Friday, April 21, 2017

It's Just Parenting

I read an article this week that re-ignited all my deep feelings about the ups and downs of my time as a foster carer. The writer, who is herself care-experienced, was expressing dismay at the desire of some foster carers to seek employment rights. Please do go and read it here - the views of those who have lived their lives in our care system need to be heard.

They need to be heard, even if they are just one side of the story, even if they upset us, even if they destroy our cherished notions of how the world works.

The basic premise of the article is that children need foster carers who will be there for them, who will make them part of their family, who see them as much more than a 'job' and who see their care as a joy, not a 'career'. I wholeheartedly agree. I couldn't agree more in fact.

I don't like to see hoardings advertising a 'career' in fostering either. Equally I'm not keen on those adverts that imply that having a spare room is basically the only asset you'll need as a foster carer. I can easily see that comments about foster carers needing holidays and 'rights' can sound heartless to young people who need security, nurture and, yes, love. But the truth is, while a child may just want a family, what the foster carer's agency expects from them is much more complex than that. Creating a family life for a child in care requires more than just basic parenting, however much we wish it could be otherwise.

This post is not going to be a list of the ways in which being a foster carer, and especially a short-term carer, is not at all like being a regular parent. I've already written that post - it's here . . . oh, and here as well. And I'm not going to write about all the ways in which a foster carer's agency can mistreat them, take them for granted and frustrate their every effort to be the family a child really needs. You can read about that here if you're in the mood, and in many other cries of frustration scattered around my blog archives.

I'm not going to write about that today because my mind is filled up by something that struck me when I read the article. This writer, a care-experienced person who presumably knows what it is like to live with a foster carer, thinks that fostering is basically just 'parenting'. I have thought about this a lot over the past day and have come to the conclusion that if any of the children I have fostered grows up to think that I was just 'parenting', and if my own adopted children think that all I do is 'parent', then I will be pretty happy with that.

I will be happy because it will mean that their memories of their childhoods are not populated with social worker visits, reviews and meetings. It will mean that they have forgotten, or never noticed, the daily logs, the training I went on, the supervisions and appraisals I had or the nights I spent reading books and articles about brain development, trauma, attachment, developmental delay, sensory processing and all of the other things you suddenly have to become an expert on so that you can do 'parenting' with children who have experienced such loss and trauma.

It will mean that they have not seen how carefully I minimised triggers, managed our environment or planned for our daily lives, our holidays and day trips so that they could be the source of good memories, rather than meltdown-fuelled catastrophes. It will mean that they don't remember how many emails and phone calls I had to make to get permission for them to come on that holiday with me, or how many times I advocated on their behalf with social workers, medical professionals, education professionals, or how many times I waited by the phone for news that would transform all of our lives.

I hope that it would also mean that they lived through a time where they lived with one family but visited another three or more times each week and managed to come out of it feeling as though they had two families and not no family. I hope that it would mean that they never saw the behind-the-scenes work that went into making this happen.

In short, I hope that it would mean that they have grown up believing themselves not to be 'damaged goods' who needed a 'therapist', but 'children' who needed 'parenting', for that is what they are. 

So yes, despite a huge part of me wanting to cry out to the heavens about the realities of being a foster carer, of welcoming children into your family, caring for them for a few weeks or months and then saying goodbye to them again, of giving your heart and soul to the children, and your life to the fostering agency, I find myself instead hoping that all the little ones that have been through my home will one day say, "It's just parenting."

Thursday, April 13, 2017

An Open Letter to the new President of the ADCS from a Foster Carer

Dear Alison Michalska,

I was interested to read that you recently gave your inaugural speech as incoming president of the Association of Directors of Children's Services. However, I was extremely disappointed to read some of the comments you made in which you seem to be saying that the concerns of foster carers, the volunteer backbone of children's social care, are "irritating" and that solutions proposed to some of the very real problems faced by foster carers are "slightly mad notions" and "nonsense".

I can only hope that it did not occur to you how patronising your tone might appear to many foster carers who would hear your speech or read accounts of it in press reports. While many of us struggle to earn the respect of the social workers we work alongside, it is so disheartening to see that somebody in your position of authority is able to speak of our concerns in such a dismissive way.

Like many other foster carers, I share your concerns about professionalising foster care. In over two decades of my working life, including many years spent as a teacher, I have never joined a union. I've never even considered it until now. Nobody knows better than foster carers that what we are trying to provide is a family for children who, for whatever reason, cannot live with their own. We work hard to achieve that, within the limitations created for us by safeguarding and health & safety considerations. I would not be willing to compromise this priority in any way.

And yet foster carers are becoming increasingly 'professional' in their approach whether we like it or not. It has become necessary. The role description provided to me by my LA includes the word 'professional' several times. As a short term carer for pre-school children I am expected to participate in a scheme of continuing 'professional' development with a minimum of five training events per year. I must interact with everyone from birth parents to paediatric consultants with a 'professional' approach. I must conduct myself 'professionally' at meetings and reviews. I have monthly supervisions and a 360 appraisal every year. I am told that I am a valued member of the team around the child.

Over the years I have worked hard to improve my knowledge and skills with regard to speech development (teaching myself Makaton along the way), neurological effects of early trauma and neglect, FASD, the effects of maternal drug abuse on a newborn baby, attachment, theraplay, sensory needs, joint hypermobility, therapeutic parenting and much more, all to meet the needs of different children in my care. I have attended training provided by my LA, paid for additional training out of my own pocket, read books and scholarly articles and interacted with hundreds of other foster carers and adopters in order to improve my practice. I can honestly assure you that my knowledge in these areas far outweighs that of my supervising social worker. Yes, not only am I 'professional', but I have also become a 'specialist'. The very things you are concerned about are already happening.

You find yourself "irritated" that proposals to improve the current situation for foster carers "take no account" of whether changes would improve the outcomes for children we care for. Perhaps I can explain. My local authority has spent a good deal of money training, supporting and developing me in my role as a foster carer. And yet now I find that I simply cannot pay the bills. As a single carer I cannot hold down a job while I foster as the demands of the fostering service on my time are simply too unpredictable to fit with other work. Three contacts per week during office hours? Meetings arranged at the last minute with mandatory attendance? Contacts changed at less than two hours' notice? Mandatory full days of training and no help with childcare? Children arriving into my home within an hour of the first phone call? My family and friends have told me that the thing they find most shocking about my role as a foster carer is the extent to which the LA dictates my whole life.

We would manage with the help of the benefits I am also able to claim if fostering wasn't so unpredictable. My LA has recruited far more pre-school carers than it needs so I can go weeks and months with no work. There is no retainer. There is no option for me to enquire whether another local agency needs my services. There is nothing to plug that gap. I have had to find paid employment. I am no longer fostering, although I stay on the books in the hope that I can return in the future. And this is how improving the situation for foster carers will improve the outcomes for children: it means that expensively-recruited, expensively-trained, experienced and skilled foster carers will be able to continue to foster.

Some time ago I read a lot of stories about the difficulties that 'hot-desking' was causing for social workers. A report by the Centre for Research on Children and Families detailed how hot-desking was adding to stress and uncertainty in what was already a stressful and uncertain role. Other stress-factors highlighted were removal of parking spaces near to offices, inefficient IT systems and noisy offices. The conclusion was that organisations should prioritise improving the workplace environment. And why? Because it stands to reason that social workers who don't feel valued, whose role is being made harder by inefficiencies and whose stress is increasing as a result will find it far more difficult to carry out their role to a high standard.

If this is true of social workers, why would it not be true of foster carers? And if hot-desking increases stress, then think what the possibility of having no work next month and no idea when you will work again can do to a person. Imagine how that stress is compounded when you have been up night after night with a withdrawing infant, or spent the early hours cleaning faeces from a child's bedroom wall.

Times have changed. The rosy, somewhat old-fashioned image of stay-at-home-mum or empty-nester foster carers providing bed and board to a child in need ought to be consigned to history, especially in the demanding and ever-changing role of short-term, emergency and therapeutic care. There is a huge shortfall of foster carers. Many children who come into foster care have complex and challenging needs which demand skilled care and a huge investment of time. I personally know many former teachers, nurses and members of other caring professions who see fostering as far more than just a nice thing to do with a spare bedroom. For us, it is a professional role motivated by love, compassion and a desire to see the very best outcomes for the children we care for. In foster care, as in social work, professionalism and compassion are not mutually exclusive.

As foster carers, we rely utterly on social workers for support and guidance both for ourselves and on behalf of the children we care for. It has saddened me to see the concerns of foster carers so publicly belittled and dismissed by somebody with such influence over social workers as you have in your role. I do not know if the solutions that have been proposed by many foster carers are the right ones, but I do know that much dissatisfaction is created by a sense that our role is not understood or fully valued by those we work with. The tone of your remarks has done nothing to assuage that concern.


Suddenly Mummy
A (former?) Foster Carer

Monday, April 10, 2017

Sensory Processing: After the Assessment Part 2

According to the occupational therapist, 'core strength' is, well, core. And OB doesn't have enough of it.

This was one of many things that came up during the assessment - you can read the rest in my first post about the results of the assessment  - but I thought it deserved more than a passing reference as it's a whole different kettle of fish from his sensory quirks.

Most of you will know that I have had OB on and off since he was a very small baby. He first came to me at four and a half months old. We had a rocky 'on and off' period after that before he came back to stay at 13 months. While this is wonderful in too many ways to list here, it does mean that sometimes I have a wave of self-doubt about his 'early childhood' which, after all, was mostly spent with me.

Core strength is one of those areas. I had read that poor core strength in children tends to be caused because they were left lying down too much as babies. Well, OB spent most of his babyhood with me, so I immediately felt the guilt rush in. Did I leave him lying down too much? Was he not rocked enough? I cast my mind back and felt awful about every moment he spent in his cot or on his back on his playmat. I bitterly regretted not trying harder with 'tummy time' despite it being such a trial for him.

However, the OT explained to me that core strength starts with neck strength; that from a child's earliest moments, each gentle movement, rock and sway lays the foundations for good neck strength, which in turn is the foundation for good core strength. If he was left lying around for prolonged periods in his first few weeks and months, not rocked enough, not cuddled or carried enough, then he wasn't developing his neck strength. It started in his first weeks and months. Including 18 weeks when I didn't even know him.

Core strength is the foundation on which limb strength and gross and fine motor skills are laid. No wonder tummy time for OB consisted of him repeatedly bashing his face on the carpet until I took pity on him and picked him up. Crawling builds core strength, but is difficult if you're not strong enough already. OB sat at 8 months, crawled at 9, stood at 10, walked at 11. As the OT said, why bother prolonging the crawling stage when standing is far less hard work.

None of this is the end of the world. OB can sit, walk, run, skip and, recently, hop and Heely. It's all good. What it means is that he has rotten seating posture, an erratic gait and a tendency to occasionally fall off things and over things. His balance isn't brilliant, which doesn't help with the bike riding. He absolutely looks the part at football and his dribbling skills are coming along, but if he has to kick the ball with any force, it's best to take cover as it could go in any direction! Thankfully, it doesn't tend to go too far. I suspect this is what also lies behind his decidedly pigeon-toed approach to walking and running.

If we weren't having the OT assessment anyway, most of this would probably never have come to light. I suspect OB would have gone on to live a long and happy life none the wiser, although a career as a Premiership footballer might have been out of the question. But, as we do now know, we'll set to work on the exercise sheet we've been given and see where it takes us. Probably not the Premiership still, but you never know!

Saturday, April 1, 2017

Sensory Processing: After the Assessment

When I met for the first time with our post-adoption social worker, sensory processing was one of the first things she mentioned. In fact she felt it was so important to assess OB's ability to process sensory information that she made a referral to a specialist occupational therapist immediately, believing that other therapy would be futile unless we knew where we stood with this area.

Sensory processing is a term that refers to a person's ability to process the sensory information coming from the world around them in an organised manner. Sensory information can come through the well-known '5 senses' - touch, taste, smell, vision, hearing - and also through the less well-known senses such as proprioception (awareness of the relative position of parts of the body) and vestibular (awareness of the body's movement in space - balance, position etc.).

Most people have probably heard of sensory processing issues in relation to people with autistic spectrum disorders - being overwhelmed by noises, or by the feel of certain fabrics against the skin. Many children who have experienced early neglect and trauma also seem to experience sensory processing problems. The Attachment Trauma Network suggests that this may be related to the problems with the attachment cycle in infancy and early childhood.

Ideally, a child's primary caregiver acts to regulate the child in part through experiences such as rocking, stroking, singing and talking. A child who experiences neglect does not learn to regulate themselves and misses out on all of this predictable, regulating sensory input at the time when their brain ought to be developing the ability to process it. In fact, they may instead be exposed to unpredictable, frightening sensory input (e.g. shouting, prolonged hunger, rough handling) with nobody to help them make sense of it all.

OB's assessment threw up a few things. Firstly, that his core strength is poor. This has a number of implications for him, but I'll save that for another blog. Secondly is that he has sensory difficulties in every area of sensory perception, but some more than others. In particular, he is hyper-sensitive to auditory, vestibular and tactile sensations, but hypo-sensitive to proprioceptive input.

What does this mean? It means that while he is content to make a lot of noise of his own, partly to regulate himself, he isn't too keen on everybody else's noise, or sudden or loud noises. While he will enjoy a hug or a cuddle, he is too ticklish for many basic grooming activities, and isn't terribly keen on any touch that isn't on his terms. The OT actually suggested that our bathing problems might be down to the feeling of water (always tepid - hot/cold sensations are an issue too) running over his skin being unbearable to him. It means that predictable movement like swinging is lovely, but expecting him to cycle on a bumpy pavement will lead to meltdown. It means that he runs too much, skips too much, stiffens up randomly like a puppet when doing physical activity, pushes against things, crashes into things and always, always leans against me just that little bit too hard.

So, what do we do? OB will have a course of sensory therapy. We are waiting for this to start so I can't enlighten anybody as to what it might entail! He has also been prescribed a 'sensory diet'. This is a list of things to try at home that might help to give him the sensory input he craves in some areas, while modulating the overwhelming sensory input in others.

Although every child's 'sensory diet' is different, there are some common themes, and much of what is suggested on OB's are things I've noticed other parents talking about. Many of OB's recommendations are around providing him with the sensation of pressure on his body that he is seeking when he throws himself onto the sofa, or onto me, so carrying a weighted backpack, having a weighted lap bag on his knee while he sits at the table, using a weighted blanket, daily deep pressure massage of his fingers and hands. Others include considering the use of ear defenders, avoiding walking on bumpy and uneven surfaces and making the most of sensory input in everyday activities, such as using different textured sponges in the bath, and encouraging him to dry himself after the bath.

So far, so good. Now all I have to do is to persuade him to co-operate with any of these suggestions!