Wednesday, October 29, 2008
Monday I had to see a geneticist who told me that I am a Cystic Fibrosis carrier. 1 in every 25 caucasians of European decent are carriers of this desease. That took all of 3 minutes for him to tell me that as a carrier I am not effected at all by the disease. Wow! I could have gone the rest of my life without wasting that 3 minutes of my day! Then, around 11:00, I received a phone call from the school secretary asking me to come take care of M... He got a step 4 in the lunch line because he hit a child who was standing too close to him. Then, he called the lunch room teacher a "Liar" when she called him on it (she had watched him do it). So, I had to meet the teacher and took M home for a bit of homeschooling, which is something he dislikes, as punishment.
Tuesday I had an appointment with M's behavioral therapist at 8:00 in the morning and a meeting with C's principal to address some issues with her deaf/HoH teacher. Matt and I had stayed up talking until nearly midnight the previous night about both M's appointment with this particular physician and C's school possibilities. The therapist doesn't work with M. Rather, she sees Matt and I to "tweak" our parenting skills. In fact, she has claimed on more than one visit that she doesn't know why we're seeing her because we're doing everything right. In regards to C's teacher... She had sent home notes about my daughter that I didn't appreciate 3 days in a row. She was critiquing my ability to send C to school with a full battery for her Cochlear Processor (an insult to any responsible mother) and claimed that C was having behavior problems associated with the inoperable state of her processor. A complete fabrication, even if I do say so myself. The teacher and the entire deaf/HoH team and I utterly disagree on what is an appopriate learning situation for C, which, in turn, causes us to be sensitive towards each other and what each has to say.
Here's what actually happened: Matt went to the behavioral health therapist and told her our opinion. He explained that we only really wanted a confirmed diagnosis for M so that he can get the additional help from school that he would qualify for. She totally understood and was utterly appreciative that we were considerate enough to keep our appointment and tell her in person of our viewpoint (I, in fact, came across her today and she was super sweet). We then cancelled our appointment with the principal and said we'd work it out with the teacher first. If things escalate then we'll go through the pricinipal. I just got tired of this woman being so adamant about how I should raise my deaf daughter (just because she is a deaf woman herself) that I wanted to take action. Sadly, the day got worse!!! M's reading teacher called me and asked if I would come sit with M. He, apparently, decided not to do his school work. He had done the same thing on Monday, too. But, she simply had to do something to ensure his work got done. So, off I rushed to the school (after calling Matt to get the van) to sit with M. He DID NOT like this treatment and I can only hope that he has learned a valuable lesson. I can tell you that I did not make this pleasant. Upon arriving home I found I had received a call from M's Developmental Pediatrician, whom I was supposed to call at 9:30 but didn't have an opportunity because of my time spent at the school. I called her back and we discussed Matt's conversation with the behavioral therapist and our desire to get M the help he needed, even if it meant putting him on ADHD meds (that's the official diagnosis).
Once the kids arrived home from school we went to the pharmacy (on post the wait is usually an hour to an hour and a half). We arrived around 3:45 and left around 4:45. I had some coloring/activity books and crayons along with some playdough and snacks and juice. The kids (both of them) actually sat quietly for then entire time!!! I was so PROUD of them... It was a difficult task for any child and excessively so for M! What a trooper! They did so well we treated them to dinner and an extra desert. We picked up M's ADHD medicine (10mg of Adderall XR) and gathered the instructions for things to watch for (positive and negative) to be implimented the following moring.
Wednesday has been just as busy. I started my day with explaining to M about his medication before shipping him off to school. C and I took Matt to work before coming home to get ready for her Developmental Pediatrician visit. In our visit I explained the new school situation. To say that the two doctors who were seeing C today were not pleased at her situation is a severe understatement. In fact, they've determined that if we cannot get C into her old school with like-hearing peers that they wanted to get her seen by a signing therapist so she can learn to express herself. They are VERY anxious about C's social skills and mental health because of this placement. They strongly feel she is being isolated at a stage when she really needs to further her communication skills and can truly benefit from socializing with other deaf children. They were especially adamant about this when they learned that she cannot even recognize the sound of her own name using the Cochlear Implant. Plus, poor C had to have her final Hep B shot. Her previous series she got in China did not "take", according to her Titers, so we had to start over again with this. Then, while we were there, they gave her the nasal flu vaccine. Needless to say, I kept her home today.
After today's visit I'm feeling frustrated again... I can't provide transportation for C and the school refuses since they already have a program in our own school, but if I can arrange transportation for the old school then M will have to move schools, too, just when we're getting to a point that he NEEDS to stay where he is to verify how the new medication is effecting him. Not fun at all!
Here's what M's teachers said about M's behavior today:
"Hello!He had a pretty good day today.He had a little bit of a hard time getting settled at the school wideassembly.But, that was quickly resolved and we moved on."
"His behavior and academic performance was not as good as it has been but better than the last two days... he seemed "sullen" sad and mad at the same time. He did what we asked but not with real effort or excitement. Mrs. ____ gave him compliments on his word cards, I thought I almost seen a smile but it was fleeting. May be the review this week will help. Full week of reading next week! Thank you for coming in. I really appreciate it!"
Monday, October 27, 2008
And the list just keeps on going! You are loved and missed so dearly! We'll see you again in the future.
And for my family and friends who have been touched by cancer but have survived... You are an inspiration! May you always win this fight:
And so many others!
All you are asked to do is keep this circulating, even if it's to one more person.
In memory of anyone you know that has been struck by cancer.
A Candle Loses Nothing By Lighting Another Candle.
Please Keep These Candles Going!
Sunday, October 26, 2008
Today, we were planning on taking a drive down to Aunt D and Uncle C's house in south-western Washington. It can be nearly a 2 hour trip, depending on weather. But, I started my girl days on Friday and found myself in a bit of pain. Apparently, the polyps that the doctor removed back in September finally decided to dislodge themselves. This excretion process is quite painful. Like my cycles weren't painful enough... I now have to deal with even further pain. Apparently, in a few months I should be loving life with far less pain. If this doesn't work we'll be aiming at a hystorectomy... Wonder if I can talk the doc into that in a year or two?!? Hmmm... Worth thinkin' 'bout! ;)
Anyway, this afternoon I finally started feeling the pain go away. I began waking up at around 2:00, so we decided to take a quick run to the store (fighting the pain was wearing me out enough that I practically slept the weekend away). I needed to buy Halloween Candy (I'm a stickler for buy and giving out candy if my kids are trick-or-treating) and M and C needed some new jeans.
I purchased 3 pairs of 7 slim pants and 2 pairs of 8 slim pants for M and little "tight" outfits for C (the kind with long dress-like shorts with matching tights underneath) in lieu of jeans. M had 2 pairs of 7 slim pants from late last year and C had several jeans that still fit (though quite snuggly). So, we went to Ross and found a great deal on jeans for both the kids. I ended up buying C 3 pairs of designer jeans for $9.00 each while M got 3 pairs of desiner jeans for $10.00 each. He got 2 more pairs from Target for $10.00 each, also. It was a fabulous find because it is always so difficult to find slim sized pants at all, never-the-less at Ross. M is simply too tall... He's lanky, super skinny and long legged like a little colt (knobby knees and all). Hopefully these pants will last both the kids through spring!!!
So, how can I get away with saying I bought clothes other than for the kids? Easy... Ross was having a decent clearance section where I was able to buy my nephews so great clothes!!! Plus, I bought myself 3 new bras! I have 1 bra that is comfy and I pull the wash and wear every day routine with it. My other 3 bras are awkward and mostly uncomfortable. We'll see how well these new bras work. I don't care what a bra looks like as long as it is confortable and holds up my girl parts! ;)
Needless to say, I was thrilled with my finds but was totally worn out by the time we got back to the van. I should have waited to do my shopping until I felt better... Like on Wednesday.
Saturday, October 25, 2008
I found my dream kitchen. It's by IKEA and I saw it while we were visiting the IKEA store in Seattle when my friend from Texas was visiting earlier this month. These pictures don't show it's true beauty by any means, but at least you'll have an idea. For those of you who have seen my kitchen in my house in Kansas you'll know just how beautiful this design could look. It's somewhat country with lots of elegance! The backsplash emulates pounded tin (it's actually a plastic of some kind). I think the backsplash in this kitchen could look great if it were done with black chalkboard paint. The the top/tall cabinets are white, some are glass fronted while others are fronted with wainscoating. The lower/base cabinets are a dark stained wood. There is a breakfast island in the center of the layout with some open storage underneath. The sink is a country sink with a fabulous country faucet that reminds me of a hose. It's so cool and this kitchen is unbeatable!
Wednesday, October 22, 2008
( ) Gone on a blind date
(X) Skipped school
(X) Watched someone die
( ) Been to Canada
( ) Been to Mexico
(X) Been to Florida
(X) Been on a plane
(X) Been lost
(X) Been on the opposite side of the country
(X) Gone to Washington , DC
(X) Swam in the ocean
(X) Cried yourself to sleep
(X) Played cops and robber
(X) Recently colored with crayons
( ) Sang Karaoke
(X) Paid for a meal with coins only?
(X) Done something you told yourself you wouldn't?
(X) Made prank phone calls (Does that count to family/friends? Then Yes.)
(X) Laughed until some kind of beverage came out of your nose or peed your pants
(X) Caught a snowflake on your tongue
(X) Danced in the rain
(X) Written a letter to Santa Claus
(X) Been kissed under the mistletoe
(X) Watched the sunrise with someone
(X) Blown bubbles
(X) Gone ice-skating
( ) Been skinny dipping outdoors
(X) Gone to the movies
1. Any nickname?
2. Mother's name?
3. Favorite drink?
Anything with Chocolate
4. Body Piercings?
My ears and belly-button
5. How much do you love your job?
I adore my job... I get to be a mom!!!
7. Favorite vacation spot?
My family's traditional annual camping trip to the Northern California Coast.
8. Ever been to Africa?
No, but I sincerely hope to get there some day (we hope to adopt from Ethiopia)!
9. Ever eaten just cookies for dinner?
10. Ever been on TV?
Yes; Matt and I were in a commercial at Ft. Eustis. I sucked but Matt was great.
11. Ever steal any traffic signs??
12. Ever been in a car accident?
13. Drive a 2-door or 4-door vehicle?
Both at some point in my driving career.
14. Can you drive a standard car?
Yes... My parents required us to learn on a stick shift. My dad's philosophy is if you can drive a stick you can drive anything... And it turned out to be very true since I've also driven an 18-wheeler.
15. Favorite pie?
16. Favorite number?
17. Favorite movie?
Sense and Sensibility
18. Favorite holiday?
19. Favorite dessert?
Do I have to pick just one?!?
20. Favorite food?
Pasta, especially spaghetti
21. Favorite day of the week?
Friday... Because that's the last day of work and school so I can have my family all together for the weekend!
22. Favorite brand of body wash?
23. Favorite toothpaste ?
Aquafresh Extreme Clean
24. Favorite smell?
Johnson and Johnson Baby Shampoo
25. How do you relax?
Sitting in my parents front yard with a glass of wine or a bottle of beer and being able to chill with them.
26. How do you see yourself in 10 years?
As the mother of numerous healthy, happy and well adjusted children (grandchildren to follow) and the wife of an awesome (and hopefully retired) soldier!
27. Furthest place you will send this message?
Around The World!
28. What is your favorite breed of dog?
German Shephards (but I also like Dobermans, Giant Schnauzers, American Mastiffs and Labs)
29. Favorite sound?
My children's laughter
Thursday, October 16, 2008
So, after taking a deep breath we have decided to impliment some strategies at home to help him learn to read better. At the end of last year of kindergarten we had withdrawn M and began homeschooling him. We utilized the k12 program (an awesome program that is perfect for inexperienced home educators like myself). Even though M had attended a regular kindergarten through last February k12 required him to start over. So, we got many wonderful supplies to help educate M, about 1/2 of which we did not have to return. One of the things we were able to keep was the Phonics workbook and teacher's book. So, we're going to pull that back out and use it to give M extra education on Saturdays and Sundays.
Wish us and M lots luck!
Tuesday, October 14, 2008
This past weekend was a blast. We hosted a long time friend for a few days. She flew in from Texas and brought the kids each a ton of stuff (she spoils them rotten). The kids, Matt and I all enjoyed having her. We went to Mt. St. Helens and saw it smoking and then we went to Seattle to check out Pike's Market. While we were there we took the short cruise around Puget Sound. That was really nice. We saw some California Sea Lions while we were out cruising along with a few jelly fish. They were huge! I was the only one interested in the jelly fish while everyone else were checking out the Sea Lions, which were pretty cool, too. I thought I saw a few whales surfacing, but since I was the only one seeing these few surfaces I must have been imagining things (though there are a pod of Orcas in the vacinity as well as Humbacks that have swum up the canal and reached Tacoma, two arrived and departed just two months ago, so it's not impossible). "K" brought the kids a lot of things from Tombstone, Arizona as well as Texas. Pictured here are M and C wearing their authentic cowboy attire from Tombstone (we'll have to have professional pics done, too).
Thursday, October 9, 2008
M asked, "Mom, how you write 'Dear Mom, I miss you'?"
"What for, Son," I asked?
"How you write it? I want to write it for my mom." Showing me his paper I finally figured out what he had done and wanted to do...
M had drawn a picture of his biological mother holding him as an infant, wrapped in a blanket. He had made this picture just for her. Nearly in tears, I walked him through the sentence. When we were done, he asked me to write the following:
"To: Biological Mom
remember (he meant that he hopes she remembers him and holding him)"
10-10-08 (though he didn't request it, I wrote the date)
Once we were finished he picked up the paper and made a beeline for the front door. When I asked him where he was headed he firmly told me, "To send off my letter."
I asked, "You mean you want to send it in the air so the wind takes it to your biological mom?"
"Yes!" he emphatically affirmed.
"Son, why don't you let Mommy do that for you. You can stay inside and finish coloring your picture for Aunt Kim-Berly and Uncle Tracy."
Thankfully he allowed me to do this. Unfortunately, as soon as I finished sending it off in the wind (a.k.a. sticking it into my back pocket) he freaked out and begged for it back. This made me a bit concerned, but I swiftly took it out of my pocket and handed it to him, claiming that it had only gone as far as our neighbor's house. He had decided to wait until he was 18 to give it to her.
Throughout the past 3 years or so (since beginning the adoption process for C) M has been very curious about his birth mom. He's wanted to find her and track her down on occassion. So, we've had to explain to him that we cannot legally look for her until he is 18 years old, at which point we will emphatically help him search for her. Though he doesn't like that answer, he accepts it. I think he recalled what we've told him and changed his mind about sending the paper (which is shown here).
Tuesday, October 7, 2008
Allow me to express the problems with this for my daughter:
C is profoundly deaf. She was implanted with a Cochlear Implant at nearly 5 years old (it is believed that children tend to loose the ability to "learn to hear" at this age). C's implant has not worked as they had hoped and she generally cannot hear people speaking. In addition, C only started learning to communicate through sign when she came home from China nearly 2 years ago (has it really been that long?). Prior to that she moaned, cried and pointed until she got what she wanted. She would squat to indicate she had to go potty, but that was the only form of communication she knew. She was never around nor had ever been introduced to other deaf persons/culture.
When we moved up here to Washington, she was placed in a deaf/HoH program that taught a significant part of their class using ASL (for reading they used SEE [Signed Exact English]). There were 13 additional deaf students within her own age range that she got to interact with every day. She just blossomed and her communication skills took off. So, I've been fighting to get her back into that program, since it was practically written with her in mind! The teacher is deaf, the para's are all deaf and the rest of the team all are family members of a deaf person (either sibling, parent or son/daughter of a deaf person).
Unfortunately, I am stuck between a rock and a hard place with C's situation. Our school district will release C to go to this previous school but will not provide transportation. Since we only have 1 vehicle I cannot even fathom being able to provide transportation for C. As it is, I have to walk to the bus stop every afternoon to pick them up. And this past week has been a wet walk. I'd gladly drive down to pick them up if it were feasible for us to purchase a second car, in which case I'd drive C to the better school.
Well, at least the deaf/HoH specialist is attempting to work with me. He's actually going to the School For The Deaf to observe and get advice on deaf culture, with C specifically in mind. Sadly, I am the only parent (out of 8 parents) who is interested in giving my child these important socialization and communication skills. And, thankfully, when we move again we'll be able to bring Matt's Jeep as a second vehicle (it's an old classic that he's been having restored to some degree. With his deployment I'm planning on using some of the savings to buy a new engine to ensure it is able to do the job of transporting him safely. He loves his Jeep so much that he'll never get rid of it... So, might as well make it safer). This will allow me to tell the current school to take a bite and drive C to school!
Whew... The luxury of having special need kiddos!
So, in the hopes of getting our son the additional help he needs with his reading, we've taken him to Sylvan Learning Center. He was evaluated this morning during a two-hour block of testing. We'll get his results on Thursday, which is when they'll also tell us what hours and days of the week they think they'll need to work with him to get him up to par in reading. The cost for the evaluation was $145 and the enrollment fee was $55, but during October they're having a special of $94 instead! The cost per hour for the tutoring is $43 - $47. I might actually have to get a job to help pay for the tutoring! (Yikes... What am I thinking? lol)
The reason we went with Sylvan Learning Center is because they have guaranteed their work with M and they have centers located across the country in almost every location we would be stationed, making accessibility a bonus (they even have one in the really tiny town we're moving to next year). Plus, his information can be transfered to any of the other locations and the enrollment is lifetime!
I hope this works miracles!
Monday, October 6, 2008
After learning about the conference from Ms. J's blog, I tracked down the leading organization. It never dawned on me before reading her blog that there was support available for our son and our family. The National Alliance For Drug Endangered Children (http://www.nationaldec.org/) is an organization that helps to educate families, caregivers and volunteers as well as providing support and connection to state programs to assist children who have been exposed to drugs through biological parental use, distribution and/or manufacturing.
What is truly amazing is that I simply started to feel the need to express my concern for these children on my blog and the next thing I know I'm being connected to resources that I never knew were available. Isn't it amazing how we're almost guided in important directions?
Sunday, October 5, 2008
Here's our story:
M came home to us in September 2002 from an 8 day stay in the hospital due to pneumonia. He was only 2-months-old at the time and was the first of many bouts with this deadly disease (which the prenatal drug exposure may have been a contributing factor). His first foster placement had fallen through; who knows why the family gave up on him, but we got a first hand show of one possibility. The first night M was home his breathing and actions were typical of any sick baby. He was quiet and sleepy but needed lots of antibiotics to continue treating the pneumonia. The second day we actually rushed him back to the emergency room because his lips turned blue and his fingers began changing colors from a lack of oxygen. We spent the following 5 days in the hospital, never leaving his side. During that time M had test after test on his heart. They diagnosed him with Astham and found a heart murmur (which he still has) while examining what appeared to be a misshapen heart. In reality, his lungs were so full of fluid that they were squeezing M's heart into an "S" shape.
During the months that followed, we were treated to the realities of a child who was prenatally exposed to drugs. A shrill scream that sounded as if someone was stabbing him over and over again with a large, sharp knife for an average of 2 hours per night was our regular routine. It was scary for us and for our son, especially since nobody understood what was happening. Family and friends thought we were simply inexperienced parents who were overwhelmed with the normal fussings of a baby. What they didn't understand was that he was experiencing withdrawals, and they were terrifying. His reactions to loud, sudden noises was non-exhistent, making him seem deaf. And he never mumbled or cooed as a normal infant would. To this day we continue to see Autism-like symptoms, many of which doctors and physicians don't know how to diagnose because they don't "fit" into place like true Autism.
Over the years, M has had Occupational Therapists, Speech Therapists and Behavior Therapists, but it was often only after a large battle with pediatricians that he was evaluated. His developmental skills were "scattered" making it difficult to show M's needs "on paper", though they were clearly displayed in his day to day life.
"Scattered" development means that he performs at/above age level in some areas while performing below age level in other areas. For example: when he was 5 months old, he could sit by himself but could not use his arms to push himself up; when he was 7 months old he was walking with assistance but could not crawl; when he turned 12 months old M could crawl but could not walk by himself. The pattern is always unusual and has not ceased as he has gotten older. In fact, the developmental difficulties are quite different, though very noticeable when compared to his peers.
His language skills are so poor that he was recently offered to attend the ELL (English Language Learner) program. This program is designed for children whose primary language is other than English and they attend this program to learn English more fluently. M was raised with the English language, but his skills are such that he is severely lacking in language. He uses what he does know quite well, but his vocabulary is limited. I continue to "interpret" for him to family and friends.
Behavior has always been the biggest issue for M. People see him as a brat who throws tantrums. What most people find hard to understand is that M is actually doing very well for the things that he has had to overcome in his little life. The tantrums that he does throw are miniscule compared to what they have been in the past. He tries excessively hard to reign himself in and succeeds to such a degree that anyone would be amazed at the changes had they known him as a 2-year-old. Unfortunately, because others do not understand why he behaves in this manner, they find it hard to accept him and acknowledge that his difficulties are drug-induced rather than a personal choice. And it is excessively difficult for me to be able to explain why M does these things because most people tend to believe that he behaves this way because I allow it. They refuse to see the true reason.
It is not M's personal desire to behave this way, but a drug-induced need to lash out, to explode, in an emotional outburst that would drain even the most patient person. When he is finally able to pull himself together he expresses deep sorrow at how he has behaved. His reactions are the same reactions I have seen from people with Epilepsy: apologetic, regretful, and fearful that he could not control himself.
The things that we deal with daily are things that could have been prevented had his birth-mom not done drugs. Oh, I firmly believe that drugs are a disease, an illness that cannot be controlled. And I absolutely believe that M's birth-mom abandoned him at the hospital when he was born out of pure love. I honestly feel that she loved her son enough to want him to have a better life than she could have provided for him, and I love her for that. But I also see the effects her actions have had on my son.
M suffers every day from the drugs he was exposed to prenatally. He has no friends, he cannot tollerate change, he has a severe language delay, he has a learning disorder in reading, he has uncontrollable tantrums, he has asthma and will always be suseptible to pneumonia and broncchial diseases and M will most likely always have his heart murmur (thankfully it is not life threatening). M was recently diagnosed with ADHD, which scientists have attributed as factor of drug use. And, sadly, for the rest of his life, between the prenatal drug exposure and his ADHD, M will have to fight the strong desire to use drugs. Every single day Matt, M and I fight the effects drugs have had, and continue to have, while fighting the stigma that has been placed on him for behavior that the public simply does not comprehend (my beloved and understanding parents were among this group until they researched the realities of a drug exposed infant; now they are among M's strongest supporters).
So, who do drugs hurt? MY SON! They've hurt him far more than most people will ever be able to truly understand.
This was an extremely difficult and emotional piece for me to write. It brought forth many of the things we have experienced and what little people are able to understand and accept about our son. With each word a tear fell as I remembered each agonizing goal that M achieved. I hope and pray that this gives birth mothers the courage to stop using drugs while they are pregnant and gives adoptive/foster families the courage to step forward to love and raise these amazing children who deserve to have a loving and caring family.
Saturday, October 4, 2008
http://www.crystalrecovery.com/GoAskAlice/GoAA.html?_top=G-PreNatalMeth.html (What follows was copied from this site.)
Pre-Natal Meth Exposure
I was clean from meth for 6 months and started using again. I am now 7 months pregnant what can this do to my baby?
Alice's Answer: Methamphetamine use during pregnancy is believed to place the unborn fetus at risk. Methamphetamine causes increased maternal blood pressure and heart rate, which can result in premature delivery or spontaneous abortion. The drug also constricts blood vessels in the placenta that feed the fetus which results in reduced blood flow to the fetus and ultimately reduced oxygen and nutrient supply. It is known that methamphetamine passes through the placenta that feeds the fetus and can cause elevated fetal blood pressure potential leading to prenatal strokes, heart or other major organ damage. It can also cause an increased or extremely variable heart rate in the fetus and slowing or alteration of fetal growth.
Fetal development abnormalities have been described sporadically in the medical literature but no true syndrome specifically linked with maternal use of methamphetamine use in the prenatal period has been described. Fetuses exposed in utero have been shown to have central nervous system abnormalities, cardiovascular system abnormalities, intestinal abnormalities, urogenital system abnormalities, and malformations of the extremities. However, though these results are very suspicious and highly suggestive of the involvement of methamphetamine use, the direct link between fetal abnormalities and maternal methamphetamine use is not clearly discernable.
With the exception of any major organ system damage or permanent vessel damage, birth outcomes are felt to improve if the mother stops using the drug in the last 6 months of the pregnancy.
The full effect of maternal use of methamphetamine on the newborn infant is not completely known and there is currently a multi-center study underway to better describe this issue. It is, however, known that the infant may suffer intrauterine growth delay and is usually smaller than the norm at birth. Some of these infants have withdrawal symptoms and a recent study showed that about 4% of that study of methamphetamine-exposed infants needed treatment for withdrawal. Newborns that were exposed to methamphetamine in utero are frequently very sleepy for the first few weeks after birth, often to the point on not waking to feed. After this time, the infants behave more like a cocaine-exposed infant and are often jittery, irritable and have a shrill cry. Infants may have irregular sleep patterns, poor feeding, tremors and increased muscle tone. These infants may also have a poor ability to habituate or self-regulate, especially under stressful situations. Therefore, if their environment is noisy and chaotic, the infants do not tolerate it well and can become even more irritable.
Finally, these infants are known to be at increased risk for SIDS, viral hepatitis (such as Hepatitis B and C), and HIV.
What are the possible areas of concern for children who may have been exposed to meth in the womb, and after they are born?
Health Conditions of Drug-exposed Infants
Birth weight: Birth weight is an important factor associated with children's overall health and development. Children who weigh under five-and-one-half pounds at birth are more likely to have serious medical problems and to exhibit developmental delays. Drug-exposed infants often do not exhibit normal development.
Prematurity: The risk of prematurity (birth at less than thirty-seven weeks) is higher in drug-exposed infants. Other complications can include an increase in acute medical problems following birth, and extended periods of hospitalization. Birth weight under three pounds has been associated with poor physical growth and poor general health status at school age. Low Birth weight infants also have an increased risk of neurosensory deficits, behavioral and attention deficits, psychiatric problems, and poor school performance. Premature infants may have experienced bleeding of the brain tissue, hydrocephalus, bronchial problems, eye disease, and interferences with the normal ability to feed.
Small for Gestational Age (SGA): This term is used to describe infants whose Birth weight is below the third percentile for their gestational age (i.e., 97% of infants the same age are heavier than the SGA infant). It is common for women who abuse cocaine to experience decreased appetite and provide inadequate nutrition for themselves and their baby.
Failure to Thrive (FTT): Infants who were exposed to alcohol and/or drugs may exhibit this disorder, which is characterized by a loss of weight, or slowing of weight gain, and a failure to reach developmental milestones. This can be due to medical and/or environmental factors. The infant's behavior includes poor sucking, difficulty in swallowing, and distractibility. Many of these children live in chronically dysfunctional families which places them at greater risk of parental neglect.
Neurobehavioral symptoms: Within seventy-two hours after birth, many infants who were exposed prenatally to drugs experience withdrawal symptoms, including tremors and irritability. Their skin may be red and dry; they may have a fever, sweating, diarrhea, excessive vomiting, and even seizures. Such infants may require medication for calming. Other infants exposed to stimulants show a pattern of lethargy during the first few days after birth, are easily overstimulated, and may go from sleep to loud crying within seconds. These behaviors usually decrease over time and subside in toddlerhood.
Infectious diseases: Infants with prenatal drug exposure may be exposed prenatally or postnatally to infectious and/or sexually transmitted diseases contracted by their mothers. The most common infectious diseases seen in infants are chlamydia, syphilis, gonorrhea, hepatitis B, HIV, and AIDS.
Sudden Infant Death Syndrome (SIDS): Children who have been exposed prenatally to alcohol and/or drugs have an increased risk of dying from sudden infant death syndrome. The causes of SIDS are unknown and its occurrence is almost impossible to predict. Apnea/cardiac monitoring is recommended for these infants.
Fetal Alcohol Syndrome: Mothers who consume large quantities of alcohol during pregnancy may have babies who are born with Fetal Alcohol Syndrome (or FAS). A diagnosis of FAS is based on three factors: 1) prenatal and postnatal growth retardation; 2) central nervous system abnormalities, and, 3) abnormalities of the face. Many of these children display significant disabilities, learning disorders, and emotional problems as they mature.
Each of the above conditions associated with prematurity or drug exposure has programmatic implications for caregivers; the children who exhibit these conditions are often referred to as medically fragile.
Developmental Outcomes: There are many unknowns involved in trying to predict the outcomes of infants and children exposed to drugs. While we know that there are certain physical problems that may remain with the child, in a structured and nurturing environment, many of these children are able to grow and develop quite normally. A small percentage of children have been found to have moderate to severe developmental problems. But regardless of their health status, all children who have a history of prenatal substance exposure should receive developmental evaluations on a regular basis: at least once during the first six months; at twelve months; and at least every year thereafter until school age. Early identification of social, language, cognitive and motor development problems is essential.
Developmental Patterns in Children Exposed Prenatally to Drugs
Birth to fifteen months: Unpredictable sleeping patterns, Feeding difficulties Irritability, Atypical social interactions, Delayed language development, Poor fine motor development.
Toddlers from sixteen months to thirty-six months: Atypical social interactions, Minimal play strategies.
Preschool children from age three to five: While average preschoolers are beginning to share and take turns, demonstrate language skills, and increase their attention spans in a group setting, the drug-exposed toddler may be hyperactive, have a short attention span, lose control easily, have mood swings and problems moving from one activity to another. These children may also experience difficulties processing auditory or visual information/instructions.School and teenage years: There has not been sufficient research into the long term biological effects of drug exposure on older children and teenagers; however, we do know that children with the behaviors described above are at greater risk of abuse and neglect, learning disabilities, and behavioral problems. Obviously, it becomes imperative to identify these problems at a very early age, access the necessary resources for the child, and build a team of professionals who regularly monitor the progress of each child.
Supporting a drug-exposed child in the course of his life may require advocating vigorously for specialized educational services; providing recreational and employment opportunities that allow a measure of success; educating parents; and providing counseling.
Techniques in Working with Drug-exposed Infants and Young Children:Respite and crisis care programs working with drug exposed infants and children may not know the exact drugs to which each child was exposed. A combination of substances, including alcohol and tobacco, may be involved.
There are a few techniques, however, which can be used in a general plan of care that may be individualized to meet the specific problems of each child:
1. Provide a calm environment: low lighting; soft voices; slow transition from one activity to another.
2. Be aware of signs of escalated behavior and frantic distress states before they occur, e.g., increased yawns, hiccoughs, sneezes, increased muscle tone and flailing, irritability, disorganized sucking, and crying.
Use calming and special care techniques on a regular basis, such as:
1. swaddling blankets tightly around the infant.
2. sing a pacifier even when the infant is not organized enough to maintain a regular suck.
3. rocking, holding, or placing the infant in a swing, or Snuggly™ carrier.
4. massaging the child.
5. bathing in a warm bath, followed by a soothing application of lotion.
6. rubbing ointment on diaper area to prevent skin breakdown.
7. encourage developmental abilities when the infant is calm and receptive using only one stimulus at a time. Look for signs of infant distress and discontinue the activity if this occurs.
8. gradually increase the amount and time of daily developmental activities; encourage the child to develop self-calming behaviors and self control of his own body movements.
Behavior Descriptions and Suggested Strategies.
Feeding problems: Feed the baby more often; feed smaller amounts at one time; allow the infant to rest frequently during feeding. Place the infant upright for feeding; after feeding, place the child on his side or stomach to prevent choking; if vomiting occurs, clean the skin immediately to prevent irritation.
Irritability/unresponsive to caregiver: Reduce noise in the environment; turn down lights; swaddle the infant: wrap snugly in a blanket with arms bound close to the body. Hold the infant closely; put the infant in a bunting-type wrapper and carry it close to your body. Rock the infant slowly and rhythmically, either horizontally or with its head supported vertically, whichever soothes. Place the child in a front-pack carrier; walk with the infant; offer the infant a pacifier or place it in an infant swing.Goes from one adult to another, showing no preference for a particular adult: Respond to specific needs of child with predictability and regularity.
May have poor inner controls/frequent temper tantrums: Use books, pictures, doll play, and conversation to help the child explore and express a range of feelings.
Ignores verbal/gestural limit setting: Talk the child through to the consequence of the action.
Shows decreased compliance with simple, routine commands: Provide the child with explicitly consistent limits of behavior.
Exhibits tremors when stacking or reaching: Observe the child and note the onset of tremors, their duration, and how the child compensates for them; provide a variety of materials to enhance development and refinement of small motor skills, e.g., blocks, stacking toys, large Leggos™, and puzzles with large pieces. Sand and water play are soothing and appropriate.
Unable to end or let go of preferred object or activity: Provide attention and time to children who are behaving appropriately; provide child with an opportunity to take turns with peers and adults.
Delayed receptive and expressive language: Create a stable environment where the child feels safe to express feelings, wants, and needs; use stories/records/songs; use hands-on activities to reinforce the child’s language abilities.
Expresses wants, needs, and fears by having frequent temper tantrums: Remove and help calm the child; redirect the child’s attention; verbalize the expected behavior; reflect the child’s feelings. Praise attempts toward adaptive behavior. Set consistent limits.
Difficulty with gross motor skills (e.g. swinging, climbing, throwing, catching, jumping, running, and balancing): Provide appropriate motor activities through play, songs, and equipment. Offer guidance, modeling, and verbal cues as needed.
Over-reacts to separation of primary caregiver: Offer verbal reassurance; be consistent, and help the child learn to trust adults.
Withdraws and seems to daydream or not be there: Provide opportunities for contact; move close to the child, make eye contact, use verbal reassurance; allow, identify, and react to the child’s expressions of emotions.
Frequent temper tantrums: Understand that a tantrum is usually a healthy release of rage and frustration; protect the child from harm; remove objects from the child’s path if he is rolling on floor. Some children do not want to be held during a tantrum and doing so can cause more frustration. Remain calm, using a soothing voice; anger will only escalate the child’s frustration. Do not shout or threaten to spank the child–the adult needs to be in control. Help the child to use words to describe emotions. Read stories about feelings. Help the child gain control by making eye contact, sitting next to the child, giving verbal reassurance, and offering physical comfort (rubbing back, etc.). Note the circumstances that provoked the tantrum, and try to avoid such confrontations when possible. Provide a neutral area for the child to work through the tantrum, (e.g., a large cushion or bean bag chair). Some children want to work through a tantrum alone; keep the child in sight, but do not interact until he is calm.
It is critical to the success of the drug-exposed infant that the eventual caregiver (parent, relative, foster parent, respite provider, adoptive parent) learn the care routine, control techniques, and background of the children for whom they will be providing care. Understanding the etiology of drug-exposure, the types of medical problems that arise, the developmental patterns, and the techniques for handling drug-exposed infants and toddlers is imperative.Program social workers, case managers, child care staff, and nursing staff must all work together with the caregiver to offer parent education (“hands-on” opportunities to provide care under the guidance of professionals), and encouragement for families who undertake the care of a drug-exposed infant. The caregiver’s understanding of the child’s behavior, physical “cues,” and developmental problems, goes a long way in helping the drug-exposed infant, toddler, and teen succeed. It also assists the caregiver in setting realistic expectations for children who enter the world battling the effects of their parent’s addiction. Many children who were prenatally exposed to drugs will grow and develop without unusual problems. However, for those infants who have physical indicators, the respite and crisis care provider can make a difference by providing, perhaps, the first stable, nurturing environment. Here, the child can be observed, positive routines for care can be established, and parents can receive the critically necessary education and support to enable them to care for an alcohol or drug-exposed child.
Summary: Staff training, caregiver training, and parent education are all critical elements of any program that will be successful with these children. Physical elements of the environment (lighting, noise, and space) may need to be adjusted to accommodate their care. The inclusion of medical support, i.e., nurses and physicians who are familiar with the problems of these children, is essential. In summary, the care of alcohol and drug-exposed children is a team effort that requires coordination, case management, special care techniques, and education to be successful in any respite or crisis care situation. With these components in place, agencies and families can witness the positive growth and development of children who have been greatly at risk.