sense two thoughts starting to argue over where I was, but this time, a third thought (me?) mentally yelled for them to "SHUT UP!" At that point, I think I got up and went somewhere else, I don't really remember.

Am I going nuts?

Monday, May 28, 2007

My Experience as a Foster Parent - 2

The first foster child we took into our home in the summer of 2005. My wife and I were excited, apprehensive and very naive. Our 7 year old daughter, Nicole (not here real name) was excited to have a sister.
Carsey (not her real name) was 11 years old. She was the oldest of four children and had been place in charge of them by her mother. Her mother had a substance abuse problem, but we were never given any details about the nature of her problem. Her father was not part of her life.
Carsey had been diagnosed with ADHD, ODD and RAD. She was also mildly mentally retarded.
Carsey told me that when she was 5 years old, her mother had put her and one of her younger sisters into the bathtub and told Carsey that she was going down the hall for a few minutes and to give her sister a bath. She also told her not to answer the door. Sometime later, Carsey heard someone at the door, and despite her mother's warning, answered it. It was a policeman.
Presumably, the policeman called CPS and Carsey and her brothers and sisters were removed. When Carsey came to our home, she had been in St Joe's residential facility for over two years. I don't know where she had been before that, though she did mention that she had been in other foster homes, had lived with some relatives and had spent some time in another facility besides St Joe's. She had not seen her mother or brothers and sisters in several years.
Our first visit with her was a supervised visit at St Joe's. Carsey started calling us mom and dad right away and started referring to Nicole as her sister. On our second visit, we took her to our home for a few hours and went out to eat at McDonald's (Carsey's choice). She ordered chicken strips with ranch dressing, ate them all and asked if she could have another order. I complied. I remember thinking at the time that they must not feed these poor orphans very well.
When we finally moved her into our home, Carsey did not want to sleep alone and said she was afraid of the dark. We tried to make her as comfortable as possible and when Nicole volunteered to let her sleep in her room, we decided to let her sleep there. We were a little nervous about it, but since we were in the next room, we didn't think there was any danger.
Carsey was constantly seeking attention and was very clingy with me. She had occasional out vocal outbursts and one time when I sternly told her that her behavior was not acceptable, she curled up on the floor in a fetal position with her hands over her face.
She was taking several medications for ADHD and, at first never gave us any difficulty when it was time for her to take her medicine.
After the first week or so, her behavior began to change. She became defiant at times and less clingy. She started teasing Nicole. One time she got upset with my wife and went and hid under the bed for an hour. She claimed she didn't know left from right.
We moved her into her own room, across the hall from Nicole, and she did not like that.
She became more defiant over time, started refusing to take her medicine and would curse when she got upset. She would play board games with my wife and try to make up the rules if she started loosing.
Two activities that she liked to do were swimming and basketball. We have a pool in our back yard and she would swim as often as she could. When I got home from work, she and I would play basketball in the driveway. One day, while we were playing basketball, she accidentally broke a window on the garage door. She got very scared and was convinced that my wife was going to be very angry and beat her. I tried to explain to her that she was not in trouble and that I saw what had happened. She tried to stop me from telling my wife about it, physically blocking me from entering the house. When I did get to tell my wife, and she agreed that it was an accident and that no one was in trouble, Carsey became uncontrollably hyperactive. She ran around the house laughing. Something changed at that moment because from then on, she was almost unmanageable. She refused to follow any directions or requests. It was time for her afternoon medicine and I eventually had to go and grab her and carry her back into the kitchen and make her take it. After that she went into her room and shouted obscenities for about a half an hour.
School started a few days later and my wife and I were hoping that school would turn her behavior around. It didn't. Carsey fell into a pattern of being defiant with my wife clingy with me and mean to our daughter. Nicole spent most of her time avoiding Carsey, usually hiding in her room.
We took her for respite for the first time that weekend. Respite is when the foster child is placed in another foster home for at last part of one day. It is designed to give foster parents and foster children a break from each other. When we took her to respite, she asked if she was going back to St Joe's. She asked it in such a way that she sounded as if she was expecting it or even wanting it.
By the end of the next week, she was acting out in class as well as acting out at home. We could no longer manage her behavior and had to make the decision to remove her. She was in our home for only 9 weeks.

A few days before she left, I was helping Carsey do her schoolwork. She was in a special education class and the work level was far below what a typical 11 year old should be able to do. The worksheet she had was a set of two digit addition problems, the point of the lessen was about carrying digits over to the next column. There were 24 problems 4 rows by 6 columns. She struggled with the first problem and got very frustrated. I helped her and coached her through the next 2. She seemed to be getting it and Nicole was asking for help so I told Carsey to work on that row while I helped Nicole. When I returned my attention to Carsey, not more than a minute later, I was hoping that if I was lucky, she would have finished that row. She showed me her paper. She had finished the entire sheet and gotten every answer correct. This made me realize just how much her behavior was damaging her own development.

Carsey was afraid of the police. Whenever we saw a police car on the street, she would hide in the backseat and tell us we had to run away before the policeman got us.

She showed many signs of RAD, ADHD and ODD. I have no way on knowing how much of this was learned behavior and how much was caused by brain damage do to her mother's in vitro drug use.

Looking back, we now realize just how much Carsey manipulated us. We allowed her to turn out home into a place where none of us wanted to be. She had no intention of staying in our home. I remember her telling me more than once that she wanted to go back to her real mother. I think that she somehow got it into her mind that if she got rejected from enough foster homes, they would eventually send her back to her birth mother. As painful as the experience became, we did learned a lot and were much more prepared for the next child we fostered.

Wednesday, May 23, 2007

My Experience as a Foster Parent - 1

Note: in order to protect the privacy of individuals, all person's names have been changed.

For over a year, my wife and I have been foster parents in our home state of Kentucky. I have decided to post information about our experience partly because we get a lot of questions and partly because it is helpful to talk about it, even if it is just in the blogosphere. Some topics are difficult to talk about without using blunt language, so expect occasional crudeness.

My wife and I got into foster care hoping to adopt a child. We have a daughter of our own and wanted to have another child, but biology did not seem to be cooperating. Since we were both in our early forties, we thought that pursuing fertility treatments might be risky. Domestic adoption is very expensive and can take years. Foreign adoption is faster, but also expensive and, in many ways, riskier. Since we knew that there were children here in the U.S. in need of good homes, we decided to look into foster care, specifically, a private institution, St Joseph's Children's Home.
I cannot say enough good things about the people that we have dealt with at St Joe's. They have always been highly professional and uncommonly compassionate. They work very hard and go well beyond the call of duty whenever the need arises. They bend over backwards trying to fill the needs of both children and parents and never forget what is in the child's best interest. These are truly wonderful people.

My wife and I went through several weeks of training starting in January of 2005. Much of this information is from those training sessions.
Some is from my personal experience and some is information passed onto me first hand by other foster parents. I am not a psychologist or a social worker or a mental health expert. I am only presenting information as it was presented to me and how I understood it.

How children end up in foster care.
Sometimes, through a combination of bad choices and bad fortune, parents find themselves in situations they are not equipped to handle either emotionally or physically. Other times, parents have children they are simply unwilling to care for. When this happens, the children end up being abused by the parents. If someone reports the abuse to authorities, Child Protective Services (CPS) may intervene and remove the child from the home.
Children end up in the foster care system after CPS has removed them from their homes. This is not something that is done lightly. CPS will only remove a child if they feel the child's welfare is in immediate danger. Abuse can take many forms including physical abuse, emotional abuse, sexual abuse or neglect.
Sexual abuse covers a wider area of activity than most people realize. When people think of sexual abuse, they generally think of child molestation (the rape of a child.) While the term certainly covers that, it also covers other activity, like
inappropriately exposing kids to sexual situations (ex: having orgies in the same room, showing them pornography...). Also note that child molestation does not differentiate between a willing and unwilling child. The law assumes that anyone under the age of consent (16) cannot willingly engage in sex.
The state only breaks up families in extreme situations. After the child (or children) are removed, the parent(s) go before a judge and given conditions that must be met in order to have their children returned to them. These generally include counseling, and/or training. The programs are rigorous and may be difficult but are not impossible to complete. During this time, the judge may award temporary custody to an extended family member (whose home must qualify for foster care), but if no suitable relative comes forward, the child is placed in foster care. If possible, sibling groups are kept together. If a child has medical or behavioral issues that make foster care impossible, they are moved to a residential facility where they are cared for by facility staff (St Joe's has their own residential facility). Visits, often supervised, are arranged between the parent(s) and the children.
To qualify as a certified foster home, the parents must go through a training course and the house is inspected to make sure it is safe, has electricity, running water, the proper number of smoke alarms, etc.
A state social worker is assigned to the case and monitors the parent's progress as well as the child's welfare. State social workers in Kentucky are often overwhelmed by caseload. The last state social worker I talked to had over 60 cases. That's not 60 children. That's 60 families - each with potentially two adults and several children.
If the adults complete whatever program the judge assigns to them, the families are reunited and continue on with their lives, though they have continued access to resources, such as counseling, for some time after that. If the adults fail to comply with the judges order, then the state will pursue a Termination of Parental Rights (TPR). Many adults will fight the TPR and may get their time extended if the judge feels they are putting forth a good faith effort. Others will voluntarily give up their rights. The entire process, from CPS taking a child from a home to a TPR, generally takes about 18 months. Once a TPR has been issued, the parent looses all legal rights to the child and is no longer allowed to have contact.
After a TPR, the child becomes a ward of the state. If possible, they are placed in foster care with a foster family looking to adopt a child. Foster parents can start the adoption process once a TPR is finalized. The adoption process may take anywhere from 2 months to a year.

As previously mentioned, the state tries very hard to keep siblings groups together, but this is not always in the best interest of the child. Sometimes older children abuse younger children just as they were abused by their parents. This abuse usually continues if the children are kept together. Other times, a single child may report the abusive behavior of the parents and when the state removes them from the home, the other children will blame that child for what has happened. That child becomes he target of resentment and anger from their siblings.

In recent years, there has been a dramatic increase in the number of children in state custody. This is at least partly due to the rise in drug abuse in Kentucky, particularly with
Methamphetamine. Very often, drug addicted expectant mothers will continue to take drugs throughout their pregnancy. This can be extremely damaging to the children causing both physical and mental disabilities. Some amount of mental retardation is fairly common along with Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder (ADD/ADHD).

Emotional and behavioral problems can be caused by poor or abusive parenting.
When a child is first born, there is a cycle of dependency that happens between it and it's caregiver (mom, dad, daycare worker...).
The process is very simple:
1) Baby senses that something is wrong (hungry, thirsty, stinky, in pain...)
2) Baby cries
3) Caregiver arrives
4) Caregiver addresses and fixes the problem (feeds baby, changes diaper...)
5) Baby senses that everything is OK and stops crying
6) Time Passes
7) go to step 1

This cycle repeats thousands and thousands of times in the first months of a baby's life. Through this process, the baby learns several important lessons:
1) I can effect the outside world (when I cry things happen)
2) Adults are here to help me
3) I am worth being taken care of

This assumes that the caregiver is doing a good job and the babies needs are being met. People are human and make mistakes, so caregivers don't always get it right the first time they show up, but in general, they are always making things better for the child.

However, if the caregiver is doing a poor job, the cycle starts to fall apart in step 3. The caregiver may ignore the baby, stop trying to help too soon, or, if they are physically abusive, hit the baby, shake the baby or yell at the baby. When this happens, the baby never gets to step 5. Obviously, if the caregiver NEVER did the right thing, the baby would die. But, what often happens is that the caregiver does enough to keep the baby alive but fails so often that the baby doesn't learn the lessons that the good caregiver's baby learned.
An abused/neglected child might learn:
1) Nothing I do effects the outside world (crying may bring help, harm or nothing so it is not effective)
2) Grownups are here to harm me as much as help me
3) Grownups are not predictable
4) Grownups cannot be trusted
5) I am not worthy of being taken care of

As the child grows up, the abuse can manifest in several different ways, often in combinations. Add to this, problems caused in vitro drug abuse (ADD/ADHD, mental retardation) and you have a child that will have a very difficult time in life.

Reactive Attachment Disorder (RAD)
If a baby thinks it cannot effect the world around it, it does not learn about cause and effect. The world is just a series of unrelated events that happen for no reason. As they get older, they can't help but get past some of this when dealing with the physical world (gravity is pretty constant), but when dealing with people, the lessons they learned as a child are very hard to change. It's much easier to learn a new behavior where none exists than to replace an existing behavior. RAD sets in when they cannot learn to properly attach emotionally to another person.

Complicating things, children have a built in attachment to their parents, even abusive ones. Their distrust of adults often gets worse when CPS enters the picture. From the child's perspective, a bunch of adults come in and take them away from the only adults they know - the abusive parents they are attached to.
Most of the time, it is not discovered that a child is being neglected until it is 5 or six years old. Younger children can be shielded from the outside world. It is generally not until they go to school and their teachers see them and know that something is obviously wrong. So, you have a child that has been living in a highly dysfunctional environment for 5 or 6 years and then a bunch of other adults take it away from its parents. A daycare worker might also recognize the symptoms of abuse but these kids generally don't end up in daycare. They are generally left alone for hours on end while the parents (or parent) goes out and does whatever they do.

Because the child has been neglected, they have had to learn to do things for themselves. Their primary concern is for themselves. They care nothing for other people other than as a means to obtain what they want. RAD kids will steal and lie and think nothing of it. They place no value in other people. There is no such thing as "right" and "wrong" there is only "what is good for me" and "what is not good for me."

Oppositional Defiant Disorder (ODD)
ODD is simple to recognize: the child will not follow directions and no amount of talking or negotiating will change their mind. They refuse to bow to authority, even when it is obviously in their own best interest. Their defiance often borders on the absurd. One of my foster children had ODD. At night time, I often read to both children, sitting in the hall between their rooms. One night, instead of getting into bed, she sat on the floor. I told her I would start reading when she got into bed. She told me she couldn't get into to bed because she wanted to sit on the floor. I told her that she knew the routine and that I didn't read until she and our biological daughter were both in bed. She continued to refuse and got more and more upset, claiming that she wanted me to read, but did not want to get into her bed. I remember her sitting there in tears saying that she wanted me to read and me telling her that I would be happy to read as she got up off the floor and into her bed. She just sat there and screamed "but, I CAN'T!" At other times, we had long fights about her not wanting to wear a raincoat when it was poring down rain or not wanting to wear any coat at all when it was below freezing and there was snow on the ground. While they don't act like this all the time, when they do, they act as if they are compelled to defy authority and are unable to comply.

Sometimes, neglected children are thrust into a parenting role. Both of my foster children were the oldest children in their birth family and put in charge of their younger siblings. This happened to each of them before they were six years old. Once this role gets entrenched, it can be difficult for them to behave as normal children. They can have a hard time playing with other children as equals. Parentification can also take the form of children taking care of parents. The child may be taking care of the home while the adult is sick, drunk or in a drug induced stupor.