Her Whole Life in a Plastic Bag

three-clock-bears

Photo: threeoclockbears.com

 

Tamina attended first-grade in a Harlem public school. She was homeless most of that year. Her mother lost the apartment after she lost her job. Sometimes they stayed with relatives but mostly Tamina, her mother and her sister slept in shelters where they could never stay very long. They carried their belongings in thick black garbage bags, protection from the weather. Tamina used to have a teddy bear, but it got left in a shelter and her mother was ‘too tired’ to go back for it. Tamina never got it back.

Tamina had very little. Other children had a home, their own bed, place for their stuff, more stuff. So she stole. Mostly small things: erasers, crayons, hair-pins. Things she could hide in her pockets and later in her black garbage bag. If confronted, Tamina would furiously demand it “was always hers.” I suspected she often believed it and wondered if some items resembled things she once had and owning them was a link to a time when life was less overwhelming. Beyond an overall language delay, Tamina seemed confused about concepts like the difference between possessing and owning: in some shelters cots were ‘first-come-first-serve’ and while you had it, it was ‘yours’ even if it did not remain so for long. You had to ‘watch’ your stuff or have it disappear. Why could an unattended eraser not be ‘hers’?

 While children often crave things that are not theirs, Tamina’s stealing was possibly about unmet needs. Her mother was “always mad and cussing” and Tamina could not rely on her for support. Children whose ‘hungers’ are neglected seek other ways: become secretive, dissociate, numb themselves with substances, steal, hoard. These behaviors often further distance them from care and social support, when they in fact communicate confusion, loneliness, anger, loss, and shame.

[The above is an excerpt from “Communicating Trauma” Routledge, 2015]

Communicating Trauma-Yehuda

Homelessness does not necessarily mean neglect, but the realities and causes of homelessness pose many risks, especially to children. In addition to loss and grief, there are increased health and safety risks, along with reduced access to care. Children without homes suffer insecurity, and their caregivers may be too overwhelmed to attend to their emotional needs. Depression, posttraumatic stress, illness, disability, poverty, domestic violence and other life-crises are all too common among parents of homeless children. Any one of these factors can overwhelm a parent and reduce their availability, let alone when such factors combine.

Having no place to call home–in all the forms it takes–can be distressing and occupying. It leaves children anxious and unavailable for learning. Homeless children are often wary and worried, angry or withdrawn. They are three times as likely to require special-education, four times as likely to drop out of school, and almost nine times as likely to repeat grades.

Homelessness devastates. It is crucial we work together to understand it and resolve it as well as support families in crisis and address risk factors before they reach a loss of home, hearth, and heart.

 

 

New Beginning: Habit & Opportunity

opportunity

“He still won’t read.”

The mother’s voice held disappointment and frustration. Her son struggles in school and was required by teachers to read every day over the summer, but hadn’t.

“I did read!” he protested, pouted. Hurt. “I read two whole books!”

“Only because we made you read!” She retorted and turned to me. “Every day is a new excuse. He’s too tired, the book is boring, it’s too hard, he’ll read later, he hates reading, it is stupid … He’ll do anything to avoid it.”

He stomped to the chair. Sat dejectedly. I patted his arm. “I’m glad you read two whole books,” I said. “Which ones?”

He brightened. Threw a “you see?!” look at his mom, and told me. We discussed what he liked about the stories, what he didn’t. What was hard, what wasn’t. We then went over a list of possible titles to follow.

I scheduled a time to speak with the mom. Her frustrations need venting, and she needs solutions, but we can talk about her disappointment without him needing to be present.

♦♦♦

Every child is different but the complaint is not unique. Children and parents rarely battle over things that are fun and easy. It is the stuff that’s hard, confusing, boring, tedious, or appears to be of import to one side but feels less so to the other … where lines get drawn in the sand and stubborn frustration ensues.

Parents cajole. They threaten. They withhold privileges. They might use shame as ‘motivator’ by characterizing the child as lazy or ungrateful, oppositional, immature …

Not surprisingly, these tactics rarely work to ‘motivate’ learning. Nor do they solve whatever problem underlies a child’s reluctance to read: difficulty decoding, difficulty comprehending, delays in language and learning, issues with processing and retrieval, attention issues, stress and overwhelm …

A new school year is seen as opportunity for new ways of learning, new progress, new habits. Parents expect their children to enter school with gusto after a summer’s break and to give it their all. They often expect improvement of whatever issues may have been present the year prior. They verbally and otherwise communicate their expectation that the child prove himself or herself as mature and hardworking, and overcome whatever habits held them back.

A new grade and new beginning indeed offers much new opportunity for doing things differently. However, for that to happen we cannot fall back on failed methods or less-than-helpful habits. If children knew to do better on their own, they would do so already. No child wants to fail. No child enjoys the negative attention of reproach if they can get the positive attention of pride and praise.

♦♦♦

“So what am I supposed to do?” the mother asked when we met. Exasperated.

“You did the best you could last year, and this year we’ll have to work together to do better,” I replied.

She was taken aback. She didn’t expect me to include her in the assessment of last year’s difficulties …

I did not mean blame, but I did mean accountability. Parents often do the best they know, but they are often overextended themselves, and some don’t quite follow through. They may want to follow suggestions but only do so sporadically, or expect the child to take full responsibility for remembering new tasks that they themselves forget … then feel pressed to blame or require … They may get discouraged at the first sign of difficulty (not unlike the child, maybe …) and not continue to work toward new habits when the implementation hits a bump or scheduling needs to be adjusted. They may balk at taking on more responsibility in a life that may already feel too stressful (again, not unlike the child…).

Parents deserve guidance. Shame does not work any better on adults than it does on children … Parents can use encouragement, not blame. Many can benefit from reminders and a pathway to setting new habits. It is not a weakness or poor parenting to make errors or get frustrated or not follow through. People aren’t perfect. We all need help in some areas.

♦♦♦

For this boy, now in mid-grades, and often argumentative and quite fed up with “everything being too difficult”–new habits will (hopefully) include less fighting and more working together, less demand and more playfulness, less critic and more problem solving, less rigidity and more predictability, less shaming and more understanding.

Practically speaking?

  • Setting a weekly schedule where one of the parents reads TO him every night or almost every night (on the benefits of reading check: How early? For how long? ).
  • Separating the child’s own reading for decoding and school, from the parents reading TO him for literary exposure and pleasure.
  • Taking care to not make a parent’s reading time an opportunity for ‘testing’ vocabulary or memory about the story (talking about the story is fabulous, quizzing is not).
  • For books mandatory for school (but too difficult for the child’s reading level), using audio books as accompaniment to printed/electronic book. This helps the child follow the written word and assist him with decoding and comprehension.
  • Placing reminders for reading-time and having a timer he can set to ensure he is reading long enough and can do this independently.
  • Scheduling daily reading (for school and book logs) at a time that is realistic, rather than opportunistic.
  • Providing assistance with homework and/or test preparation, so that the child is not left to manage what is too difficult on his own, and ends up too stressed and exhausted to optimally process information.
  • Incorporating narrative into the day to day and offering modeling of narrative instead of requiring the child to constantly answer questions.
  • Offering a model for making time for reading. Adults who read are more likely to have children who enjoy reading.
  • Setting the child up for success, not failure: rather than focusing on a day he didn’t read or what he isn’t doing well yet, offer praise when he does do his reading without arguing; remind the child what worked before and what he can try to do again; offer solutions, not reprimand.

♦♦♦

In this new school year, what old and less than desirable habits can your child replace with brand new opportunity?

What steps can you take to help?

If you need help to formulate a plan–it is okay to ask for it. That, too, is an opportunity.

reading-extinction-buzzfeed

from Buzzfeed.com

 

 

Heat-wave

Met a neighbor downstairs yesterday. She was sitting on the stoop with her dog by her feet. My neighbor is usually quite peppy. She looked wilted and a little green around the gills. Sweaty. Bleary eyed.

I asked it she was okay, and she shook her head.

“I feel like I’m going to throw up,” she said. “Got dizzy. Maybe it’s the heat.”

I gave her a cold water bottle. Asked the café next door for a towel moistened with ice-water and wrapped that around her neck. I’d have helped her to my air-conditioned apartment but I didn’t think she should climb several flights of stairs.

She didn’t want me to call 911. Said she’d just sit on the shady (but steamy) stoop and rest. I offered to help her into the café next door instead. Had her sit down in the air-conditioned space. The dog could not enter but the waiter understood and let us sneak the leash out through a crack in the door so she can still keep hold of the pooch.

I asked again if to call 911. Didn’t want to scare her, and indeed it could be heat-exhaustion, but heart-attack in women rarely displays the classic ‘clasp your chest’ as in men. It could be something else …

She shook her head. “I don’t need 911. I’m taking this new medication and maybe it made me more sensitive to the heat. I think there was something about it on the label. I’ll be okay.”

She said the cool air already had her feeling better. So we sat. I watched her, ready to call 911 if she got worse. She didn’t. She took small sips of her water. The waiter brought another cool rag to replace the one that already warmed. She took deep breaths.

Her coloring improved. The dog, who’d been standing vigil by the door and anxiously observing her, finally lapped the water we’d placed for him, then lay down with head calmly on front paws. His reaction reassured me. It reassured my neighbor, too. She smiled and took a deeper breath. The dog lifted eyes to her and his tail slapped the ground in return greeting. Both relieved.

We sat a little longer. When my neighbor felt like herself again, we thanked the café workers and I walked her home. She was going to take it easy the rest of the day. Hydrate. Stay indoors.

Summer is lovely, but it can be tricky for many. Medications are often not taken into account, yet should.

I can be a certifiable momma hen … so, bear with me. … It’s been hot yesterday and it is hotter still today. A heat index of 109F or so. Life doesn’t need to stop, but know the signs of heat exhaustion and heat stroke. Don’t ignore them. Take precautions, check your medications for heat-sensitivity warnings, and take good care of you, of young and old or people who are in any way infirm or vulnerable to heat. Be mindful of pets, check on neighbors. Keep hydrated. Keep cool. Keep well.

SacramentoReady.org heatstroke

Stressful Situations Simulation: A resource

Below is a good resource and simulation of stressful situations that can be immensely helpful to parents and caregivers. I especially recommend the ones involving “Family Support”: “Calm Parents, Healthy Kids” and “Building Family Bonds.” These scenario simulations inform, teach, and actively guide parents and caregivers through various scenarios of interactions with toddlers in commonly challenging situations.

The resource can be invaluable information for parents and caregivers who are inexperienced and/or may have had less than good enough parenting themselves, and who may not know how to facilitate clear, supportive interaction with their own children, especially under stress. The simulation is presented in a non-shaming, educational way, and provides the participant with an active role in choosing different ways of responding … and being able to see the possible reactions to them … It also allows the participant to ‘re-do’ situations so they can experience how better choices can bring better results …

Practicing is important for any skill, let alone for skills one needs to apply in stressful situations. The very way our brain processes information is affected when we’re stressed, so it helps to already know what to do beforehand. Also, our own stress and how we manage it gets communicated and passed onto children in our care. This makes it doubly important to learn and practice (and then be able to model) new skills when one is calm and in neutral situations–as this simulation allows one to do.

Calm, informed caregivers help raise calm, healthy, competent kids. This can help!

I highly recommend you take a look and see:

https://conversationsforhealth.org/#conversations

bubble happy

 

Communication and Collaboration

Upcoming Webinar!

Communication and Collaboration: Multidisciplinary treatment of traumatized/dissociative children

Friday, May 20, 2016
2:00 PM – 3:30 PM Eastern Time

Registration now open! (please see disclaimer in bottom of post)

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Photo Credit: A.A.

Abstract
Treatment of traumatized and dissociative children is most often discussed in the context of psychotherapy. However, traumatized and/or dissociated children often come into contact with additional professionals. Like all youngsters, traumatized children need to manage everyday interactions with caregivers, educators, and routine childhood medical and dental care. Yet many also face clinical interactions with speech-language pathologists, occupational therapists, physical therapists, medical professionals, and more. This is because trauma places children at a high risk for developmental issues, and because children who already have developmental and/or health issues are highly vulnerable to trauma. In addition to clinical care, many traumatized children encounter legal personnel, forensic evaluators, child protective services, foster care staff, etc.

Posttraumatic and dissociative reactions are not limited to the therapist’s office. Just as communication issues aren’t segregated to speech-language pathologist’s office, asthma to the doctor’s, or sensory integration issues to occupational therapy. Various issues can complicate children’s presentation and behavior, and traumatized youngsters are often judged as difficult, aggressive, manipulative, immature, unpredictable, and inattentive. This can result in painful consequences (e.g. loss of placement, shaming, treatment failure), which further increase stress and reinforce the need for dissociative coping. In addition, caregivers routinely face challenges that can affect course of treatment, and professionals do not always ‘speak the same language’ when it comes to describing, assessing, and treating the child (and/or family). Even when professionals are trauma-aware, coordinated care is not always easy to achieve … and yet is essential for effective stabilization, minimizing compartmentalization, and carryover.

This webinar will look into the often complex realities of caring for traumatized/dissociative children and adolescents, the tapestries of clinical encounters many face, and how these may shift throughout infancy, childhood, and teen years. The challenges (and potential) of coordinated care and communication will be discussed, as would logistical and ethical limitations and suggestions for managing them. Clinical vignettes will serve as a window into ways for improving communication among child/family professionals, and will provide examples for practical solutions for increasing regulation and decreasing posttraumatic activation in all involved. The role of caregivers and the child as part of the team will also be examined.

Objectives
Upon completion of this webinar, participants will be able to:

  • Identify the connection between trauma and care utilization in children and adolescents.
  • Describe three challenges to coordinated care
  • List five strategies therapists can apply to improve communication and coordination in the multi-disciplinary treatment of traumatized/dissociative children

For more information and to register

Disclaimer: I volunteer my time and expertise for this webinar, and do not receive any financial gain from it. Registration fees are collected by ISSTD, which hosts the webinar, is responsible for all fees and/or refunds, and provides an option for CEs for attendance.

What PTSD teaches us about human frailty and resilience

The link below will lead you to one of the best interviews about PTSD I have ever seen, hands down.

The fact that Rachel Yehuda is my cousin is an added bonus–I am ever so proud of her: for the person she is, for the work she does, for the wisdom and empathy she imparts, for how she has literally changed the field of PTSD in the last 25 years.

(I recommend reading the transcript, not just viewing the snippet of video on the site)

Take a look. Take a read. You will be glad to have taken the time:

Ingenius: Rachel Yehuda

http://nautil.us/issue/31/stress/ingenious-rachel-Yehuda

 

experience

Kids and Screen Time: Data, Reality, and Possibility

ScreenTime

When I grew up, television was a very small part of daily life, and was the only screen in the house. Telephone conversations were usually brief (and attached to the wall through the cord in the main room of the house, they only allowed limited privacy). Most daily interactions were face-to-face. Social interaction with peers and siblings certainly were face to face.

Now most homes in developed countries have several screens in different configurations: TVs, laptops, computers, tablets, phones, game consoles, DVD players, other interactive toys that come with a screen.

Children spend a lot more time facing a screen than they ever did. What is the impact of that?

Like every tool, screen media is neither good nor bad–it is HOW you used it and HOW MUCH you used it and what it DISPLACES that matters.

In this electronic age, children have more access to more education materials in quicker and more convenient ways than ever before. Media and information are powerful, but not neutral: If not taught how to discern information on the web, children do not learn how to conduct research or pick out primary source or secondary source, how to identify fact from biased blog or a complete fallacy. They may believe everything they read online–both truth and blatant misrepresentations. They need to be taught how to use information, how to cross-check, how to learn.

Education with the use of screens has replaced some of the methods of learning that were used in not-too-long-ago times. They have benefits and limitations. They can replace some older methods of research and increase efficiency and effectiveness of learning. They can connect people from far places to work together. They can bridge over differences and stigmas. However, they can also displace the interactive collaboration of listening, analyzing other people’s opinions and views, and working together interactively in real space (rather than over the internet in shared documents or through ‘attachments’ or searching to copy other people’s reports through google …).

Outside of educational screen time (i.e. the time children spend watching screens for learning, whether formal or informal), there are also the many hours a week that children spend playing or gazing at movies or music videos, or in texting incomplete sentences in stunted spelling to their friends on social media or phones. These hours often displace actual face-to-face interactions and all that comes with them: reading social cues, body language, emotions, tone of voice. Electronic communication is a poor substitute to actual interaction. Emoticons are a very crude representation of people’s facial expressions, and while they can lend ‘color’ to a message, they are not the real deal.

Children who spend too many hours staring at screens spend too few hours interacting with others and learning skills for interpersonal communication, for reading other people’s emotions and body language, for taking turns and listening.

In an article on NPR, about “Kids and Screen time–what does the research say”, researchers found that removing screen time (and effectively, the replacing of that back with social interaction and TALKING TO EACH OTHER and engaging with others), helped children be more able to recognize facial expressions. The benefits were significant even after five days of no screen time.

While some people advocate total electronics removal … I am not an advocate of removing all electronics: we live in a time where media and internet, email and web searches are enormous tools. It would be a form of social isolation to cut children off from the ability to interact with the world. However, it can be unhelpful to have too much screen time, as it displaces other kinds of social engagement that are just as important. Children do not know what they are missing when they stare at screens instead of interact with people–it is our job and responsibility as adults to help them learn to communicate and socialize.

Infants learn how to interact, how to engage, how to interpret communication and intent–through facial expression and through immediate dyadic interaction in many different settings over many interactions. It is a learning that continues throughout childhood and into young adulthood (and some may say, throughout the lifespan). We need to be mindful of not displacing personal interaction with screen time.

It is possible to do both–though that calls for moderation and boundaries (things that children need to learn, anyway). Additionally, it needs to be not only the children … adults who spend all their times staring at a little screen are displacing time of interaction WITH their children and are becoming models for what we do not want to reinforce.

There is no one recipe that would work for everyone–the right balance is different for different people at different times. What does make sense to me, is to be mindful and be honest:

  • Do not demand of your children something you do not follow yourself …

* Create windows of time when screens are not used in your home: a ‘curfew’ time for phones, or an evening a week without any electronics, a ‘no virtual communication’ weekend day, maybe decide on no electronics in mealtimes (basic politeness, that …), or on other ways to limit screen time. For everyone.

  • Make sure that you are a good model for turning off electronics and doing more than just lifting your eyes momentarily from one …

Young children, especially, are vulnerable to not developing what they SHOULD be developing. If their little faces are stuck to a screen rather than interested in another person, and if their interactions are the brief raising of eyes (or the parent’s brief raising of eyes) from a screen to nod or follow a direction; they would not learn how to engage well, they would not know to be good communicators, or listeners, or readers of social gestures, facial expressions, body-language, and signs.

This is not an either/or. Electronics and screen time, interpersonal social time: It can be an and/and, but it needs to be mindful, lest we raise a generation of children who do not how to interact … and fail them by not providing them the opportunities they needed to learn.

To read the article: “Kids and Screen Time–what does the research say” on NPR, click on the title, or click below:

http://www.npr.org/sections/ed/2014/08/28/343735856/kids-and-screen-time-what-does-the-research-say

Nadine Burke Harris on: How Childhood Trauma Affects Health Across a Lifetime

What if there is an exposure that affects health and development dramatically and is more prevalent than HIV, cancer, and Hepatitis combined and yet most doctors do not screen for it? What if you knew of an exposure that increases the risk for heart disease, diabetes, early death, inflammatory diseases, premature birth, metabolic syndrome, depression, anxiety, suicide, and more? What if that exposure was at the base of many learning disabilities, attention issues, and behavior issues and if there was a lot to do to help reduce this risk?

Wouldn’t you want to know about it?

Wouldn’t you want it to be treated as a priority in healthcare and public interest? I know I would, and do. Nadine Burke Harris is sure, too. Listen to her amazing Ted Talk–this is a brief talk that you’ll want to pass along!