Saturday, January 30, 2010

Charlie Crist's Priorities

This is heartbreaking.

U.S. Suspends Haitian Airlift in Cost Dispute
By SHAILA DEWAN
Published: January 29, 2010
MIAMI — The United States has suspended its medical evacuations of critically injured Haitian earthquake victims until a dispute over who will pay for their care is settled, military officials said Friday.

The military flights, usually C-130s carrying Haitians with spinal cord injuries, burns and other serious wounds, ended on Wednesday after Gov. Charlie Crist of Florida formally asked the federal government to shoulder some of the cost of the care.

[...]

The suspension could be catastrophic for patients, said Dr. Barth A. Green, the co-founder of Project Medishare for Haiti, a nonprofit group affiliated with the University of Miami’s Miller School of Medicine that had been evacuating about two dozen patients a day.

“People are dying in Haiti because they can’t get out,” Dr. Green said.

[...]

Some of the patients being airlifted from Haiti are American citizens and some are insured or eligible for insurance. But Haitians who are not legal residents of the United States can qualify for Medicaid only if they are given so-called humanitarian parole — in which someone is allowed into the United States temporarily because of an emergency — by United States Citizenship and Immigration Services.

Only 34 people have been given humanitarian parole for medical reasons, said Matthew Chandler, a spokesman for the Department of Homeland Security. The National Disaster Medical System, if activated, would cover the costs of caring for patients regardless of their legal status.

Crist later defended himself.

Miami Herald: But Crist too has denied he's responsible.

In a statement Saturday, he noted that ``between 60 and 80 Haitian orphans arrived at Miami International Airport'' Friday night, and that ``at no time has Florida closed our doors to those impacted by the earthquake in Haiti.

``To the contrary, Florida has been at the forefront of the crisis in Haiti -- caring for the injured, reuniting families, comforting those who have been devastated by loss.''

What a scumbag. Of course Florida is at the forefront, because it's right next door to Haiti. (Just a note... I used to live there, and I even used to have a job in the Little Haiti neighborhood).

From what I can gather, Crist is arguing that as long as they accept airlifts of "orphans", it's OK for them to stop every other medical evacuation. So let's say a Haitian family has one child they were living with, and that child was severely injured in the quake. Their other child was in an orphanage when the quake happened, and is healthy. Guess which child gets a flight to Miami?

The Superbowl is apparently a part of this disgusting mess, as well. Officials need to save hospital beds for Superbowl visitors.

I don't know what to do about this... maybe I'll send an email to the Secretary of State or my representative. I'll try typing something up later.

Friday, January 29, 2010

Foster Care Adoptions: How Not to Give Up (Part II)

Thanks for all the comments on the last post! It's time for some corrections and additions before I move on.

When it comes to religion, at least one parent and one social worker have left informative comments and mentioned that in their experience, they don't see being a non-Christian as a major handicap in their area. That's great. I don't think I need to take back or delete anything I said earlier, but I do need to add quite a bit more qualification.

I live in Georgia, which is one of the Bibliest parts of the Bible Belt. I also live in Atlanta, which is fairly diverse and open-minded, though the city is so informally segregated that it's hard to see that. We elected the first Buddhist representative to Congress, after all. Much of the rest of Georgia complains about Atlanta being full of "gays, blacks, and liberals". So this is an environment where non-Christians are not exactly ostracized, and Christianity is incredibly diverse, but it's still intensely Christian. On Sunday morning, you'll often find the gay black liberals dressed up and on their way to the gay black liberal church.

If you're a non-Christian prospective parent who lives in, say, San Francisco or Manhattan, and you're signed with a county agency and are not doing any interstate, then you should probably just ignore all my dire warnings in that section. But if you are doing interstate, you might want to plan for the worst-case scenario... a child's social worker in rural Oklahoma might have a totally different perspective on what makes the right kind of family than your local worker does.

SocialWrkr24/7 also left some great information on family ranking. Ranking is definitely subjective and will vary enormously according to your region and the kind of child you are submitting your homestudy for. Single dads and single moms may be preferred for children with specific kinds of histories and issues.

Matching

Once you're licensed and homestudied, the agonizing wait begins. More than anything else, you'll want to know, HOW LONG? But no one can tell you. According to Page 32 of the Adoptuskids.org report, this is the stage at which the majority of families who drop out will drop out.

Each agency does things different ways. When you're working with state and national photolistings, you'll follow this general procedure:

1) register (usually a quick process)
2) search the photolistings
3) submit inquiries on children. You might do this through the site, or perhaps the site will give the child's worker's phone number and.or email address.
4) submit your homestudy. Usually, you cannot do this yourself. Your worker needs to do it for you.

This is an emotionally draining process. It can start to feel like bargaining at a swap meet. You quickly realize that the younger, healthier children will have had a ton of studies submitted on them, and you have a minuscule chance of being accepted. Then you feel guilty not submitting it for an older child with more special needs who might not have any inquiries at all. You begin to feel an uncommon mixture of emotion: humiliation mixed with guilt and inadequacy.

The process isn't helped by the fact that many of the photolistings are poorly run. At one point, it took me about three months of calling before I got in touch with someone about a particular listing. Then they told me the boy had been adopted six months ago. Apparently, this is very common.

At this point, your time networking and being in touch with other adoptive parents is hopefully starting to pay off. You'll probably need to just give up searching on certain states and certain locations. You'll begin to realize that some of the photolistings are really phantoms and no one will ever actually adopt interstate out of that location, anyway.

If you're working with a county agency, your search will most likely concentrate on local placements. Many children won't be photolisted at all. You're relying predominantly on your worker to network for you.

Another path is meeting children at adoption events. We never went to any of these. However, if you're looking at older children (roughly 10-18) you need to think really long and hard about going to them, even though nobody ever wants to go to these events. Social workers hate them, I'm sure the children hate them, parents hate them. You'll imagine your nightmare scenario... a child walks up to you and asks "will you be my mommy?" Then you break down and start sobbing uncontrollably.

There is only one ethical, positive thing about these events: these older children deserve some say when it comes to their future family. This is a chance for them to gather information for themselves, to choose, and to have some small degree of control over the future of their childhood. You can't expect a 13-year-old to pick their own family based only on a pile of homestudies, so meeting their potential future family at some point in the process, in some way, before final decision... this is absolutely crucial.

I also think that many of these events are highly structured, in recognition of the chaotic emotions involved, so it's not like the workers just throw the two groups into the same room and yell "PICK ONE".

How long is too long?


The only way to answer that question is to ask other people who've gone through the same agency. Is your wait time still in the average, or starting to stretch to the extremes?

It took us eight months to get full homestudy approval. Then it took another eight months to go to committee, and we were matched the first time we went to committee. Towards the end I was seriously considering starting over again somewhere else.

A very rough guide might be that if you never even get to committee in a year, you should re-evaluate. Once you get to committee, at least you know that people are considering you seriously and the process is working somehow. Going to committee doesn't mean you have to accept the placement. It does mean you will have the opportunity to get a lot more information on the child(ren), so you can make a truly informed decision as to whether you should withdraw your application, or stay.

Here are some reasons you might not be getting to committee:

1) Your worker is doing a bad job because they are a bad worker. They are not submitting your homestudy or not getting in touch with any other workers. The solutions are to switch workers at the same place, or leave. You might also try to do much of the worker's job for them in terms of contact, but this is an exhausting and dangerous project.
2) Your worker is doing a bad job because they think your family isn't that suitable. Maybe you have alienated them for some reason. This could be your fault, or their fault. Ideally, social workers would tell you to give up and go away outright, but sometimes they might not want to deal with the confrontation. If you can't repair your relationship with the worker, you'll have to switch or leave.
3) Your expectations are not realistic. You are not applying for a wide enough population of children. This could be out of entitlement, or simply out of naiveté. For example, if I'd restricted my applications to Asian children only, I doubt I'd be matched today.
4) Your homestudy is bad.

If you think it's because your homestudy is bad, and your agency can't or won't fix it, you have some hard choices. If you think it's their fault, you should go start the process again with another agency. If you switch, do it politely and without burning bridges. Social workers from your old agency might be friends with social workers at your new agency.

Also, try to be as objective as possible, without beating yourself up, and consider the possibility that maybe your family is just not suitable. If you make that determination, I still don't think you need to give up. If your passion for the goal is still burning, then take a break for a year. Work on yourself, work on your family. Then start fresh. I know that sounds really insulting. But not everyone is suited for this. You can't be perfect, but you have to be strong.

Facing Change


You may realize that you're changing many of your attitudes and parameters. All kinds of things can change. Some people even start the process married, and then end up reapplying as single parents.

One common thing that happens is that you radically reevaluate your attitude towards contact with birth/first parents. According to the report I've been using, it seems the majority of foster care adoptive parents (about 2/3 of them) do have post-adoption contact. You might not understand why at the beginning. Aren't these the people that have abused and neglected their children? By the end, you will probably have changed your mind and realized that the issue is a lot more complicated. Most trainings have a strong focus on the importance of some kind of contact for the wellbeing of your child. Sometimes, of course, contact is absolutely out of the question, but there's usually at least one or two extended relatives who represent a safe connection.

It's hard to know how much you can and should change when it comes to special needs and number of children. Sometimes, you need to trust your instincts and hold to your original parameters. You are the person who knows yourself best.

What to do during the wait


- Don't put your life on hold
- Join internet support groups and keep doing research
- Go to extra trainings. Sometimes you can satisfy hour requirements by online study and book reports, but it's so much more useful to go physical events and meet other people
- Keep the healthy relationships with your partner, friends and family; don't shrink into yourself and become isolated. It might feel like you've walked through a door into a totally different world, and everyone else has stayed behind on the other side of the door.
- Be aggressive about contact with your worker. Follow up and stay in touch. Don't let them forget you. Ask for rough timelines on anything they promise. If they get irritated with you, try to manage this irritation. You can remind them that you just want to be "proactive" and you will be equally proactive on behalf of your child(ren) when they are placed with you.
- Don't be too aggressive! And don't contact them just because you happen to be feeling especially pissed-off and depressed. Put down the phone, take a deep breath, and ask yourself if you really need to contact them at that very moment. You might mention in general ways that you're feeling a bit stressed, but keep your inner turmoil to yourself. They are very busy and it's not their job to be your therapist. They also need to know that you can manage difficult, stressful situations. If you think the wait is too stressful, then how are you going to handle placement, which might be 10x as stressful?


To be continued

I was reminded that two things I should have brought up in Part I are a) partner issues and b) a history of abuse or trauma.  I'll try and get back to them in Part III.  Any other topics I should cover?  I think I'm going to stop the series pretty soon after the matching process.  Post-adoption support is just such a massive topic...


(link to Part I)

Thursday, January 28, 2010

Foster Care Adoptions: How Not to Give Up (Part One First Draft)

I've seen a lot of comments in various debates recounting how some parents were forced to adopt internationally because they were not allowed to adopt from foster care.

I'm skeptical of most of these claims. Not all. Just most. You can see a comment I left here for more details. I've also addressed it several times in older blog posts here. I won't recap those arguments. Instead, I'm going to try and do something constructive: giving a guide to overcoming barriers to adopting from foster care.

I'm really not the best person to do this. I'm sure I'm going to get some things wrong. If anyone wants to comment or email correcting me on details, please go ahead, and I'll update this blog post later and credit you.

This guide is mainly for people who feel overwhelmed by the process, who don't understand it and are terrified of it, and who are worried they'll be discriminated against.  You might be even more scared after you finish reading, but you also might feel better about being forewarned. If you've already adopted from foster care, or have a lot of experience, it won't apply as much.  It also applies much more to adoption than to fostering.

Get educated

Read this report: Barriers & Success Factors in Adoption From Foster Care: Perspectives of Families & Staff. Concentrate very hard on the staff section. Also read this report: "Listening to Parents: Overcoming the Barriers to the Adoption of Children from Foster Care". These two reports will go a long way in giving you a realistic perspective on the process.

Look for Yahoo! Groups and forums and communities for foster care parents, foster care adoptive parents and older child adoptive parents. Get involved and ask questions. Try hard to get as much specific information as possible about your geographical area. Foster care adoption is incredibly local. You might be in a good location, or a hopeless one. Read lots of blogs. Accounts by adults with experiences of being in foster care are especially important to find and read.

Homestudy Yourself

Read this page about homestudies from childwelfare.gov and try to do the process to yourself, in a general way. Are there any general weaknesses or general strengths? Now is the time to address those weaknesses.

If you don't have much documented experience with children, volunteer as a mentor or tutor. Do this with two different age groups, if possible, and also try to find some volunteer work with special needs children. This will help your homestudy and it will help you immeasurably in order to determine what your specific weaknesses and strengths are. You might find that you loathe carrying babies and changing diapers, and adopting an older kid would be just great. You might find that you have a tendency to get overly irritated with certain behaviors or certain needs. Can you change your own mentality? Are you sure this is right for you? Your motivation is important, but it's less important than your strengths and weaknesses.

You really need to think long term here. In fact, a year of preparation before you walk through the agency doors might not be out of order for some families. If you have children, you need to have talks with them about it. This is a very complicated subject and I don't have any experience with it. While I don't think it's necessary to have your other children's full permission when starting, you'll need to realize this is going to be a huge event for them as well as you. This is a good link specifically for fostering.

If you're living somewhere with no room for another child, you're going to need to move. Finances are also an issue. You're going to need to have documented stable income. You don't need to have a lot of money, and you don't need to be debt-free, you just need to be able to show reasonable stability of income and housing. Don't start the process if you're in the middle of a foreclosure or bankruptcy.

Start going to church. I'll go into this later, but you should develop some kind of involvement with some kind of at least vaguely Christian church. If you're an atheist, pagan, Muslim, Buddhist, Hindu, Jewish, etc., this is going to be especially crucial, and especially complicated. An interfaith volunteer organization might be the best compromise so that you don't have to lie or compromise your beliefs in any way.

Start Going to Orientations & Meetings


Private and public (county) agencies have regular orientation meetings. Start going to them. This is the point at which you need to start creating a positive impression. Don't dress up or dress down too much, pay attention, and be respectful to the presenter, even if they're terrible. Ask a couple good questions. Otherwise don't talk too much.

If there are support groups and foster care parent meetings in your area that also include prospective adoptive parents, start showing up. Stay in the background and ask questions.

The reason I'm saying not to talk too much is that at this point, I've seen that parents start to become very emotional. This is a wrenching process. You're going to start hearing things that touch you in deep ways. A natural response from many people, if they're particularly extroverted, is to open up and share deeply emotional things from their own lives, or show disagreement by getting into arguments that are much louder and passionate than they would otherwise be...

To put it into a nutshell, the process is going to drive you a little crazy. You'll get over it (probably), but you need to keep a hold on your expression, and prevent others from seeing you out of control, because these others may have some input on the adoption process. If you need to talk it out, go get a therapist and talk it out with them. Or do it in an anonymous internet support group.

Networking with other parents is also very important. You want to start doing respite work for other parents as soon as possible. Other parents will be happy to share lots of stories and advice and tips with you.

Start Making Basic Decisions

By now, you should know yourself better. You're ready to start making decisions. Don't decide on your agency yet, but think about age range, number of children, special needs and fostering versus straight/general adoption. Go back and read those reports again in the first section.

- if you're set on adopting a baby, you'll need to foster. Adopting a baby from general adoption is basically impossible, unless they're extremely medically fragile with severe special needs.

- if you foster, you have to be prepared to work primarily for family reunification. If you think this is impossible, if you think it would hurt you too much, and/or hurt your other children too much, you obviously can't foster. But try revisiting the idea from time to time. At a certain point in the process, a mental switch might flick and you will realize that you can still love while letting go. Children are also very resilient in that they're able to comprehend other models of "family" than the norm. By fostering, you aren't necessarily teaching them that children are mobile and replaceable. You might be teaching them that you can love someone who stays with you, and you can love someone who doesn't stay with you.

- one of the most important decisions you can make is how many children. There's a really, really urgent need to keep sibling groups together. But at the same time, parenting more than one child can be incredibly difficult, especially if you don't have a lot of experience or a support network. This is a decision I suggest you spend a lot of time on.

- if you stick with straight/general adoption (adoption without fostering) keep in mind you need to establish a realistic age range. If you tell the workers you are only willing to adopt 1-2 reasonably healthy children from ages 1-4, they might either tell you outright to give up and go away, or else sigh behind their backs at you, and give you passive signals to give up and go away. You'll waste a lot of time.

- knowledge of special needs is crucial. Research them exhaustively. Keep in mind (I'll return to this later) that special needs are both under-reported and over-reported. No matter what the paperwork says, you cannot rely on your child not having substance/alcohol exposure or attachment disorder or mental illness. Also, some foster parents overreport special needs in order to get a higher subsidy level, and some parents overreport special needs out of sheer inexperience. The paperwork gives you clues. It doesn't give you answers. Also, keep in mind the difference between "sexual acting out" and "sexual perpetration"... don't automatically flip at the sight of the word "sexual".

- gender is a tricky one. The trend is that more parents prefer to adopt girls; there are also fewer girls in the system. If you say that you will adopt girls only, the social workers will not be very happy with you. Consider this point very carefully and re-examine your preferences.

Some Categories of Parents

I don't see anything about this in the reports, here are some rough groups of families in the process, and the dangers they face. Think about if you fit in any of these categories, and realize social workers might be slotting you into them.

1) Desperates. They go into fostering with a primary goal of adopting a baby. They frequently burn out when they have to give babies back. Social workers love them when it's emergency baby placement time, but otherwise don't respect them or treat them very well. I think there's a large turnover.
2) Empty-nesters. They're older and they've already raised a batch of grown or nearly-grown children. They're often very relaxed about placements because they don't feel the same urgency to parent, having already done it before. Their main danger is that they might think they know it all based on raising their biological children, and they fall apart when they realize this new kind of parenting is quite different. Social workers will be looking closely at their potential flexibility. However, they generally like this type of family, especially because they're frequently looking to adopt sibling groups.
3) Saints. These are often evangelicals, but they can also be secular ultraliberals. They have no age or special need requirements.  They tell the workers they want to be placed with any number of children that have the greatest need. They often have very unrealistic ideas about these needs, and are unprepared. The social workers will be deeply suspicious of these people. They burn out frequently.
4) Targeted. These parents have often done a lot of research, and want to adopt a specific targeted population. For example, the parents who say, "we want to adopt a child with cerebral palsy because we have another child with cerebral palsy." Or "we are deaf and would like to adopt a deaf child." Social workers love these parents because they can be relied on to adopt frequently hard-to-place kids. However, if the parents end up at the wrong agency, they can be exploited... the social workers will keep them around, and string them along, even though another agency might have plenty of the kind of children they want to adopt.
5) Aggressive. These are people that have a fairly specific idea of what they want, often in a high-demand population, and are insistent that the social workers can get them that placement. The social workers will sometimes give these parents quicker placements simply because they're "in their face" and don't get forgotten. Alternately, they develop a dislike for these parents and move them to the bottom of the priority list. Being aggressive can be positive, in a way, because if you advocate this strongly for yourself, you will probably advocate strongly for your child, as well. And you will need to argue and fight with a lot of teachers, doctors and bureaucrats when you adopt a special needs child. But there's a fine line between being aggressive and being a jerk, and if you cross it, it may reflect very badly on your future parenting skills.
6) Photostruck. These are parents who have seen a particular child in the photolistings and are starting the process for the purpose of adopting them. The workers know that there is almost zero chance they'll be matched with that particular child. Their goal is to gently let down the parents and focus them on adopting other children too. The parents are probably frantic to get their process as down as quickly as possible so they can adopt that particular child, and the workers may become irritated with their urgency and give up on treating them gently.

Some Categories of Parents with Specific Problems

Criminal Records

You're going to get fingerprinted and have a background check. How clean do you need to be? What we were told at our agency is that everything was examined on a case by case basis. Anything very violent or anything directed at children is going to disqualify you, of course.

I don't know what to tell people with serious convictions. But I do have some advice for the large population of Americans who've had light brushes with the law. First, the criminal justice system disproportionately targets minorities and poorer people. Second, drug offenses are incredibly common, even for richer white people. Strictly enforcing a no-criminal-convictions-whatsoever rule would be racist and classist, and most social workers recognize this.

My husband had a drug conviction from when he was 18. He fessed up, and our agency asked him to write an addendum explaining what he learned from the experience. He included the sentence "I learned I wouldn't make a good criminal" at the end, but I edited that out because it sounded way too flippant.

I was arrested for shoplifting when I was 15. I did my community service and my record was sealed when I was 18. I don't think this has any bearing whatsoever on my fitness as a parent, so I didn't include it. I would also recommend not sharing any similar juvenile misdemeanors. If the records are sealed, there's no legal requirement to do so.

Having a checkered juvenile history might even help you if you're adopting an older child with a similar history. Hopefully, you also have a documented record, since then, of helping young people avoid similar mistakes. If not, start creating one. Otherwise, having any kind of record is going to be neutral at best, and be another reason to disqualify you for a particular child, or move your homestudy further down the pile.

LGBT

The scale of family desirability for social workers goes something like this: hetero couple > single woman > lesbian couple > gay couple > single dad.

If you're a gay single man or woman, I guess an important question is how much of your sexuality to disclose. But I have a feeling that most social workers assume single dads are gay, anyway, unless proven otherwise.

If you're a couple, you have to work very closely with the agency on how to manage this. Your agency choice is going to be especially important. In some states, gay people cannot adopt at all. Florida's ban may be changing soon, hopefully. This link contains some helpful resources to determine laws in your area. If you live in an especially regressive state, maybe you should consider moving. I know that's a hurtful thing to say, and might involve separation from your roots and other family, but in practical terms, it might be the most reliable way to start your own family.

I really wish I could provide a link to specifically transgender resources. I looked, but haven't been able to find anything.

If you sign with a decent agency, they'll support you and try to work around any homophobic social workers. They'll also be honest with you about your chances and avoid creating false hopes. Your status may help you in terms of adopting older LGBT children, but only if conditions are right. Otherwise, any random homophobic worker you submit your homestudy to will sabotage it.

On the bright side, many gay and lesbian couples successfully adopt from foster care. If you read the first report I linked to, you'll see that less same-sex couples drop out before placement! Some of this must be because LGBT parents know they have fewer options, so they work harder and don't give up as easily.

Non-Christian

The vast majority of children are going to be from a Christian background. Not being Christian is a major, major handicap. The foster care system pretends to be secular, but in most areas, it's really not.

This wasn't a serious problem for me to deal with. Neither of us are Christian, but we joined a liberal congregation that doesn't require any particular belief system. I realize that for other non-Christians, this can be a really agonizing issue. The advice I'm giving is hurtful and humiliating, but necessary.

Regular church attendance establishes a support network. You have to think about the social function of churches more than the spiritual function. It provides a sense of stability to the family to do at least one thing the same every week. Social workers want to see as many support networks as possible. Most don't really care what you believe. They just want proof that you're connected to some greater community. The majority of Americans do this through churches.

Find a church that allows you to believe what you believe, even if you have to drive an hour to get there. If you don't like services, find some other way to be associated... maybe do volunteer work for them. Or find an interfaith organization and get involved with them in some regular way.

Beyond and beneath the support network aspect, which I actually agree with, many Christian social workers are prejudiced against non-Christians. I'm not talking about fire-and-brimstone condemnations... it's more subtle than that. Many will doubt your ability to parent a Christian child. I think it's important to prove in some documented way that you don't hate Christians, you like Christians and you're comfortable around Christians.

When your worker brings up these questions for the homestudy, and in your autobiographical statement, don't talk about what you believe, just talk about what you do and what your level of involvement is. That way, you're not lying about anything. And don't overshare.

Maybe in some very liberal places or places with a lot of non-Christians, all this doesn't apply. But if you're submitting your homestudy in any wider area, they will apply.

Race/Ethnicity

I'm not going to give a lot of advice to white people adopting transracially. There are a gazillion other resources for that. My only advice is: do your research, and don't act like a martyr. White couples are at the top of the pile when it comes to family rankings. You're number one for white children, and you're a very close number two for everyone else. Do not complain about how being white hurts your chances, especially in front of black social workers. Yes, I've seen that happen, and it's really pathetic.

If you're black, you have higher chances of being matched to black children, and almost zero chances of being matched to any other race. The big exception is going to be sibling groups. There are a lot of multiracial sibling groups out there. If you're considering that seriously, you should try and have something in your homestudy about your connections to other ethnicities and races.

If you're Latino, and you don't live in a very Latino area, it's hard to give advice. If you're a black Latino, white and black social workers will probably just slot you into the "black" category. Latinos will be sort of preferred for Latino children, but if there aren't many Latino social workers in the area, this preference won't be very strong.

If you're Asian, like me, you've got especially big problems. Outside of Hawaii, there aren't many Asian kids who end up in the photolistings. White (foster or otherwise) parents who say they aren't comfortable adopting black children are frequently just fine with adopting Asian children, so many of them don't get to the photolistings. Nobody really cares about recruiting Asian foster parents or adoptive parents. Any adoption you do is going to be transracial. Black and white social workers don't really know what to do with you. You might exist in a strange Twilight Zone, beating your head against a wall.

If you're Native American, you may have difficult issues in the regular system, depending on your geographical location. But you probably have the additional choice of working with a tribal agency to get placements. Networking with other parents is going to be key.

Interracial couples will experience some combination of these issues. In opposite-sex couples, the mother's race is always going to be more important. Adoption is an intensely female sphere, and adoption social workers are overwhelmingly female. That's true for any of these categories, by the way... the woman's attributes are going to be scrutinized most intensely, and she'll have to do most of the work. I think for same-sex couples, a parallel dynamic applies. One partner will get pegged as more "feminine", therefore more maternal, and given greater scrutiny and responsibility.

Like any other of these barriers, the older the child and the more severe the special need, the less they apply. Social workers for hard-to-place children will often set aside many superficial prejudices because they're desperate to get a match.

Physical and Mental Disability

These can both hurt and help, though mostly it hurts. Having a physical disability means you are very unlikely to get placed with a young child. There will be a questions asked about capable you are of carrying children, bathing them, restraining them in a rage. You can anticipate some of these yourself. What would you do if your child is about to run out into the middle of a busy street? If they start attacking another, smaller child? On the other hand, it may help you in getting placed with another child with a physical disability. For example, having a wheelchair-accessible house.

Mental disability can be neutral, but only if you manage it carefully. Many, many children in the system have mental illness. If you have a history of successfully "dealing" with the illness, and "dealing" is defined in such a way that the social workers accepts it, that shows that you won't be afraid with some of the more common issues that children often present.

In short, these are very serious barriers to adopting younger children, but can be neutral or even positive when adopting older children. Again, don't overshare. What you talk about with your therapist should stay with your therapist. Don't volunteer anything that won't come out on the physical anyway.  Many social workers have prejudices against specific kinds of disabilities.

Choose Your Agency

Once you choose your agency, you'll go through licensing, training, approval and homestudy. This could take a few months, or maybe even a year. It represents a huge investment of time, energy and emotion.

Even if you do tons of research and networking and make a really informed decision, your agency might still be wrong for you. You have to know when to cut your losses and move to another path. Otherwise, the disappointment will crush you.

The agency choice is going to vary enormously according to region. Some basic divisions:

1) Nationwide. I can only think of two: Adopt America Network and WACAP. I personally did not consider WACAP because they don't focus solely on foster care, and also because they charge some amount of money for the homestudy.
2) County. The quality of your county agency is going to vary. They will have a lot of children to place. Many county agencies pressure parents to switch form adoption to fostering, since they usually have greater need for fostering. County workers are also frequently overworked and have little time for hand-holding or supportive advice. Since county agencies are nominally secular, if you're LGBT or non-Christian, they might be your best bet.
3) Private religious agencies. Again, variable. Some of these have restrictions and practices that horrify me. Otherwise are really about as secular in practice as the county agencies, with slightly better resources.
4) Private secular agencies. These are frequently specialized. There are ones for medically fragile children, for sibling groups, for African-American children, for older children and so on.

A smaller agency might give the matching process more care and attention. On the other hand, if you get stuck with a bad social worker, that makes it harder to switch later on.

Don't be a Jerk in Training

No snorting, eyerolling or loudly arguing with the presenter! Yes, I've seen this. Especially when the topic of spanking comes up. I'm not going to elaborate on this too much, but I feel it deserves an entry.

You need to build up as much goodwill as possible in this stage. Later, when you get aggressive and starting calling your social worker every day to bug them about your homestudy, you will need this store of goodwill. Bring food to the trainings, volunteer to help with training-time childcare, do anything you can to make their difficult job a little bit easier.

Write your Autobiographical Statement Carefully and Stay on Top of Your Homestudy

Our first worker was terrible. The homestudy consisted of large chunks of my own autobiographical statement, woven together with sentences full of misspellings, grammar errors and more serious content errors. I gave it back with edits marked in yellow highlighter and red pen and asked her to fix it. She said she did. I believed her. She didn't, and we only found out about six months later.

The most serious problem is that it said we could parent children with "mild" special needs. It should have said "moderate". If I had to write it over again, I would have written "severe", because I realize that quantified need levels are a bunch of garbage due to massive underreporting and overreporting.

When a child's social worker received our homestudy and saw the word "mild", they would throw it in the trash, because all the children we were submitting for were marked as "moderate".

We only started to see movement once our worker left and another, much better one, took over our case and fixed our homestudy. This time I demanded to read it in order to confirm.

Homestudies are not set in stone, even though your worker will probably act like it. You should demand to read yours and look for serious errors. Social workers are very resistent to changing homestudies, but they will do it if you make a strong enough case. Ideally, if you have a friend or relative who is a social worker and knows a lot about the process, see if you can show them your homestudy.

If your homestudy is bad, and doesn't reflect your family strengths, you should leave and start again somewhere else.

Be Realistic and Be Humble

I'm assuming a somewhat combative relationship with social workers. At the beginning of the process, I believed everything they ever said, and looked up to them greatly. I was disappointed. Ultimately, they're just human beings doing a job. Many of them are very young and inexperienced women who entered the field with idealistic goals that have since started to seem rather far away and futile. The system chews them up and spits them up. They stop caring as much. Some of the ones that stay are amazing, some are terrible, most of them mess up a lot but try to do their best.

I don't think you should trust social workers, but until they prove otherwise, respect them. They know more about the process. If a social worker tells you that have a problem -- attitudinal or otherwise -- listen to them with an open mind.

And realize that although the process is humiliating and difficult, it's nothing compared to what your future child may be going through. This is a chance to experience a tiny portion of what they experience: the fear, shame, guilt and uncertainty. You can back out at any time. They can't.


Matching


Well, I ran out of juice, and time. I'll have to continue this later...

ETA: Here's the link to Part II.  I also corrected the comment link in the beginning.

This is Reassuring, and Interesting

Many children 'hear voices'; most aren't bothered

By Anne Harding Anne Harding Tue Jan 26, 5:22 pm ET

NEW YORK (Reuters Health) – Nearly 1 in 10 seven- to eight-year-olds hears voices that aren't really there, according to a new study. But most children who hear voices don't find them troubling or disruptive to their thinking, the study team found. "These voices in general have a limited impact in daily life," Agna A. Bartels-Velthuis of University Medical Center Groningen in The Netherlands wrote in an email to Reuters Health. And parents whose children hear voices should not be overly concerned, she added. "In most cases the voices will just disappear. I would advise them to reassure their child and to watch him or her closely." Up to 16 percent of mentally healthy children and teens may hear voices, the researchers note in the British Journal of Psychiatry. While hearing voices can signal a heightened risk of schizophrenia and other psychotic disorders in later life, they add, the "great majority" of young people who have these experiences never become mentally ill.

[...]

Children's brains are amazing places.

Tuesday, January 26, 2010

Follow-Up

I really appreciate all the comments in the last post. 27 now. I think it's my record here! This post went up on Racialicious today as well, and it's reaching a wide audience, which is what I'd hoped for.

I also want to let any new readers know that if you're frustrated by the comment registration policy, I'm sorry. If you really need to get in touch with me, try email. But I like having the registration policy in place because it means I never have to deal with comment spam or drive-by flaming, and I have limited time to manage my blog. Google registration also keeps comments centered on a regular group of people -- other adoption bloggers -- that have been reading me for years, as I've been reading them for years.

As for a comment policy, I don't have one. If you take the time to type up a negative comment, I'll probably leave it. I will note that I don't hate transracial adoption. I'm a transracial adoptive parent; I have a hopefully-healthy-rather-than-narcissistic love for myself. Also, I reserve the right to judge pretty much everything and everyone. I usually define the word "judge" to mean "think critically". I'm aware that many other people have different definitions of the word "judging", such as "saying anything I don't like" or "being a jerk".

I'm probably not going to revisit the topic for a bit, unless I become aware of an important immigration action item (I'm hoping that a proposal will come up soon to at the very least double the number of Haitian visas).


Again, I really appreciate the comments.  And if you want to stick around, great! Just warning you that most of what I post about regularly is more day-to-day mommyblogging type of stuff.

Saturday, January 23, 2010

The Dangerous Desire to Adopt Haitian Babies

I'm a foster care adoptive parent. I can't speak for all of us, since we're a diverse bunch. Some of us have also adopted internationally and support international adoption strongly. Others despise the institution, and are angry about what the perceived hypocrisy of parents who walk past the foster kids in their own cities and states so that they can adopt from a far-away country. I'm somewhere in the middle, but definitely leaning more towards the anti side, especially after this week.

This week, I've been deeply disturbed at the swelling public desire to adopt Haitians. Haitian orphan babies. The very name is problematic. In our imagination, an orphan has no family, but the vast majority of "orphans" all over the world have living parents, and almost every single one has living extended relatives. And the children that need family care are, overwhelmingly, older children.

Quite a few other parents I know are really pissed off about it. If you want to adopt, why not consider adopting from foster care? Why Haitian babies? I can guess at some of the answers. Most of them will not be very flattering.

There's a certain group of white adoptive international parents that dominate much of the discourse around adoption in this country. The most organized of these are evangelical Christians, but many of them are secular in their beliefs on adoption. They're across the political spectrum, ultraconservative to ultraliberal, though if I had to hazard a guess, most of them are center-right in politics. I believe these people are, basically, a force for evil. If I put it in any nicer words, that would be a lie. Examining their belief system, and their potential political influence on the recovery efforts in Haiti, is a pretty terrifying process.

I was first made aware of the Rumor Queen website several years ago. I was doing some research on Chinese adoption for a blog post. They're a large community of parents adopting from China, and the site is known for posting a lot of useful data about wait times. A few years ago controversy happened in the forum when some Chinese-American parents were accused by white parents of "jumping the line". There is, in fact, an expedited program for some Chinese-Americans; it's quite restrictive and any Chinese-American greater than second-generation does not qualify. The fact that some of these Chinese-Americans were possibly be more worthy of Chinese babies because of factors like "language" and "culture" and "race" apparently enraged some of the white parents. I read about it second hand from a couple of really angry, hurt Chinese-American families. This episode should give you a taste of the quality of discourse at this and similar websites. There are dissident voices, but the environments are most often dominated by white parents who refuse to consider any of the complex ethical issues surrounding transracial, transcultural, international adoption. They're saving children. How can you argue with that, right?

These online communities are often very hostile places for adoptive parents of color. They're even more hostile, of course, to adoptees and birth/first parents who want to discuss more complicated perspectives of adoption.

I stumbled on Rumor Queen again recently and was shocked to see what was going on. The whole site has gone gaga over adopting Haitian babies. It began with concerns about Haitian children, and is evolving into a coordinated plan of action to put pressure on political representatives for a Haitian babylift.

Also, I’m hearing about plans to bring more children (as in, thousands) into the U.S. all at once on airplanes. There are some precedents for this, there was Operation Peter Pan / Pedro Pan in Cuba in the 60’s, and then there was Operation Babylift in Vietnam in the 70’s. IIRC they did something similar in Korea in the 50’s, but I’m not sure it was given a name. At any rate, there is precedent for allowing a whole bunch of orphans into the U.S. who do not already have parents waiting for them. The U.S. government has not yet given the green light on this, and I’m unclear at this point who exactly gets the final word on it. If anyone out there has more information about it, please share. If it can be done in a way that ensures they are only bringing true orphans over then I’m all for it and would get behind it in a letter writing campaign. However, I would want someone overseeing the effort who can make sure things are done ethically. Someone with the ability and the clout to insist upon it.

The concern that "things are done ethically"... that's a nice thought. The comments dispense with that window dressing. They're full of demands that we have to get the kids out now, now, now, before they die, die, die. The practical reality is that after a horrific disaster of the magnitude of the Haiti quake, it's completely impossible to determine whether any abandoned child is a "true orphan". It's a process that is going to take months and even years.

This post from a more informed international adoptive parent blogger is a more reality-based examination of the issue. Adoptee bloggers who also study adoption academically -- among them Harlow's Monkey and A Birth Project -- are deeply concerned about the parallels to massive child extraction events like Operation Babylift. These were not shining humanitarian moments. Many of the adopted children found out later that they had parents and siblings left behind who wanted them, or even relatives in the United States who were searching for them.

In countries like Haiti that suffer so severely from poverty, citizens have to take the risks of globalization, but reap few of the rewards. Families are split apart as young people go to the cities to work, or to other countries, leaving their children in the care of relatives. Family ties are weakened by poverty, by the constant presence of disease, death and loss, but also paradoxically strengthened as families come up with new ways to endure hardship and stay together. A white middle-class Midwestern mother doesn't understand why a Haitian mother would leave her children at an orphanage, hoping to take them back later. The white mother could understand if she really thought about it on a rational basis. But the lure of the white savior narrative is powerful, and sweeps her up in a rush of emotion: fear, longing, desire. It's because the Haitian mother is a bad mother who doesn't deserve her kids anymore. The innocent baby is not yet contaminated by this evil culture. They deserve something better, cleaner, richer, more tender, whiter.

Here's another comment from that thread.

RumorQueen Says:

And how many children will die while they are building a new infrastructure?

Sometimes you do what you can, not what the ideal would seem to be.

It’s like the guy rescuing starfish on the beach, there are a hundred thousand starfish and a guy is throwing some of them back in the water. Someone tells him there are too many, he can’t possibly make a difference all by himself. And he says, as he throws one in the water “I made a difference to that one”.

There are going to be all kinds of issues these kids will deal with. I’ve gone out of my way so my kids know I did not “rescue” them... but that isn’t going to be able to be said for these kids. Sure, it’s not an ideal situation. But would it be better to let them die?

Analogies simplify complex issues, sometimes in an accurate way, but this analogy is just smoke and mirrors. International adoptive parents are really fond of this starfish metaphor and this is not the first time I've seen it in play. It always boggles my mind. Why is adopting a third-world "orphan" like throwing a starfish back in the ocean? Maybe the poor starfishes needed to be on the beach as part of their mating cycle and the guy is messing with them because he's sadistic. Maybe he has a weird sexual fetish about echinoderm-hurling. Or maybe he's just a dumb-ass. The analogy effectively obscures the issue of motivation, as well as the implication of "saving".

Let me try another analogy. Let's say you live with your child in a house that burns down. You're dazed, confused, and burned. Your neighbor says, "I think I should take care of your child". You say, "Thanks for your offer. But my child really needs me now, and I think they wouldn't sleep well in a strange house. If you could just give us a tent and some food and some bandages so we can camp out while I get better and look into rebuilding, we'll be OK." Your neighbor says, "that's too logistically complicated and I'm concerned about the security situation. I just want your child." You say, "Thanks again for your concern and I'm grateful for any help you can give me. If you're so worried about my child, maybe you could let both of us stay in your guestroom for a while? That way my child could be safe and would sleep well too." Your neighbor says, "No, we have an interdiction-at-sea policy and visa restrictions will not be relaxed. Just give me your child. Actually, nevermind. I don't even need your permission anymore. I'll just take them."

Here's the worst comment on the thread. It was let through without a rejoinder. Mine was blocked.

49. Proud2Adopt Says:
EthioChinaadopt – the issue is that if someone is paying $30,000 to adopt a child, they want a baby! Its as simple as that! I’m really tired of hearing about how so many of these kids are just split from their parents. Lets get the 380,000 kids that were ALREADY orphans OUT of the country & into waiting homes, that way the focus of orphanages can be on those children who are NEW orphans or split from parents & families. The reality to me is, I would LOVE to adopt one of these children. No, this isn’t a NEW passion spurred from seeing photos on TV. But hopefully with the dire situation they will waive much of the 25K+ fees for families like mine to adopt one of these children here! Amen!



I admit I wasn't nearly as diplomatic as I could have been. But that's not my strong point. I was way too irritated with these people. In case you're wondering why the maniac above me was referring to $30,000 for a fresh baby, I really don't know. I'm not up-to-date on the latest prices in the international baby market.

The next babylift thread was racist beyond belief. Rumor Queen ran footage of a riot at a food distribution point.

Desperate target Haiti’s orphanages

In a country where it is survival of the fittest, what chance do babies and children in an orphanage have?

The Vietnamese Operation Babylift was driven both by racism and fear of communism. But this framing, on the other hand, is pure 100% unadulterated racism, invoking the most damaging stereotype of black people invented by white imperialists. "Survival of the fittest" implies that Haitians are nothing more than animals. Their children need to be removed immediately or they won't even grow up to be human beings.

I haven't watched a lot of news in the past week -- probably less than 10 minutes of footage a day from sources like CNN -- but in those brief times, I've seen plenty of examples of orderly food distribution. I've seen Haitians rescuing each other. I've read accounts by independent media, small media and even the mainstream media -- "Despite isolated incidents of looting, violence and other criminal activity, the overall security situation remains calm" -- that security fears have been massively overblown.

Rumor Queen attacked me for my blocked comment later on in that thread. I then left a harsher comment (I refrained from profanity but did use the word "strip-mining") and my comment was, of course, also blocked.

Luckily, policy makers aren't listening to these people with full attention anymore. There are competing voices. UNICEF, Save the Children, SOS Children's Villages, pretty much every single large secular children's aid organization, plus some of the religious ones, are advocating a total stop to new international adoptions until quake recovery gets underway and far-flung families begin to come together again. Adoption should be the last resort. I agree with that. I'm somewhat moderate in that I don't see a huge problem with removing children who have already been through most of the process and have already met their adoptive parents. If a bond is already there, there's no point adding another loss. And a lot of the adoption process is true red tape that doesn't serve anyone's interests. But airlifting children who just "appear to be orphans" (as several Catholic leaders in Miami have been demanding) and almost certainly cutting them off from their roots... this is wrong. It's wrong for the children, it's wrong for their relatives, and it's wrong for the country of Haiti.

There was an adoption story I heard on NPR yesterday that really touched me. It's not the typical adoption narrative we've been hearing:


Margalita Belhumer, a Haitian-American who lives in New York City, was visiting Haiti when the quake struck nine days ago. She shaded her eyes from the tropical sun as her 8-year-old daughter, Melissa, squatted at her feet.

"I'm seeking to leave with my daughter. People are dead, place crumbled. She has nowhere to live, so I can't leave without her," Belhumer said.

She said she raised Melissa since the girl was a newborn infant, wrapped in a sheet and left on the sidewalk in front of St. Joseph's Catholic Church. Child abandonment by destitute mothers is not uncommon in Haiti. While Belhumer worked at her job as a security guard in New York, she paid a family to take care of Melissa. Belhumer said she had begun the adoption paperwork before the quake struck.

"I started the adoption process, but I started last month. But I've had her since the first day she was born," she said.

If any adoption is expedited, it should be these ones. But these are also the people who are least likely to have the ears of politicians. Everyone wants Haitian babies. Haitian adults, and Haitian families, are another matter. There has been no announcement that more visas will be granted to reunite Haitian-American families.

This report by a US adoptee-rights blogger, based on notes from a USCIS teleconference, has a chilling quote.

Hundreds of adoptive parents, paps, orphanage directors with dozens of children, and even, apparently, loose children gather outside the US Embassy. Many come unannounced demanding entry. Officials have set up and are refining procedures for entry into the compound, interviews, and decision making. (Procedures were discussed in detail, but I"ll hold that for another entry.) They emphasize that the Embassy needs advance notice of petitioners so someone can go outside, locate them, and escort them through the gates. Only adoption cases are being handled. (Haitians with other Embassy business, including those with pending pre-quake visa and immigration applications are being turned away for now.)

Talk of adopting orphaned Haitian babies seems to be swirling all over. And though I'm concentrating my ire on a certain class of white adoptive parents, I'll have to note, not everyone full of this dangerous desire is white.

"I wanna just go down there and get some of those babies," Latifah said on the Today Show Thursday. "If you got a hook up, please get me a couple of Haitian kids. It's time. I'm ready."

As someone who has adopted before, here's some questions I'd ask of anybody in the U.S., of any race, who is really serious about this.

- Do you know what a homestudy is? Are you ready to pass one?
- Do you realize it will be almost impossible to adopt a baby, hard to adopt a toddler, and that the vast majority of children who really need to be adopted are older children?
- Do you know what attachment disorder is? Children with inconsistent caregiving in early years often develop this to some degree. They may experience the expression of love as a terrifying loss of self. They may do anything in their power to make you stop loving them, including physically attacking you, your pets or your other children. There is no known 100% effective therapy for this.
- Do you understand the effects of various prenatal exposures? Do you understand and accept that your child may grow up with irreparable brain damage?
- Are you ready to establish routine visits to one, two, three, all of these and more: therapist, psychiatrist, physical therapist, neurologist?
- Are you prepared that your child may resent you or hate you for taking them away from everything and everyone they've known and loved? And that even if you've explained to them that they're never going back, they may still try to push you away, because in the back of their minds, if they're bad enough, you'll send them away, and they'll go back to everything and everyone they've known and loved?
- Are you prepared to have a child so terrified from trauma that they act as if they were half their developmental age? That they wake you up screaming every night at 3 in the morning? That they rage uncontrollably if you don't stay by their side every waking minute?
- Are you prepared for your friends and family to perhaps shrink away from you because they don't understand why your child acts the way they act -- maybe it's because you don't love them enough, or you don't spank them enough -- you're doing it all wrong and it's all your fault.

If you can answer "yes" to all of these, congratulations. You might be ready to adopt from foster care. To adopt from Haiti, answer all the above questions, add the effects of malnutrition, add a language barrier, and multiply the child's trauma by a factor of ten. And subtract a lot of money. Unlike foster care adoptions, which are basically free, you're going to have to pay legal fees. Maybe even $30,000. And children from foster care will have permanent Medicaid, no matter your income level, but if you adopt internationally, it's up to you to find a way to pay for all those psychiatrist visits you'll almost certainly be needing later on.

Here are some additional questions:

- Are you aware of transracial adoption issues? If you're a black American, are you aware that transcultural issues can be just as intense as transracial ones?
- Do you have a connection to a Haitian-American community? Do you speak Kreyol or French?
- Your child will likely be Catholic and think of themselves as Catholic. Are you? If not, how will you handle the difference?
- The ethical thing to do is to try to establish contact with your child's relatives in Haiti. Are you prepared for the fact that you, as a rich American (no matter what your income level) will then be regarded as a financial benefactor/patron? If you've grown up in the US and absorbed our surface-egalitarian values, you will be unaccustomed to this kind of role, and extremely bad at it. If you refuse to make contact because of this issue, or because of fear that your child will love you better if you cut them off from their roots, then... well... you suck. I'll leave it at that.

You'd better be sure you can handle it. If you can't, your child will pay the highest cost. If the adoption falls through, your child may end up in foster care, possibly so scarred that they'll never get another chance at a family.

I've said a lot of harsh things in this post. But I also want to note that this desire can also be understood in a positive way. Children inspire love. I believe in certain universal values, and across every culture and all of history, people love children and want to take care of them. An equally universal trait, unfortunately, is the desire to exploit children. Children don't speak fully for themselves, so we speak for them. It's necessary, but it's also dangerous. Exploiting a child can be as blatant as child sexual abuse, or sweatshop labor... and it can be as subtle as wanting our children to validate us as parents. Wanting them to love us, and being angry when they don't show us love.

We're getting into grounds of philosophy and religion here, but I don't think a completely pure love is truly possible on this earth, because love needs knowledge, and pure knowledge is impossible. We try, but we don't know fully what's best for the other person, so we make guesses, and our guesses are based on imperfect knowledge. And so exploitation creeps in.

My religion talks a lot about the impossibility of individual purity and makes the acknowledgment of imperfection absolutely necessary. I think many other belief systems address the same issue in different ways. For example, in Christianity, Jesus Christ represents a pure kind of love, and other kinds of love exist in relation to that standard. The answer is not to stop loving, or to stop trying to understand, but to realize that our love is always endangered by selfishness. If we ever think our love is pure, we need to stop thinking along that track, take a step back and think again. Don't stop loving, just stop thinking that your love is infallible and all-knowing.

I'll close with a few reality-based ways to help Haitian children in Haitian families:

- Donate to SOS Children's Villages, Save the Children or UNICEF.
- Sign this AIUSA petition to request an end to interdiction-at-sea policy
- Contact your representative. Ask them to support an increase in refugee visas for Haitians and expedited family reunification visas for Haitian-Americans. Ask them to support the airlift of Haitian children unaccompanied by family ONLY for the purposes of temporary medical hosting and NOT for the purposes of adoption.
- If you live close to a Haitian-American community, contact their organizations and ask if there is anything you can do to support community efforts.

I may add more later as I become aware.

Friday, January 22, 2010

Follow-Up and Miscellaneous

From the therapist (I love quoting emails, it's so easy).

Thanks again for the update.  I wanted to address the issue with visiting your cousin in greater detail than I was able to last night.  First of all, I think it was extremely savvy of you to figure out the emotional connection for [Sunny] between visits with your cousin and his biological mother.  It sounds like you hit the nail on the head and were able to deescalate the situation quickly as a result.  As I mentioned, [Sunny] and I discussed grief and bereavement and read a story about losing a loved one through death.  He seemed interested in the story as he sat quietly throughout, which is unusual for him.  He struggled to talk about the story afterward, likely due to the discomfort he experiences in facing his emotions head on.  We have been and will continue to work on this as I think it is the heart of the issue for him.  To answer your question regarding whether or not he should be allowed to continue with visitation, my answer is most certainly.  It is important to show him he can visit your cousin and say goodbye to her and that the goodbye will not be forever.  I would also encourage you to verbalize this to him (i.e., let him know when you will be coming back) and acknowledge and label his feelings for him (i.e., sad, scared, etc.).  This last part will be extremely important in whatever you are doing as it seems [Sunny] may not always know what he is feeling so the more help he can get with the identification of feelings the better.  Please let me know if you have questions.

I've tried reading books about loss with him before, but it's very difficult.  When we read Everett Anderson's Goodbye, he was crying bitterly by the end of it, and told me he never wanted to read it again because it was too sad.  It's nice to finally have some professional backup and guidance.

However, it's not entirely true I was able to "deescalate the situation quickly".  It took about 30 grinding minutes and felt like an eternity.

To a commenter who asked what medication Sunny is taking: it's a popular atypical antipsychotic that also begins with the letter A. If you look up any reference on that drug class it'll be right there.  That's the only med he's on.  I don't have him on any of the strictly ADHD drugs.  His foster mother tried Adderall at one point, but said it made him "act mean", even though it did improve his ability to concentrate.  Given his generally good academics, and the fact that I don't think he has standard ADHD, I don't want to give him any med that will change his personality, as long as he can get along OK in school with the support of his 504 plan.

Thanks to everyone else who's commented!

Later today, I'm going to start working on a blog post on the media around Haitian "orphan" adoption.  I need to get back to some controversial posts after a long string of just-about-family ones.

Sunday, January 17, 2010

A Lightbulb Moment

We visited my cousin a week and a half ago at her psychiatric clinic.  I think I did mention the visit in a previous blog post.  I never had any qualms about the clinic environment, because it's a pretty nice, high-end type of place.  It's bright, airy, the staff are casual and friendly, and I've never heard anyone screaming.  When we go over there Sunny usually plays games with my cousin and anyone else who happens to be hanging out in the lounge area.

Last time, Sunny had some very bad behavior after we left.  We had to spend about ten minutes in the parking lot and back porch.  I always refuse to get into the car with Sunny once he passes a certain point of emotional turmoil.  It's because I don't want him throwing stuff at me while I'm driving (if he gets worked up while I'm driving, I immediately pull over).

Tonight, when we went to visit, I prepped him extensively.  I reminded him that my cousin might not feel well.  "If she has a headache, we have to turn around and go home." I reminded him that the clinic might have an outing, and we might have to leave early.  I told him to try and keep calm when it was time for us to leave.  I gave him all sorts of reminders covering various contingencies.  I was a little nervous of taking him anyway, given the rough week we just had, but he seemed to have recovered, and he'd been begging all weekend to visit my cousin.

So we showed up at 5pm, in the middle of visiting hours.  Luckily, my cousin was feeling well enough for a visit.  She always lights up when she sees Sunny.  He really is a little ray of sunshine (except when he's a thunderclap of doom, of course, but mostly, he's a little ray of sunshine).

We had dinner together, although she didn't feel quite well enough to eat.  She's on a lot of medications that do unpredictable things to her appetite.  He was so happy to see her.  He even repeated, unprompted, what I'd told him earlier: "if we come visit and you have a headache, it's OK.  We'll just come back when you feel better."

Sunny had a fantastic time playing Pictionary with my cousin and three other patients.  I told him we were going to leave at 6:30 and gave him plenty of reminders.  The game wrapped up naturally around 6:30, then we said our goodbyes, signed out, and walked out the back.  Again, out in the parking lot, Sunny started breaking down and picked an excuse to fight with me.  He wouldn't do his deep breathing exercise when I asked him to calm down.  He just got more and more worked up.

"All you ever do is mean things to me."
"I say I'm sorry a million times, but you don't listen to me."
"You just want me to freeze to death" (but this time I had moved back into the heated back porch and I was preparing myself for the breakdown)
"You never listen to me."
"You don't care about me."
"You're mean."
"You're a total idiot."
"You don't listen to me, you don't care about me, I hate you, you hurt me and you never say I'm sorry, you don't listen to me when I say I'm sorry, you're never nice to me, you're mean to me..."

At one point one of the staff came to the back porch and asked if we were having trouble with the door.  I just gave her a forced smile and told her we were going to be on the porch for a little bit because my son was having a tantrum, but he'd get over it.  I'm past the point of being embarrassed when things like this happen.  The only thing I ever worry about is people calling the police or child protective services.  I wasn't too worried about that here.  It's a psychiatric clinic, after all.

He screamed and cried and accused me for a while.  He started pushing and grabbing at me.  Finally, I had to put him in a light basket hold.  His fit wasn't as bad as it could have been.  He wasn't screaming curse words or trying to hit me in the face.  In his worst fits, I can't use a basket hold at all, since I have to restrain him so that he's incapable of head-butting.

Finally, he moved to the inevitable stage: from blaming others to blaming himself.  This is the only point where I talk.  I can't argue with him when he's blaming me.  He just doesn't listen.  But I can argue when he's blaming himself.

"I hate myself for doing stupid things all the time."
- "You shouldn't hate yourself and you don't make bad choices all the time, just some of the time.  You should say 'I'm nice'.  You should say 'I love myself'."
"I'm nice I'm nice I'm nice I'm nice.  IT DOESN'T HELP."

At this point a lightbulb went off in my head.

-"Does saying goodbye to [my cousin] remind you of having to say goodbye to anyone else?"
"Yes! It reminds me of the time I said goodbye to Mommy ___ and it was my last visit ever and I never saw her again and then she died and I'll never see her again ever.  It makes me feel JUST THE SAME."

Oh... my... God...

Sunny loves her deeply.  She suffers from a mysterious disease that adults can never really explain to him well.  Communication and access to her is completely out of his control.  Visitation takes place at a supervised institutional setting.  Of course it's exactly like saying goodbye to his biological mother.

One day, his worker and his foster mom told Sunny that there wouldn't be any more visits with Mommy __.  Termination of parental rights had been completed.  But there would be one last visit.  So they took him to the official visitation room and let him play together with Mommy __ for a few hours, and then he had to say goodbye, a goodbye on the last visit ever.   It brings tears to my eyes thinking about what he must have felt.

Sunny's rage towards me, and towards himself, completely vanished at that point.  He just cried and cried.  We talked a bit more about missing Mommy ___.  I told him that whenever you feel sad, it makes you feel better to tell another person why you feel sad.  And even if there's no one else around, you can tell yourself why you feel sad, and that will make you feel a little better.  Not all the way better, but a little better.  And of course he misses Mommy ___ and it was a terribly sad thing to have to say goodbye to her like that. 

It was 7:00.  We starting driving home.  I reminded him that he could talk about missing Mommy ___ anytime, and he could also call Nana N and talk to her about it, because Nana N missed her just the same as he did.  We did call his Nana N when we got back home, but he didn't feel like talking about it by then, even though I gave him a little reminder.


He was his normal happy self for the rest of the night and went to sleep right at his bedtime.

The difficult part for me is that I can't talk to my cousin about all this.  Her mental state is too fragile.  I'm going to take Sunny to visit her again next week but this time I'll bring someone else as well (Guy or Nana) and make sure we're totally prepared.  I think visiting and then breaking down afterwards is going to suck, but ultimately it's good for him to see that he can say goodbye, but my cousin is still going to be there next week.  I think it would be worse if I didn't take him on visits at all.

If she ever kills herself, I'm going to kill her!


Sunny is dangerously full of need and full of love.

No Hell Week Part II Post! Purgatory, at the Most.

We made it.  Whew.

Tuesday was the worst. I outlined the basics in the email to the therapist that I posted on Wednesday.  Sunny was in a terrible state.  He seemed full of hate.  It was like the hate came from outside and took him over.  He took the hate out on us, but I could tell, more than anything else, he hated himself for being that way.  When he told me in the car about the voices in his head that said "I hate you", it made me feel so sad for him.

We started him back on his old med that night.  Wednesday was a little better, but he still got called him from school for acting out.  We had a school meeting about him on Thursday -- we kept him out of school that day -- then let him go back for a half day on Friday.  He made it.

Thank goodness I can trust the people at his school. They're treating this like a "lost week".  They're full of sympathy for him.  There won't be any lasting consequences.  At another kind of school, they might have been talking expulsion or a move to a special education classroom.

By Friday, he was begging to go back to school! He was missing his "Math Message".  I don't know exactly what that is, but he sure does love it.

He had a sleepover with Nana on Saturday night.  Guy and I took a much-needed date night and saw The Imaginarium of Dr. Parnassus, then went to Loca Luna for tapas.  We didn't go to bed until midnight and slept in until 10AM.  Then we met Sunny and Nana and another friend of ours for dim sum.  Overall, this has been a pretty good weekend.  The smile is back on Sunny's face.

The situation in Haiti, of course, has been weighing on my mind.  I emailed a Haitian friend I met through the Obama campaign and asked him how his relatives were doing and if we could do anything else besides donating (which we've already done). 

This man worked harder than anyone else on the campaign, and he couldn't even vote.  He must have registered hundreds of new voters.  When our small group went on a weekend vanpool together, he drove the whole time.  And he knocked on twice as many doors as any of us, with a bigger smile on his face, in the blazing summer heat... all while wearing a three-piece suit.  I really admire him and I feel terrible for what he and his family (a wife and six very sweet kids) must be going through now.

Sunny's therapist talked to him a little bit about the voices.  She told him that when he heard voices inside his head saying mean things about him, like "I hate you", he could tell himself positive things, like "I'm nice".

So we're back to square one with his medication.  I guess we'll try taking him off again next year.  I don't want him to go through the rest of his childhood on meds, but I can't risk 1) his  school and 2) our sanity.  Thinking about my younger cousin and his life, the thing he really regrets most bitterly is how he was warehoused in special ed because of his behavior, and never even learned to write until middle school.  He made me promise that I would never do that to Sunny.

Wednesday, January 13, 2010

Quick Links to Help Haiti

These are some of the organizations that can move the quickest.

  • Red Cross: American Red Cross Pledges Initial $1 Million to Haiti Relief - Send a $10 Donation by Texting ‘Haiti’ to 90999
  • MADRE: Emergency in Haiti! Please send humanitarian aid
  • CARE: CARE Deploys Additional Emergency Team Members to Haiti
  • MSF/Doctors without Borders: Haiti: MSF Teams Set up Clinics to Treat Injured After Facilities Are Damaged

Hell Week Part I

Hello [therapist],

Unfortunately, we have had a very bad week so far. On Monday, [Sunny]'s behavior in school was bad and we got a note from his teacher. Tuesday, [Guy] had to pick him up from school early because he was pushing other kids in line, and then had a tantrum and threw things when the teacher confronted him. They told [Guy] he was "out of control". They are having a meeting Thursday morning.

Yesterday, his gym teacher also said he behaved badly and was almost asked to leave the class. I also had to restrain [Sunny] numerous times yesterday. Once in the morning and once after school and twice after gym class. He would get very, very oppositional and when he was asked to do something say "I don't have to!" or "I hate you!" or "you're ruining my life by not letting me (watch TV/do XYZ)". We eventually got the routine done: dinner and reading and bedtime. [Guy] is especially stressed out.

[Sunny] is grounded (he can play outside but not go into anyone's house) and also has no TV privilege until he can have at least one good day at school.

One thing I have been worried about is that in the last week or so [Sunny] has seemed to hear voices when no one is talking. Sometimes I won't say anything, but he will ask "what?". This seems to have increased. I talked with him about it last week, and asked him if he was hearing voices that weren't really there. I didn't make a big deal out of it (he's kind of a hypochondriac so that would encourage him to get carried away). He said he does hear those voices sometimes and they say things like "I hate you".

He told me in the car yesterday that he was hearing those voices, that they were bothering him, and that "maybe he should see a doctor". Again, I didn't make a big deal out of it, I just asked him some questions about them. He knows they are not real. They don't come from the front or the back, they come from the inside of his head. I'm very concerned because I don't think he would say he wants to see a doctor unless he was really hearing them. He's not a big fan of going to the doctor, because that almost always involves getting a shot (though he loves going to the dentist because they have video games in the waiting room).

With all of this going on, I made the decision to put him back on medication. I just read that [the atypical antipsychotic] takes a long time to fully clear out of the system. So his good behavior last week, off the med, was not really indicative. He had a pill last night. This morning he did OK.

Response:

I am sorry to hear it has been such a rough week. I would agree with your decision to put [Sunny] back on the medication. I would also speak with his psychiatrist about this. You are correct that it takes time to clear the system of [med] which is likely why he did so well when he was initially taken off of it. In terms of the voices, auditory hallucinations actually seem as if they are coming from outside the body. In other words, it seems as if someone who is not present is talking to you. More than likely, [Sunny] is experiencing self-deprecating thoughts he is unable to control which translates (in his mind) to a voice of another. This is likely to abate once the medication becomes effective in his system. I would encourage you to monitor it to see if it changes over the next few days. Thanks again for the update. Don't hesitate to contact me with any additional questions or concerns.

Sunday, January 10, 2010

Music Video Night with Sunny

Sunny's been a bit grumpy today, but no fits.  We had a fun time tonight watching videos on the computer.  He made me play that TI & Justin Timberlake song, "Dead and Gone", over again several times (I played the clean version, of course).  It was a huge hit on the radio here, and Sunny loves the song.



The video is rather pedestrian.  Plus, Justin Timberlake looks like he has some kind of fungus growing on his upper lip.  I don't know much about him, but I've heard he's supposed to be a sex symbol, which amazes me.

Sunny asked me what the song was about.  I asked him what he thought the song was about.

- "What does it tell your imagination?" 
- "I think it's someone singing about how his father just died.  And he doesn't have any other family so he's all alone with no one to take care of him.  So he gets in a car and he keeps driving.  He's going to drive all the way to another country to find a new family to take care of him."

What an interesting story!

We watched a bunch of other music videos.  I usually hate 80s nostalgia, but I have to say, they made some fun videos back then.  Take Golden Earring "Twilight Zone":



Sunny: "THEY'RE MAKING HIM CRAZY!  THAT'S CRAZY! AAAAGGHHH!"

We wrapped it up with the Sledgehammer video.
 

That got him so excited, he broke out into spontaneous breakdancing at the end.

I didn't show him the craziest 80s video of all: the original version of "Relax" by Frankie Goes to Hollywood.  It was censored for being really, really, really gay, and never shown on MTV. It starts off with a bunch of people waving condom-covered bananas around, and just goes downhill (or uphill?) from there. Not many Americans have seen it. It's pretty awesome.

Sick, Cold Weekend

Ugh.  I stayed in bed from 5pm Friday until 5pm Saturday.  My sinuses hurt, I felt achey all over and my neck had stabbing pains.  I feel a bit better today.  My health has not been good, in general, for this last week.  I think it's the cold weather.  I really want to get back to my exercise schedule.

Sunny's behavior deteriorated a bit.  Friday, all the schools were closed because we got a quarter inch of snow.  I'm sure everyone up north thinks that's hilarious.  He had two fits that day.

Yesterday, since I was sick in bed and my husband had to work, Guy dropped him off at Nana's.  My mom often jokes with me -- "I don't see what your problem is, he's always fine with me!"  We both share a dark sense of humor, so I know she really doesn't mean it. She's great with him, since she has a very strong personality and the ability to maintain calm.  But sometimes, yes, it does irritate me a bit that Sunny reserves the worst of his behavior for me...

He was helping his Nana take off the Christmas tree ornaments and accidentally-on-purpose broke one because he didn't feel like helping right then.  Whenever he breaks something or hurts someone on accident, he gets very perturbed, and he has to be assured that his apology is accepted and everything is OK.  Otherwise, he flips out.  I've had lots of talks about this with him.  When he does something wrong, either on accident or purpose, he is supposed to think about other people's feelings first.  They key in these situations is to speak to him very calmly, but tell him to think about what the other person feels and what he can do about it.

Anyway, after breaking the ornament he started crying and screaming.  My mother told him to go to the other room to calm down (first mistake).  I've grown to realize that telling Sunny to go away and be by himself is like telling him "I hate you and I hope you die".  When he screamed even louder, she actually lost her temper for a minute and said "For Heaven's sake, shut up!"  I arrived shortly afterwards and Sunny was screaming about how Nana hurt his feelings and told him to shut up and "spoke to me in a harsh voice".

I took him to the bedroom and had to hold him down for a while when he got more disturbed and began lashing out.  Then we had a long talk and I made sure he didn't leave the bedroom with me until he took responsibility and started seeing things in a more realistic light.  What we discussed:

- if an adult in your family asks you to do something reasonable, you have to do it.  No matter if you think their voice is harsh.
- saying "my feelings are hurt" is not a magic phrase that allows you to avoid responsibility for your actions.
- you have to think about the feelings of other people as well as your own.  For example, Nana's feelings were hurt when her Christmas ornament was broken.  That didn't mean she's mad at you, it just means her feelings are hurt.
- three-stage apologies!  I remind him of this almost every day.  Saying "sorry" is worthless unless you then take responsibility and third, see what you can do to make up for it.

I have to hope that eventually he'll start to internalize some of these messages.  He was remorseful afterwards and apologized to his Nana, and she gave him a big hug.

I'm not happy about his behavior deteriorating, but on the positive side, he's really no worse than he was on medication.

I'm still working on getting a neurologist appointment.  I think I have a line on a neurologist in a town not too far outside the Atlanta perimeter.  It's always a chore finding decent providers.  I think doctors that take Medicaid are 1) more altruistic than normal and/or 2) really crappy and substandard.  Our pediatrician falls in the "altruistic" category.  The office is a bit disorganized, but based on the hours they keep and their stated mission, they're doing it for all the right reasons, and I love the service we've gotten from them in the last year and a half.

Generally, though, based on reviews of doctors I find on the internet, the badly reviewed ones take Medicaid, and the well reviewed ones don't.  To find a good one that takes Medicaid I have to cast a pretty wide net.  Luckily, we live in a populated region.  If we lived out in the country, we'd be screwed.

I had a long talk with Sunny and BB's foster mom the other day.  At 18 months, she estimates he's about 4-5 months behind, but making steady progress.  She thinks he'll catch up.  I trust her opinion since she's taken care of a ton of babies with all kinds of special needs.  BB is starting to say words!  He says "Nigh-nigh" when he goes to bed.  He can also understand simple commands like "pick up your bottle". She thinks his brain is developing faster than his motor system, so he could speak more if he had better control of his mouth.

I'm starting to think about childcare when BB comes to us.  Our choices are basically daycare versus a live-in nanny.  We can't afford a regular professional nanny, live-in or live-out, but we could get someone from the refugee community to come and live with us in the basement studio... that sounds kind of exploitative, but the weird thing is, we have certain connections that if we DON'T do this, my mother and some other people who work with the refugee community would be kind of peeved.  The idea would be, "if you can afford to give someone a job, so that they don't have to work in the chicken processing factory, you're obligated to give them that job."

Going that route would be complicated, ethically.  If we could get someone who was a night student, or had a small child they could live with here, so I wouldn't be causing another mother to have to get her own childcare, I would feel OK about it.  On another level, I'd want to make sure it was someone whose approach to childcare I agreed with... a professional nanny (we couldn't afford one anyway) has all sorts of references and certifications and things, and we'd be kind of flying blind without that.

Then there's daycare. That would cost anywhere from 400-1000 a month.  It has a lot of disadvantages but BB would be around a lot of kids, and he's already showing that he's very social, much like Sunny.  It's important for him to bond with us when gets here but he's also going to need a LOT of stimulation from other kids, and maybe daycare would be the best way to get that.