Thursday, October 15, 2009

Picking up where I left off--Tortuga

This is a continuation of yesterday's post about working with Tortuga's ODD. There are some aspects of what we have been doing that I don't write about and there are also many details about his behaviors and responses that are not noted here. I don't want to give the impression that it was all smooth sailing. It wasn't. Anytime there is a change there is going to be resistance. However, the resistance in this case has been no worse (and actually better) than what we have usually seen from him.

I want to backup a little bit to clarify a couple of things. Tortuga did fight us on the changes at the start because we made this shift when he still "owed" us sentences that he had refused to finish. We use "writing sentences" (like some of us had in school) as a way to address behaviors and attitudes that violate family values, expectations and rules when the behavior is continually engaged in. In many cases they serve as a "reminder" to change or stop the behavior and we have been using them as a last resort when reminders and redirection from C. & I. doesn't work. Unlike most of our other consequences which are given immediately and swiftly (we use natural consequences as much as possible) these are "saved" for Saturday or Sunday and must be done before they can participate in other "fun" activities. When Tortuga or Corazon "earn" sentences we might say "That means you have forgotten about ____ That's ok. Writing some sentences will help you remember. Let us know if you need more." This has really worked for Corazon and especially Tortuga and has gotten rid of 75-80% of the "small" behaviors that he constantly engaged in such as rolling his eyes or sticking his tongue out at us EVERY time we spoke to him. (Corazon would cross her eyes at us, teachers, coaches or any adult who annoyed her or checked her for something.)

The other thing I want to clarify is that we started acknowledging that Tortuga ALWAYS needed the safety and structure that one would use with a toddler/preschooler. We weren't being condescending and never belittled him for it. We just recognized that the gaps in his learning and his behavior were such that sometimes he responded like a 2 year old while other times he was behaving like a 5 year old or an 8 year old. That wasn't his fault but it made it hard for us and him because when he behaved in a more age-appropriate way we started treating him and expecting him to do so and then in a similar situation he would act like a toddler. From our vantage point, there was no rhyme or reason to this. We decided that we needed to recognize and take stock of as much as we could which is why we treated everything as a "test." We might say, let's see if you can _____ and if not that is ok, you aren't ready and we will try again later." Most importantly, we have stuck with it.

At the end of the last post I noted that things started to change. It was most noticeable with the eating and bathroom behaviors. Once he started eating more normal portions I started teaching him to say things like "mom, I am full" or "mom, I got enough to eat." Yet, I continued to fill his plate beyond what he needed and I started hearing him say things like "I don't need to eat the rest of my food" and "I don't want the rest of my food." I felt it was important for him to be able to articulate and control his response to the food and acknowledge that his need was being met. He has had food issues for as long as we have known him and I didn't want to make the mistake of treating this as something that he was "over" so I have maintained the extra food thing because each time he turns down a snack or leaves food on his plate he gains more confidence that there will be more than enough food, that he has some control over something so critical to him, and that I will take care of this need. (I think it is also important to note that in our house we always prepare and serve the kids' food. We don't let them serve or help themselves because it reinforces that we will be there to meet this need.) Sorry if I am going into too much detail here.

The other thing I did was I NOTICED when he started using a strategy to calm and control himself and I played it up. For example, in the last post I also mentioned he started saying "yes, mom" and "thank you for helping me, mom" when I was redirecting him or telling him to do something. He started saying this on his own and sometimes through gritted teeth but I could tell how hard he was working to stay in control and his "yes, mom" helped him do this. I pointed out that we all use strategies like that to help us not get mad, lose our tempers, or stay in control and it was good for him to try new ones until he found one that worked. So far this strategy has worked and we are seeing that he needs to use it less and less.

The next thing I did is I identified a "routine" that was important and listed all the steps for him. He read it and could decide to change the order and I would rewrite it in the agreed upon order. Then he had to rewrite it for himself and post it in his room. He was then expected to follow that routine as agreed upon. It may sound rigid but it provided safety, consistency and structure for him while giving him control. Initially we didn't allow any exceptions/explanations (RAD and ODD issues) until he would show that it was internalized. When he couldn't or wouldn't follow it we had him rewrite the routine as a "reminder." So far he has "nailed down" routines for mornings, mealtimes, riding in the car, laundry, errands/shopping and afterdinner/bedtime prep. We are now working on a routine for his schoolwork. We will also work to add things to his routines as he is ready. I think the routines really provide safety and security for him. Plus he is generally pretty disorganized and has some ADD issues on top of that so they help him in other ways. We are at a point where small deviations from the routine are ok (give him choice and control) but we have to be careful that we don't let that slip too far because when we gave him too much control it was a disaster. We learned our lesson.

When we had to go out I would prepare him for each outing by identifying the challenges he would face, reminding him what was expected, telling him he would mess up and get sentences but it would be ok and he could do it, etc. We would review the routine, if he had one, and when we returned if things hadn't gone well he would go straight to his room and we would talk about it as he was ready. If things had gone really badly we had him practice patience (strong sitting), yoga breathing and tapping/rubbing before letting him go up to his room. There have been some bumps but this has been working thus far.

Again, this is getting too long so I will stop here.


BT said...

I so appreciate your posting about Tortuga. I'm guessing that he and our P are very close in chronological age, and they may be quite close in family age as well. P is chronologicaly 9.75 yo, and is 4.5 yo in family age. Like you, we see tons of mixed maturities, and it can be a big mystery figuring out what age P will be in any given situation -- even a situation in which he previously displayed a certain age can change the next time!

We kept P's world very small for so long, and it has only been recently that we have been able to occasionally let routines/schedules slide slighly and not have him totally regress. Like you, we do a lot of talking him through what's coming up and what the expectations are.

Also, the food issues. We have begun to see P turn down food and not finish what is on his plate. We have tried to stress "listening to your body" with him, and lots of proof that we will always provide enough food and that he will never be hungry again like he was in Ukraine. We give a ton of positive feedback when he listens to his body and stops eating. I stress a lot about the food because I don't want him to have food issues later in life, but I try to appear calm about it in front of P.

Anyway, I'm rambling. Just wanted you to know that I can relate hugely to a lot of what you are posting about, and it is extremely helpful to me.

You are doing good! Keep it up.

Dia por Dia said...

Thank you so much for your comment. Tortuga is probably around 4.5 in terms of developmental age but the "mixed maturities" as you call them get me every time. It's a mystery what registers and what doesn't sometimes and so we have done alot of the "making world small" over time but I think this time it felt more "life and death" because of his age and my fear of losing a potential window here. I think we always made the mistake that we perceived ourselves as being too rigid and trying to be flexible and understanding when he slipped on routines only to have more issues arise. The routine got lost, he got mad at being checked, he got mad at the perceived inconsistency of us checking him sometimes and not others when we were trying to be understanding that people do "forget." The more "rigid" we have been on these the better he has progressed.

Food issues--we have been right where you describe. He had NO shut off valve. Not joking. I tested it and shocked/amazed doesn't describe what he could eat. We've been through phases with him about this and he has always had more than enough to eat but this time I decided I needed to help get it out of his system once and for all. Hence, the OVERFEEDING and we continue to do this so that he understands he has control, can regulate and YES, is listening to his body too!

So glad you understand.

P.S. You never ramble and I do appreciate your sharing of this.

ldw said...

As always I am so impressed with your ideas and follow-thru...I will get there!

matryoshka said...

thank you for posting the things that help you. I gave Jupiter a sentence the other day after reading it on your blog..she only had to write it once. Well twice, because she changed "I am sorry I used unkind words" to "I am NO sorry I used words." But she did accomplish the whole thing. She hasn't used unkind words at that particular person far anyway.

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