Thanks to COVID, I am Getting More Gray Hair

COVID-19 has uprooted so many lives, especially children. It is even harder for children who have ADHD and other disorders or special needs. For the parents of children with ADHD, mental health issues, and other special needs, COVID-19 has been, for lack of a better explanation, a roller coaster ride. 

During normal times, J is hard enough to deal with. Since, COVID, it has been twice as hard. In J's defense, we live on a street where there are no kids for him to play with. His play companions have been our neighbor's dogs. It has been quite difficult for J to find things to do to occupy his time. What he primarily wants to do, he cannot while I am working. The family offers J suggestions but we are often met with: "That's boring," "I don't want to do that," "That's stupid, " and so on. All that he wants to do is stream YouTube which he cannot do while I am working. When he doesn't get his way, a tantrum ensues. 

Before he went into the Child Diagnostic Unit, J's behavior at home following the school closing down due to COVID was horrendous. J constantly interrupted me while I was working. He would bang on my office door, barge on in while I was on a call, fight with his older brothers, make demands, refuse to do what he was told, wake us up at 6 am, aggravate the dog... just to name some behaviors. The medications he was on were little to no help. My hair was getting grayer by the minute. I was afraid it would be months before he would be accepted for the Child Diagnostic Unit program. Fortunately, he got accepted early and we had an opportunity to breathe a sigh of relief. Praise God!

If you happen to have a child with behavioral problems and issues, check with your state's leading research facilities and colleges of medicine. It is possible they may have a program that can assist you and your child. If you are receiving Medicaid assistance, check with your child's case manager. You can also check with your state's department of health. The key is to ask questions and keep asking them until you find the right person who can give you the direction, guidance, or answers that you need. 

So, J returns from the program, COVID is still highly active and the outlook for attending school looks bleak. I attempted to take care of my gray hair but after a month of him being back, it is turning gray again. Go figure...Anyway, I had to take a different approach with J (and try to keep my hair intact). I created a schedule for J. With J's help, I took several pictures of J doing various activities from eating breakfast, brushing his teeth, doing crafts, etc. I then placed all these images on a board and wrote down a time for each activity. It hasn't been 100% effective or perfect but it has definitely helped in managing J better. 

COVID-19 does not look like it is going away any time soon. The school reopening looks bleak at this time. Even if the school reopened, I would have to seriously reconsider J not attending.  He already has such anxiety about the virus that sending him to school may make things worse for him. Since he has ADHD, he does not always remember to wash his hands, wear a mask, and stay 6 feet apart from others. If I sent him to school, he would not be able to socially distance himself, keep his mask on, wash his hands, etc. And, while he cannot remember to do these things, his anxiety over catching the virus will just increase possibly contributing to increased behaviors. So, as these thoughts roam around in my mind, my hair gets grayer. 

There are many parents in the same boat my husband and I are in. It definitely gives you a better appreciation of teachers and everything they do for your child. Teachers are angels! However, in these times, we have to remember what it must be like for our child. We cannot get too upset if they interrupt a meeting or a phone call. During a meeting I was in, I thought I had my phone on mute. I kept getting kicked off the internet. I finally ended up yelling at J to get off the internet. The next thing I heard was my supervisor saying, "whoever that was may need to put themselves on mute or something." I was so embarrassed. I know a few strands of hair turned instantly gray that day. I ended up emailing my supervisor apologizing for my "outburst" during the meeting. 

COVID-19 has turned everyone's world upside down, especially for children. Children, whether they have ADHD or not, will interrupt your day, especially if you work from home. As embarrassed as I was, I was not required to apologize. People understand and may even find it a nice distraction to see your child interrupt a meeting for a brief moment. So, don't apologize. 

I know first hand the frustration and aggravation of a child constantly seeking your attention while you work. Fortunately, the schedule I created for J has decreased those interruptions significantly. The key is to stick to it and make your child stick to it. Some days we are spot on with the schedule and other days not so much. Some days he fights me on it and other days he does it without much prompting. Either way, we stick to it. As we continue to use his schedule in this COVID-19 world, maybe, just maybe, my hair will be a little less gray. 

J's Schedule Board:

The Many Sides of ADHD

What exactly is attention deficit hyperactivity disorder (ADHD)? It is a diagnosis so common among children that many adults, teachers, doctors, etc. do not even think twice about it. A child presents behaviors of ADHD and suddenly they are on medication with no explanation on exactly what this diagnosis is or how to handle it. It is a diagnosis that is thrown around without really trying to understand it.

J showed signs of ADHD very early. As a nurse and a mom, you pick up on behavior that your children display which is not entirely normal. At 3 years old, I started to see signs in J that he could possibly have ADHD. He was restless, moved around a lot, easily distracted, could be hyper focused on a topic, etc. and most importantly he would seem to calm down after drinking a Mt. Dew.

Now, I know that giving a 3 year old a Mt. Dew is not something most parents would do. I knew that stimulants are often given to children with ADHD to help control symptoms. They seem to have the opposite effect versus making them more hyper. Knowing this and out of desperation, we decided to give J Mt. Dew to see what would happen. To my dismay, it calmed him down. Recognizing this I knew that he could possibly have ADHD. However, I do not recommend that parents rush out to buy their hyperactive child Mt. Dew. It was not something we gave J all of the time. It was only when his behavior was so uncontrollable, did we give him a small drink of the soda. It is also hard to determine if his behavior is due to being a typical 3 year old or possibly ADHD. Only a physician or a psychologist/psychiatrist can determine that diagnosis. Diagnosis is not often made until after the age of 7.

J was first evaluated for ADHD when he was 5 year old. When he started kindergarten, it was obvious to teachers and the psychologist who evaluated him that he has ADHD. Initially, the psychologist and psychiatrist gave him the diagnosis of rule out ADHD without really examining it further. I accepted the diagnosis at face value based on what they had said and based on what knowledge I knew at the time. J was immediately started on medication. He was given clonidine. Little did I know the extent of J's ADHD.

J's symptoms progressively got worse as he grew older. We tried various medications and combinations thereof to try and help control some of his behaviors. After struggling for a  few years, we finally got J into a month long program designed to help determine exactly what was causing his behaviors. The psychiatrist diagnosed him with severe ADHD combined along with three other diagnoses. After hearing the diagnosis, I started researching ADHD to understand it better.

There are so many facets to ADHD including types and severity. I was already aware that a child or person could simply have attention deficit disorder (ADD) and not the hyperactivity part. I was also aware a child could have both the attention and hyperactivity disorders. However, I was not aware that ADHD is considered to be a type of neurological disorder. A disorder in the brain which involves an imbalance of neurological signals.

ADHD has been known by many different names and descriptions. However, research conducted within the past 35 years indicates that ADHD is a neurodevelopmental disorder versus "brain damage" or hyperkinectic disorder (Zayats & Neale, 2019; Mahone & Denckla,2017).  It is a neurological disorder which involves a dysfunction in how the brain receives, interprets, and responds to information (Marcel, 2018). Imaging scans of the brain show children with ADHD to have a brain that is 10% smaller than normal (Rodden & Nigg, 2020). The actual causes of ADHD are not fully known. In recent years there has been a shift from psychological and environmental causes to biological and biopsychosocial causes (Mahone & Denckla, 2017).  The most recent studies point to genetics as being one of the causes.

According to Zayats and Neale (2019) genetics does contribute to the development of ADHD; about 60-90% can develop the condition if it is present in a family member. It is more prominent in identical twins versus fraternal twins (Zayats & Neal, 2019; Marcel, 2018). Although research is demonstrating genetic involvement, the causes still remain highly variable. A child's environment can still be a contributing factor. The latest research is showing inflammation can also be a risk factor for the disorder. Other factors include: exposure to drugs and alcohol, inadequate or no prenatal care, low birth weight, prematurity, nutritional deficits, etc. (Marcel, 2018).

Several symptoms need to be present before the age of 12 before a diagnosis of ADHD is made. Symptoms fall into two types: inattentive and hyperactivity/impulsivity. According to the latest DSM criteria, symptoms can merely be present as opposed to causing impairment. In adults only 5 out of 6 symptoms need to be present (Mahone & Denckla, 2017) for the diagnosis. The symptoms are then classified as either mild, moderate or severe (CHADD, 2020).

Symptoms can cause mild to severe impairment in children. Mild classification is given when there are few symptoms present beyond what is required and little to no impairment in school and other activities is observed. Moderate classification is given when the number of symptoms is in between mild and severe and there is moderate impairment in activities. Severe classification is given when a child displays many symptoms and their severity is significant enough to have a major impact on school, family, and other social activities (CHADD, 2020).

Symptoms of ADHD are varied. Children with ADHD tend to behave younger than their age, have emotional outburst and responses that are overblown. Fidgeting and inability to sit still are very common. They are easily distracted - much like how a dog can be distracted by a squirrel. A child with ADHD can struggle following directions, completing tasks, loses things, talks constantly, forgetful, makes mistakes, interrupts/intrudes, and so on (CHADD, 2020).

Children diagnosed with ADHD often have another co-existing condition such as anxiety or mood disorders, learning disorders, etc. It is actually rare if a child is only given the diagnosis of ADHD without another behavioral disorder (Mahone & Denckla, 2017). However, a child diagnosed with ADHD is at risk for developing the following: poor school performance, low self-esteem, social isolation, injuries due to accidents, occupational failure in adulthood, suicide, divorce, and so on (Faraone & Larsson, 2018). ADHD diagnosis has most recently been recognized as a public health concern which causes billions of dollars every year. The US education system bears about 1/4 of the costs each year (Mahone & Denckla, 2017).

J has ADHD combined, severe. This means he has both the inattentive and hyperactivity/impulsivity symptom areas. His symptoms and behavior are so extreme that he cannot be handled without medication. Medication is the most common way of treating ADHD. However, it is only effective about 70% (Zayats & Neale, 2019). This is largely due to there being so many different causes behind ADHD. With J, we have tried multiple medications. We have now circled back to a previous medication but have added a "booster" type medication to help it along. Medications are also not a cure and they do not totally suppress symptoms. ADHD varies from child to child. Medications that work well for one may not work for another. Since medications are not a cure, children with ADHD may also need therapy on a regular basis to help them to respond and manage their impulses better.

Gone are the days we give J Mt. Dew. He now takes two medications to assist with his ADHD symptoms. They do not take them away entirely. He still shows many of the signs of symptoms just not so severe that it will interfere with his daily activities. By evening the medications have worn off and he is back to bouncing around and talking incessantly. Fortunately bedtime is not too far off and he receives a medication to help him sleep.

Now that I have more knowledge about ADHD, I have been working on changing my mindset related to how I respond to J. It has not been easy. He is so smart and I forget how much he struggles with just the simplest things. His struggles do not lessen his intelligence nor his abilities. I just have to remember to give him time and patience.

References:
Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD) (2020). About ADHD. Retrieved from https://chadd.org/about-adhd/adhd-and-autism-spectrum-disorder/ .

Faraone, S.V & Larsson, H. (2018). Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry, 24:562-575. Retrieved from PubMed.

Mahone, E. M. & Denckla, M. B. (2017). Attention deficit/hyperactivity disorder: a historical neuropsychological perspective. Journal International Psychology Soc, 23(9-10);916-929. Retrieved from PubMed.

Marcel, C (2018). Attention deficit hyperactivity disorder: dietary considerations. CINAHL Information Systems. CINAHL. Retrieved on July 11, 2020 from CINAHL database.

Rodden, J. & Nigg, N. (2020). Is ADHD a spectrum disorder? The ADHD Brain. Retrieved from https://www.additudemag.com/adhd-is-spectrum-disorder/ .

Zayats, T. & Neale, B. M. (2019). Recent advances in understanding attention deficit hyperactivity disorder (ADHD): how genetics are shaping our conceptualization of this disorder (version 2; peer review 3 approved). F1000 Research. Retrieved from PubMed.

A Not So Sweet Smell of Revenge

It can be hard to believe that a 5-6 year old child would be capable of revenge; or at least perform an action symbolic of revenge. A 5-6 year old may not realize what they were doing was an act of revenge but on the surface it definitely appears that way. J may not have realized what he was doing but it was a simple act of revenge a young child like J could think of. 

When J started kindergarten we were still having trouble trying to toilet train him. Of course at the time we did not know of his diagnosis of developmental coordination disorder and we did not understand why we could not get him toilet trained. He would urinate in the toilet but using the toilet for bowel movements was a different story. 

J would often soil his pants. We had good days when he would be clean all day and use the toilet like he should. But we had many bad days when he would not. Whenever we left the house we would have to pack a bag with extra underwear, diaper wipes, and trash bags. There were many times we had to take a trip to the bathroom to clean him up. It was very distressing for all of us. We finally got to the point where we made him clean himself up hoping this would teach him a lesson. However, it never did. 

I had taken J to his pediatrician to see if this was a physical condition. An x-ray showed that his bowels were backed up thus causing him to have "leaks." His doctor gave us some recommendations on how to help him. Let me just say giving a 5 year old an enema is no picnic. We also had to give him over-the-counter medication to help him. J was also on a schedule. We tried to make sure he went to the bathroom every 2-4 hours depending upon what we doing at the time. Needless to say, we went through a lot of underwear. 

Kindergarten was a tough year for all of us, especially for J. When he was in pre-K there were issues but nothing truly terrible. It gave us a glimpse for what we would be dealing with in kindergarten. It was during this year we began getting therapy and help for J. He started seeing a therapist at the school and we were taking him to see a psychiatrist. J was started on clonidine for some of his behavior. Some days were good but it was often a hit or miss. However, he continued to soil his pants. 

It was so embarrassing and frustrating for us. My husband and I would often receive calls about J soiling himself. We had to make sure we packed extra underwear and diaper wipes in his school backpack. He was often sent down to the office because cleaning himself up was a trigger for him. I met with the school and his teacher multiple times over the issue. I gave them suggestions on what to do but I do not think his teacher followed them well. 

It was reported to me that his teacher would often call him out in front of other kids in the class, his peers. J would often say she would say things to him in front of others. J had a classmate that reported the same thing. This was a huge concern for me. I spoke to the teacher and the assistant principal about it. The teacher would often deny it but I was more inclined to believe J. 

Once day while at work, I received a call from the school. By this time in the school year getting calls from the school was a weekly and almost daily occurrence. The assistant principal informed me that I needed to come in for a meeting and pick up J from school. This was also not unusual by this time. It was not the first time meeting with them and picking up J to take him home. I hung up the phone, gathered my things and headed for the school. 

I arrived to the school and was ushered into a private room. The assistant principal then proceeded to tell me what J had done. J had gone in his pants again. He was told to clean himself up, which he did. Okay, I thought...so why was I called? She began to tell me the real reason why I was there. 

J was told to clean himself up, which he did. However, he saved a "sample" from his soiled underwear. He then took this "sample" back into the classroom with him. How he managed to sneak a "sample" back into the classroom we still do not know. Then, he took his "sample" and placed it by the teacher's purse which was located under her desk. He managed to do this without anyone noticing, not even the teacher. Later another student,while talking to the teacher, noticed J's "sample" and picked it up. This student then showed the teacher J's "sample." J was immediately in trouble. 

As the assistant principal was telling me this, I felt appalled and in awe of J at the same time. And, while all these emotions are going through me, I am working very hard to stifle a laugh. The whole scene was hilarious to me. Here was a 6 year old who methodically planned out how to get back at his teacher for something. I figured J wouldn't just do this for the sake of doing it. He had to have a reason behind it. As the principal is telling me about J's behavior, it took every ounce of me not to break out laughing. All I could think was thank goodness he did not place his "sample" inside of her purse or on her chair for her to sit on it. Just imagine what the outcome would have been if he had done that? With a straight face, I had to tell J what he had done was wrong. I later told my husband what he had done and he immediately burst out laughing. 

At home I began to investigate why J did what he did. J informed me the teacher had embarrassed him and he felt bad. He wanted her to feel what he was feeling, what she had made him feel. Apparently J had soiled his pants and the teacher called him out on it in front of the entire class. She was told not to do this to him. J's actions was his attempt to get back at her. He told me he wanted to embarrass her. 

His actions that day was something typical 5-6 year old children do not think of. It gave us insight into how J thinks and feels. By the time this event occurred, J was in the spring term of his kindergarten year. He had already endured months of embarrassment in this classroom with this particular teacher. His actions that day was the result of months of embarrassment and frustration J had felt. In his mind he had had enough. 

I would like to say this was the last time J would soil his pants in school. Unfortunately it was not. We still struggled with this well into 2nd grade. The number of incidences decreased but it was still an issue. Fortunately, we never had another "revenge" incidence like the one in kindergarten. 

The Thomas the Train Affair

Have you ever been to a store or a restaurant and witnessed a child throwing a tantrum? Have you witnessed them scream and cry at the top of their lungs, kick and stomp around, and shout at their parents as they stood by and let them? And, in that moment you began judging the parents? You may have thought to yourself or made a comment such as: "They must spoil their child," "That child needs a good spanking," "Take your child out of the store. Don't just stand there and let them behave that way," or even "They should have left that child at home, found a sitter or something. We are trying to eat here." and so on and so on. I was such a judgmental person.

My two older boys who are in their twenties never behaved badly in public. The moment they did (which was rare), I or my husband would immediately remove them from the store. I can honestly count on one hand the number of times this occurred with my older boys. They obeyed my husband and I. Every time we went somewhere, their hands would immediately grab onto the cart. They were so good at it that by the age of 10, they would begin to start pulling the cart away from me when something caught their eye; they would pull just enough to annoy me but never letting go. I finally gave them permission to let go of the cart. Even then, they still stayed by my side and never ventured off. My older boys never ran up and down the aisle, made noise or cried at the movies, and behaved themselves whenever we went out to eat. Looking back on it, they made things quite easy for us. Hence, my ill gotten ability to be judgmental of parents who let their children throw tantrums in public.

As I mentioned, J was 2 years old when he joined our family. We were naïve into thinking we could treat him like we did our older boys. Yes, I knew he was already at a disadvantage compared to my older boys but we figured we would just leave if he begins to throw a fit. When we flew out to meet him, DHS gave us permission to take J anywhere in the state as long as we did not cross state lines. So, my husband and I decided to take him to the ocean which was only about 45 minutes from where my aunt and uncle lived. It was a small beach town and we agreed we would just leave with J if he began to throw a fit. It just so happened that J was on good behavior. We went to a restaurant and about the most he would do was say "chicken" every time the waiter walked by. It was rather cute. Our first outing went well. Later, we found out that my husband and I were the first ones to ever take him anywhere, let alone to a restaurant. It was the first of many outings we would have with J.

We told my aunt of the outing and how well it went. She informed us she was told by DHS that J was not to be taken out in public because of his behaviors. I stated J would never learn social skills if he is never taken out. She started taking him out after that.

Like every two year old, J had things which interested him. Things like Mickey Mouse Clubhouse, PJ Masks, hot wheels, and especially Thomas the Train. I seriously think that Thomas the Train was invented by someone with malicious intent. There is something fishy about a train that moves its eyes back and forth and nothing else. I think it is an effort to hypnotize kids and cause parents everywhere to spend loads of money on these trains. They are not cheap!

Thomas the Train has been around for years, decades even. My oldest son liked Thomas and he had a few of the trains and always enjoyed the train table whenever we went to Toys-R-Us. We would let him play for awhile and then say it was time to go and he would come willingly. He liked Thomas but was never obsessed with the toy and he had other interests. J on the other hand... is a different story.

Before J came to live with us, my aunt mailed out most of his things to us which included his Thomas collection. Well, okay, we have been through this before, no big deal. At least J would have his toys with us when he arrives plus toys we have gotten him. It would give him some comfort and a sense of being home. Thomas brought joy to our oldest son so who am I to deny a child a source of joy. I was looking forward to watching him play with his toys.

J lived, ate, and breathed Thomas. He carried those trains around with him just about everywhere. If we told him he had to leave them at home, he would get immediately upset and we would have to take the time to explain why they had to stay home. To make matters worse, we do not live that far from an actual railroad. J would get so excited to see an actual train go by he would shout out "Thomas!" If we went anywhere near the toy section at Walmart, we would take steps to avoid the Thomas aisle for fear of a full blown tantrum. Thomas was a huge trigger for him, positive or negative.

One day we decided to go to the bookstore. I was always looking for books to read to J and for myself. Every single bookstore I have ever been in has a section where they keep toys. The toys would often be categorized by type and age. Well this particular bookstore had an entire section devoted to Thomas the Train. My husband thought it would be a nice idea to take J over to see the trains while I shopped. As I was looking through books, I suddenly heard a young child start screaming at the top of his lungs. My heart sank. I recognized that scream. I quickly made my way to the Thomas toy section.

My husband was struggling with J to get him to let go of a train. J absolutely refused to put it down. We tried to explain it did not belong to him. Thomas's eyes had to be working its spell. Anyway, we finally got the toy away from this screaming child and then it became a battle to remove him from the section. I could feel every eye in the store on us that day as we struggled with J. We had to drop everything and take this screaming and yelling child out of the store as quickly as possible. I felt so embarrassed.

As we struggled with J, all I could think was how people were judging me. They must be thinking all the same things I once did; all the things I was thinking about myself at that moment. I was also getting very angry with J. Angry because I felt embarrassed. Angry because I could not control his behavior. Angry because I did not get to finish my shopping. I could feel my face burning red as we departed the bookstore.

The incident in the bookstore was the Thomas the Train affair to end all affairs. I decided from that point on we had to wean J off of Thomas. Over the next several months we took steps to slowly wean him off. We introduced him to other toys and characters. Eventually, Thomas's hold on J subsided.

The incident in the bookstore that day was an eye opener for me. It wouldn't be the last time J pulled a tantrum in which we had to leave a store. And, it was not the last time I would feel embarrassed about it. With each incident that would occur, I would become less judgmental of other parents. I began to sympathize with parents I would observe struggling with their child's tantrums in public.

The Thomas the Train affair was the first in a series of steps I have been taking over the past 6 years. I began to realize how much I depended on the opinions of others based on how well my children behaved. I felt it was a reflection of me as a mother and a person. In the last 6 years, J's behavior has challenged me to rethink my own behavior, thoughts, and responses. Thomas the Train may no longer be physically present in our house but the lesson I began to learn that fateful day still continues.

Today, J does not throw the tantrums he once did in public. We can take him to restaurants, movies, and even shopping. Occasionally we may have an incident or two but nothing like it was before. As for Thomas, well that weird train is a distant memory. He has now been replaced by Bey Blades...and that is a whole other story.

J and us at the beach:

J and Thomas the Train Birthday Party:

So, You Think Your Child is Clumsy

Have you ever had a brother or sister, maybe even a friend who was clumsy all of the time? They were so clumsy that they would be picked last to be on a team or would take forever to complete a simple task. Perhaps the friend you knew would often drop items so you would call them "butter fingers," or something else along those lines. Maybe your brother or sister seemed to be tripping over their feet all of the time. Worst yet, maybe they had such terrible handwriting they always got in trouble at school for their penmanship.

My son J has such terrible handwriting. His words would be smashed together and it was hard to see a sentence. It looked liked one long continuous word. Or, his letters would be written on top of each other. It was also difficult to tell if he was writing an "o," from an "a." He would also have a hard time writing capital letters from lower case ones. J would also lose his balance at times. He was always falling or tripping. He would have so many bruises on his legs. There were many times he would choose to use his hands to eat instead of using the fork or spoon I gave him. He would put his clothes on backwards or inside out, sometimes both. There were times I would find him standing on his head on the couch or recliner. In each and everyone of these cases, I attributed it to him being lazy, defiant, sloppy, ADHD symptoms, and boredom. In most cases I would get on to him and sometimes even punish him. Little did I know.

J was recently diagnosed with 4 disorders, one of them being Developmental Coordination Disorder (DCD). The occupational therapist I spoke with stated J was the classic text book definition of this disorder. As she spoke about J and the struggles she observed him having, I began to cry. I felt so guilty for being hard on him, punishing him for something he struggles with, something he could not help. What I thought was defiance was in reality a kid who was struggling to do something that caused him anxiety and frustration and out of that anxiety and frustration he would refuse to do it. This disorder has caused J to be self conscious about certain activities and to have low self-esteem.

According to The Understood Team (2020), about 5% of children develop this disorder. It occurs mostly in males versus females. It also tends to occur with over conditions such as ADHD, autism, OCD, and others. However, this disorders is not linked to the others. DCD occurs separately. It can be difficult to determine considering many of the DCD signs and symptoms are similar to other disorders, especially ADHD (The Understood Team, 2020; Psychology Today, 2017; Healthline 2016).

Developmental Coordination Disorder, also known as dyspraxia, has no known causes. Risk factors for this disorder include being male, low birth weight, premature birth, small for gestational age, and genetics. Some researchers believe it is the result of delayed brain development (Healthline, 2016). They have determined that it is not a learning disorder. Many children with DCD have average to above average intelligence. However, there is a disconnect between their mental understanding their physical ability to carry out the task (Psychology Today, 2017; Healthline, 2016). The DSM-IV, a classification of mental health illness and disorders, classifies DCD as a neurodevelopmental motor disorder.

Dyspraxia is not associated with any type of brain injury. However, children with DCD show deficits in various areas that impacts their daily living and school activities. These areas can include basic hygiene to performing geometry. Affected children have trouble sequencing events or tasks. It is very difficult for them to remember and follow directions. For example, it may be difficult for them to remember how to do a simple task such as wash their hair (Caple and March, 2018; Psychology Today, 2017). The signs and symptoms of DCD include:

• Difficulty holding crayons, pencils, scissors
• Trouble holding spoons, forks, knives
• Difficulty throwing a ball
• Plays roughly with others or constantly bumping into others
• When writing doesn't form words or letters well, or space out words
• Struggles going up and down stairs
• Has trouble with self care
• Trouble recognizing spatial objects - will tend to do poorly in geometry
• Difficulty learning to drive
• Trouble with tying shoes
• Trouble keeping balance

There are even more signs and symptoms practitioners and psychologists use to determine a diagnosis. Severity of the symptoms can vary from child to child. Patient Care Practitioners and/or Psychologists make a diagnosis based on a child's presenting symptoms. 

When I learned about this diagnosis of J's, I had hoped this would be something he could receive treatment and then he would be cured. Unfortunately, this is a disorder he is going to struggle with his entire life. It will go with him into adulthood. However, there is hope. With proper treatment and interventions, J can learn to overcome some of his challenges and learn to compensate for some of the things he struggles with. He will have to receive occupational therapy every week. He will also have to do exercises everyday to help build his coordination and hopefully his confidence. 

In the meantime, I will have to learn patience. The things I take for granted every day, he struggles with, some tasks more than others. It does not mean he is stupid, lazy, disrespectful, or defiant. It means I have to give him time, repeat things continuously, create visual reminders, and give him space. 

J is not like other boys his age. He is smart, clever, and always willing to try. Yes, he has some challenges to overcome and many people will view him as "not normal." But that is okay, being normal is often overrated and quite boring.

Some examples of J's handwriting:

References:

Caple, C. & March, P (2018). Apraxia, Development. CINAHL - Quick Lesson. Retrieved from CINAHL database.

Healthline (2016). The Truth Behind Clumsy Child Syndrome: Developmental Coordination Disorder. Retrieved from www.healthline.com.

Psychology Today (2017). Developmental Coordination Disorder. Retrieved from www.psychologytoday.com. 

The Understood Team (2020). Understanding Developmental Coordination Disorder. Retrieved from www.understood.org. 

You Are Your Child's Advocate!

Advocacy is defined as: public support for or recommendation of a particular cause or policy. Being an advocate is hard. No matter what your belief or cause is, advocacy is never easy but it is warranted.

Advocacy comes in many shapes, sizes, and forms. It is not always a public issue or requires a group of people to champion. As a parent you are an advocate for your child. Only a select few see your advocacy efforts. It is not on public display for the world to see and comment on. It is for your child. How much you want to advocate for your child depends entirely on you.

There was no one there to really advocate for J when he was born. I have been told the hospital tried to step in but J was still allowed to go home with his biological parents who were homeless and had a significant history of drug and alcohol abuse. It is the primary goal of DHS to try and keep families together. Honestly, I get it. Whenever possible, families should remain together and help given to those willing to take and apply it. However, there has to be a line in the sand. Otherwise, who is really being protected? J was not taken into DHS custody until after the damage was already done.

So, how does one pick up the pieces of a broken vessel and put it back together? The vessel will never be completely whole again. It will not be smooth or seamless. It will have cracks, holes, visible and not so visible issues, misshapen and so on. You can put the pieces back together using glue or another type of adhesive but the damage is still present, still known. You can try filling the vessel up to hide or distract from the cracks but they are still there. They will always be there. A person is then left with two choices: do one's best to work with the broken vessel's pieces or ignore it and walk away.

Being an advocate for your child is not easy, especially when they have mental health issues. A majority of parents are natural advocates for their children and will do anything they can to help their child. In normal situations and circumstances, advocating for your children is not that difficult. You know what is needed, who to talk to, how to address it, etc. However, throw in mental illness and it becomes an entirely different mountain to climb; full of avalanches, falling rocks, wind gusts, etc.

One of the DHS hoops my husband and I had to go through was training and education on children in the foster system. Being a nurse I was already familiar with many of the topics they were teaching. They are not bad topics and the courses give potential foster families an idea of what they may deal with. However, one topic that was missing was how to be an advocate for a foster or adoptive child.

We did not know what we were doing with J the first 2-3 years. We fumbled around. I tried to treat him like I did with my older two boys. I loved on him and showered him with things but also disciplined him the same way. In those first few years it was apparent J had issues. I just did not know how to address them or where to get help for him. But I had to start somewhere. Starting somewhere is just the first in a series of steps toward becoming an advocate.

My first step resulted in a big fat dud! I was discouraged. He did not qualify for this particular school's services. I had no idea where to go from there so another year passed and then he went into kindergarten. It was then an opportunity to take the next step occurred, so I took it. When advocating for your children, it is just as important to take the steps that occur as it is to make them. Over the course of the next three years, I took additional steps that lead to dead ends and no answers.

With each step I would take the recommended actions and interventions to no avail. It did not matter how consistent we were with him, some steps yielded no results. It had gotten to the point where we became stuck. So stuck that if something couldn't be done, we would have no choice but to ignore the broken vessel and walk away. No opportunities were available to take and I could not see what step to take next. My son's psychiatrist's solution was to adjust his medications again and again. I had J put through so many test evaluations which yielded very little to no results. J has gone through at least 4 therapists. I had him tested twice to see if any of his diagnoses would change and again no new results. We were in quicksand and sinking fast. I felt I had no choice but to reach out to my son's insurance case worker and plea for help - cry for help is more like it and I mean literally cry.

My sons's case worker offered another step I could take. So, this step would lead to many hoops to jump through and there was no telling after I jumped through every hoop, how fast my son would be accepted and admitted into the child diagnostic unit (CDU) program. One of those hoops was filing a FINS petition with the court. FINS stands for Family in Need of Services and its purpose is to make parents and the child accountable for their actions and recognizes that they need help. Its mostly used in instances where a juvenile is truant, has been suspended or expelled from school, etc. I jumped through all the remining hoops I could. I was prepared to wait it out the next few months but prayed he would be accepted to the CDU sooner rather than later. The situation in my house was getting worse and I prayed it would be a quick acceptance. Thankfully it was! Praise God! By far it has been the best step I could have taken for J.

There are still many steps I will have to go through with J. He will never truly be healed and he will have challenges to overcome the rest of his life. He is back home now and we are all going through a readjustment period - just one of many steps. But all I can do is take one step at a time; it's all any one can ever do.

Being an advocate is hard. It requires persistence, diligence, and passion. Keep digging your heels in. The first diagnosis is not always the correct one. Keep asking questions, turn over stones, don't accept diagnoses at face value - research. You are your child's advocate. How far you are willing to go depends on you. Keep in mind, the race is never won but milestones are gained and it does make a difference no matter how small or big.

Up the Hill, Down the Hill

J was two years old when he came to us. My husband and I had to go through the foster system in two states in order to have J come live with us. We had to meet the requirements of both states before J could come live with us. We had to undergo 5 different background checks and several hours of training. Although the information we received in the training classes was adequate, it still did not prepare us for J.

It was suspected that J had autism. He barely spoke, grunted mostly. He would rock or bang his head and overall displayed signs of a child with autism- at least a child with autism on the lower end of the spectrum. When we met him for the first time what I saw was a child who was behind emotionally and behaviorally. He was quiet and observant - loved to watch us cook and did interact with us. Since he didn't speak well enough or form words, he was being taught sign language to communicate. He seemed to understand what was being told to him but could not express in words what he needed.

After jumping through all of the DHS hoops, we finally had J living with us. We did not use sign language to communicate. Instead we spoke to him often. I read and sang to him often. But for the first few months or so, J spoke very little. The times he did speak drove us absolutely crazy.

Now, I know what you are thinking. How could we have been driven crazy by a child who barely spoke? Most parents would be overjoyed by a quiet child speaking in sentences. At first, we were. Instead of one or two words, J was speaking in a full sentence after being with us for a few months. Ah, progress! I was excited that he was speaking more when earlier that year we were told he may not speak well at all. My husband was thrilled too. The first time he spoke his words we both laughed and smiled at J and responded with, "That's right, we are."

J's first words he strung together after those first few months were: "Up the hill, down the hill." Not only were these his first significant words to us, he used it every single time we drove up or down a hill. He would repeat this phrase every time we came across a hill. He would also use them correctly in context. As we would go up a hill, J would state "up the hill," as we went down "down the hill." After our trip over the hill was completed, he would string it together, "Up the hill, down the hill." He would not say this just one time. No, he would repeat the phrase until we acknowledge him.

Now, there are several hills we have to travel over whenever we leave our house. How were we driven crazy? Every single hill we came across, J would say his phrase whether we were leaving the house or coming home. "Up the hill, down the hill," was all my husband and I heard for weeks from J. It's like having an earworm. You don't mind having the song stuck in your head for a little bit; but, when it stays there - well, you know, it is the hardest thing to get rid of. In our case, it is a small two year old child causing the earworm.

He began to understand the use of pronouns - mainly because how we responded to him, he would then say: "We went up the hill. We went down the hill." Sometimes, he would use "I" instead of "We." Eventually, it became "They went up the hill. They went down the hill." Ugh! J gave new meaning to earworms and a broken record. Hence, why we were driven crazy by a child who barely spoke.

It is ironic that his first phrase to us would be symbolic of what we have been going through with J. Over the past 6 years, we have had many peaks and valleys with J. It has not been a straight steady road but full of valleys, hills, and curves. His vocalizations of going up and down hills are a thing of the past.

Today, J does not stop talking. Sometimes he flows right into one idea after another. There are times he will drift back to his original statement or thought and wants to talk about it some more. I think we have shouted "Quiet!" so many times our ears ring with it constantly whereas it just flows in and out of J's ear. With all that has happened in the past 6 years, it does make me appreciate how far we have come with J and the days when all he would say was "Up the hill, down the hill."