Sunday, May 24, 2009

Adrienne's Post

Adrienne & Jim adopted Owen from Vlad at 18 months of age. She gave us permission to post one of the passages from her blog that speaks volumes about attachment. Thanks Adrienne!

Why Does He Do That?

I can't count the number of times I've been asked this question or read this question in the look on someone's face during the past year. The questions we've heard... Why won't he look at me? Why doesn't he like me? Does he ever sit still? Why won't he just sit and play with me? Why can't I hold him? Why don't you leave him with a babysitter or take him to daycare? Why does he want to look in all the cabinets? Why does he want to see our washing machine? Does he understand English? Why won't he listen to me? Why do you pick him up when he cries? Why do you carry him so much? Why do you still feed him/help him so much when he's eating? Why do you play with him all day long? Why don't you just let him play by himself? Why does he do that?

For a long time, it really bothered hearing questions such as these and watching Owen explore every new place we went and not immediately focusing on an activity or staying with me. Whereas many children stay very close to their parents in new environments and with new people before venturing out, Owen was so eager to leave us and explore each new environment without every turning around to see if we were still there. Upon arriving somewhere he didn't go very often or had never been, he immediately wanted down to walk around and explore where he was, locating any and everything that was familiar to him (things we had at our house such as bathrooms, dishwashers, washers and dryers, outlets, etc). He wanted to open every cabinet to see what was inside and just couldn't settle down until he had inspected every single hidden surface. I remember last Fall when we decided to take Owen to a Gymb0ree birthday party, knowing we could try it and leave if we needed to, Owen couldn't have cared less about the slides and balls and all the fun music and games, going straight to the bathroom and cabinets at the back of the room. It was hard as a mother watching all of the other children participating in the party activities while my little boy just wanted to escape, escape all the noise, all of the people, all of the overstimulation to find a quiet familiar place of refuge. A few months later, we went to a friend's house for a small birthday party, and I found myself chasing Owen around the entire time as he explored the house and then at one point, when I just couldn't hold it in any longer, closing a bedroom door keeping Owen in the room with me as I sat in a rocking chair trying to compose myself as tears poured down my cheeks. I wanted so much for Owen to be able to participate with the other children. I felt like going to the party was a mistake, but I knew the more Owen was able to experience different environments and other people, the better he would be able to function effectively in different places. He used to be the same way at our own house, wandering around looking at everything and not settling down enough to just play, but with time he learned to play all day long as he became used to all of the various stimuli (people, sights, smells, sounds, textures) in our home. I knew this could improve in other places, but it definitely was going to take time.

Before we brought Owen home, we read multiple adoption books, focusing greatly on those discussing attachment and the potential issues that may occur with a child who has been adopted as an older infant or toddler, especially those who have been adopted from an orphanage setting and have never known a consistent caregiver and have no meaning of what a "Mommy" is, who believe "Mommy" is replaceable because that is all they've ever known. When we met Owen at 14 months, we immediately noticed the signs we'd been reading about. Owen had no attachment to anyone at the orphanage, and he didn't have any preference for who held him, arched his back anytime we tried to hold him close, and never made eye contact with us. He was so interested in the toys we brought for him and didn't care a bit if we paid him any attention, ignoring us in the greatest sense of the word. We knew we had our work cut out for us but we couldn't imagine our life without this precious little baby boy.

When we first came home from Russia as a family of 3, Owen was almost 19 months old. We had talked with a friend of ours, Rob, who is an occupational therapist, about the various things Owen could and couldn't do for his age, and he recommended that we wait a year before having Owen evaluated for occupational therapy. He noted that Owen had been so deprived of so much stimulation and sensory input that he knew that we would see huge changes in Owen over the course of a year as he explored more textures and environments, and we did. For the first few months, we watched Owen explore his new toys and objects in his new home, rubbing them with his little fingers, flipping them over to study all sides, shapes, and textures, and literally gagging when he touched anything that wasn't smooth. Touching our hair made him gag, and he immediately pulled his hand/body away anytime his skin made contact with ours. Holding a stuffed animal to Owen was like forcing him to eat brussel sprouts. And as for eating, Owen only ate pureed foods by spoon and drank formula from a bottle. He gagged when any other texture was placed into his mouth. He didn't know how to chew. Anything that wasn't pureed immediately came back out. For so long, Owen's eyes couldn't focus on anything that wasn't right in front of him, and if that thing was a person who was talking, he definitely couldn't focus. He could track objects just fine and was very focused on objects as he played with them, but he was so distracted by all of the sounds in his environment that he could only attend to one or the other (the sound or the object) and sometimes focused one eye on the direction of the sounds in his environment while trying to focus the other eye on the person talking to him. He was good at focusing on the camera's light/flash so it was difficult to see this in many of his pictures, but you can see his arm between us and him in almost all of the ones where we're holding him. Owen was so attuned to sounds in his environment that even with a white noise machine, fan, and bathroom fan on to make white noise for his room, if we walked down the hall outside his room and made a peep, he woke up. This happened for months before we saw improvement and a more sound sleeper emerged. Just last weekend, Owen fell asleep to the sound of not white noise but people talking and dancing to loud wedding reception music sitting in a high chair leaning against my chest. When we picked him up to put him on my lap, he didn't wake up. Wow, progress.

One of the most difficult parts of Owen's attachment difficulties has been earning his trust and being blessed with the joy of his eyes looking into mine. With babies who were born biologically into families, from day one they are held close and fed as they gaze into their mothers' eyes. Over time, they are talked to and googled over as their mothers gaze into their eyes and respond with the same eye contact, smiles, and coos. They are picked up and comforted with touch and soft voices when they cry and receive consistent caregiving from one person (or a group of persons) and learn from these interactions. Children who have lived in orphanage settings do not receive this type of parenting. They do not receive parenting but caregiving. A child may have multiple caregivers within the same room, coming and going throughout the day and night, being transferred from age group to age group and caregiver to caregiver. They may be fed facing away from the caregiver or with limited eye contact as the caregiver does her best to feed multiple babies at once. There is minimal talking and playing with the babies as they are one of many who need to be attended to. Diapers are changed, bottles are given, and babies are left to "play" on their own. These children do not learn to attach to one person as a parent as they have never had one parent but many caregivers who come and go. They see "Mommy" as a replaceable entity, someone who comes and goes who they can't always depend on to be there when they need something.

Despite the large number of young children living there, orphanages are often very quiet. For example, there were approximately 125 children under 4 years old at the baby home Owen lived in for 13 of his 18 months in Russia (he was in a hospital before then due to his extreme prematurity), and the baby home was as quiet as a library. The sounds we heard were not those of babies cooing, laughing, and playing or even crying, but the sounds of caregivers' spoons clanging against their bowls as they finished their lunches, of the caregivers speaking to each other, not to the babies. Owen had 1-2 caregivers in his room he shared with 10-15 other babies. We met different caregivers nearly each day we were there. How can it be so quiet you may ask? When babies are in orphanage settings such as Owen's with many babies and few caregivers, they learn that no one comes when they cry so they stop crying. No one coos back at them when they coo. No one stares back into their eyes when they gaze at them for attention and affection. They learn they cannot depend on people, that they cannot trust the people who take care of them and who may love them most.These children form attachment issues that may make it difficult difficult for them to have meaningful relationships in the future and to know the difference between strangers and people they can trust, which can be very dangerous for the children.

Over the course of the first year at home, we watched as many of Owen's difficulties faded away. Within a short period of time, he learned to play with the toys he had, so intrigued by how each one worked and what he could do with them, and all of the sensory exploration of toys disappeared and functional play emerged. The hours of wandering around new places became reduced to shorter periods of checking things out before playing and participating more fully with other people. He went to a birthday party in early June at a local children's indoor pretend play/playground center, and Owen had the most wonderful time. He fully engaged in all of the activities (with the exception of the puppet show) and led us by the hand to each activity he wanted to do instead of running off by himself and going to familiar things instead of playing functionally. What a victory this day was for us!

The trips to the grocery store that used to cause Owen's eyes to wander in and out the entire time we were gone, unable to focus on anyone or anything as we drove to the store and shopped for groceries as he tried to filter all of the sights, smells, and sounds, have turned into fun little field trips for Owen (that he actually requests to go on). As we enter the store, he recites the grocery list to me as I've read it to him, eagerly searching for each object on the shelves, locating them, and putting them in the cart as we shop, and then saying a loud "Hi!" and showing all of his prized possessions to the sweet Miss Bonnie who is our favorite cashier. For a long time, Miss Bonnie tried to talk to Owen, and he was so overstimulated by all of the sights and sounds, that he couldn't even focus on what she was saying. It was as though she wasn't even talking to him. At first, my talking to him about her didn't seem to make a difference, but with time, I could say "Owen, Miss Bonnie is talking to you. She said "Hi." Can you say "Hi?" He would look toward her but not at her and say "Hi" then, whereas now he initiates the "Hi" and smiling gaze into her eyes. Take a minute and close your eyes and think about all of the things you see, hear, and smell during one trip to the grocery store and then imagine living in a crib for all your life and then being taken into one of these places and trying to focus on what someone is saying to you. When I did this, it made me realize, even if just a little bit, just how hard this was for him. I am so proud of how much he enjoys going to the store and saying "Hi" to Miss Bonnie now. He has come such a long way.

Over time, Owen learned how to chew a variety of textures as well as tolerate touching objects that weren't smooth. He now loves to run his hands through my hair and actually holds onto our hands, arms, and legs when he's held close. He doesn't squeeze us the way most children do when they hug their parents, but he does tolerate and actually seems to enjoy skin-to-skin contact now. When he received an occupational therapy evaluation after being home a full year, he only qualified for consultative services one time per month to help with his self-regulation and to monitor other areas of sensory processing and fine motor skills, and I believe this may not have been recommended if I hadn't wanted a little more help and reassurance that what we were doing at home was all we could do. Owen still loves to stand on his head and play Ring Around the R0sy when he's not engaged in activity and still has difficulty staying with one activity for very long and focusing immediately in new environments, which were our main concerns for seeking an OT eval at all, but every day this gets a little bit better, and we celebrate every little bit of progress!

When we adopted Owen, we were awakened the first night by the sound of him rocking himself back to sleep and also banging his head on the side of the crib. It was so hard to see him do this, and we knew we needed to teach him he didn't have to soothe himself any more. We did this by going to him and picking him up immediately anytime we heard him wake up and start rocking or banging his head, and by doing this he learned we would come to comfort him and that he could depend on us to help him soothe himself to sleep, which was something he had never experienced before. This was the beginning of our attachment process. For so long, even when we tried to comfort him and also when rocking him before bed, Owen turned away from us. He has never looked into our eyes and maintained eye contact as we hold him the way biological babies do at a very young age. He never had this and is still learning to feel comfortable with sustained eye contact in affectionate situations. He has pushed our faces to turn them away from his, has physically moved his body to the furthest most point of our laps away from our bodies as we held him, and anytime we tried to pull him close, he'd push harder against us. Recently, if he wakes up during the night, he cries out, "Where's Mommy?" and asks for me to come to him. He has begun crying actual tears (which are rare for him unless he's hurt) if he thinks I am going to leave his side when he wakes during the night. He begs, "Sleep Mommy's bed. Please!" When I pick him up to comfort him, he relaxes and puts his little head on my chest, seeking that skin-to-skin contact he rejected for so long, and falls back to sleep so peacefully.

When he is sad or hurt, he no longer shakes it off (literally) or takes off running into the other room to deal with the pain or sadness by himself but comes to us with tears and wanting a hug and kiss to make things all better. He still doesn't give outward affection easily. He doesn't hug us with a squeeze but now puts his arms around us and leans in with his face touching ours instead of turning away and putting his arm between us. He gives kisses willingly, often without asking and climbs into our laps to have stories read to him instead of picking up a book and opening it only to jump right back up and put it back on the shelf. He often asks to rock and just sit a while with me when he wakes up from his nap, whereas for so long he wouldn't even look at me when I came in his room to greet him after a nap or in the morning, seeing me as just another caregiver.

Nearly every day we see progress with Owen's bonding, attachment, and sensory processing difficulties. It has been and still is a challenging process on a daily basis. Some days are better than others, and we definitely have more great days than not now. We're so grateful that we haven't had the difficulties other families we know have had with their children hitting, biting, and fighting their parents, and I really feel for those of you who have been through these attachment problems. I can only imagine how much harder it must be to attach to your child and have them attach to you when they are rejecting you not only with their eyes and an arm between you at all times but with such physical rejection. It is difficult to explain to others when they ask, "Why does he do that?" as the explanation cannot be provided in just a simple explanation. Before we came home with Owen and during the process to adopt a child from Russia, we talked with our families and close friends about all of the attachment strategies we would be using with Owen once we were home, how we would be the only ones to touch him, hold him, give him affection, feed him, bathe him, change him, provide for any and all of his needs. We knew Owen would have a long road to building a secure attachment with us and to overcome the effects of such a lack of appropriate stimulation and interaction for such a long time, but we didn't know how long it would take. I remember telling family members that hopefully by his birthday and Christmas (6 months after coming home) they could at least give him a hug or hold him (I was wrong and I know how hard it was and still is for them to hold back their affection and love for Owen). I was told by someone or read somewhere that it can take as long as Owen was without us for him to develop a secure attachment to us as his parents. I remind myself that he lived in a hospital bed for 5 months and then a crib for 13 months. He had very little affection and motherly love. He learned that mothers are replaceable, that he couldn't depend on his "mother" to be there for him as all of his caregivers changed so often. He put up a guard between himself and the rest of the world. So much of his stimulation for so long was purely auditory that he learned to protect himself from trusting others and that he could tune out the rest of the world when he was overstimulated by diverting his eyes or letting them wander in and out and focusing only on what he heard. He is still learning to filter all of the stimulation, especially in new environments, but each day is a new day, a better day for him, as his body and mind learn to live in this noisy, beautiful world of ours.

Because Owen is not completely attached yet, when we see Owen take a step backwards in the progress of his attachment, we stop and take a step backwards ourselves, working a little bit harder again on making him rely on us to help him, holding him more, asking other people not to touch him in an affectionate way or help him for a while, doing more activities that require eye contact and requiring eye contact before doing/getting what he wants and needs, and responding to his needs and any cries for affection from us with more affection and playing with him more than usual. We have been amazed by how well this works for him. When he goes to a new place and wants to get down immediately to explore and take in all the stimuli around him, we require him to stay in our arms until we've been there a little while and have noticed that even though he fights it (verbally saying he wants down over and over again and trying to get down) at first, when he does get down he is calmer and able to focus more on everything and everyone in his environment. It's a learning process, and we are not experts in attachment or sensory processing difficulties, but we are learning over time what works for Owen. With help from wonderful people who are more experienced in these areas and books as resources, and by watching and working with Owen 24/7, we are learning not only what helps him with immediate situations, but also what will help him long-term as he continues to learn the meaning of a family, of having a Mommy and Daddy who will never leave him, who are not replaceable, who will love him no matter how much he may reject us at times, and that he can trust us to be there when he needs us.

Because he must securely attach to us first and depend on us as his parents for his wants and needs before he can be able to learn to trust and depend on other friends and family members, and because his brain is still learning to filter all of the different stimuli in his environment, we know that we will continue to hear the questions... Why does he do that?, Why won't he look at me? Why won't he just sit and play with me? Why can't I hold him? Why don't you leave him with a babysitter or take him to daycare? Why does he want to look in all the cabinets? Why won't he listen to me? Why do you pick him up when he cries? Why do you carry him so much? Why do you still feed him/help him so much when he's eating? Why do you play with him all day long? Why don't you just let him play by himself? WHY DOES HE DO THAT? But, it's okay. There are still days when we want to cry for him, when we look at him and just wonder what his precious little mind is thinking, what all he went through before he came to us. We still feel frustrated at times and want so much for Owen to be "there," the place where we'll know he's fully attached and has overcome his sensory processing difficulties. When this happens, we remind ourselves just how far he has come and continue to focus on all of the progress he's made and the bright, joyful 2 1/2 year old he has become, and have to stop to remember that it will take time for him to be able to function like a child who has been with his family from birth. We love Owen so very much and want nothing more than for him to be able to be all that God created him to be, that he will become fully attached to us as his parents and that he will be able to overcome all of the effects of being deprived of so much his first 18 months of life. We see how far he has come and rejoice in knowing he can do it! We can do it! It will just continue to take time and dedication. Each day with Owen is a gift, and we have promised him we'll make the best of each one of them! Thank you all for your prayers, support, and for understanding (or trying to understand) the complexities of attachment and sensory processing difficulties and for accepting and loving Owen the way he is as he continues to grow more attached to us and better adjusted each day! Why does he do that, you ask? If you didn't know before, now you do! :)

1 comment:

  1. What an amazing entry! It really brings attachment issues into perspective.