Vol. 17, No. 2 • May 2013

Trauma's Impact: My Family's Journey

by Mark Maxwell

Today I know how important it is to understand how trauma can affect children and to be able to see their behaviors through a "trauma lens." I only wish I knew that six years ago, when I first met "Tyler." (Tyler isn't his real name; to protect privacy I've also changed some details in this story.)

How It Began
I got a call from Jill, our agency case manager, about Tyler, who was then 12 years old. She said he needed placement immediately because of a problem that occurred in his last foster home. I hesitated when I heard Tyler had had a dozen placements in recent years, but ultimately agreed to provide respite.

Our Family
At that time, we were like many families. We were a two-income, middle class household. I was in graduate school, working on my master's degree. We wanted children.

Our older child, placed in our home from foster care, had challenges, but like many parents we weathered them. We believed we could make a difference in children's lives with "love and logic," and that this would work with Tyler, too. Before we knew it he was in our home: a smiling, tiny little boy with a love for nature and camping.

Tyler's File
At my request, Jill shared Tyler's file with us. It consisted of a hodgepodge of case notes, IEPs (Individualized Educational Plans), report cards, and lots of acronyms, including PTSD (post-traumatic stress disorder), ADHD (attention deficit hyperactivity disorder), ODD (oppositional-defiant disorder), and RAD (reactive attachment disorder).

Now, we were trained as therapeutic foster parents, so it wasn't the first time we'd seen those acronyms. Naturally, we were concerned.

Tyler's file explained that he had experienced an average of one move a year since the age of five. The state confirmed he was badly neglected by his biological family. The file stated that he was sexually abused by an uncle and exposed to marijuana. There were remarks within the reams of paper about Tyler "acting inappropriately with younger children" and having issues with boundaries. In addition, the files described his issues with stealing and "compulsive lying."

After reading all this we were fearful, but wanted to help.

I asked Jill about the family Tyler was placed with for three years. She explained that they wanted to adopt Tyler but the mom returned to school, and his needs proved too much for them.

No Honeymoon
As foster parents we are often told about the "honeymoon period" that occurs just after a child is placed in a foster home. We did not receive one from Tyler.

Shortly after his arrival, we noticed small items missing from our bedroom. Over time, we placed a lock on our bedroom door. Food would vanish only to be discovered hidden and moldy in Tyler's bedroom closet or under the bed. Items that required double AA batteries never seemed to have a working set. We would find batteries with teeth marks like the ones found in a discarded piece of gum.

Tyler's toys and personal items were often destroyed with no rationale. We learned over time that giving Tyler a consequence for his actions really meant we were on lockdown, because that meant we had to supervise him constantly.

At school Tyler would steal from fellow students and teachers. On three occasions he was captured on school surveillance cameras taking property. Each time he denied involvement until images were produced that showed him in action.

A Permanent Home
Through school visits, court hearings, and case management meetings we were encouraged to provide Tyler with a permanent home. We agreed a year later. We believed providing him with a loving, stable home and psychiatric services would give him what he needed to heal from his past.

That's not quite how it worked out. Today we understand that the pain from his past trauma created a pattern of behaviors that Tyler found difficult to manage.

He excelled as a Boy Scout, yet was suspended from school for stealing and banned from community youth activities. When he received a consequence for an action, his response was not to accept it, but to get revenge. This included making false allegations to authorities about the adults around him, including members of the family and school staff.

The school psychologist said to me, "I know you love this child and want to help him, but because of his past trauma he is severely emotionally disturbed." Those words were written into Tyler's IEP.

He met weekly with a therapist but refused to take "legal" psychotropic medications. By age 17 his behaviors had earned him time in youth detention facilities, a stay at a wildness camp (which he ran away from six times during a 10-month period), and an adult criminal felony conviction.

My Advice for Foster and Adoptive Parents
Though the journey with Tyler hasn't been easy, our experiences with our other children have been less extreme, more successful. My family remains engaged with the child welfare system. I'm an active member of the NC Foster and Adoptive Parent Association and I
continue to want to give back.

To foster and adoptive parents caring for children who've experienced significant trauma I offer the following suggestions:

• Be your child's number one advocate when it comes to requesting and receiving mental health services. Engage in treatment. When it comes to treatment interventions, know there's not a single treatment that works for everyone. Keep looking until you find the one that works for your child.
• Educate yourself about trauma. Take classes, read, and ask questions. Work hard to develop coping skills that will allow you to help your child.
• Take breaks and take care of yourself to avoid burnout.
• Communicate with the child's support system (teachers, coaches, and others) about your child's needs. The child's community supporters will reassure and empower the child to move forward.

Mark Maxwell is Vice President of Region 2 for NCFAPA. He has four children, three adopted from foster care with his life partner. Mark is a PhD candidate at Walden University.

Tips for Improving Outcomes for Children with Trauma-Related Behavior Problems

Explore evidence-based treatment. Certain treatments have been shown to work well for children who've experienced trauma. Ask your child's therapist about their approach and experience with treating trauma. If your child is not in therapy, ask their social worker about trained therapists in your area by using the NC Child Treatment Program website at http://bit.ly/XNEpwS. Build children's healthy attachments. Making sure children maintain and strengthen bonds with important people in their lives can reduce the damage caused by trauma and improve the likelihood of a healthy outcome. Work with your child's team to determine ways to use visits, phone calls, or online contact safely to help keep children connected. Identify "trauma triggers." Most children have certain situations or sensations that make them feel unsafe or remind them of past trauma. These triggers can cause especially difficult behavior. Work with your child's team to identify triggers that may be contributing to challenging patterns of behavior. Value assessments. Maltreatment can alter the chemistry and the formation of a child's brain. A comprehensive medical and mental health assessment can help identify problems your child may have developed as a result of his early history. Get moving! Regular physical activity benefits all of us, but it is especially important for children dealing with neurological or emotional challenges. Find ways to fit in time for kids to run, climb, and play--it will pay off for everyone! Learn more. Visit the following websites: National Child Traumatic Stress Network, National Center for Posttraumatic Stress Disorder, American Psychological Association, and the National Institute of Mental Health.

To view references cited in this and other articles in this issue, click here.

~ Family and Children's Resource Program, UNC-CH School of Social Work ~