Inside I'm Hurting by Louise Bomber

[coff33pot]

Ok has anyone read this book? Any teachers or TAs or past TAs that have read this book that can help please?

Reason being I have..............drums roll FINALLY got the half report prepared by the Senior EP (head of the one that did half a assessment in feb and went of sick and still is)

The only assessment that was done was cognitive skills British Ability Scales II (BAS II) And the old EP had a short meeting with myself on that day.

Now this Senior EP agreed to do a report based on the other womans notes so the school can send it off with their statement request. In it she puts some ideas/strategies the school could use. ALL of which I am pleased to say that I have already suggested and given to the school so although they havent tried any of them at least I can stop doubting myself that I am barking up the wrong tree.

However at the end this woman suggests the school read this book? Now I have took a look on the net and all it says is that it is a very good book focused on helping children with attachment difficulties and mentioning that we dont want children to 'acquire more labels' but it does help with those that have attachment disorders. Talks about the effects of adopted DCs and the book is for children that have suffered trauma or loss or trauma and abuse.

Well my DS hasnt suffered either and isnt adopted? He is under CAMHS being assessed for AS. Are they barking up the wrong tree? Will any strategies in this book actually do him more harm or will this book help them to understand my DS? Hope someone can help. I read 'Ten Things' and in there I can understand my DS and see him. But dont know about this book.

No one read it? :) I have looked the net over and looked up attachment difficulties but cannot link their reasons with my DS although he has a personal space issue and hard to keep peer relationships or play with anyone without losing interest or them with him. The more I read the more I can see why camhs asked me personal questions regards to bonding with my ds due to pnd and him not opening his eyes till his official due date. But it was daft assumption because I still maintained a good relationship with DS. Are there any other reasons that attachment difficulties take place? is it just another autism problem or am I seriously missing something in which case I am not helping ds :(

I have not read the book - but had exactly the same approach from CAMHS.
Our DS is not adopted, nor has he suffered abuse. I did have PND and of course carry some guilt and defensiveness about that. But while we were waiting referral for a second opinion regarding AS (local professionals did not believe he met criteria for DX, would not countenance it at all), this is the line they took. Basically saying that even though he had not suffered abuse and was not adopted it was attachment that was the problem. Interestingly only his and mine - surely attachment issues of this nature would show in all his relationships .

I found this realy hard, though I could see how they might think it, but having tried and tried all the strategies before, there was no way it would work. I had to read things from 'The Child who Hurts' (think that was the title). But DS just does not work the way this book suggests.

After second opinion and all appropriate assessments this involved, we received clear AS dx and it was never mentioned again .

I've read this book on recommendation of our EP and CP. Ds was prem and in special care for 8 weeks and this can affect attachment (as I understand it).

Not 100% sure about attachment disorder and at times I am quite sceptical about the whole thing.

School have now bought their own copy and use quite a few ideas from it. They make sure ds is sat in a position where he can see everybody, doors, windows etc. He also has transition time and a transition object and that has definately helped his anxiety.

We are going to start work on control issues next school year as well as confidence. The school seem to like the book and have used it alot.

It is hard to think there may be some attachment issues but we seem to have picked ds apart, with help from CP, and although autism and attachment can present similar problems some of ds issues are definately not from the ASD.

It's all very confusing at times but the suggestions work for our ds so we are happy to go along with them.

HTH

I think they are insistant that it is an attachment issue because DS has an obsession with soldiers and guns. Unfortunately he is explicit in that he will shoot your head off if he is unhappy. He uses his "hero mode" to shut out the world so to speak. I wish it was just plain old thomas the tank as then they can focus on his actual needs and what is making him unhappy instead of carrying on saying he has "violent fantasies" there are pages and pages of the same bloody comment in the three reports I have and it is doing my head in because this is not the issue. I can see that they can also come to conclusion from this that he could have been abused or neglected (from reading write ups on attachment difficulties) But they have seen DS with me and DH and I have two other kids that have grown up with no issues (NT) So they are barking up the wrong tree and its not helping DS one bit because it is clouding his 'real problems' iyswim. Think I will have to buy this book and read it so I know what the school is planning for him....

It sounds a bit like the old 'refrigerator mother' excuse being trotted out!

I have a friend with two adopted children, siblings, however, and the oldest definitely has attatchment disorder. Some of the strategies they use wouldn't hurt someone with ASD.

I'd get a copy of the book and see if what it recommends would help your boy. He may be exhibiting similar issues to someone with attachment disorder but just for a different root cause. My friend has read up extensively about the subject, I can ask her about this book, maybe next week? She has said that it can look very similar to neurological conditions like ASD.

TBH, I'd still be feeling a bit insulted that they seem to be doubting his possible DX, but the EP may just know more about attachment disorder than AS.

EllenJaneisnotmyname
insulted is not the word! :) and I cant print what I am thinking sometimes
It would be great if you could have a word with your friend it will be much appreciated from this corner of the woods thank you.

The children dont bother with him because he is 'strange' (childs outlook) But he does approach children and will at least talk to them but it is always about the same subject! or he goes 'killing game daddadadadaada with his fingers like a gun' well the girls dont want to know and the boys want to know for 5 mins or so but then they change to another game and leave him. He cant seem to just change route to another game and follow them so he goes off on his own. If he sees a younger child struggle with something he will offer help. He is 6 next week, but only a younger peer or an adult. He will cuddle TAs the same as he cuddles me. He needs this reasurance constantly but tbh that is what I do so he is only expecting the same at school and I have made them aware of that.

He is out of school at the moment (long book another thread lol) But I have been triumphant in at least getting them to prepare a whole new timetable, stratagies and they are getting advise from another teacher in a SS with Autism experience. The EP report was only based on a half assessment although it doesnt say that and she was not the actual EP that saw DS. I admit that all the other proceedures she has said to try I have told the school to use so that is a bonus and even the woman I saw at camhs said she hopes the school use my suggestions without wasting time as she feels the SS teacher will come out with the same strategies so I feel quite confident there but I am a sod for wanting to know everything inside and out where DS is concerned from how he ticks to how they are going to deal with his issues. Call it paranoia or protectiveness lol but they have let him down too many times so far which has made his meltdowns huge at school hence why he is home.

I will watch this page for your friends advice many thanks :)

Agree with Ellenjane - if your child is presenting with a neurological difficulty then, it needs to be managed within that framework; the book they have recommended may help, however, Tony Attwood's book on Aspergers might help you also.

Recent research involving 55 families from Van Ilzdendoorn et al (Holland): Parental Sensitivity and Attachment in Children with ASD: Comparison with Children with Mental Retardation, with Language Delays; with typical Development (2007) has found:

? Attachment Theory is unable to explain the ?disordered attachments? in children with a major social impairment (asd) ? (Mary Ainsworth?s Strange Situation Procedure was used (SSP), ie the strange room, the stranger and the coming and going of the care giver).
? Parents do not cause disordered attachment in their ASD children.
? Attachment based therapies are inappropriate and counter-productive for asd?s.

This study in Holland showed that 40% of the children who took part were ?attachment disorganised? although no connection was found between ?parental sensitivity and attachment security in the group of children with asd? and therefore attachment criteria for ?sensitive parenting? may be inadequate for developmental and neurological problems in children.

Van Ilzdendoorn (2007) concluded that children with less severe asd predicted more attached security, however overall the paper challenged the validity of Bowlby?s attachment theory.

Interestingly, a further study was undertaken by Rutgers (2007) Autism, Attachment and Parenting: A Comparison of Children with ASD, Mental Retardation, Language Disorder and Non Clinical Children (89 families took part) and the outcome was that, although, children with asd were related as being less secure compared to the other clinical and normal comparison groups, it stated that parents coped remarkably well with the challenges of raising a child with asd.

Sorry, get fed up with label of attachment being attached to family's with children on the spectrum, it's unhelpful, unnecessary and lots more! Rant over! x

Cankles, great post, really interesting.

Attachment based therapies are inappropriate and counter-productive for asd?s. This seems to be a key conclusion in your case coff33pot

Sorry its a late comeback to your reply Cankles (meltdown pm but now all tucked up in bed :) )

Thank you very much for that write up. That has helped me greatly! I have spent all day watching my actions with ds and how he responds and how I have talked to him etc etc I give him home lessons at the moment as trying to keep to a school routine so that he knows work has to be done at home or at school. It does do your head in because at the back of your mind there is always the doubt that you are doing something wrong and its your fault and I am sure as hell they send letters or as questions to deliberately to confuse the hell out of you own mind. It isnt but sometimes you wish it was to put it all right and others you just get on and accept that its neurological and fight the good fight for them.

Doesnt help with me being very similar to ds (no I have given the soldiers up no I am older mine was actually fire engines when it comes to being out of sync so anxiety sets in and then you are days putting your own self right.

I am very grateful for that rant as you called it and will be taking notes! :)

Had a quick chat with my friend with the adopted children. She doesn't know the book, but her take on it was that it's the same part of the brain that's affected (ASD and attachment disorder) which is why they seem similar. Attachment disorder can be caused by a traumatic event in a child's life, not necessarily to do with parents, and can be something that parents didn't even realise a child found traumatic.

So unless your DS had some sort of trauma in early life, death of a loved one, losing contact with a parent etc, probably not. (But could be something you think minor.)

Her adopted daughter finds physical closeness (hugs etc) very difficult, and may be to do with inappropriate restraint methods as a small child. This one probably to do with parental actions, unfortunately, and her foster parents have also been struck off the register.

So similar looking problems, with different causes, and as cankles says, different strategies are needed. I'm sure some strategies will be similar, but that's not the point, is it?

Thanks for mentioning it to your friend. The only thing traumatic in ds life was that he had his leg fractured in two places at 3 due to a child running front on into him on a bike and the second at 4 was that he had his elbow disclocated at nursery due to a stupid carer who tried to get him out of the sensory room and didnt have the sense to let go when he turned to go back in and I was told it took some force to do the injury as at that age the "elastic band" (dont know the name) attaching the bottom have of the arm/elbow to the top has fully strengthend. Now after that he wouldnt hold hands with anyone for a while and who could blame him so he learnt that he could run away. Needless to say he didnt go back to nursery very long after that once I made arrangements which was a shame as it was a lovely place but Thomas wasnt happy there after that and I wasnt happy him being there. This went on for 12months but now he has the confidence to hold anyones hand automatically he would only do it by his choice. They are aware of this so perhaps they are using this senario for the attachment bit. However he freely cuddles anyone will talk to everyone and will sit on ppls laps because he likes the assurance and the hand holding has got back to normal. (unless in meltdown as he hates being touched at all till after the event then wants a hug)

Waiting on this meeting with school now as the Autism teacher from an SS went in for a talk with them yesterday. They havent got back to me so I am thinking that their eyes have really been opened by this woman and they have a lot to plan...................heres hoping! :)

Write to the EP citing those studies and concluding that since attachment parenting techniques have been found to be inappropriate for children with ASD you would appreciate it if the school would read a book that WAS appropriate instead of this one. Suggest Lovaas

Just to throw a spanner in the work DD2 (8) has AS and CAMHS have identified that she has an attachment difficulty. This is no reflection on my parenting or her early attachment relationships but they feel that her social communication difficulties and rigid thinking make it very hard for her to form attachments with staff at school. She does not trust anyone to look after her apart from the SENCo who has been a family friend all her life.

CAMHS identified it as an attachment issue because they want the school to understand that they need to work to build a relationship with her in order for her to feel secure in their care.

I don't know if this could be the reason that CAMHS feel that the strategies in the book could help your DS, OP, but perhaps the idea is for them to be used by the school and for developing trusting relationships with others rather than a reflection on your own parenting.

Thanks Al1son and no it isnt a very big spanner at all :) It is good for myself and ds to have as many views as possible so thank you.

DS does have social communication difficulties in the sense that he has a one only conversational interest and that is guns regardless of what else is going on and "challenging behaviour" as they put it. He walks into school fine but when he is there he changes completely. He loves two of his TAs to bits and even runs to the Heads office when he hes pressured so I think the trust is or was there till this last mad meltdown a week ago now and he avoids the Heads office completely because he is taken back to the same situation he ran from. Also he has so many TAs doing 1 to 1 with him I think it is just too many faces to actually build a whole relationship with at the moment. His problem is if they change routine he goes nuts. Or if he has to stay in the classroom for any length of time again he cant cope and runs off and hides under tables or in a regular cupboard. On teaching him at home I have found that he can only concentrate for 10 mins and then needs 15 mins doing something else like going outside. Also by the time he has done all his work he just point blank zoooooms around like its a pent up rocket due to all the concentration iyswim.

CAMHS havent suggested this book it was the EP who didnt actually see DS in the first place. It was half an assessment at school and there was never a second visit to actually observe him in a class etc they just did cognitive tests and had a chat.

I think I am going to quote that research in an email now to the head and very kindly make her aware to not expect miracles as he has other impairments to consider. She has sent an email with a new timetable to go over with DS and wants to see me tomorrow. She still hasnt advised me on what proceedures she is going to put in place in how to deal with ds anxiety or sensory problems which is my main concern as whatever timetable you do if they cant have helping strategies in place it will still go write out the window. The SS teacher has been and should have phoned me to give me an update yesterday but hey ho that didnt happen.

You need to ask that they keep to a small team of TAs. One TA would probably be too few as it's really hard to spend all that time with a 'challenging' child that you don't love! But a much more consistent approach with maybe 2 or 3 TAs maximum so that, as you say, they can build a trusting relationship.

how DID you know I just put that in my email! Psychic!

After the quote I was polite in saying to her that what I am trying to say is........should they use advice in this book and find they are going backwards with DS because of his other issues, not to lose heart because his issues are so complex.

I feel it is only fair that I am fair with the school seeing as they have listened to me and are trying to get help and advice and get him a new programme in place

In my opinion Inside I'm Hurting is an excellent book.. It's easy to get tied up in knots over labels, but actually it's strategies for supporting anxious children that really make the difference. I think this book is helpful for teachers to read to understand the emotional needs of children, and how to address these needs, whether they have ASD, attachment difficulties, etc. etc. with practical strategies.

I have found that recommendations made to schools sometimes have a hidden message. For example 'Read this book 'Inside I'm Hurting.' could be interpreted as "Oy, school, consider this child as a child with emotional needs, like all children, not just as a child whose behaviour challenges you. Perhaps think of ways you could offer nurturing support, rather than sanctions?" Because I think sometimes it can be easy for a school to forget a child's basic need to feel secure and understood.

I may have rambled a bit, but in short... supportive strategies can sometimes suit all children, not just those with dx...

Thanks SammySea :)

Well the EP suggested giving him Time In instead of Time Out which he is forever taken away to do. Encourage him to stay longer by saying "what a good brain you have" etc etc. And to go by time which I have already suggested as he is a constant go by the clock till whats next. So yes I suppose you could read for that hidden message......

Head/Senco has emailed me back already thanking me for the ASD/Attachment research information and that she already has this book as she used it for someone else and said she will show it to me tomorrow. I might ask her if I can borrow it myself seeing as I have lent them a few of mine over the last few months :)

:) Yep, I think it's probably helpful to hold in mind "This book is being recommended to offer the school helpful ideas", it may not necessarily be out to label your child, but just to plug a gap in the support the school are currently offering.

I'm actually very impressed that an EP is clued up enough to know about this book!

My children are adopted and one has attachment disorder and ADHD. Attachment disorder, developmental trauma call it whatever present with the same behaviours as ASD children and so a lot of the strategies that with for children with attachment disorder can also work with ASD children. Basically it's the same part of the brain which is affected by either.

I've bought the book for my child's soon and they've found some of the strategies very helpful.

It may or may not be appropriate for your child but I have to say that I've read it and found it really helpful to explain to me more about my child's behaviours and best to manage them.