An Op-Ed

I want to say something here.  I don’t know who even reads this tiny patch of writing in the blogosphere, but I still want to say it.  It was recently brought to my attention that there is a different paradigm “out there” regarding mental illness in children.  That point of view goes something like this:

Children should not be medicated for mental illness regardless of their condition.  If they are depressed, anxious, violent, or even psychotic, then they should be sent to therapy and taught to live with their condition no matter how debilitated they are.  If they hallucinate and hear voices, then they should be taught to make friends with their hallucinations.  Their brain is trying to tell them something.  If they are violent, then they should be taken to therapy and given cognitive behavioral therapy until they stop acting out.  Bipolar Disorder doesn’t exist in children anyway so a child couldn’t possibly suffer with mania.  He really has anxiety, depression, or he is acting out from past or present abuse.  He’s trying to tell you that he’s traumatized.  If the child has Oppositional Defiant Disorder, then he must be taught how to obey.  If he is homicidal or killing animals, then he has been abused.  His parents have obviously hurt him.  Call Child Protection Services immediately, but all pharmaceutical supports of any kind are always wrong.  Always.

There is a tiny kernel of truth here.  We all know that child abuse is real.  Children who are traumatized certainly do communicate behaviorally.  Cognitive Behavioral Therapy (CBT) as well as Dialectical Behavioral Therapy (DBT) have a place in the treatment of childhood mental health problems.  When a child presents with certain behaviors, it’s imperative to assess the parents or primary care givers.  Sometimes there actually is abuse.  I was questioned by more than one of Grace’s therapists.  It’s part of the intake process.  It’s not fun, but it’s necessary.  You always want to make certain that a child is safe and living in a nurturing environment.  You also want to make sure that a child is not mimicking behaviors they have previously seen.  This does happen.

Where does this point of view, in my opinion, go off the rails? Medication is often a necessary and very appropriate part of a child’s treatment plan.  To assert that psychosis is partially normal and should be an appropriate part of a child’s life is absurd! Long-term psychosis causes brain damage.  Normalizing psychosis is never appropriate.  Teaching a mentally ill child to 1) make friends with potentially dangerous hallucinations that may give harmful instructions to either harm others or the self is wildly irresponsible and 2) accept a life that is ruled by mental illness rather than pursue every avenue of mental health cultivates hopelessness and myopia.

Yes, it’s true that the medications available to treat mental illness are not fabulous.  I’m the first to stand up and say that I don’t like the choices.  It’s a helluva lot easier to treat anxiety and depression in young people than it is to treat psychotic disorders, but I’ll pursue every avenue of treatment before I’ll let Grace sink into the depths of madness and neurodegeneration.

So, if you are of the mind that fish oil, magnesium, Asian mushrooms, yoga, talk therapy, CBT, and summer camps where kids do ‘trust falls’ while braiding each other’s hair is the only solution for pediatric mental illness, then I respect your point of view but respectfully disagree with you.  Part of that equation, however, involves your respecting my efforts to support my daughter.  Grace will not be making friends with the armed gunmen that follow her around because they are not her friends.  Guess what? They are not real! Grace will not be learning to live with her psychosis, her depression, and her mixed states because her mental illness is eating her alive–quite literally.  She is losing white matter.  If she has the radically neuroprogressive form of schizophrenia that I pray she does NOT have, then she could lose up to 20% of her brain tissue in the next 5 years! So, yes, I’ll be fighting for her with everything within me just like so many other families out there.  You do what you must when it’s your child.  So, please, stop harassing those families for attempting to build a life for their children.  Using medication to try to bring stability to an ever-increasingly unstable and ill brain is not child abuse.  Calling childhood-onset schizophrenia nothing but misdiagnosed autism or a manifestation of childhood brilliance, however, just might be.

::climbing off my soapbox now::

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The Daily Limp

I’m not entirely sure why I write this blog.  I think I write these posts because I need a place to put “all the stuff”.  I also write these posts because I’m hopeful that it might be useful to someone else.  Maybe our daily limp with a childhood-onset schizophrenia spectrum disorder, what it looks like, trying to treat it, how it affects our family, and all the rest of it will make a difference in another person’s life.  One hopes…

Well, we saw Dr. Klerpachik on Friday, and I must say that I genuinely like him.  How can one not genuinely like a man who openly speaks of needing to watch his carb intake while glancing down at his belly? He is a truly collaborative psychiatrist, and that’s rare.  So, how is Grace doing? Poorly.

The bump in Abilify has not helped.  The bump in Lamictal has not helped either.  Her mood is still mercurial, and she is still hallucinating.  Then, I mentioned Grace’s bouts with mixed states.  “Oh, tell me about that.”  I went on to describe Grace in a mixed state.  “Well, she’s paranoid, manic, and deeply depressed all at the same time.  Frankly, it’s awful.” He grimaced.  “What do you do when she’s like that?” I sighed, “I try to get the family out of the house, and then it’s kind of like herding cats.  For a few moments she’s really elevated and wandering around the house.  In an instant, she switches.  Then she’s openly weeping and stomping.  She becomes very belligerent.  She usually tries to lock herself in a room and refuses to come out.  Then she’s paranoid, thinking someone is watching her.  The cycle lasts anywhere from three to twelve hours.  If I can get her to fall asleep, her brain will usually reset.” He got up and paced for a bit.  “Have you tried Benadryl?” I laughed, “I’m way ahead of you.  She has a paradoxical reaction to it.”  He put his hands on his hips, “Hmph.  That can happen.”  I went on to say, “You might not like this, but I give her Dramamine to try to induce sleep because of its soporific effects.”  He looked thoughtful.  “That’s not a bad idea actually.  Does it work?”  I nodded, “Sometimes.”

In the end, he gave me a PRN (pro re nata) prescription for Seroquel to be tried during psychosis (the mixed state).  It is in the same class of drugs as Abilify, but it is known to be sedating.  He’s hopeful that it might cause Grace’s brain to calm down and let her sleep, thus, resetting during these psychotic times.  We shall see…

We moved on to speaking about Grace’s social skills regression.  I am deeply troubled by her behaviors, and it pains me to see her losing her ability to know what is and is not socially appropriate.  Dr. Klerpachik explained that this sort of regression is common with schizophrenia spectrum disorders because of the cognitive impairments that go along with it.  He began with, “Because of the cognitive impairments due to the neuroprogression of the schizophrenia spectrum disorders, kids can appear to behave as if they have autism.  Not that Grace is autistic, but there is something called…” I interrupted him, “Are you going to talk about ‘theory of mind’ (ToM)?” He said, “Why, yes!”  I got a little excited here because ToM is central to what I do for a living.  This is something I could wrap my brain around. “Are you trying to say that ToM difficulties are also common to people on the schizophrenia spectrum, and I should expect Grace to struggle with this now and in the future?” He replied, “Yep.  She’s actually going to need social skills classes much like the autistic kids do, but no one is going to put her in with the ASD kids because she’s not autistic.  It’s really too bad.  There’s not enough resources for these kids because there aren’t a lot of them out there.”  Well, I can do something for her.  This is what I do, and then we’ll see what develops.  At least I don’t feel  helpless, and that’s worth a lot.

Remember how I talked about taking care of yourself? Well, I’m trying to practice what I preach so I went to my book club meeting even though I hadn’t read the book.  Yes, I’ve become one of those people.  The woman who goes to book club but doesn’t read the book.  I don’t have time to read novels right now, but I’ll get there again.  I have to say that the women in this group are all lovely individuals.  Every time I show up they inquire after Grace almost in unison, and they listen to me drone on.  They even take their time explaining the novel’s plot just for me so that I can follow the discussion.  They don’t have to do that.  In fact, it might be annoying, but they do it anyway.  I appreciate it to no end, and it’s little supportive offerings like this that go a long way into making our ‘daily limp’ more enjoyable.

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Because Gracie loves the LOLCats

Progressive Regression

Well, it’s been interesting around here to say the least.  I’ll get right to the point: Grace is not doing well.  I keep hoping that she’s just having a bad day, but she’s not.  She’s getting worse.  Her antipsychotic medication was increased, but she’s still hallucinating.  Her mood stabilizers are not working.  She’s stuck in this purgatory of the dreaded mixed state.  She’s elevated, depressed, and paranoid at the same time.  She’s unable to make decisions, and she’s belligerent.  She is losing her ability to discern what is socially appropriate so her sisters are very reluctant to bring their friends to our home now for fear Grace will do something…odd.  The decline is astounding.

Grace had yet another migraine last week, but I had to work so I dragged her along with me.  My business partner and I were out and about Grace in tow when she suddenly declared, “I see the men.  I see the men! One of them has a really big gun this time! It’s huge! It’s really big! The one with the brown bowler hat has a big hunting gun.  They’re everywhere I look.  Do you know what I mean? Those big hunting guns?” From there she wouldn’t stop.  Every few minutes she would interrupt, “They’re over there!” She looked pale with dark circles under her eyes.  My friend looked at me.  I looked at her.  She’s been with us since the beginning.  She’s been my companion at the Behavioral Health ER a few times now.  She’s known Grace for years.  She remembers Grace BEFORE.  This Grace? This isn’t the same Grace.

“She’s deteriorating.  I don’t know what’s going on.”  

“Yeah, there’s some kind of regression present.”

“She’s worse in the afternoons, and the evenings are nightmarish.”

“Some kind of ‘sundowning’ effect.  Michael talks about that with Jani.”

She’s talking about Michael Schofield, father to Jani Schofield, one of the youngest children to be diagnosed with schizophrenia.  Jani was six years-old when she was diagnosed, and she’s still not stable a few years later.  The Schofields have been through hell and back, and they have been heavily criticized for putting a young child on what is sure to be frightening cocktail of drugs.  Let me explain something before you judge Michael and Susan or even me.

Schizophrenia is not just some mental illness contracted by people like my daughter, and now little Gracie is sad or weird.  Schizophrenia destroys brain tissue.  Do you know why Grace can’t make decisions now? Because she’s lost gray matter.

According to Dr. Paul Thompson, professor of neurology at UCLA:

Mapping this timeline (of brain tissue loss) was one of the things we wanted to accomplish through our imaging studies of young people with schizophrenia. From images taken at regular intervals of literally hundreds of patients and control subjects, we created an aggregate image of the disease process — basically, time-lapse movies of what happens when and at what rate. In the movies, you see this traveling wave of tissue loss, starting with the parietal cortex and then relentlessly sweeping forward into the frontal lobe. We’ve calculated the tissue loss at over 5 percent a year, which is comparable to Alzheimer’s disease — brain cells are actually dying as a result of schizophrenia.

It appears that the amount of tissue loss depends upon the age at which you develop the illness. If it comes on in your early teens, up to 25 percent of your brain tissue can be lost over a period of about five years. That is very severe — comparable to Alzheimer’s in the degree of damage, but different in that schizophrenia does not attack every area of the brain.

If you develop schizophrenia later, with your first psychotic episode in your latter 20s, brain tissue loss appears to be no more than 1 percent a year. Because it is a much slower process, the opportunities to intervene with drugs are greater. In brain scans of people who developed schizophrenia later and have lived with the illness for a long time, we see maybe only 10 percent to 15 percent of tissue loss over all. (Visualizing Schizophrenia)

While Alzheimer’s seems to affect the entire brain, schizophrenia damages the parietal cortex, responsible for helping us process our sensory experiences, and frontal lobe, which helps us to “organize our lives, go to work, analyze information and make decisions”.  Can you imagine losing 25% of your entire brain but solely in the parietal cortex and frontal lobe? That’s what children like Jani Schofield and possibly my daughter are up against.  This might explain why Grace is gripped by crippling migraines.  Her brain tissue is dying.

She can no longer clean her room without an adult helping her.  She can’t make decisions anymore of almost any kind.  She can’t regulate herself.  The only way to stop the progression of the disease is with drugs.  Would you deprive a child of whatever future they might have with whatever intact brain tissue they might be able to keep by attacking their parents for using whatever drugs are available to stop the progression of this awful mental illness?

At the rate of the progressive regression I see in Grace, she will never leave the house.  She will never marry.  She will never go to college.  She will never be able to fulfill her dreams because she will lose her mental capacity to live a normal and fulfilling life.  Is it any wonder that 10% of schizophrenics commit suicide?

My husband and I are living in a reality that feels surreal most of the time, and we hold onto our hope.  But, I can’t tell you how devastating this reality is.  It’s hard to describe how it feels to watch your beautiful girl deteriorate day by day knowing that the brain that grew and developed in my own body 12 years ago is dying off, cell by cell, taking pieces of that child with it, little by little.  The depth of suffering that I witness in her on a daily basis which, in turn, causes my other daughters to suffer is almost more than I can tolerate sometimes.

For the record, schizophrenia and all its spectrum disorders is not autism.  It’s not a manifestation of childhood brilliance.  It’s also not a result of bad parenting.  It’s a devastating organic brain disorder that needs treatment in an attempt, however feeble, to stop the disease progression.  One can’t tell a child to just live with it and remove all treatment.  One can’t CBT it away.  No amount of cognitive behavioral therapy will ameliorate schizophrenia because schizophrenia is not a behavioral problem.  You can’t perform a functional behavioral analysis on schizophrenia anymore than you can on dementia resultant from Alzheimer’s.  Are you getting it?

Aaaanyway….

We see Dr. Klerpachik tomorrow.  I don’t know what he’ll say.  I know what I’ll say.  We need a med change because the Lamictal ain’t workin’.  Get this kid on something that will.

Resources:

Visualizing Schizophrenia (New York Times article)

The Jani Foundation founded by Michael and Susan Schofield

January First by Michael Schofield

Taking Care of Yourself

Self-care is an essential topic particularly in the context of parenting or even caring for special needs people.  You could have a spouse with a chronic health condition, or you could be an adult child caring for an aging, ailing parent.  Or, like me, you could have one or more children with special needs.  I’ve named this blog “Empowered Grace” after my daughter Grace who has childhood-onset schizophrenia, but, in reality, I have four daughters three of whom have special needs.  My youngest has an autism spectrum disorder, and my second daughter was diagnosed with cyclothymia last Friday–a bipolar spectrum disorder.  Clearly, my husband’s and my genetics have combined in a most interesting way.  We won the genetic lottery.

It seems counterintuitive to put yourself first if you are the primary caregiver, and, at times, it’s damn near impossible.  I have learned through experience, however, that it is crucial to take care of yourself–to nurture yourself–or you will be useless to the people in your life depending upon you to nurture and care for them.

A few months ago I noticed that my hair was falling out.  I also noticed that I was getting gray hair.  I had to go to the dermatologist as well because my skin had transformed into that of my 17 year-old self.  Gray hair, hair loss, and acne? What curse had befallen me? My nails had become brittle, and I was chronically exhausted.  I also had a terrible taste in my mouth that no amount of teeth brushing and gargling would eradicate.  My libido had vanished, and within 6 months I had lost fifteen pounds.  The problem with the weight loss is that I didn’t need to lose fifteen pounds.  I don’t need to be 6 feet tall and size 4, but I was well on my way.  As it turns out, I was anemic, my vitamin D levels were in the toilet, my thyroid was sluggish, and I had a zinc deficiency.  This was all due to my not taking care of myself.  To getting lost in Grace’s multiple and relentless crises. I was no longer able to manage the stress in my life so I made some kind of tacit agreement with what circumstances seemed to only confirm: “I don’t matter.  Just keep calm and carry on even if that comes at my expense.”  I stopped sleeping and eating with any kind of consistency.  I stopped exercising because I couldn’t leave Grace alone or with anyone other than myself or my husband.  I just…eroded into a state of existential transparency.

I see a lot of people take this road because they feel forced onto it, almost cut off from the world of the living by horrible circumstances and a lack of resources.  It doesn’t take a lot in our present economy to tip a family over the edge into financial uncertainty or even crisis.  I know the statistics.  There are many families dealing with pediatric mental illness who are under or even uninsured.  They struggle to make rent and even feed their families.  I’ve been told more than once that I’m one of the lucky ones because we are insured, and I’m able to make the necessary sacrifices in my schedule to be home should a child need me.  Alas, the finger wagging, and “shoulding on” and “Oh, aren’t you lucky that you can stay home and take care of your children,” doesn’t make it better because those aren’t really supportive statements at all.  They are minimizing statements that cause suffering people to internalize their pain lest they sound “whiny” or “ungrateful” because they start to think that it could always be worse.  “I guess I shouldn’t share how I feel about my schizophrenic daughter and my autistic daughter and my bipolar daughter ( or fill in the blank with your circumstances) and my struggles to be a good mom.  I mean, I’m not homeless WITH these children in tow.  My husband isn’t beating us.  We have insurance although the deductible is high.  I guess I should just be quiet about it.  I can stay home, but I have to stay there.  I’m landlocked.  Oh, but that’s fine.  It’s all good.  Some people don’t have insurance at all.  I suppose I really should just swallow it and cope.”

So, Step 1 in taking care of yourself is: Find a supportive community where your circumstances won’t be minimized or normalized.  While I want to know the truth of other people’s circumstances so that I can offer support and keep a clear perspective on my own situation, I don’t want my life to be compared to someone else’s nor should we compare our pain, struggles, and issues with those of others.  It will never be a valid comparison because no two people are alike.  For example, The National Alliance on Mental Illness offers support groups for parents and siblings of those suffering with mental illness.  There are ‘Moms’ Night Out’ opportunities and other similar offerings.  To find your local NAMI, go here.  A note: Beware of what I call The Professional Victims.  I’ve run into quite a few women who compete with one another in the area of “I feel worse than you do” when it comes to taking care of their special needs children.  It seems that many of these caregivers will deliberately neglect themselves for the sake of playing the martyr.  I know I’m making a bold statement here, but it’s very important to listen to their language and then watch how they interact with their children and with others.  They are very loud and draw a lot of attention to themselves about their fatigue and lack of sleep, sighing loudly all the time.  They carry on about how little time they have for themselves casting contemptuous glances at their children.  They emanate bitterness and anger, and they are one of the primary groups who will minimize your pain because they are always suffering more than you.  If you’ve managed to shower and comb your hair as well as match your socks? Beware.  Clearly, your child must not really have a legitimate problem because YOU look relatively presentable.  I was actually told once that I was not being taken seriously in our IEP process because I didn’t look exhausted and sick enough.  This comment reflects the aforementioned toxic attitude so prevalent among this group of people.

Step 2 in taking care of yourself is: Pay attention to how you feel about yourself.  When I was in the thick of Grace’s psychosis last summer, I felt absolutely adrift and, well, ugly.  I’m a Southern gal at heart when it comes to my appearance, and I love being a girl.  I love hair, make-up, and mani/pedis, but I had lost all motivation to care for myself not to mention the time and money.  Most of our extra money had been usurped by medical bills.  I felt discouraged, uncomfortable in my skin, and ashamed.  I wanted nothing to do with my husband in the bedroom.  I was honest with myself about what it would take to feel better.  I just wanted a cut and color.  I could give myself a mani/pedi.  I found a local cosmetology school that offered cuts and color at a substantially reduced price, and I got my cut and color for $40.  I felt like a new woman, and that boost to my self-esteem energized me enough to get me through the rest of the summer.  So, do what enhances your self-esteem be that finding time to exercise, giving yourself a mani/pedi, or finding affordable ways to make yourself feel better by getting back to your hobbies or the like.  Some of those cosmetology schools also offer massage.  When we nurture ourselves in this way we tend to nurture those around us, too, not to mention we are modeling self-care.  A suggestion for reduced price self-care opportunities: The Aveda Institute.

Step 3 in taking care of yourself is individual counseling.  I did and continue to see a therapist.  I have found it extremely helpful in checking my reality and getting support as a mother, wife, friend, and woman.  It’s the one place I can go and just be myself.  My therapist is a wonderful woman who is immensely supportive, and she is like a cheerleader for me.  People like this can be few and far between in our lives, and I recommend that everyone find time to develop a relationship with a therapist.  Many fantastic therapists have sliding fee scales so be persistent when searching.

Step 4 in taking care of yourself is addressing one’s diet.  In my case, eating.  Period.  I stopped eating for days at a time during Grace’s crisis.  I was nauseated much of the time, and I had no desire to eat.  This was a huge contributor to my nutritional deficiencies and unnecessary weight loss.  I have Fibromyalgia, Celiac Disease, and Chronic Migraine Disease.  Not eating is only going to exacerbate the migraines and cause “fibro flares”, but, at that time, it just felt that everyone else’s needs surpassed mine.  I felt lost in the maelstrom.  I still have a problem eating due to the side effects of medication, but I have since learned to fill in the gap with supplements.  Supplements can eat away at a budget but figuring out what gaps need filling in has changed things drastically.  I follow a gluten-free diet religiously due to the Celiac Disease, but the GF diet can cause certain deficiencies.  I do not drink soda–ever.  Because I struggle to maintain caloric intake I can’t include empty calories in my diet.  I do drink tea and coffee, but both have noted health benefits.  I make my own GF breads so I can choose which flours to use and what to add to enhance their nutrition.  After visiting my doctor, I have a list of supplements recommended for inflammation (Turmeric, Vitamin D, and Fish Oil) and stress (Rhodiola and Schizandra).  I take a few others (zinc, L-Arginine, B-12 due to longterm anticonvulsant use, Vitamin C, multi-vitamin, Elderberry, Milk Thistle for liver support, and Calcium-Magnesium).  After adding the turmeric whose active component is curcumin, I have cut my NSAID usage by 80%.  That’s substantial.  My migraines have improved as have the Fibromyalgia symptoms.

Step 5 in taking care of yourself is remembering who you are as a person outside of your family and whatever troubling or trying circumstances envelop you.  After years of dealing with crisis after crisis, I began to feel like I only existed to meet the needs of my family and my ill or needy children.  If it wasn’t autism, then it was something else.  Now, it’s schizophrenia and a bipolar spectrum disorder.  What will it be tomorrow? I needed an attitude adjustment, and I needed to find myself again.  I needed to remember who I was.  I started going to the local museums that I so loved, having tea in the afternoon in my pretty tea cups, listening to music I like, dancing in my room, and doing little things here and there that awakened me to, well, myself.  Don’t miss this.  Gracie was still around.  She was still skulking around the house in either a manic or depressed state.  She was still hallucinating.  Milly was still banging on my bedroom door claiming to need something, (“The cheese is broken!“)  I just chose to finish dancing to my favorite song or calmly drink my Monkey Picked Oolong in the midst of the latest psychiatric crisis.  This is my life.  It’s not going anywhere so I needed to learn to find the beauty and the joy in it.  I needed to remember that I was so much more than just Grace’s mother or a homeschooler or a…  I am me, and I was me long before I was Grace’s mother or my husband’s wife.  To me, that’s the best thing you can do to take care of yourself.

Hold onto yourself because YOU are what everyone around you loves, needs, and leans on.  And, YOU are still your best advocate.

The Nurturing Educator

My Gracikins is attending her new school! The short bus arrived on time this morning and picked her up.  She was so excited to go that she got up at 5:45 AM.  I heard her tromping around in her boots at 6:30.  She loves it.  She’s the only girl in her class of 7 students, and two of the boys are sweet on her.  George, the boy who offered her one of his Christmas cookies during our school tour, has already engaged his wingman to ask Grace to “go with him”.  Grace is shocked.  She is a 12 year-old girl through and through.  She asked for a leather journal and Calico Critters for Christmas.  Oh, and she thinks that the Barbie doll that looks like Grace Kelly from Hitchcock’s “To Catch a Thief” is the best Barbie doll…like ever! She wants nothing to do with boys.  Boys are fine to have as friends, she says.  They are less complicated and more predictable, but “what on earth do you do with a boy when you go with him?” she earnestly asked.  Indeed.

The school tour went off without a hitch sans my district representative.  This program uses Howard Glasser’s Nurtured Heart Approach combined with Classroom Economy in their classes.  I watched it in action, and it works quite well with this population of students.  I have ordered a few of Glasser’s materials so that I can use them with Milly (my ASD girl) and continue the approach with Grace at home for consistency.  So many schools use the Responsive Classroom approach, but that approach did more harm than good to Milly.  Plus, as lovely as it looks on paper (and I almost drool with admiration when I read about it), it is not implemented properly much of the time.  It requires a shame-free, non-reactive, non-controlling personality who does not struggle with rigidity issues of any sort for proper implementation not to mention a smaller class.

I’m fortunate in that I have access to extremely educated people in the academy who have devoted their lives to studying cognitive development, psychology, and education.  I was able to ask a certain department head of education at a certain well-known university what his opinion of the Responsive Classroom was.  He specializes in childhood and adolescent cognitive development and psychology as well as special education and the teaching of math.  He said that it looks good on paper, but it’s rarely implemented well.  He’s not a fan.  He explained that it was created in response to the self-esteem movement begun in the late 1960s.  You know, “Why Billy, you’re such a good breather! Everyone look at Billy breathe! Isn’t he special!” We see this addiction to self-esteem everywhere in American culture.  Look at the language of the Academy Awards: “And the award goes to…” as opposed to “And the winner is…”  Americans don’t want to feel like losers even if they’ve lost.  Everyone must be a winner.  Everyone has to get an A even if it’s only for effort.  The Special Snowflake Syndrome fueled by entitlement which is, ultimately, fueled by this addiction to self-esteem (because there isn’t much apparently) is what the educational system is battling.  Their solution has been the Responsive Classroom where there is no longer praise.  Be gone “Good Job!” and “Well done!”  Now a child is asked, “What do you think?” and “Tell me about what you’ve done here?”  (What do you suppose an ASD child would think of these questions?) My professorial resource said that it’s a good approach for high schoolers and college students  but not for young children who are in desperate need of nurturing.  Developmentally, elementary school children need to be told that their work is done well.  They still require nurturing from adults, a pat on the back, and the reassurance that comes from the safe adults in their world.

One of the bigger problems that exists with the Responsive Classroom is the Take A Break chair.  The Take A Break chair is a chair in the classroom where students go when they are unable to engage in learning.  Theoretically, it’s much like a sensory break.  If the student is antsy, unable to stop talking, distracting other students, or even distracting themselves, then they are to take a break from the educational environment by sitting in this chair until they can re-engage–in full view of  their peers.  Do you think this actually works out properly in reality? My professorial acquaintance flipped out when he was told about the Take A Break chair because he knew instantaneously what I have learned through observation.  The Take A Break chair is a Dunce Chair.  I have yet to see more than one teacher use it appropriately.  I’ve seen teachers scream at students to go sit in the chair.  I’ve walked by classrooms and seen children shaking and crying in that chair.  That chair is used far more as a shaming tool to force compliance than it is as described in The Responsive Classroom curriculum.

Using shame to force compliance is effective because it works quickly.  That is the dark side of the Responsive Classroom.  Students are taught to make choices that will benefit the group.  Classroom rules are created together at the beginning of the year so a sense of classroom ownership and even citizenship exists at the outset.  One is trying to teach children that the reward for effort is the result of the effort itself–not praise.  Be good for goodness’ sake.  Be good and make good choices for the collective.  Classroom harmony is a goal.  This is why group punishments are used so often.  When one or two students refuse to obey–as in stop talking–the entire class might miss recess.  Group pressure to force the obedience of the few.  This is how this approach is used in our district particularly at the middle school level.  A few students annoy a teacher and misbehave so the teacher makes the entire class late for their next class and informs the class that the reason they are being punished is due to the behavior of Student 1 and Student 2.  If they would like to be on time tomorrow, then they ought to go and speak to these two students.  It’s inappropriate to say the least.  It encourages mob bullying.  If a couple of students didn’t like Student 1 and Student 2, then they would feel permitted by their teacher to teach the two insolent students a lesson.  After all, those two students were in violation of the Responsive Classroom and didn’t honor the good of the collective.

I can tell you that an ASD child–my ASD child at any rate–does not do well in this type of classroom.  Her self-esteem is very low.  She apologizes all the time.  For everything.  She has no sense of a job well done.  She is riddled with self-doubt.  She believes that if she misses one problem on a math worksheet, then she must be stupid.  This is not due to our home environment, and, for the record, I don’t think that self-esteem is the end goal of proper parenting.  I do believe, however, that we should like ourselves, not loathe ourselves.

When Grace went on her school tour and observed how the teachers interacted with the students she asked, “Where’s the Take A Break chair?” Her soon-to-be teacher said, “Oh, we don’t do that here.  That’s not good for a person.” Grace smiled with relief and said, “Oh, I’m so glad.  Everyone here is so respectful and nice.  You’re not mean at all! All the teachers at my other school never say nice things.  They yell at us and send kids to the Take A Break chair all the time.  It’s really awful.  So, you’re not going to lecture us and tell us how awful we are all the time?” The staff just stared at me with wide eyes and then smiled at Grace and shook their heads.

I know that there are devoted followers of the Responsive Classroom approach.  I think it does have its good points, but, for my two special needs children, it has not worked.  It also requires a lot from the teachers who use it; possibly more than some teachers have within them.  For special needs children like Grace and Milly, I would recommend the Nurtured Heart approach.

For a third grade overview of the Responsive Classroom, here’s a link.

The Nurtured Heart Approach–link to website.

Interesting and short article–Classroom Economy vs. Responsive Classroom