Never Shake that Baby

http://kidshealth.org/parent/medical/brain/shaken.html#

Please go to the link above and read the article.  If you are a foster or adoptive parent read it.  A shaken baby does not always have severe damage.  Sometimes the damage can be silent.  Sometimes you won't understand why your child is struggling.

Both Anthony and Larissa have been diagnosed with damage caused from being shaken.  We received Anthony at 2 1/2 and Larissa at 4 months.

Anthony was nonverbal, wild and thought to have mental retardation (an Intellectual disability in today's terms).  Anthony received services at home and when he turned 3 received services at school and extra private speech services.

By time he was in kindergarten he was in a regular class and although he had some delays and behavior issues he was able to learn with his peers.  He repeated kindergarten because of his immaturity (his birthday was a few weeks before the cut off date so he was the youngest in class).  He went to therapy for his violent behaviors and sexual acting out.  Therapy was worthless as the therapist kept comparing him to her son and recommended interventions that worked for her son. I studied his issues and worked with him at home.  It was at this point that we adopted both children.

He was diagnosed as bipolar but I was not able to get him medicated until a later age.  Once he was medicated for mood disorder his world improved greatly.  His resource teacher still remembers that time and the profound difference in his behaviors with the medication.

Anthony will soon be 12 and the brain injury is starting to really catch up with him.  He is getting further and further behind and is struggling in all areas except for dance and art.  He loves to dance and participate in art.  As his struggles have increased so has his anger issues.  I wonder if perhaps it is time for a different mood disorder medication.  Either way, he needs to learn some better ways to deal with his anger so I will work on that this summer.

He struggles with friendships and his anger and rudeness gets in the way of maintaining meaningful friendships.  Right now his best friend is the son of my best friend.

Anthony also has the capacity to be very sweet and compassionate.  He has a huge heart for me and wants to please me.  I have decided to not homeschool him next year for several reasons.  We will work on home issues at home and leave the educational issues at school.  I don't feel that I can do both and homeschool Emma and Larissa as well.  I do plan on requesting that he go to art class at school and I know that he will get a lot out of that.  I will see how the next year goes to determine what I will do for the following year.

I am still trying to determine what resources I should get for him.  Comments from a reader about labeling drawers and such has made me realize that I need to pull out my training experiences and see what I can apply.  My master in special education is in severe and multiple disabilities and autism.  I wonder if some of the training for autism would cross over into TBI.

When we received Larissa her head was tilted to the side and her arm on that side was straight with a bent wrist.  She also has swallowing problems. She also received services at home until she turned 3 and then she went to school for services as well.  She was diagnosed with selective mutism at the age of 3.  Three years of visitation really impacted her in a negative way.

We moved to Texas for a year after we adopted the kids and it was there that she was diagnosed with seizures coming from the frontal lobe.  She had actually had seizures for a while but it was misdiagnosed here in South Carolina. 

Larissa received services until after her kindergarten year.  When she started kindergarten we put her on anxiety medication and it really helped with her selective mutism.  Research in that area showed that medication was the best approach.  We had taken her to a play therapist who claimed to specialize in selective mutism.  After a short period of time she refused to see Larissa anymore because she wouldn't talk to her, uh, I don't think she really understood selective mutism. She has not been to any therapists since.

At the end of kindergarten the school took Larissa off of her IEP.  That was a huge mistake.  Her first grade was horrible.  She started having major mood swings and major crying issues.  She was diagnosed with bipolar earlier so we were able to switch her seizure medication to one that covered mood disorders.  That helped with the mood swings but not with her struggles in school.  Homework took hours and was agonizing.  Her seizures were not controlled, she was tired all the time.  

I homeschooled her for second grade and I could really see her struggles with math.  At home we were able to get her back on grade level for reading and limped along in math.  She wanted to go back to school so this year she went back.  It has not been a good experience.  She quickly lost grounds in all areas.  She was so tired that she couldn't function and she currently is going half days. She thinks that going back was a mistake and wants to be homeschooled....for as long as possible (her words).

Like Anthony she enjoys dance and art. She is very loving and has no social problems.  Her selective mutism merely comes across as slight shyness.  She no longer takes anxiety medications, only seizure medications.  She has some type of sleep disorder that has not been determined and it really impacts her daily living.

She is able to do multi-step tasks and is better able to function at home.  Academically she is struggling and losing ground.

Both kids have frontal lobe damage.  Both can not do math and struggle with very similar academic issues.  However, emotionally, socially and life skills they differ.

Functions- Frontal Lobe

• How we know what we are doing within our environment (Consciousness)
• How we initiate activity in response to our environment
• Judgments we make about what occurs in our daily activities
• Controls our emotional response
• Controls our expressive language
• Assigns meaning to the words we choose
• Involves word associations
• Memory for habits and motor activities

Observed Problems

• Loss of simple movement of various body parts (Paralysis)
• Inability to plan a sequence of complex movements needed to complete multi-stepped tasks, such as making coffee (Sequencing)
• Loss of spontaneity in interacting with others. Loss of flexibility in thinking
• Persistence of a single thought (Perseveration)
• Inability to focus on task (Attending)
• Mood changes (Emotionally Labile)
• Changes in social behavior. Changes in personality
• Difficulty with problem solving
• Inability to express language (Broca's Aphasia)

To a lesser extent, they have damage to the parietal lobe.

Functions- Parietal Lobe

• Location for visual attention
• Location for touch perception
• Goal directed voluntary movements
• Manipulation of objects
• Integration of different senses that allows for understanding a single concept

Observed Problems

• Inability to attend to more than one object at a time
• Inability to name an object (Anomia)
• Inability to locate the words for writing (Agraphia)
• Problems with reading (Alexia)
• Difficulty with drawing objects
• Difficulty in distinguishing left from right
• Difficulty with doing mathematics (Dyscalculia)
• Lack of awareness of certain body parts and/or surrounding space (Apraxia) that leads to difficulties in self-care. Inability to focus visual attention
• Difficulties with eye and hand coordination