Friday, June 12, 2015

Beyond Behavior

I am not an expert by any means, but I have had a lot of occasion to think lately about parenting an older child who was prenatally drug exposed. As we have spent more time focused exclusively on E and understanding how to nurture our relationship with him, I find that his disabilities pose mysteries that I hadn't considered before. (Though both boys were born severely premature and exposed to cocaine, for whatever reason, E shows long term signs of resulting disability, while T does not.)

I feel like you can learn a lot about traumatized kids by observing how they respond to stress and change, and we've had the occasion to see both boys react to big life events over the years. T tends to take over. He activates his natural leadership skills and uses his cognitive abilities to get his situation organized, even in the most difficult of circumstances. He is formal and reserve when he is uncertain, but even then, he can be extremely charming, even manipulative, trading on his good-looks, mature point of view, and winning ways to forge useful alliances. He likes to keep his clothes tidy, his papers in order, and his schedule predictable. Even at his worst times, he always had the coming week's schedule committed to memory, in detail. Even in his moments of greatest anger with me, he would pause to tell me that the color of my shoes clashed with my purse, or that I should remember to get dog food. He is capable of mastering many trying situations, and if he cannot get what he needs, he exercises a powerful denial to push the thing that is making him anxious far from his mind; if that fails, he uses drugs to go the extra mile, numbing himself to what he cannot control. Dysfunctional and damaging, yes, but it follows a certain rational progression.

E is quite the opposite. He responds to stress or disruption by getting severely emotionally upset, almost immediately. His changes of mood happen extremely quickly. Under duress, he quickly begins to whine, sigh, pout, and otherwise express a great deal of self-pity. He regresses to total dependency, asking others to decide and do things for him even when he is capable of doing them himself - things as simple as, say, opening a milk carton or adjusting the stereo speakers. He tends to become self-involved and pessimistic, to cling to whatever authority figure is present. If that's us, we minimize all stimulation and he gradually recovers. But if there is no authority figure at hand whom he can trust when he is upset, he can quickly spin out of control, having tantrums, running away, or--if severely taxed--becoming self-destructive. I know from my gut that what plagues him is not just the aftermath of a deeply traumatic childhood that he shared with his brother (as if that weren't enough), but the frustration and confusion that result from disabilities that he's had since birth. His wiring is off, in layperson terms.

What I mean to describe is his behavior, and some of the challenges of parenting a young adult who is disabled as a result of prenatal drug and alcohol exposure. What that leaves out is that he is very much an individual, with spiritual and emotional depth and highly original gifts. We've drawn naturally closer until we are indisputably his parents. He calls us mom and dad, and recently asked to change his name, entirely unprompted by us, because he wants to take the same last name as Tim. With great effort, he has become less actively self-destructive over the last several months. We helped him get from the department of child services to a department of mental health services program where he gets better care and has freedoms appropriate to his age, and that means we have been able to better integrate him into our daily life. He uses public transportation to go places he'd like to go, he spends time not only with us but with our friends and family. He walks the dog, he cooks meals alongside Tim, we take little trips. He is as close as he has ever been in the last ten years to having a normal life.

Recently we had such a small triumph, nobody else would have noticed or recognized it as an accomplishment at all: we had adult friends to our house for a game night, and E included himself, sitting with us for over two hours, playing board games of great complexity. He smiled, laughed, competed, and even won. He is intelligent, sensitive and capable, when he is operating within a safe environment in a very familiar setting with people he trusts. After this magical evening, I wondered at how "normal" he had seemed, and questioned (as I often do) whether I was underestimating is abilities.
It occurred to me that we were playing board games - there were rules, visible indicators of progress, and a routine governing who got to take their turn as the main actor at any given moment. The environment of the game brought us all into a small, controlled microcosm where it was easy to see what was happening and what would happen next. Under those circumstances, he was very nearly indistinguishable from someone with no impairments at all.

But the world is not such an environment. I think of what it must be like for him. I imagine that in school or even now in some of his programs, he must feel people are functioning at an intellectual level above his. He has so often been excluded, for example from conversations between social workers, judges and service providers. He has real limitations in his inability to keep up with fast-paced or unanticipated activity, and reacts with uncontrollable emotion.

It is rarely E's disabilities or cognitive limitations that get in the way in his daily life; rather, the problem tends to be people who expect or demand a level of function that he is not capable of. Over the years, I have seen him expelled from so-called therapeutic foster homes, arrested, incarcerated, put on probation, and more, for "crimes" that are a direct and obvious behavioral result of circumstances that are deeply provocative to him because of his disabilities. No wonder he is sometimes overwhelmed by despair!

He also has very severe limitations in his social interactions with peers and his ability to make and keep friends, and so he gets terribly lonely. We are not just his parents - we are his best friends. For long stretches, we are sometimes the only people who play with him, go to the movies or the mall with him, laugh, sing or dance with him. We structure our weekends with him to maximize those experiences and minimize stress and intrusion. He gets enough of that during the week, when he is navigating the network of service providers and others who are part of his web of support, or (as in the case of his probation officer) the consequence of his mistakes.

Sometimes we'll go for several weeks feeling that he is very easy to be with, easy to love, and loads of fun. Then come abrupt interruptions during which he can be much harder to be around, and at those times, his pessimism can be contagious if you aren't careful. Occasionally, though it happens less often now, we feel some measure of despair and anxiety that we aren't able to help him and don't know what is going to happen to him. I am not religious, but at those times, we turn it over to God, for wont of any other workable strategy, which is to say, we stop trying to have all the answers. And so far, right when I'm about to feel like I have no idea what I can do to help him, he snaps out of it and shows us the way.

Tuesday, April 21, 2015

Hand-Me-Down Parenting

I'm having a great time lately being one of E's parents. After his recent struggles we've settled back into an easy rhythm of weekends at our house, while he spends weekdays in his program nearby, punctuated by mid-week visits from us. Throughout the week, we have facetime video calls and a volley of text messages, very much the way one might with a child his age away at college, except that he's in a transition-aged youth program for young adults with mental illness. He's doing great.

I think we're still in a honeymoon phase. I jokingly think of us as his hand-me-down parents; it was only when T grew up that E decided he had the right to have us all to himself. He finally trusted us, because we had "belonged" to his older brother already. So now he wears us around proudly, his older brother's hand-me-down parents.

Being E's parent is so very different than being T's parent! He's a more casual, more loving, more emotional kid. He expresses himself freely; there are few surprises. He is very aware that he needs support to get by in life, and so he accepts help readily and doesn't resist interdependence.

I'm not a good compartmentalizer. When T was living at home, it often felt all-absorbing. After T moved out, I focused more on my career, and had the chance to quiet the emotional part of me and indulge the analytical. But as E became more and more dependent on us, I've found myself distracted from my job much more. Dormant emotional instincts have reengaged. This unexpected chapter of my life in which we are hand-me-down parents to E has me riding a wave of profound feeling.

There is something about parenting traumatized older kids that highlights the highs and lows, the beauty and injustice in the world. This is part of why I hate it when people tell me that what we're doing is "good" and "wonderful" - it's not charity work, and we don't sit at a comfortable distance bestowing benefits on our kids. We are right down there in the shit with them, trying to figure life out, and it's hard, and we're not always good at it, and a lot of what we see makes us mad or sad. The kids are so innocent, and we are so imperfect.

When someone tells me that we are "such good people" for foster parenting older kids, I get mad, because I feel like they are telling me I'm not REALLY a parent - I'm just a nice person, a selfless volunteer. And I know that's wrong; foster parenting isn't charity work, it's just an alternative way to build a family. However, foster/adoptive parenting IS different than other kinds of parenting; among other things, the daily contact you have with pain makes it different. No kid enters the foster care system without enduring tremendous loss, often over a long period of time. So to be fully present in the lives of foster youth is to be fully present with suffering and its aftermath. And that makes it life-changing and mind-altering.

That doesn't mean that kids like E are sad and depressing. In fact, E is by nature a tremendously joyful person. He sings constantly and he lives to crack people up. But his reference points are painful. Just passed a Raleigh's burger joint? He went there once when he was living with a relative, for the only meal he ever remembers eating in a restaurant, and he really loved it, but he never went back because he was removed from her home shortly thereafter because she beat him. Want to know what his favorite color is? It's grey, because the group homes he grew up in had to give him $40 a month for clothes, which isn't much, and he found that if he bought everything in one color, whatever he had always matched. He's not trying to make anyone feel sorry for him when he says these things. He's just referring to what he has experienced, and a lot of his memories will make you really feel things.

Over time, loving and living with a young person with so much wisdom and experience makes me tender, although by nature I tend to be tough. At work lately I get jumpy. Casual banter and petty problems and office politics seem particularly soul-less. Dinner parties or book clubs feel hopelessly superficial. I get impatient more quickly. I covet and hoard the time I spend alone with my family.

I've been in this state before, when T was younger and new to us, so it feels familiar, and I know now that it's temporary. It's my way of being a mom, going a bit feral to better leverage my instincts to connect with and care for my kids. I treasure it. Such times suspend me in a state of emotional awareness and heightened consciousness, clear the bullshit and highlight my priorities. They wear me out, but they lift me up, high enough to catch a glimpse of life from beginning to end.

Friday, March 27, 2015

Stitched Together

These days, our time is more focused on E than on T, who, at 21, is living on his own and working full-time, not always doing what we wish he were doing, but doing it his way nonetheless. E, as I've described before, is very different than T and has never lived with us full time. In fact, he's lived in institutional settings for as long as we've known him, ranging from psychiatric group homes to juvenile detention facilities. In our early years with T, it was hard to get to know E; the boys had been separated by the foster care system many years before, and E moved so frequently and was so often in crisis, it was hard to even get permission to see him.

Eventually, he settled in a highly structured residential facility near our home. T no longer required daily parenting by this time, and we were able to work with the facility to establish a relationship. We started visiting E there every weekend, which led to eventually having him with us every weekend at our house.

E has suffered unimaginable trauma, abuse and neglect for his entire life. As a teenager, he's had many bouts of suicidal behavior, and it's not hard to imagine the desperation and rage he must feel and why. But he also has a rich, deep personality, a fantastic sense of humor, a real gift for music, and a lovely capacity for spontaneous affection. He and his brother couldn't be more different in nearly every aspect of their personalities and points of view. Very little that I learned in parenting T applied at all with E. I had long been intimidated by E's needs, and yet, when he started spending every weekend with us, we fell in love. He and Tim have a magical connection. They write music together, sing, laugh and even take little trips. Weekends with him came to feel like a totally normal part of our life, and the part we looked forward to the most.

And yet, however you want to describe it, E has formidable special needs. He is developmentally disabled, having suffered significant effects of prenatal drug and alcohol exposure, and he has had symptoms of mental illness throughout his adolescence. Since the age of 5, when he was removed from a relative's home, he has almost never lived or even spent much time in a regular home. In many ways, the environment of a regular family home, with its casual intimacy, lack of structure, and relative chaos is disorienting for him. I think being with us on the weekends and returning to his group home during the week was a good solution for him during this time. He could dip a toe in the water without having to fully rearrange how he is accustomed to navigating the world.

That sounds convincing, I'm sure, but I've had to work hard to convince myself to accept what feels like a partial commitment to him. Emotionally, I want him with us. His life often seems difficult and lonely. I struggle to trust the various professionals who help care for him, and often believe that Tim and I (and to some extent, his brother) know better. And recently, those feelings of mistrust intensified dramatically.

Over the summer, E turned 18. He elected to remain under extended foster care available until the age of 21, because he knew he still needed a lot of support. But the department of child and family services struggled to find appropriate services for him. His social worker was overworked and didn't know him well. The group homes that were appropriate to his needs only housed kids 18 and under. The  transition-aged-youth programs are all full, and transitional housing available to only 4% of the transition-aged-youth who need it in our county.

One day, during an outburst, E kicked a worker at his group home and they called the police and he spent a weekend in jail before pleading to a misdemeanor. We were all shocked at this turn of events, and realized that the world for a mentally ill young adult over the age of 18 is a place none of us were ready for. When he was released, he was forced to leave the group home, and his social worker moved him through two totally unsuitable environments, where he destabilized terribly. We spent part of every week managing various crises, including having him hospitalized on an involuntary psychiatric hold on one occasion. During this time his social worker never returned our calls.

Then, two months ago, the worst happened: he got in a fight in a group home, broke a window, threatened someone, and was charged with a felony. He was put in county jail in the ward for the mentally ill. It was awful. We visited him every weekend, and longed to "fix it", but bailing him out would extend the resolution of the charges against him, during which time he would be vulnerable to extra legal consequences should he be picked up again. It's a scenario that I've learned is all too familiar to many parents and families of mentally ill young adults.

Finally this week, it seemed we had reached an agreement with DCFS that he could live with us full time. We sent what we thought was a reasonable list of services we would require to meet his needs in our home: wrap-around services, independent living classes for him, help getting him medical and psychiatric care. We were shocked when we were told hat he would have to emancipate from foster care in order to live with us, and that would effectively cut him off from various social services that are vital to his well being, including independent living programs, job training programs, access to psychiatric care, and more. Then the criminal court revealed that because of his mental health status, they would only release him if, as a term of his deal, he went into some kind of mental health care facility, rendering our whole fight with DCFS a moot point.

In the end, the court transferred his case from DCFS to the department of mental health. If I look at the situation objectively, I'm hopeful. DMH workers have an average of seven simultaneous cases, we're told, whereas DCFS workers in our county can have as many as 50. DMH and their programs serve adults, so he will no longer be subject to the chaos of being a legal adult in a world organized around the custody of children.

And yet on a personal, emotional level, I'm sad. I'm sad that in his case love is not enough. I'm sad that our home, where, everyone admits, he is happiest and most stable, is nevertheless not structured or safe enough to protect him. I'm sad that Tim and I have to work during the day and can't attend to his needs. I'm scared that he'll be misunderstood and treated badly again by the people charged with helping him. I know that in order to have the greatest chance to survive and thrive, he needs more support that we can give him without the involvement of social services. Not even all the money in the world would change that - in my limited experience, the kind of support he needs isn't even available at a price. You have to jump into the cumbersome social services bureaucracy and just piece it together bit by bit and the process is sometimes rough and humiliating, no only for the recipient of the services, but also for the people who love him.

I wish I could get all of them to see the person we see in E: the funny, easy-going, double-jointed, artistic, warm-hearted, playful person he is. He stole my heart when I was, frankly, reluctant to give it because I was intimidated by his needs. If we could carry him with us and keep him safe, we gladly would. I hope that as he tries to find solace and safety with the cobbled-together network we've tried to help assemble for him, he carries with him the knowledge that we love him deeply and that he is much, much more than the sum of his circumstances to us.

Tuesday, February 24, 2015

Why I Don't Mind When My Kids Don't Call Me Mom

In six years of foster parenting, it has never bothered me that the person T and E call Mom is not me. Other people in my life occasionally make a big deal of this. "Why doesn't he call you mom?" "When do you think he'll call you mom?" "Did you want him to call you mom?" Honestly, I never gave it much thought. I truly don't care.

To me, the question misses an essential truth of foster/adoptive parenting of older children in foster care: you are a partner for the birth family, you share in their family, support their family, become part of that family yourself, in admittedly awkward ways sometimes. And the kids most often already have someone they call "mom" by the time they bond with you. So they might call you something else. And that's fine, because it's not a competition. It is NEVER  a competition. Love and respect for one person never reduces the amount of love and respect you can give to another person, do they?

I had the most stunning experience not too long ago, while talking to a colleague who knows me pretty well. She asked if T and E have other siblings, and I said yes, they do. Their mother has several children. She asked if any of the children were raised with their birth mom and I said, yes, the youngest is growing up with her now. And my colleague, someone I thought until that moment might be a casual friend, replied "Some people should be sterilized." It was unimaginably vicious, from someone I know to be otherwise gentle. Her comment left me absolutely stunned. I am rarely speechless, but in this instant I was totally unable to make a sound.

What I wish she knew is this: her words sickened me, because on some abstract level, I love the birth mom of the kids in my life. There are unique and beautiful things in each of them that have filled me with delight and wonder and they came from her, and from their father. To disparage her is to disparage them. To assert that she should have been sterilized is to suggest that it would be better if the kids I love so much had not been born. To sit in judgement of her is to avoid compassion and empathy, not to mention decency.

Many months later, I finally want to scream at her, and I would say this: we have NO RIGHT to judge her. We have NO IDEA what pain it must cause to carry and give birth to children who are taken away. There is no woman on the planet who could go through that without enduring a wound that won't heal. I have no idea how one can carry on after that. But she did, and not only that, she conquered drug addiction, and she pieced her life back together and put a roof over her head and her daughter's. I've achieved far less in my life if we're measuring on the basis of distance traversed and odds conquered. The boys spend time with her now, and it's complicated, but I'm glad - it is a good thing for them to feel the connection they have with her, to know her, as part of knowing themselves.

Neither my colleague nor I have any concept of what it is like to grow up extremely poor, developmentally disadvantaged, addicted to drugs, and without the backbone of family to emulate, as she did. Truly, we just have absolutely no idea and therefore no right to sit in moral approbation of someone in those circumstances. Like many foster/birth parent combos, with her I have a policy of non-intrusion: I have never met her, though I have spoken with her on the phone, I have stood by through many a conversation as she and the boys reached out to each other (not always kindly or successfully), and I have delivered cards and gifts on occasions ranging from Mother's Day to the death of her eldest son. I expect neither hostility nor gratitude from her for my role in her son's lives. In fact, I'd prefer she not feel any need to think about me at all; we are both pieces of what I hope might be a whole, and as such, we have no need to overlap, but just to touch lightly along the edges that define our difference.

Thursday, December 4, 2014

Gone Again

No sooner are we up than we're down. Just shy of the 60 day mark, T relapsed, and hasn't yet pulled out of it. He's not living with us anymore - he's staying somewhere, he won't tell us where. The relapse unfolded in melodrama, chaos, confusion, and conflict. In fact, our first whiff that things were taking a turn for the worse was a sudden bout of extreme belligerence and blame and bad behavior on everyone's part. What's happening? I asked myself. And then felt sheepish for not seeing it coming. When he took all his financial aid money, dropped out of school, and blew it in a weekend drug binge, we realized what we'd been sensing on the horizon. And that was only the beginning.

I admit, I didn't do a great job as a parent - not even a good job in those last couple weeks before he left. I'm worn out by the cycle, out of practice at parenting since he lived away from home for awhile, and unsure of my role, as he nears 21. Following him through treatment and participating in the family sessions at his program over the summer left me with some perspective. I know that my role is to live my own life, to let him know as best I can that I love and support him, and that I hope he returns to treatment--but not to throw myself off the deep end to try to retrieve him. Nevertheless, I feel badly that in my anger and confusion as he fell off the wagon I was less than the parent I strive to be. It is what it is.

A long time ago, my mom gave me this piece of advice: "Your home cannot be a revolving door," she said. "You are not a place of last resort, somewhere to crash when he has burned through all of his other options. If you let that happen, it will be very hard to regain your boundaries." That was good, harsh advice. I'm torn, feeling so keenly that if he could do better, he would, and that he is genuinely disoriented to find himself beyond childhood and yet unprepared. I would give anything to rewind time and let him linger a little longer. But that isn't possible. He is a young man now, with a desire to master his own destiny, and the obstinate, understandable feeling that he should live life on his own terms, coupled with a very formidable disease of addiction that keeps causing him to sabotage himself.

I'm not sure a kid like T could ever leave home in a smooth transition. I feel like this is a new era of being a foster/adoptive parent of a traumatized kid - navigating the messy, frightening process of disengaging from their daily lives, knowing they aren't ready but you have to let go anyway. Even kids whose developmental needs were mostly satisfied can be cast upon the rocks at this stage of life. For kids for whom prenatal drug exposure, trauma, abuse, and displacement produced formidable fault lines so early in life, it's a terrifying transition. If I'm this scared, I can only imagine how he must feel.

But if I want his life to be his, my life has to be mine. Ever day I ask myself, does he know we love him? Have we shone a bright light on a good option that is available to him right now (at the moment, it's residential treatment, and following up on a prescription for antidepressants)? Did I at least attempt to apologize for my own wrong doing? And if the answers are yes, I try to move on, and let myself be happy, and invest time in other people including his brother, and my friends, and Tim. It's a bittersweet moment, a mix of acknowledging the looming truth of the trouble he's in and not taking it on, because I can't, and it won't help either of us.

Saturday, August 2, 2014

When It's Time

This new episode of parenting T is fascinating. He just hit his 40-day sobriety mark and he's twice as alive as ever before, twice as awake and perceptive. The whole point, as he describes it, of getting and using drugs every day was to dull perception, to numb feelings and to cloud out painful realizations. It wasn't working so well, but it was the best he could do at the time.

I would have done anything to hasten his recovery, but I learned I couldn't do anything at all. Or rather, I could only refuse to participate in his self-destruction (not giving him cash, not putting a roof over his head when he was using, not bargaining with his addiction). When given the opportunity, I could also remind him that we would like to see him in recovery and that we would be there for him should he ever choose that path.

That strategy sounds logical and obvious, but as a parent, it was damned hard. It meant waiting months while he slept on the floor of his brother's crowded apartment, doing nothing except planning his next high and trying to figure out how to pay for it. It meant not seeing him during the times that he was angry with us for not letting him live at home while he was using. It meant maintaining the flexibility to respond when he was ready for recovery. It meant forgiving myself when I was sad and angry about our relationship and I let it show. It meant making sure that our own lives moved forward and that we did not let his self-destruction drag us off course from loving his brother, each other, and our own lives.

And then it was time. This round of recovery feels different from earlier attempts. He is all in. He is beaming love and gratitude and wisdom and happiness. He's living at home, going to out-patient treatment three days a week and meetings on the other days, so we have a very firsthand sense of his experience. He goes to group every night, and his treatment plan has required that he share his most intimate thoughts and feelings about being born addicted to drugs, losing his family, growing up in the foster care system, feeling disappointed that his relatives didn't maintain a connection to him during that time, and finding adoptive parents during his teenage years.  Everyone else in his program has their own story, and they embrace him in his struggles and celebrate his progress with him. Whereas he once believed that nobody could love him if they knew the truth about him, he has begun to see that his life story is part of what gave him the wisdom and compassion that draws people to him.

We go to family group for three hours on weekends. With each passing week, he gets stronger and more authentic. We see the effect of his charisma on the friends he's making in treatment, who turn to him for support, humor and wisdom, despite his young age. Often during these sessions, he expresses profound gratitude - to us, and to others.

I used to shy away from his expressions of gratitude. I didn't want him to feel thankful to us for adopting him--I felt that all kids deserve parenting, and I hoped it would be something that he learned to take for granted.

But I realized recently that I was being selfish in downplaying or not welcoming his gratitude. The gratitude he expresses to us is gratitude to the higher power in which he believes, to the great force of life for giving him another chance. It's an expression of his optimism and faith in the world and in other people. My own tendency to shut it down was not humility, as I thought; it was an expression of my mistrust of myself and of other people. Far beneath the surface, I think I declined gratitude because I felt like I wasn't a good person. I believed that if I wasn't screwing up right now, I would probably screw up soon, so his gratitude made me feel guilty. I thought it was my job to be perfect, and if I could just achieve perfection, he would get better. Falling far short of that goal, I felt he had nothing to be grateful for. I felt sure that I was going to disappoint him.

That was all a bunch of fearful, selfish anxiety. Lately I try to just sit back and follow his lead. Whatever he has plugged into, it is an awesome force that is propelling him forward in leaps and bounds. It's finally time: time for him to expose what was hidden in his heart through all the years that he clouded his experience with drugs. It's time for me to step back and accept that he knows me, he loves me, and he's thankful that I'm in his life, and just let that be. There is no flip side, and the universe isn't playing a trick on us, where we might turn the page and find out I'm a fraud and I couldn't come through for him after all.

In place of my previous quest for perfection and absolution, which led to an eternal dance of guilt and exagerrated responsibility, lately, I find myself thinking: I am so fucking lucky! I have this crazy, loving family that connects me to what is true and profound in life. I'm able to mirror his gratitude with my own, for once, and that feels great.

Monday, July 14, 2014

Not So Big

Recently we went through a rough patch with E (T's younger brother, see below). He had a few days with us during which he was a remarkably different person, totally beyond any of our abilities to manage him. It ended without disastrous consequences, but it was a close call. (At one point, we had to involve the police and file a missing person's report and spent hours looking for him before he resurfaced.) We're trying to work closely with his group home now to try to develop some strategies in common for helping him manage his behavior, and get him the ongoing services he's going to need to help him into adulthood. The problem is, he's big on the outside, and not so big on the inside.

I'm relieved that his current group home obviously understands kids like him. We couldn't parent E full-time on our own. We would be in way over our heads and unable to provide the constant supervision he requires. E is turning 18 this month, and we're trying to work with them to secure his situation there until he's 21 to give him more time. We're hoping to get a conservatorship and disability services to help support E into adulthood and minimize the risk he poses to himself. T is part of that equation, and we've talked about the importance of the three of us working together, taking time-outs from E when he is too much for us, supporting each other so that no one of us burns out, and maintaining realistic expectations about what E needs and can manage.

As we've pieced together our understanding of how to help him, I've done some reading about fetal alcohol syndrome. I'm not a professional, but by this point, I am a well-trained foster parent, so I feel qualified to say that I have some knowledge of the impact of fetal drug and alcohol exposure. (Important to note: while E has traits associated with fetal alcohol syndrome, he also has a lot of other traits that are his own unique god-given personality, that have nothing to do with FASD.) Among the consequences of FAS that I see in E: he has poor impulse control, unusual difficulty making and keeping friends, a tendency to embellish the truth, and a need for near-constant supervision in order to stay safe and calm.

In these, our first months with him on a regular basis, we've found a few things by trial and error that help him manage:

1. He does best at our house, where things are quiet, relaxed and comfortable. He likes the garden, and knowing he can go someplace and take a time out or a nap when he needs to. He needs a lot of down time.

2. We have a (very) sensitive, snuggly dog, Monte, who works wonders with E. Monte greets him with wild enthusiasm, and they spend hours snuggling. E comforts Monte when he's nervous, and it makes him feel good to be the caregiver. Consistent with what I've read about FAS, E has a lot of trouble making and keeping friends, because his social development and sense of appropriate behavior is underdeveloped. He feels a lot of pain about this. But his bond with Monte is true and steadfast and reciprocal.

3. E sucks up the energy in any situation, so it is a bad mistake to expose him to environments where there is too much excitement, of any sort. He needs LOTS of quiet, fewer people, less noise and activity than other kids.

4. We need to know when we are in the danger zone where his behavior might exceed our ability to protect him and ourselves, and have and execute, quickly and consistently, a safety plan, which involves getting him back to his group home, or, if necessary, involving the police or taking him to a hospital.

One one very helpful website, I read this: "Children with fetal alcohol syndrome are vulnerable, naive, immature, and prone to getting into trouble with their poor communication skills, lack of impulse control, underdeveloped conscience, and poor judgment." That is pretty much consistent with what we see with E.

When E crosses a line, it feels unfair to discipline him for behavior beyond his control. By the same toke, to the extent that he's able to learn, we do want to try to teach him appropriate behavior, and hold him accountable. The trick seems to be to match that to his level of emotional development.

T was such a different kid; he was always supremely rational, and rational consequences worked with him on a lot of occasions. T's issues were post-traumatic stress, substance abuse, guilt and shame, and a lot of suppressed anger about what had happened to him. He always made sense to me, even when he was driving me crazy. He responded to love, high expectations, and tough, fair discipline appropriate to his behavior, combined with lots and lots of love and occasional, deserved indulgence.

E is not that way - his brain seems to be more injured and his development much more delayed. He needs an entirely different sort of guidance and support. But beyond the difficulties I'm describing here, he is such an easy young man to love. He is guileless and artistic. He's incredibly funny, a real comic genius. He's quick to demonstrate affection, and when he's comfortable, he's naturally friendly and outgoing. His smile and his laugh light up the room. He is absolutely worth everything we can give him and more.

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