Sunday, February 13, 2011

Where I'm Coming From

At the end of my last post on Situational Anxiety in Adoption, I made a rather strong statement:

"I, for one, am tired of the idea that this is just the way adoption is; we all  experience it, we all live through it; we just have to do the best we can to make it through. With this series of posts on SAA, I am rejecting that idea. Nobody should have to enter the potentially most challenging phase of adoption, the transition of the new child into the family, emotionally exhausted by the wait."

I don't know about you, but that surprised me. It didn't surprise me that the act of writing pulled together ideas that were not previously fully formed; writing does that for me. Instead, the strength of my feelings surprised me.

So I've been pondering, Why? Why, seven years after my greatest struggle with SAA and PADS, is it coming together now?

It is true: we have seen a recent spike in higher levels of SAA and I've been spending more of my time supporting waiting families. But that that isn't the main reason.

The main reason is that, thanks to God and the children who have become my daughters through the emotional labor of adoption, I'm at a different place in my life than I was seven years ago. Until very recently, I believed, "...this is just the way adoption is; we all  experience it, we all live through it; we just have to do the best we can to make it through,."

The shift in my thinking is typified by two things that happened in therapy this week. Hope and Joy have concurrent OT appointments twice a week and I spend the hour shuttling back and forth between mirror-windows that allow me to see and hear what is going on in both rooms. Then at the end of the session, I debrief with the girls' therapists.

Joy has the quadriplegic form of cerebral palsy. While her food repertoire continues to expand, she has not outgrown a rather crazy way of eating crunchy food like crackers. So Thursday I asked Leah (her OT, who is also a feeding specialist) to watch her eat a graham cracker and tell me what she thought. Leah immediately saw what Joy was doing and confirmed it by tucking a dum-dum sucker into Joy's cheek back by her molars. Joy could not lick a sucker presented to the side of her tongue. So she also can't use her tongue to retrieve and swallow food like crackers that gets pasty when chewed. (Imagine what your tongue does to get peanut butter off your molars. It's that motion.)

A few minutes later I was debriefing with Hope's OTs. We've been working on two things: figuring out what helps Hope calm down her body's "engine" when it is running too fast, and trying to sort out her widely variable ability to pay attention. Hope is beginning to relax and trust her therapists now and is more free to be herself instead of on best behavior. I saw through the window that Hope was having a classic "Hope" morning and was curious to see what her therapists thought.

"What would you think," one asked, "of the hypothesis that Hope has a much easier time paying attention to things than to people?" It was an epiphany for me. Hope struggles much less to sustain an appropriate level of attention to tasks like putting together a puzzle or completing a page of handwriting or math (especially if the room is not busy) than she does listening to a story read aloud or following verbal instructions.

I walked out of the clinic buoyed by the findings that one daughter can't move her tongue sideways and the other (who, ironically, is very social) can't pay attention to people.

Am I crazy that these things make me happy?

No. I am rejoicing in the fact I'm not crazy. Because now that we know why Joy eats crackers like a chipmunk, it is easy to see that after couple of months of dum-dum therapy at home (we're going to entice her tongue to move sideways to lick suckers) she will be able to feed herself crispy/pasty foods. And Hope's finding is a clear indicator of something we've suspected: auditory processing differences.

The brain damage that underlies CP is permanent. But some of the impairing effects can be overcome. The brain damage that underlies Hope's behaviors is also permanent. Some manifestations will always be with us. But auditory processing glitches often improve with therapy.

Do you see? Every time we find a new piece to a puzzle we sort it into one of two categories: have to live with it (short of Heaven, Joy will never walk independently) or potentially can be remedied (she can be taught to lateralize her tongue).

So that's where I'm coming from with the series on Situational Anxiety in Adoption. I have mentally moved SAA from the "have to live with it" to the "potentially can be remedied" category. Situational Anxiety will always be with us. But why should we just live with the handicaps that come with higher levels of SAA?

Joy doesn't have to eat crackers like a chipmunk forever and we don't have to settle for having our adoption journeys hijacked by the biochemistry of situational anxiety.

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