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Infant/Child Response to Grief

Sun, 2007-08-05 04:26 - Kerry

When a child is placed in foster care or an adoptive home, care and concern must be given to the grief and loss that infant or child is experiencing.  It is my belief too many adoptees and foster kids are being sent to psychologists because parents do not understand the grief process of children.  Remember, the new child in your life now has lost the only parents he/she has only ever known.  Imagine what that must be like.

Signs of a Grieving Child

http://www.tlcinstitute.org/PTRCgrieving.html

Infants/Pre-verbal Toddlers:

  • Decrease in activity level
    Infants who were attempting to rollover, crawl, and walk prior to the traumatic event may stop attempting movement. This is typically temporary and after some time will begin those attempts for movement again. However, it is important to offer infants/toddlers the opportunity for those attempts at movement. Also, be sure to continue to play and encourage, but not coerce, those attempts at movement.
  • Decrease in appetite
    Due to change in routine and caregiver, infants are often unsure of their environment and while they are becoming familiar with their new routine they often are irritable and will not eat as much. There may also be a weight loss. If the child’s decrease in feedings and weight loss continues for several weeks, it is important to have a check-up with the child’s family doctor or pediatrician. However, typically the infant/toddler will adjust and begin eating the same amounts as before the trauma.
  • Increase in irritability and/or change in personality
    Caregivers often report that children in this age range typically experience irritability, primarily because of a change in their daily routine. In general, when there is a change in any child’s routine, there will be some amount of stress, which will cause irritability and/or a change in personality. However, once the child becomes adjusted to his/her new schedule they typically return to the infant you knew prior to the trauma.
  • Sleeplessness
    Once again a change in routine will also affect sleeping patterns. The infant must again learn to trust their caregiver. So, be sure to provide him/her the individual attention s/he needs. This may include sleeping in the room or being present while they fall asleep. We do NOT recommend that caregivers allow infants and toddlers to sleep in the adult bed with caregivers. There are several safety concerns and an increased risk for accidents coinciding with infants sleeping beside adults. The sleeplessness should deplete over time as well.


Toddlers, Preschool, and School Age

  • Decrease or increase in appetite
    Eating “comfort foods” is an appropriate response to any type of stress in adults and children. Many children challenge their caregivers by demanding to eat the same types of foods for every meal. This is a child’s attempt to restore a sense of power and safety after experiencing a powerless situation. It is acceptable to allow the child to eat “comfort foods” during this time. Caregivers may choose to compromise with children, in that children can eat their “comfort foods’ as long as they also eat healthy foods. This will ensure that the child is receiving the nutrients they need for extra energy. It is typically a short term coping mechanism for every human and will dissipate after a couple weeks
  • Severe increase in activity level
    You may observe in children, typically males, an increased activity or hyperactivity. Many traumatized or grieving children are misdiagnosed with Attention Deficit/Hyperactivity Disorder (ADHD). However, for traumatized children this is once again an attempt to gain control over their already powerless situation. Children also cope with fears, anger, and intense emotions in the physical sense versus verbalizing their fears, anger, and emotions. This is a healthy, normal response to a traumatic event.
  • Severe decrease in social activities
    You may observe that children who were once very active in school or social activities becoming withdrawn and quiet. These children are choosing to cope by processing this experience individually before processing with family and friends. It is wise to let this child process alone, without pressuring him/her to “talk about” the death.
  • Hyper vigilance
    Children will often participate in attention seeking behaviors that may or may not be harmful to self or others. As an educator, you have to be sure the safety of other students and staff is kept at all times. Therefore, if a suspension is needed, view it as a “teachable moment”. During your parent-teacher/administrator meeting have the social worker or counselor educate the child, parents, teacher, and administrators about typical grief responses to death visible in children. Adults surrounding this child may be unaware that this behavior is related to any type of loss. As a parent, you must attempt to communicate consequences to behaviors. If your child’s behavior continues seek professional help in efforts to restore that child’s sense of safety and power.
  • Dreams and nightmares
    Children directly exposed to a traumatic event, such as a shooting, domestic violence, car fatality, or witnessing a classmate’s death, are likely to have intrusive nightmares. However, children who experience a death of loved one may also have vivid dreams about the loved one. Do NOT assume that their dream was scary. Simply ask your child to describe the dream or nightmare. Be sure to process those dreams and nightmares with your child. If they refuse to talk about the dream, simply offer your support and encourage them to talk to peers if they feel comfortable. Always, ask children what ways you can help them to feel safe. This might include a spray bottle of “magic disappearing potion” or a flashlight. To reduce dreams it is important to provide an environment for your child that is peaceful, cozy, and safe. You can do this by playing calming music before bedtime, reading calming books before bedtime, and allowing children to sleep where they feel safe, which may include the closet, couch, and floor.
  • Sleeplessness
    Children are simply fearful and afraid of what might happen next, causing intrusive nightmares leading to lack of sleep. These children may also begin sleeping in odd places, such as on your bedroom floor, in the closet, under the bed, or on the couch. These children are attempting to restore a sense of safety and control over their fears. Children may show this behavior for several months. As adults and caregivers it is essential that we show our support by making that a comfortable place for that child. This may include allowing them to sleep in their favorite sleeping bag or bedroom comforter, having a dog or cat sleep beside them, or having a nearby light on throughout the night. Once the child observes that the adults around him/her believe in their “safety plan” the child has a restored sense of safety and will most likely return to their own beds
  • Break down in communication (specifically in adolescents)
    Parents may notice a decrease in communication with their adolescent. Teenagers, specifically, will process their grief with people outside the traumatic event to protect those that they care about. We often refer to this as the “protection game.” Parents also want to protect their child from intense emotions and trauma-inducing incidents and therefore do not speak of the incident. Children do not want upset their parents either and protect them by not discussing the incident. However, both children and parents still grieve, but by "protecting" each other they are forced to process their grief by themselves. It is okay for parents to share their own response to grief with their teenager and vice versa. However, some teens will still choose to process their emotions with peers or other adults, which is also healthy. Parents can still share their grief, but should not without a discussion. Teens who do not share their emotions with their parents are most likely processing their grief with peers and teachers. This is typical and healthy of adolescents.

Points to Remember:

  • In all aged children it is essential that caregivers attempt to keep a child’s daily schedule as close to their own routine as possible. Children become easily agitated when they do not know what to expect next. If there is a change in their routine, let them know before it happens if at all possible. Communicating with children helps to restore their trust in you as a caregiver.
  • Children grieve intermittently. Children’s grief is similar to a ping-pong ball; you never know which direction they are headed. Therefore, follow children where they lead you. Allow them to tell their story, on their terms, magically or seriously, let them lead!

Comments

Sat, 2008-02-02 12:54 — tina

adopted and human

Good or bad adoptions, one thing is the same, we are adoptees first children second and equal individuals NEVER! or thats how it seems sometimes. I lurked in an adoptive parents forum and was shocked (serves me right I suppose for lurking) a whole topic debating whether to tell the child it was adopted.

We live in a world made up of different countries and cultures. People practice different religions and beliefs. In parts of the world there is hunger and wars and little hope. In other parts of the world there is vast wealth. The world is home to everyone.

From the queen in her castle to the villagers in their huts. It has good people and bad people and everyone in between.

Every human being in the world is born, breathes and lives. Adopted children our the only ones who have their birth details removed and replaced with fictitious ones. They are the only ones who have their name taken from them. And the only ones who have to go through a third party to try and recover the missing pieces.

Should you tell your child they are adopted?

Hell, damn right! That is not a decision for anyone to decide. It is a basic human right for them to know.

Thu, 2008-07-03 00:09 — Kerry

Institutional Autism

In my most recent blog, "Longing to Belong", I cited a story from Newsweek that mentioned the term "Institutional Autism" for an adoptee who came from a Eastern European orphanage.  [http://www.newsweek.com/id/65655/page/2]

Compare the stages of parental loss and grief (as outlined above) to the following evaluation:  (http://www.adoptionarticlesdirectory.com/Article/Institutional-Autism-and-the-adopted-child-from-Russia/33)

Many children who are available for international adoption have either been placed in hospital-run orphanage or a classic institutional care setting for a multitude of reasons. These reasons can range from illness or untimely deaths of biological parents, to the parents' inability to care for the child’s basic needs necessary for survival. Over the past 15 years there has been a dramatic rise in the number of children who are internationally adopted and a majority of these children have been raised in an institutional care facility.

In countries from the Eastern European block such as Russia, Romania, Ukraine and Moldova, children are still being placed into orphanages at an alarming rate. Reasons for abandonment stem from the fact that since the fall of the Communism, democracy and freedom have left many people poverty stricken and homeless. The lower socioeconomic class no longer has the social support of the government to help with their survival. Because of the poor economic situations of these people, families are no longer able to care for the medical, physical and psychological needs of their young. Families that are condemned to a life of poverty find orphanages to be the only viable alternative that their children have for survival and maybe even a future. Strange as this may sound it does occur all too frequently.

Hospital-based institutions are still state-run facilities with little or no resources. Children who have any type of medical condition (even minor problems) are placed in institutions, which also house patients with the more severe and sometimes neuropsychiatric conditions that no child should ever be exposed to. Children with more complicated or chronic medical conditions (such as blood disorders; infectious disease, congenital malformations and classic autism) are doomed to a forgotten life behind closed cold walls of the institutions.

The biggest problem that I personally have with the institutional setting is medical diagnoses that are given to these children. These diagnoses often are false, exaggerated and unfortunately sometimes very real. The disparity to the severity of the medical problems found in these children is is sometimes incomprehensible. They mix the severely mentally retarded, autistic, and handicapped patients with the relatively normal child who is abandoned, with mild developmental delay or the child who required minor surgery that is unable to acquire the procedure in order to lead a normal and healthy life..

Unfortunately, once a child was placed in a orphanage, that label follows the child for years, especially in countries like communist Romania during the 1980s. These children were fated to remain there for a life without appropriate medical care or even the possibility of having a family to care for their needs..

Developmental delays are frequently found in many of the orphanage children, even before they are placed in the institution. This is usually a direct result of poor pre-natal and post-natal factors, nutritional inadequacies and medical neglect. Once placed in an institutional care setting, these minor delays are often misconstrued as a metal deficiency or mental retardation.

During the critical years of neurobiological development of the child's brain, orphanages are notorious for being deficient in providing the social, emotional and cognitive stimulation required for normal development of the child. Many children are starved, neglected, and forced to stay in their cribs in order to follow safety protocols.

Children are frequently and repetitively moved from one age group to another. As the child ages out, he can no longer learn anything new for the younger children in the group and often regresses to a more immature behavior.

All of these factors, combined with profound medical, nutritional, and physical neglect cause these children to revert back to a more primitive state in the child’s mental development. Speech, language, and intellectual abilities languish, and over time developmental milestones deteriorate to levels where the child may appear to be truly mentally delayed or retarded.

As a defense mechanism, in order to maintain the child’s own inner well being, neglected children generally shut out all environmental and interpersonal contact that could cause them harm. There is sometimes a component of learned helplessness. It is this type of behavior that often gets labeled as Institutional Autism. Once this pattern of regression occurs, it tends to be insidious and progressive.

The following is a list of characteristics that children with Instititutional Autism exhibit:

  • Loss of physical height and weight. These children look much younger than their chronological age.
  • Severe language delay which can regress to infant babbling
  • Lack of eye contact, aloofness
  • Failure to orient to child’s name
  • Lack of interactive play
  • Lack of interest in peers
  • Failure to use gestures to point or show
  • Sometimes there are severe issues with bedwetting and soiling
  • Behavioral control issues and lack of social development
  • Attention and concentration problems. Example: ADHD-like behavior
  • Deficient in learning and memory
  • Institution-acquired autistic behaviors
  • Some of the most worrisome and disturbing characteristics of children afflicted with Institutional Autism are that when they have complete regression, they resort to self-stimulating behaviors in order to fill the lapses regarding loneliness, deprivation and despair.

Examples of these behaviors are:

  • Rocking and head banging
  • Uncontrollable outbursts of rage and aggression
  • Body thrusting into inanimate objects such as walls
  • Self-mutilating behaviors such as hair pulling and picking at the body
  • During the adoption process many parents are faced with the dilemma of acquiring a child who exhibits some or all of the above mentioned characteristics. Parents become saddened when the child does not come running or show any type of emotion towards them when they arrive to meet the child. During the first hours to days for these children to be withdrawn, exhibit lack eye contact and lack of communication with the families. Observation over time is the best means to differentiate adjustment problems versus more severe conditions.

After the adoption process is complete and the child returns to the United States, some of these children continue to display some quasi-autistic behaviors learned from in the institution for a period of time after the adoption is completed.

It must be remembered that all orphan children have significant impairment in both communication and their social skills. These children cannot be expected to come home, put on a pair of blue jeans and function immediately in our society. There is a great deal of work that is required to rehabilitate these children. In contrast to true Autism, Institutional Autism tends to improve with time and proper interventional services. It has also been found that some children who arrive with severe mental impairment upon arrival have a dramatic improvement in their IQ points in the first years post-adoption.

I must once again stress the importance of rehabilitation, education and a great deal of work on behalf of the parents in order to obtain these results.

*Institutional Autism is not a term found in your everyday Pediatric Textbook. It is a term described by Ronald Federici, Psy.D who has done extensive research and was the first to write about this subject in his book "Help for the Hopeless Child: A Guide for Families (With Special Discussion for Assessing and Treating the Post-Institutionalized Child), Second Edition, by Dr. Ronald S. Federici*

*More information and research on the topic of Institutional autism can be found at www.Drfederici.com** *

by George Rogu M.D.

Disclaimer
The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it - only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made. This Web site does not constitute a physician-patient relationship.

For more info: visit www.adoptiondoctors.com or call them at 631-499-4114.

Article Source: International Adoption Articles Directory

 

Is it me, or has the adoptee been completely deprived the natural grieving process ALL humans experienced after the loss of a parent, and instead with adoption documents, they are given a new diagnosis to fear and dread?

Thu, 2008-07-03 00:27 — Kerry

Failure to recognize another source

Just for my own amusement, I searched the term "Failure to Thrive", to compare it's symptoms/causes to this newly defined "Institutional Autism".  Note what risk-factor is missing in potential causes of failure to thrive [HINT:  Think orphanages stock-piling babies for adoption]

What Is Failure to Thrive?

Although it's been recognized for more than a century, failure to thrive lacks a precise definition, in part because it describes a condition rather than a specific disease. Children who fail to thrive don't receive or are unable to take in, retain, or utilize the calories needed to gain weight and grow as expected.

Most diagnoses of failure to thrive are made in infants and toddlers - in the first few years of life - a crucial period of physical and mental development. After birth, a child's brain grows as much in the first year as it will grow during the rest of the child's life. Poor nutrition during this period can have permanent negative effects on a child's mental development.

Whereas the average term baby doubles his or her birth weight by 4 months and triples it at 1 year, children with failure to thrive often don't meet those milestones. Sometimes, a child who starts out "plump" and who shows signs of growing well can begin to fall off in weight gain. After a while, linear (height) growth may slow as well.

If the condition progresses, the undernourished child may:

  • become disinterested in his or her surroundings
  • avoid eye contact
  • become irritable
  • not reach developmental milestones like sitting up, walking, and talking at the usual age

What Causes It?

Failure to thrive can result from a wide variety of underlying causes. Some children fail to thrive because of:

  • social factors. In some cases, doctors may not identify a medical problem, but may find that the parents are actually causing the failure to thrive. For example, some parents inappropriately restrict the amount of calories they give their infants. They may fear their child will get fat or put him or her on a limited diet similar to one they follow. Or, they may simply not feed the child enough either because of a lack of interest or because there are too many distractions in the household, which contributes to the neglect of the child. Living in poverty can also lead to an inability to provide a child with the necessary nutritional requirements.
  • conditions involving the gastrointestinal system like gastroesophageal reflux, chronic diarrhea, cystic fibrosis, chronic liver disease, and celiac disease. With reflux, the esophagus may become so irritated that the child refuses to eat because it hurts. Persistent diarrhea can interfere with the body's ability to hold on to the nutrients and calories from food that's eaten.

    Cystic fibrosis, chronic liver disease, and celiac disease are conditions that limit the body's ability to absorb nutrients. These are known as malabsorptive disorders - the infant may eat a lot, but his or her body doesn't absorb and retain enough of that food. Celiac disease results from a sensitivity to a dietary protein found in wheat and certain other grains. The immune system's abnormal response to this protein causes damage to the lining of the intestine, interfering with its ability to absorb nutrients.

  • a chronic illness or medical disorder. If a child has trouble eating - because of prematurity or a cleft lip or palate, for example - he or she may not take in enough calories to support normal growth. Other conditions that can lead to failure to thrive would include cardiac, endocrinologic, and respiratory disorders. These disorders can increase the child's caloric needs so that it becomes difficult to keep up with them.
  • an intolerance of milk protein. This condition can initially lead to difficulty with absorbing nutrients until it's recognized. It can also put an entire class of food out of reach, restricting the child's diet and occasionally leading to failure to thrive.
  • infections (parasites, urinary tract infections, tuberculosis, etc.), which place great energy demands on the body and force it to use nutrients rapidly (and the appetite may be impaired as well), sometimes bringing about short- or long-term failure to thrive.
  • metabolic disorders, which can also limit a child's capacity to make the most of calories consumed. Metabolic disorders might make it difficult for the body to break down, process, or derive energy from food, or they can cause a buildup of toxins during the breakdown process, which can make the child feed poorly or vomit.

In some cases, doctors are unable to pinpoint a specific cause.

Although doctors in the past tended to categorize cases of failure to thrive as either organic (caused by an underlying medical disorder) or inorganic (caused by caregivers' or parents' actions), they're less likely to make such sharp distinctions today. That's because medical and behavioral causes often appear together.

For instance, if a baby has severe reflux and is reluctant to eat, feeding times can be stressful for a caregiver. He or she may become tense and frustrated, and this may make it difficult for the caregiver to sustain attempts to feed the child adequate amounts of food.

How Is It Diagnosed?

Many normal babies go through brief periods when their weight gain plateaus or they even lose a little weight. However, if a baby doesn't gain weight for 3 consecutive months during the first year of life, doctors usually become concerned.

Doctors diagnose failure to thrive by using standard growth charts to plot the child's weight, length, and head circumference, which are measured at each well-baby exam. Children who fall below a certain weight range for their age or who are failing to gain weight at the expected rate will likely be evaluated further to determine if there's a problem.

Along with obtaining a thorough medical and feeding history and performing a detailed physical examination, the doctor may order a complete blood count, urinalysis, and various blood chemical and electrolyte tests that can be helpful in the search for underlying medical problems. If the doctor suspects a particular disease or disorder as a possible cause, he or she may perform additional specific tests to identify that condition.

To determine whether the child is receiving enough food, the child's doctor (sometimes with the help of a dietitian) will do a calorie count after asking the parents what the child eats every day. And talking to the parents can help a doctor identify any problems at home, such as neglect, poverty, household stress, or feeding difficulties.

How Is It Treated?

Children with failure to thrive need the help of their parents and a doctor. Sometimes, an entire medical team will work on the child's case.

In addition to the child's primary doctor, the team might include a nutritionist to evaluate the child's dietary needs and an occupational or speech therapist to help the caregiver and child develop successful feeding behaviors and address any sucking or swallowing problems the child might have. Occupational and speech therapists are often helpful because of their expertise in the muscular control that's involved in eating.

Because treatment of failure to thrive involves treating any disease or disorder causing the problem, specialists such as a cardiologist, neurologist, or gastroenterologist may also be part of the care team.

Particularly in cases of failure to thrive that are thought to be caused by caregivers' or parents' actions, a social worker and a psychologist or other mental health professional may help address problems in the child's home environment and provide any needed support.

Often, in cases of poor nutrition, the treatment can be carried out at home, with frequent follow-up visits to the doctor's office or clinic. The doctor will recommend high-calorie foods and place an infant on a high-calorie formula.

More severe cases may call for tube feedings in which a tube is put in that runs from the nose into the stomach. Liquid nutrition is provided at a steady rate through the tube. Once the tube is put in place, the child is usually fed at night, so as not to interfere with his or her activities or limit the child's desire to eat during the day. (About half of a child's caloric needs can be delivered at night through a continuous drip.) Once the child is more adequately nourished, he or she will feel better and will probably start to eat more on his or her own. At that point, the tube can be removed.

A child with extreme failure to thrive may need to be hospitalized so that he or she can be fed and monitored continuously. During this time, any possible underlying causes of the condition can be evaluated and treated appropriately. This also gives the treatment team the opportunity to observe firsthand the caregiver's feeding technique and the interaction between caregiver and child during feedings and at other times.

How long treatment lasts varies significantly from case to case. Weight gain takes time, so several months may pass before a child is back in the normal range for his or her age. Children who require hospitalization may stay for 10 to 14 days or more to establish satisfactory weight gain, but it can be many months until the symptoms of severe malnutrition are no longer present. Failure to thrive caused by a chronic illness or disorder may have to be monitored periodically and treated for even longer, perhaps for a lifetime.

Does My Child Have Failure to Thrive?

If you're worried that your child is failing to thrive, remember that there are many reasons why he or she might be slower to gain weight other than failure to thrive. For instance, breastfed babies and bottle-fed babies often gain weight at different rates in the early newborn period.

Genetics also play a big role in weight gain, so if you and your spouse are slim, your baby may not put on pounds quickly. However, infants should still gain weight steadily and it can be difficult to monitor this from home. So, it's important to see your child's doctor on a regular basis.

As a guideline, babies usually eat eight to 12 times in a 24-hour period (a couple of ounces [60 milliliters] every few hours) in the first weeks after birth. By the time they're 2 to 3 months old, the number of feedings has dropped to six to eight, but the amount they eat each time has increased. At 4 months, about 30 ounces (890 milliliters) a day provides sufficient nutrition for most infants.

Your child's doctor will have plenty of opportunities to identify a problem at regular well-baby checkups. You can also periodically check your baby's weight at home, if you feel you need the reassurance.

When Should I Call My Child's Doctor?

If you notice a drop in weight gain or your baby doesn't seem to have a normal appetite, get in touch with your child's doctor. Any major change in eating pattern also warrants a call to the doctor. Toddlers and other kids may have days and sometimes weeks when they show little interest in eating, but that shouldn't happen in infants.

If you have trouble feeding your baby, your child's doctor can offer some advice. For any reason, when a child doesn't readily eat, parents tend to become frustrated and feel they aren't taking care of their child well. That can magnify the problem and increase the stress for both you and your baby. Instead, get help for both of you by consulting your child's doctor.

Updated and reviewed by: Barbara P. Homeier, MD
Date reviewed: April 2005
Originally reviewed by: Steven Dowshen, MD

http://kidshealth.org/parent/nutrition_fit/nutrition/failure_thrive.html

 

Sat, 2008-07-12 11:34 — Kerry

Federici's Findings

From a parenting-perspective, I find it a little alarming an adoptive parent is creating a whole new term for future pediatric diagnosis when so many "special needs" labels are already alienating and hurting a child's chances to grow and thrive.  

Dr. Federici has 20 years of experience completing complex neuropsychiatric evaluations with children having significant neurodevelopmental and emotional difficulties. He is a professional consultant to numerous schools, mental health clinics, pediatric and adolescent medicine clinics, court service units and adoption groups, and is frequently called upon to perform “second opinions” for the most difficult to diagnose cases. Dr. Federici also works extensively in forensic neuropsychology and has served as an expert witness in cases involving the assessment and rehabilitation of traumatic brain injury or other neurological disorders" (http://www.careforchildreninternational.com/Dr.Ronald%20Federici.htm)

With all due professional respect, I think it's safe to say where this doctor's interests lay... and in terms of the long-term emotional effects adoption causes a child, I am simple in my belief that a person is either part of the problem, or part of the solution to the problem.

So... what's the problem I have with Federici's finding?  I find it criminal to mis-label a child with a ficticious medical diagnosis when that child will forever be seen as a "special needs funding project."  Imagine for a moment what this means in terms of average-parent tax-paying money and how fixating on a new label will affect our school systems.

Before Institutional Autism, an adopted/fostered child would come with the more commonly known labels of ADHD or RAD.  Does anyone know how "Special Needs Programs in schools" are funded and resourced?  Does anyone know what type of para-professional network is needed to keep both school and child safe from uncontrolled angry-outbursts?  Does anyone care that a grieving angry child is NOT the same as an autistic child, and unless this is recognized, the road within Child Placement is only going to direct an innocent child to and through a life of misundertoood hell.

To help illustrate my long-term concerns about wrongly-diagnosing a child with special needs, I'd like to refer to an article about ADHD posted today on MSN.com

Kicked Out of Preschool?

By Melissa Slager

In many ways, Joanah is your typical 4-year-old. He sees Spaghetti-Os as a fashion statement, not just a dinner option.

But an active nature complicated by attention deficit hyperactivity disorder, ADHD, can make him a handful some days.

For his former preschool, there apparently were too many "some days," which included defying his teacher's instructions and hitting classmates. After just a few months, the school's director called in Joanah's mother.

"They just seemed kind of intolerant," says Lori Napier, of Lakewood, Ohio. "He wasn't a holy terror. Basically, they couldn't handle him -- or didn't want to -- and asked me to remove him."

Joanah, then 3 years old, had joined the unlikely but populous ranks of expelled preschoolers.

Yale researcher Walter S. Gilliam says preschool programs exist to ready young children for kindergarten and the elementary years that lay ahead. So expelling a kid so young, even with problem behavior, just doesn't make sense.

"I can't think of a child who's more in need of a school-readiness program," says Gilliam. "It's like taking sick people out of the hospital."

More likely than a teen

More than 5,000 children were estimated to be kicked out of state-funded preschool programs in a 2005 study of the phenomenon by Gilliam. That's less than 1 percent of the total enrollment of the programs included in the study.

At the same time, preschoolers were far more likely to be kicked out of school than their counterparts in the K–12 system. The preschool expulsion rate of 6.7 per 1,000 preschool students was more than triple that of older grades.

"It shocks a lot of people," Gilliam says.

The study didn't look into the reasons for expulsions, but anecdotal evidence from preschools points largely to aggressive behavior, including biting and hitting, and other hard-to-control behaviors, such as running away.

Reasons for removing a child from preschool run the gamut, however. Gilliam recalls a 4-year-old who was expelled for having marijuana in his backpack. The boy's mother's boyfriend had hidden his stash there when police visited their home. The boy had no idea. But school policy sent him home anyway.

Perhaps more troubling is that Gilliam's expulsion rate calculations do not include students who were transferred to a special education program or other setting. They were simply booted. And that can start a vicious cycle.

"I've seen some children who were expelled from preschool after preschool, and then they got to kindergarten and they were expelled from there, too," Gilliam says.

The rates also don't touch on those families who leave just before the point of expulsion.

Jill Besnoy removed her 3-year-old son, Wyatt, from his private preschool outside New York City after staff repeatedly complained of his "active" behavior, including running away from class twice.

"I moved him because I was so unhappy ... but they were very happy when I said we were leaving," she says.

Visits to doctors and clinicians had showed there was nothing abnormal about Wyatt's behavior, Besnoy says. "He wasn't hitting anyone. He wasn't aggressive. He just didn't like being told what to do. He's 3 years old, you know?"

Wyatt didn't like to stay at an academic station like instructed, or sit still for 20 minutes of class time, things Besnoy sees as "unfair demands" for a little kid.

Not always a "problem child"

Many parents and experts see a preschool system that has lost sight of what's appropriate to expect of a 3- or 4-year-old.

"I think some people have expectations that children that age are able to sit for 20 minutes and listen to a lesson," says Lisa McCabe, associate director and cooperative extension associate of the Cornell Early Childhood Program at Cornell University.

"You stick them in that environment and they start acting out and hitting, and then they're labeled a problem child, when they're not -- you're just expecting things that are inappropriate."

It's natural for a little kid to whack their playmate to get what they want, in part, because it works.

Most young children haven't yet mastered how to "use their words," much less the patience and internal check system to follow through.

"That's one of the problems at this age," McCabe says. "How can we tell the difference between a child who's showing some problem behavior now but in two years will have outgrown it" and the one who is dealing with deeper issues?

A 1996 Canadian study of 2- to 11-year-old children showed that physical aggression peaks between 2 and 3 years of age, and that most kids outgrow the behavior. According to another Canadian study from 2006, only about one-sixth of children, mostly boys from disadvantaged families, show a more persistent pattern of physical aggression.

Biting and hitting are "relatively minor issues," and kids shouldn't be expelled for such behavior, says Beth Green, vice president of the Research and Training Center on Family Support and Children's Mental Health at Portland State University in Oregon.

"A lot of kids go through those stages. And a lot of kids are asked to leave for things that teachers should be able to deal with and have the support needed to know how to deal with these types of behavior," Green says.

Even if a child shows more persistent use of aggression, expulsion isn't the remedy, experts say. If anything, it will only make things worse.

Preschool programs help children perform better in reading, math and other subjects when they enter kindergarten, as well as increase their chances of succeeding later in life, according to the National Institute for Early Education Research.

The key? Giving teachers the support they need and including social skills lessons alongside those ABCs.   http://spotlight.encarta.msn.com/Features/encnet_Departments_Elementary_default_article_KickedOutPreschool.html?GT1=27001

Isn't it interesting how Early Education Research states "expulsion [REMOVAL] isn't the remedy... if anything it will only make matters worse."

The suggested solution?  Teach the parents and educators the ABC's of child socilization, always remembering the displaced child is the most scared and grief-stricken little human you will ever find.

Sat, 2008-07-12 12:23 — Niels

Vanity of vanities; all is vanity

from: childrenintherapy.org

Ronald Federici makes the claim that he is “regarded as the country’s expert in the neuropsychological evaluation and treatment of children having multi-sensory neurodevelopmental impairments.”

Federici has denied that he is an Attachment Therapist and sometimes avoids the term “Attachment Disorder” (AD) that is widely used by other Attachment Therapists. He instead claims to be a “developmental neuropsychologist,” specializing in the treatment of “institutional autism” (which he also calls “post-traumatic autism,” or “post-institutional autistic syndrome”). His broad range of signs for the alleged disturbances, and the treatment he recommends for them, nevertheless resemble those routinely proferred by Attachment Therapists to diagnose and treat AD. (The AD diagnosis is not recognized by conventional psychology or psychiatry.)

For years — and as recently as 2008 — Federici has claimed to be licensed by the Virginia Medical Board, when in fact he is licensed by the Virginia Board of Psychologists (both as a clinical and a school psychologist). Moreover, he claims to have several “diplomate” or “fellow” credentials which have little or no general acceptance by, or recognition within, the psychology profession (possible “vanity boards”):

  • American Board of Professional Neuropsychology (ABPN)
  • American College of Professional Neuropsychology [same as above, but listed separately]
  • American Board of Medical Psychotherapists (ABMP)
  • Fellow (in Advanced Psychopharmacology), International College of Prescribing Psychologists (ICPP)
  • American Board of Disability Analysts (ABDA)
  • American Board of Medical Consultants
  • American Academy of Behavioral Medicine
  • National Academy of Neuropsychology
  • American Board of Cognitive-Behavioral Therapy

Despite the suggestions above, there is no evidence that Ronald Federici possesses a medical degree. Nevertheless, he is listed as an “MD” by adoption placement agencies and others, including Adopt for the Love of a Child, the Child Welfare Training Institute (University of Southern Maine), China Connection newsletter, Dillon International, Families for Russian and Ukrainian Adoption (national advisory board), and Hawaii International Child. There is even a Yahoo review (with a 5-star rating), categorizing him in “general practice medicine” and neurology.

One must have either a PsyD degree or a PhD from an accredited school to be licensed as a clinical psychologist in Virginia, but Federici’s publically available biographies shed no light on where and when his qualifying degree was obtained. He does not appear, as asserted in his Curriculum Vitae, to have a most unusual “dual doctorate” — or indeed any doctorate — from the University of Illinois or the University of Chicago. In times past, he has claimed an EdD and an MBA from Shaftesbury University, a diploma mill in England. There is evidence of a dissertation for work toward a PsyD from the Illinois School of Professional Psychology in the 1980s, but curiously this school is not listed in his CV.

Federici has in the past touted affiliations with Dr Charles H. Zeanah and Sir Michael Rutter, prominent attachment theorists and experimenters, and particularly with their respectable studies of children adopted from Romanian orphanages (before Romania stopped foreign adoptions in 2004). However, neither of these individuals have publicly commented on Federici’s recommended treatments for children, nor accepted that their research data validate his theories or his proposals for identifying disorders.

Neuropsychological and Family Practice Associates (in McLean, Virginia; recently restaffed and relocated from Alexandria, Virginia) is wholly owned by Federici, and he is CEO of Care for Children International. In 2007, he filed for bankruptcy to discharge his personal guarantees of business debts for his practice, but the filing was eventually dismissed. The filing was shortly after he tried, and failed, to be gain legal guardianship over one of his adopted children, who was an adult at the time.