Assessment 2018-19: Ladybug

Ladybug had a tough year.

Behavioral issues stole the limelight and kept us focused on survival.

However, she did make some significant academic progress, and I'm learning from her psychiatrist and therapist to say--no matter what she's doing--that she's doing the best she can.

I'm learning to feel that is true.

Social/Emotional--Let's start with the tough stuff so that we can end on a hopeful note.

Last summer, because Ladybug's behaviors were increasingly difficult to cope with and because her  therapist-at-the-time recommended it, I asked her pediatrician about getting help for RAD.  The pediatrician seemed confused, but she did give us a list of services in our area, and I made some calls.

The first stop was MOCSA for group therapy.  It felt like putting a band-aid on a chest wound, but it was the best first stop for us as her behaviors qualified for mandated reporting, and the fact that we voluntarily sought help from MOCSA meant no investigation by social services.  It was a long, long program, and it consumed our time and energy for many months.  While Brother and Beowulf got assessed and diagnosed by clinical psychologists, Ladybug worked on learning about healthy sexual development and how to follow the Turtle Steps.

These are posted in several rooms in our home, and we use them constantly.

Ladybug completed the entire program at MOCSA, and she graduated because she was cooperative, but none of her behaviors changed at all, and the therapists at MOCSA agreed that Ladybug would benefit from more psychiatric services than they offered.

We got her a therapist for private sessions at CAPA, and we got her a psychiatrist at TMCBHFC.  The psychiatrist did a brief intake and felt that she would benefit from ADHD meds in order to reduce her impulsive behaviors and give her time to follow the Turtle Steps before acting.  So far no meds have worked because they turn her into a zombie, and I refuse to drug her to zombie state.  Fortunately, the psychiatrist agrees, and he's taken her off meds immediately, offered new meds, and counseled us through the difficult decision to keep trying meds.

As of this writing, Ladybug is on her 4th med, a non-stimulant called atomoxetine.   She's on 1/3 of the allowed dose for her age/weight because we're trying to be very careful about side effects.  It is a slow-acting med, so even though we're on the 3rd week of dosing her, it is hard to tell if it is doing any good.  It is NOT making her sleepy or zombie-ish, so I will be okay with increasing the dose at our next appointment in another week.

I am not certain that ADHD meds will work for Ladybug.  Thus far, we've seen no improvement in focus or reduction in impulsivity. 

However, I am certain that she needs something, because we could barely live with her before we began this therapy/med regimen, and for the 4 or 5 day gap during which insurance argued about paying for yet another med, her negative behaviors skyrocketed back to the place we were last summer.

Ladybug has an appointment with the clinical psychologist for testing in August.  I imagine it will be completed by October or November, and I hope to have a better idea of what we're dealing with and a better plan for how to help Ladybug than drug #1, drug #2, drug #3 . . .

In the mean time, Ladybug is still supervised around the clock.  During quiet time, and sleeping hours, she's in her bedroom with an activated door alarm.  We've worked out a safety plan with our church leaders so that she can attend primary on Sundays and weeknight activities (we kept her from them for several months this past year), and I am more grateful than I can say to the good women who accept the assignment to watch Ladybug for me during those times.   She is supervised through grooming and toileting, at meals, during school, and at all play time.  Out-of-doors, she is separated from the rest of the children on our gated deck unless someone is available to watch her.  In the house, she stays in whatever room I am in--mostly the kitchen and dining room (school room)--unless Sir Walter Scott or a teen is willing to supervise her play with other children.

She is friendly, and she likes children that are her own age, but she doesn't play maturely enough to maintain a friendship with an age-matching peer.  She plays better with younger children.  Based on my observations, she likes younger children because they are more likely to do what she wants them to do without questions.  This is something I watch closely.  I'd like very much to think she likes the little ones because she has a healthy maternal instinct, but my gut tells me otherwise, so I intervene often.

Truthfully, she is not a danger to herself or other children 100% of the time, and so far, she's harmed no one but her siblings--both biological and adoptive--but that's 5 children, and she's unpredictable.  It's her unpredictability that keeps us watching, watching, watching . . . because even one unsupervised moment could be the moment she harms another child.

All of that said, Ladybug can give all of the "right" answers about social skills and correct behavior.  She prays to be able to choose better than she does.  I've seen her really try to process what is right and what is wrong.  She gets discouraged about her failures, and we teach the doctrine of repentance many times each day so that she knows (will know) that it is never too late for forgiveness and change.

Her behaviors kept her from "doing school" many, many days in the first half of the year.  It took me some time to pray and ponder the issue, and eventually I received the inspiration to get her up half an hour earlier than the other kids and give her one-on-one school time before she had time to engage in anything negative that could spoil our school day. 

It worked!

She's made steady academic progress ever since.

We have not changed this habit for the summer.  Until I feel directed otherwise, she will get up early and have that time with me all to herself.

Physical Development
Ladybug is quite small compared to her peers.  She is growing well on her own pathway, though, and she is strong, strong, strong.   Her gross-motor skills are probably her greatest strength.  She turns cartwheels, does back handsprings, balances on her hands, climbs, and jumps with remarkable agility.

Sometimes I think I should enroll her in gymnastics as a place to shine.

But then I think about the stress and competition and cost of anything beyond recreational lessons, and I know it would do more harm than good.

In spite of her great strength and balance, she's not a gifted dancer, but she likes our dance team, and she does her best.  I hope that, for now, our shows will provide the positive reinforcement she needs for a healthy self-esteem--along with the sense that she's doing a good work for people who really need good works.

Under her psychiatrist's supervision, she takes melatonin to help her sleep.  The door alarm at least keeps her in her room, even if she can't sleep through the night.  We had to remove all furniture and personal objects from her room because while she was up at night, she'd climb and jump and tear things up, and we found her trying to move her dresser over to her window in order to climb out.  Even though there's nothing to climb on anymore, we keep the windows locked at all times.

(Emergency Safety Note:  There is a fire escape ladder in her closet that an adult or teen can unlatch and use to help her out.  We have safety drills.)

She does not like eating, but I serve her a minimum portion of each food and require a clean plate at each meal.  I'm teaching her that she doesn't have to like it, but she does have to eat it because her job as a child is to grow.

She has no food sensitivities, and removing gluten and/or dairy from her diet made no difference in her well-being, so she's not on a restricted diet at all.

Her toileting issues seem to be by choice rather than a physical problem.  However, they are just odd enough that I still wonder if there is a chance there's some physical issue contributing to the negative toileting behavior.   It's on my radar to discuss this at her annual physical exam later this summer.

Morning Meeting/Academy
These are our two group sessions of school each day.  Ladybug is polite, and she participates in the discussions.  We worked on raising hands before talking because we have a big enough group to make that necessary, and she has learned how to do that this year.

In spite of her best efforts, Ladybug is easily distracted, and she often tunes out what is going on around her.  This means she often can't answer recall/comprehension questions, but the general ideas we're learning via lots and lots and lots of repetition are beginning to be retained.

Ladybug's drawn and written narrations improved dramatically this year.  She mimicked Nature Angel's artistic style until it became her own, which shows a certain level of artistic competence.  Her drawings are interesting, and as long as she understands the subject matter, she draws pictures that show some creative symbolism (e.g. She drew a bunch of dollars on a page when we learned about bartering vs money).  About half way through the year she became quite determined to write her own narrations--one sentence or so explaining what she drew.  Her spelling was/is completely inventive, but I was able to make out what she tried to say each time.

 She can't tell the difference between main ideas and details, so she's often side-tracked by the details.  Our daily narrations are helping her to get a better hold of the main ideas.

I don't see any enthusiasm for science or history lessons, but she seems to like a good story.  She struggles to make connections from one subject to another, but I see her trying.  She will occasionally raise her hand and excitedly say, "That's just like _____________ !"  Usually her observation is about some small detail, e.g. she'll notice a drawing of a bird in a picture book about Abraham Lincoln and tell us she saw a bird like that outside last week.  It may miss the main point of the story, but she's trying, and she's learning something--even if it's not what is on my agenda. :)

Birds
I need to pause and document an interest that seems to be growing in Ladybug.  Because she is so often separated from the other children for playtime, and because she breaks so many toys that she is often left with nothing to play with, she has only the trees, birds, and insects for entertainment.  She spends a great deal of time watching the birds in our yard (and we have plenty as we are on a nearly 1 acre wooded lot).  She comes into the house often to report the number of birds she's seen and to compare her observations to a department of conservation bird poster we have on the kitchen wall.  She tries to identify them, and she tries to mimic their calls.

I'm thinking I need to find a way to support her interest without pushing or taking over.

Personal Scripture Study
Ladybug's reading skills do not extend to reading The Book of Mormon or the KJV Bible themselves.  However, she did finish Book of Mormon Stories (started during the previous school year) and New Testament Stories this year, reading each day under my supervision.

In early spring, I had her start New Testament Stories over again, and I put together a binder full of narration pages--top half open for drawing, bottom half lined.  Each morning she reads a story, narrates it back to me and then illustrates her narration.  We are doing this through the summer, and I expect she'll be done by the time the new school year is ready to begin.  I coach her heavily through a paragraph long narration, and I see significant improvement in her ability to relate the main ideas.  Some days are better than others, and after a day or two of really excellent narrating, I have to be ready for a day of complete inability to recall anything.  But the good days always come back, and she's getting familiar with the stories of Jesus Christ.

Math
This is a hard subject for Ladybug.  We started the year with Shiller Math, and it took about 2 weeks to see that Ladybug and Shiller would never be friends.  The Montessori method is supposed to be excellent for struggling learners, but not so for Ladybug.   Too many manipulatives and too many open-ended questions and creative problem-solving scenarios stumped her into stony silence--or violent tears.

We returned to Rod and Staff--starting Grade 1 Arithmetic all over again.  Last year she got quite lost, and I stopped using it with her, but this year it fit.  The simple pages, consistent format, and frequent repetition have been a blessing.  Ladybug has about 24 lessons to go to finish the Grade 1 book, and she will keep doing these lessons about 4 days a week so that she'll finish in time to start Grade 2 in the fall (though I'm debating working for another season on first grade skills with Schoolaid Math).

*She can count.
*She identifies numbers correctly, and she's learned to read numbers into the hundreds.
*She can identify more and less into the hundreds; however, she cannot read the > < symbols, and she cannot take two numbers and tell whether they are <, >, or =.  Her comparison is limited to "Circle the number that is more," or "Circle the number that is less."
*She adds and subtracts to 10 using her fingers.  Anything more than 10 is beyond her ability, and she has not memorized any of the facts at all.
*She's been introduced to skip counting by 2, 5, 10, and 25.  She cannot skip count in the abstract, but if nickel, dime, or quarter cues are on the page, she can use them to help her count.  She needs a "cheat sheet" to count by 2s, and she has yet to understand that skip counting follows a pattern. 
*She is starting to understand place value, but her hold on it is tenuous and likely to slip on any given day.
*She's been introduced to fractions, and she reads basic terms like 1/2, 1/3, and 1/4 correctly.  She does not understand that they mean part of a whole.
*Rod and Staff is distinctly weak in early geometry skills; Ladybug can only just identify basic shapes. 

I administered the MAP Growth Test in mathematics for 2nd grade to Ladybug.  As she's only done first grade math, and she has very little true mastery of those skills, her score was very low and the recommendation for remediation came with every skill subset.  I am pleased just to have a baseline score with which I can compare next year's test to get a bit of a picture of what she's learning.

Language Arts
Ladybug's reading skills are a fascinating puzzle.  She took the 2nd grade MAP Growth test for reading in late May, and her test results placed her at a skill level appropriate for about halfway through 2nd grade instead of at the end.  I don't have any arguments with this, as her various reading skills are all over the chart.

Her preferred method of reading is to have someone tell her what the words are, and with enough exposure she'll memorize them.  That's how she learned to read from the very start, but that leaves her dependent on me or another reader to help her at all times.  This year we drilled phonics skills, so that she can develop some spelling basics and get more independent in her reading ability.

She seems to read smoothly and comfortably at a 2nd-ish grade level if there's a story.

But words in isolation stump her, because she relies heavily on contextual clues to decode.

I'm pleased with that.

The fact that she can put clues together and make sense of words is great!

But it is interesting that when learning the long e sound for the vowel team "ea," and when presented with a list of words for practice, she'll say 25 of the words correctly, suddenly say the wrong sound for "ea" in the 26th, then go back to the correct sound for the remaining words in the list.

I've watched that happen for C-V-C words (she'll break the pattern and try to pronounce a short a word with a long a), C-V-C-e words, words with "aw" or "au", and countless other phonetic rules.

The fact that the lessons are trying to present patterns to follow means nothing to her at all.

And one of her biggest reading tantrums of the school year was when I tried to point out that "all," "tall," "hall," and "wall" rhyme and are in the same phonetic family.  She was livid, screaming to me that "all" did not have a letter at the start, so it could not be the same as the other words.

(That lesson ended very quickly.)

But if any of those words appear in a story, she has no problem reading them.

Ladybug was given an anthology of fairy tales for Christmas (no illustrations), and since then, she has worked on reading that book on her own.  It takes her days to read one of the stories, but she perseveres through them.  And she reads them over again, saying, "I like to read them again because I like to know what is going to happen."  She says The Snow Queen is her favorite because she likes when the shard of ice in Kay's eye melts away and he's able to see correctly again.

Ladybug's reading comprehension is very low.  She must read/hear something many times before it makes sense to her.

She makes few inferences or predictions as she reads, rarely draws correct conclusions, and has almost no sense of cause and effect.  I think this is because interesting details overshadow the main ideas in her mind.  By the fourth or fifth reading of a text, she can happily say what she knows is going to happen, but she can't explain any clues that lead to a logical conclusion.

If I ask, "How does the drawing show the person is sad?" she can point out a sad mouth and droopy face.  If I ask, "How can we tell the person is sad?" she cannot say.  She needs the specific direction of looking at the drawing in order to find the answer.

Finding textual clues is even harder for her.  "What words help us know the person is sad?" is sure to be met with confused silence even when the words "sad" and "crying" are used.

Ladybug likes to tell stories.  She gets lost in the details as she tells them, and she'll ramble for many long minutes explaining minutiae of any experience, but she sure likes sharing with us.

Spelling is a puzzle that confuses Ladybug to no end.  If she's given a word list of 7-9 words, she learn to spell the words in a week or a month as long as the words stay in a list and are associated with a spelling lesson.  If the same word is presented to her in a narration or if she wants to spell it for a note she's writing, she cannot.  She defaults to inventive spelling or asks someone to write it so she can copy it.

Over the year, she has mastered a few basics such as "the," "and," "a," "I," "we," "this," and a passel of C-V-C words as well as a handful of C-V-C-e words.

Ladybug specifically requested the opportunity to learn to write in cursive.  I did my best to honor this request, and now she writes in cursive whenever she gets the chance.

 Ladybug worked her way through quite a variety of resources for language arts this year:

   *Shiller Language Arts Kit A (abandoned quickly)
   *Primary Phonics Workbook 2 and matching set of readers
   *Core Skills Spelling Grade 1
   *Memoria Press Storytime Treasures
   *Steck Vaughn Phonics Level B
   *New American Cursive Penmanship Workbook 1
   *The Good and the Beautiful Language Arts Level 1
   *Memoria Press Simply Classical Spelling Book 1

As of this writing, she's still using The Good and the Beautiful LA 1, as well as the MP SC Spelling book.  We won't take a break from these this summer in order to keep what she's learned so far and to help her be ready to move forward in the coming school year.

One of the therapists recently asked me if I have any hope for Ladybug. 

I had to think for a long time, and in the end I answered that I feel resigned . . . and committed.

Resignedly committed.

Ladybug is a fighter.

And while I feel like giving up all of the time, apparently I'm a fighter, too.

We fight each other all of the time--not intentionally, but just because we're both so fiercely committed to her survival.  And we are equally fiercely trying to achieve survival in opposing ways.

It would be lovely for me to say that we need to find a middle ground, but I'm not willing to concede that much . . .yet? . . . ever? . . . I'm not sure.  For now, I'm holding on to the fact that I'm the adult, there are acceptable and unacceptable ways to treat other people, I have more knowledge than she does, and I am doing my best to amass resources from our community and from our mutual Father in Heaven to help us survive.

But I looked up a variety of definitions of hope, and I found this one:

"want something to happen or be the case"

Yes, I want Ladybug to feel whole and happy and healthy. 
Yes, I want Ladybug to learn as much as she possibly can.
Yes, I want Ladybug and me to be friends.
Yes, I want Ladybug to be free to govern herself.

Yes, I want Ladybug to qualify for community and health resources that will help her.
Yes, I want Ladybug to know she is a beloved daughter of God.
Yes, I want Ladybug to feel great!

So . . . it seems I am far more hope-full for Ladybug than I told that therapist.