Reflections on Foster Care

I was lucky enough to attend a one day seminar on therapeutic foster care recently, presented by Kate Cairns, a long time foster carer and social worker from the UK. What an engaging speaker she was.

Much of what she had to say focused on the effects that an unsatisfactory or disrupted attachment has on a baby’s development. None of this is new to me (I’m an avid attendee at seminars and conferences, and love to read parenting and fostering “text” books) but she had a very personal way of describing the process which really brought home to me how an attuned baby engages with his caregiver.

This engagement lays down patterns in the brain to ensure that they develop all those important life skills like how to form a trusting relationship with another person, how to self-regulate and to curb impulses and control rage, how to recognise and acknowledge their feelings and those of others.

Any foster carer can look at a child and see the behaviours that indicate “this child’s brain did not form the necessary templates in that first year or so of life”. The child very obviously demonstrates the consequences of this deficit: is unable to trust others or rely on them for help and comfort, needs to control everything and everyone around them, hasn’t learnt to check their impulses or control their rage, and shows no awareness of their own feelings and certainly is unable to show empathy for others.

I look at my own daughter Portia, who has been with us for all but the first year or so of her thirteen years of life and recognise that these behaviors still form a noticeable part of her personality. Her need to control members of her family, particularly her little brother and her dad, drive them both to distraction. She tells them what they should be doing, or how they should be doing it, with utter confidence in her own infallibility.

Luckily, she’s doesn’t get into a rage very often (although plenty of those hissy-fits that teenage girls seem particularly prone to) but she still has a great deal of difficulty curbing her impulses. Despite the guidance she’s had at home and school with the mantra “stop, think, do” we’ve yet to see that being consistently used although she’s not in trouble for scrapes, damage and breakages as much as a few years ago.

But I’m happy to say that Portia is learning how to recognise how others are feeling and to change her behaviour accordingly. At nine or ten she often had social problems at school and most of it stemmed from her own tactless comments and actions. It seemed at that stage that the only way to boost her shaky self-esteem was to put down everyone else and build up her own accomplishments with lots of bragging and showing off. I’d say she’s come a long way since then.

Certainly I now see a quieter and more genuine awareness of her own strengths. She doesn’t need to brag or compete as much as she used to, and when she makes a derogatory comment about someone she’ll catch herself and try to explain why it is she feels that way, which opens up the opportunity for a bit of a learning discussion on why people behave as they do.

When she came to us as a quiet, timid, undemanding, slow-developing one year old, I didn’t know about the effects of neglect and trauma as described by Daniel Hughes and Bruce Perry. I knew nothing about therapeutic fostering and reparenting, but I knew from parenting my own babies that this little girl and I needed to bond. So I did what came naturally, treating her as if she was a much younger baby, which wasn’t at all hard because she was a tiny little thing and nowhere near walking yet.

I wrapped her in a cosy bunny rug and snuggled her into my body as I rocked and sang to her (even though she seemed to never need soothing or to be settled to sleep). I carried her around in a baby pouch on my chest despite her legs dangling down past my waist and making it very difficult to go upstairs or climb up hills and rocks when bushwalking.

Eventually I transferred her to a hip sling which didn’t keep her quite so close but was a great deal more convenient. When giving her milk I always held the bottle and snuggled her on my lap. I would not let her hold the bottle, which she was used to. She needed to rely on me for that warm soothing milk, and trust me to provide it.

I managed to keep that routine going till she was over two, despite her little foster brother arriving in the meantime who also needed constant feeding and soothing. I played baby games with her at a time when most kids have moved on to more sophisticated pastimes. Lots of patty-cake and peek-a-boo games, riding horse on my crossed legs whilst facing me as I sang to her, silly rhymes that babies love, with tickling and blurting on bellies and pressing of noses. All attempts to regain what she’d missed in her first year of life: attunement with a caregiver.

Unfortunately for Portia and I this process of attachment was often interrupted over the next two years, mostly by failed attempts at reunification with her birth mum. This would sometime take Portia away from our family for days, weeks, and at one point three months. Also, as I mentioned before, baby Seth joined our family when Portia was not yet two and his withdrawal from alcohol in those early months of his life took a lot of my time and energy.  I guess that Portia, while getting plenty of care and attention, may not have been getting the intensive mothering that her early neglect demanded.

But of course attachment is an ongoing process. Over the years I made extra effort to pull her in closer to me. It wasn’t always easy as through her toddler and preschool years that the quiet, mousy little baby was replaced by a willful, controlling, angry child. I always felt she was distant and detached from me. Even her younger foster brother Seth, who was with us from five weeks of age, developed a very normal secure attachment to me.

It’s sad but true that the more horrible your child’s behaviour, the more you want to distance yourself from them, and the more frustrated and discouraged you feel. Unfortunately this is exactly when you need to be spending more intensive time with the child to bring them in closer again.

Over the years I noticed a cycle. Portia’s problem behaviours would escalate and I would be forever scolding her, feeling cross and annoyed with her and would crave distance, retreating from the intensity of the frustration and stress. Then I’d recognise where I was in the cycle and realise it was time for some very significant bonding.

A child psychologist who saw Portia when she was five for just a few visits, helped me to realise how, when I was overwhelmed by her behaviours, I would pull back emotionally from her and she gave me a few ideas on how to regain some closeness. She encouraged me to simply spend more time with Portia, doing stuff she enjoyed showing her she was worthy of my attention. Playing simple board games, colouring and making things together, singing and dancing to a music CD, cooking yummy sweet things to eat together, standing outside watching her ride her bike up and down the footpath, sharing stories and making up our own.

It amazed me how much time I could find to spend with her once I’d changed my attitude. I concentrated on softening my tone with her, making sure I met her advances with a smile instead of a frown, decreasing my scolding and nagging and replacing them with encouragement and joy in her accomplishments. It felt so good to begin liking her again, and that was made easier by the fact that her horrible behaviour quite noticeably decreased and she did become more likable by everyone else in the family too. Extra bonus - they weren’t always yelling at her and sending her away from them anymore either. Everyone was happier.

This relationship and behaviour cycle continued over the years. Even now I sometimes feel myself slipping and I have to remind myself to seek out Portia’s company and conversation a bit more - a bit more difficult now she’s a teen who naturally tends to spend more time alone in her room with her homework or reading or just listening to loud music. But it’s still worthwhile working on strengthening that still shaky attachment and the rewards are gleaned by seeing a corresponding shift in her behaviour and attitude.

Nowadays the activities are a little different. Watching her play basketball or skate or dive with lots of encouraging words and gestures, inviting her to help me with cooking, or asking her to make her famous choc fudge cake for afternoon tea. It’s sharing funny things on TV or YouTube or reading an article out loud from a newspaper that I know she’ll be interested in (or listening to something she wants to read out, even though it’s not really that interesting to me) or telling her something funny that I think she’ll appreciate. Sometimes it’s just showing her that I am keeping her in mind, that she is important to me.

I sometimes wonder when Portia’s behaviour reverts a little to that impulsive, oppositional, tantrum throwing four year old that she was, could it have been different? Maybe if we’d managed to do more, known better or tried a little harder, focused just on her and not continued fostering (but then we wouldn’t have our sweet son Seth). Or should we just look at the long way she’s come and promise ourselves to never let up or give in, but keep working hard to make sure this kid stays connected to family and community, feels strong and worthy, has focus in her life (thank goodness for all those sports she loves) and do our best to get her through the teenage years unscathed, to successful adulthood.

Well, that’s certainly an outcome worth a bit of hard work!

In my last post I talked about our difficulties in getting a diagnosis for Seth.

In Australia there is no real recognition of Fetal Alcohol Spectrum Disorders (FASD). We have no diagnostic teams who understand the problem. We have to flounder around, making appointments here and there for hearing tests, sight tests, blood tests, genetics consultations, IQ tests… and at the end of it all, months after starting, we were no closer to understanding the big picture.

Until a lucky break.

An organisation in my home city, ARBIAS, who deal with adults suffering brain injury from the effects of drug and alcohol use, realised that children suffered this problem too and launched the first Australian clinic to look at FASD. No team approach, just one neuropsych assessment, but I had my referral in within days of finding out about the clinic, and Seth was booked in for mid December. I was ecstatic, not just for us but for all those other foster families I knew who suspected their kids were alcohol effected.

Seth was reluctant to submit to yet another assessment, but I explained to him that this time we would be looking at his brain and how it works, and even how it doesn’t always work properly, and that with this information we’d be better able to know the best ways for him to learn. At this point in time, having given up on the home schooling, he had been attending a small private community school half an hour from our home with small classes (only ten in his class) and individual work programs, and he seemed quite settled and happy. He had just the day before completed grade five, and after the long summer break, would enter his final year of primary school.

It was a long day for Seth, who is easily fatigued by cognitive activities, but my discussion with the neoropsychologist at the end of the day left me optimistic that this time Seth’s real problem (brain damage from fetal alcohol) was being acknowledged and the final report would be a major stepping stone to acquiring the services he would need to be educated to the best of his ability over the forthcoming years.

I was maybe a bit too optimistic, but a month later I finally did get that report, and as I mentioned, it did tell me what I’ve been waiting to know. What is more the detailed results of all the testing gave us an accurate profile of Seth’s cognitive abilities, including attention and memory, executive and adaptive functioning, auditory and visual reasoning, language comprehension, reading and maths levels. I was confident as I read the report (although it occasionally brought tears to my eyes as I realised the extent of damage my little boy’s brain had suffered) that it would be of great assistance to his teacher in the school year ahead.

What was a disappointment was the news that the organisation, after barely six months, was closing the FASD clinic. Apparently they’d overreached themselves, and could not actually afford to provide these services to children. Although we were one of the lucky families to receive a diagnosis, it meant there were no further services offered, as had previously been promised. We were on our own again.

So here we are with a seven page assessment outlining Seth’s neuropsychological abilities and impairments.  I need to work harder at being an advocate for Seth, but I’m not sure how to go about it. I feel too emotional and passionate sometimes to present as cool and logical. I need someone else to be able to come to the school and talk on Seth’s behalf about his disability. Unable to find anyone knowledgeable about FASD except the neoropsychologist who did the original assessment and with whom I sometimes have phone and email contact, I am ringing around organisations that provide services for children with acquired brain injuries and I’m hopeful they may have some services to offer Seth. I have also contacted an educational psychologist who seems sympathetic to Seth’s needs and claims some understanding of FAS, and she is willing to come work with the school (but that will be at quite some cost to us).

I can’t be the first Aussie mum to have a child with a FASD but I feel like it. I know of no other child with a diagnosis (but have my suspicions of a few children in foster care who show quite definite symptoms). I’m hoping someone might read my blog (or a few someones) and maybe one day I can get a support group going. The only support organisation I’m aware of in Australia is NOFASARD. That’s in another state (South Australia), but at least they provide some information, and are a lobby group for families living with FASD in Australia. Anyone else in this country who suspects their child has fetal alcohol damage would find this a good starting point for information.

For now I need to look at my son and determine his immediate needs and how we can meet them.

Of course, it’s not all about FASD, but when it comes to his school experience somehow it always comes back to concerns about his behaviours and learning difficulties. At home it’s easier just to see the sweet and active boy he is. He loves riding his bike, learning tricks on his skateboard and mastering his inline skates (actually his big sister’s but I’m hoping she’s actually passed them on to him). He is delightful with his little foster brother (who he’ll so miss when he has to leave our family) and is totally obsessed with the computer game RuneScape which he loves to play on line with Portia and their friends. He is an interesting conversationalist, often branching off on some illogical but fascinating tangents, and makes for good company when he has to stay home from school (which happens quite regularly) and we’re forced to spend the day together.

People tell us how lucky it was for him to be placed in our family all those years ago, but despite the hard work and heart ache, he’s a joy and we’re the lucky ones.