Monday, May 14, 2012

Boo Boo Bear's Current Struugle

     Boo Boo Bear is currently at Heron Creek, a K-12 therapeutic school in Oregon City.  He's been there since pre-school, and is now in second grade.  Heron Creek's primary focus is therapy first, secondary is curriculum. 

     Boo Boo Bear has really struggled at school this year.  He's done everything from pounding his fists on desks to stab his counselor in the face with a pencil.  I've had to pick him up from school a few times because he wasn't able to ride home safely on the bus and he's been suspended for a few days. 

     In December of 2011, Boo Boo Bear's suspension led to a review of his IEP, which left us all in agreement that full days are to demanding of a schedule for him.  We determined half days would be in his best interest, allowing him to build some successful interactions in his school day, and minimizing his possible failures.  He is currently still attending only half days at school.

     Boo Boo Bear's behavioral issues don't appear to be decreasing however, and are becoming more a part of his "norm".  He is easily agitated and becomes confrontational both physically and verbally nearly every day.  Once home, he is very tired and shows less frustration tolerance than what I would expect from a child only attending school half days.

     Because of this increased behavioral issues at school, I am looking into a day treatment program.  I'm nervous because of the possible negative impact this could have on him.  I worry to have Boo Boo Bear influenced by the kids who are worse off than him.  I'm equally worried that if I chose to do nothing, then either nothing will change or things could continue to worsen. It's clear to me that he needs additional therapy in a school environment. 

     I would appreciate ANY advice, any stories good, bad or otherwise.  I know I'm not alone here.

Casey Everly


  1. I have a child with similar issues and behavior. When he was seven, he was an "in your face 24/7" kid. He used to attack me physically, virtually every day. I've had to have surgery to repair one of the injuries and medical treatment for some of the others. We changed therapy modes about twenty months ago, a couple of months before my last and most serious injury. That was the beginning of the end of the physical attacks.

    So what helped? Somatic Experiencing is the name of a trauma therapy, developed by Dr. Peter Levine, aimed at children (and adults). I don't understand it all that well, but it has made an enormous difference for my son. The therapist concluded that my son's attacks on me were incomplete defensive moves, visited on the person (me) who was now standing in the place of the person who abused him. My son was so oppositional, that he would not do anything that he thought pleased anyone else. So therapeutic and stress-reduction exercises,like strong sitting or pushing on walls were a lost cause. The therapist started having my son discharge and complete his incomplete defensive moves by using either his hands or feet to shove furniture across her hardwood floors. Both she and I would get on her chaise-lounge and my son would sit down with his back to the wall and use his legs or arms (kicking or hitting moves) to push us across the room. You know that you have an angry child when he can easily push a non-wheeled sofa with 300 lbs. of people on it across a room in two or three shoves, simply by thinking of the person who hurt him. Within two sessions, we saw a decrease in aggression and within six weeks, we had seen his last punch. A little too late for me to avoid serious injury, but I'm just thankful that something worked. We also used some other SE techniques for making the idea of emotional regulation more concrete, such as twisting plastic water bottles as slowly as possible to express anger in a controlled and regulated way, to making marks on my son's arm to act as a 1 to 10 anger scale, so that he could move his anger level down his arm from 10 towards 5. There's a lot more to it than that and my son is a completely different person than he was before. He is nowhere near his peers in emotional, social, or academic development, but he is light years from where we started.

    Our son goes a full day in a mainstream classroom with pull-outs for resource, sensory, and counseling. We can't let him think that by losing control of himself, he can get us to shorten his school day. The school would happily go for that (one less difficult child to work with for half a day), but he has enough trouble transitioning to begin with, so a shorter day just means less time between transitions. My son needs to be in an environment where he has to work hard to control himself. He does try really, really hard.

  2. Had to add a second comment to get this all in:

    At school, he goes to the sensory room three times per day and has a teacher with whom he feels safe. If he does not feel safe, his behavior quickly escalates to "over-the-top" status. I avoid going to pick him up, even when the school calls, because I can usually talk him down and help him regain control by talking to him on the phone and reassuring him that he is safe. I also explain to the teacher anything that is going on with him that may be making him feel unsafe, e.g., I've been sick, one of his siblings has gotten caught stealing, the therapist cancelled due to illness, we got a new respite worker, etc., so that she can address those things directly and reassure him that nothing bad is happening, no one is leaving, and everything is going to be okay. If I know that he his having a particularly hard time emotionally and that he really needs some concentrated "mom" time, I will pick him up or occasionally keep him home. But I try to avoid doing that in a way that would cause him to try to create those situations. He would far rather be home with me than in school. We are looking at whether to send our son out-of-home for school in the fall.

    After school, my son has little frustration tolerance, but it isn't any better when he has early release. School, i.e., self-control, is exhausting for him. So I do my best to make sure that he has time to nap or do something quiet if he needs it, or time to run off some extra energy and steam if that's what he needs. He doesn't do homework unless he wants to. We have eliminated that as a source of strife at our house. If he wants to do it, then he gets lots of praise and positive attention. If he doesn't, then we don't even discuss it. It just isn't worth the hours and hours of daily battle. There are some other, trauma-related reasons that the homework battle isn't in his best interests, but I won't go into those here.

    Rewards and consequences just don't work to change our son's behavior, except for those rare times when he is teachable in that way. When he is, we have to jump right on it, but in general, they don't work.

    Do you know which therapeutic model your son's school operates on? Most of the schools in my area for emotionally disabled children use the "Nurtured Heart" approach, which has had some great results. We used to be with an agency that used it in their residential programs and they had a 90% reduction in therapeutic crisis intervention. Some severely traumatized children don't respond well to a rigid environment. Structure is good, but too much rigidity triggers my children to the point where they get into a negative feedback loop--acting out fear/anxiety, then getting negative consequences, which produce more fear/anxiety, giving rise to more and more acting out.

    Sorry for the tome, but it's not an easy question. I hope you find what works for your son so that he can heal. There's no magic bullet and the most important thing is being attuned to your specific child, since there is no one else in the world quite like him and who has experienced exactly what he has. It's tough to figure all of it out when you aren't your child's first mother and haven't been there the whole time. I'm my son's eleventh mom, so attunement has been a long road.