Sara arrives
When Kathy Nallan phoned to make arrangements
to meet Sara, we were surprised by the information we were given. At six,
Sara was so young to be considered for the type of specialized care offered
by Professional Parenting. She was younger than Erika, and we thought she
might be just the little sister Erika so desperately wanted.
We became apprehensive as more and
more information poured forth. Sara had been identified as significantly
developmentally delayed at 20 months. She had had a grand-mal seizure and
had been resuscitated by emergency medical workers at the age of twenty-two
months just after receiving her vaccination. Sara had been in rehabilitation
and special education for three years and had been diagnosed as epileptic,
hypotonic and hyperactive at four years of age with severe delay disorder.
Evaluations at five years improved her clinical picture to include ‘possibly
trainable’ when testing included an IQ score of 34. She had been in a special
class for the ‘trainable developmentally delayed’ for less than a year when
her behaviors alerted the staff to the possibility of sexual abuse. She was
considered to be non-verbal although she was echolalic and could say her
name.
I arrived at the Professional Parenting
office for a meeting with the staff and with Sara’s teacher. I listened
as specific details of the events leading to Sara’s placement in the emergency
shelter were given. The teacher, Alene was inquisitive, and I felt as though
I was being cross-examined although the concern for Sara’s well-being was
evident. Her love for the child, whom I had not yet met emanated from her
every gesture, and her obvious faith and determination had been directed
towards what was best for the child. The details of what Sara liked to eat,
what simple accomplishments she had made under this teacher’s tutelage, and
details of bizarre behaviors spilled forth.
Then there was the bigger picture.
The teacher had risked so much to get this child to safety and would have
taken her into her own family if the courts had allowed it. Even in the safety
of the emergency shelter, threats from the biological family demonstrated
the need to find Sara a safe haven. The professional recommendations indicated
that institutionalization would have been the most rational course of action,
but the difficulty of finding an institutional placement for a five-year-old
whose parents’ parental rights had not been terminated, as well as the need
to get her into long-term care, led to the evaluation by Professional Parenting.
Sara’s early life
The first three years of Sara’s life are not
at all clear. She had first been evaluated before she was two years old
when her Sunday School teacher had become concerned that she was no longer
meeting developmental milestones. She had had some language development
but regressed noticeably after a bout of chicken pox and was absent for
several weeks. Her interaction ceased and she became withdrawn and echolalic.
Sara just wanted to flip the light switch off and on again and again, or
rock back and forth. She screamed when it was time to go home from church,
did not want to be touched and would scream and kick if an adult attempted
physical contact. Her Sunday school teacher persisted and it was because
of her involvement that Sara was initially evaluated. She was found to be
severely delayed/disordered and was placed in a special education pre-school.
At 22 months Sara received her regularly
scheduled vaccinations: DPT, MMR and polio. During that night and through
the following day she developed a high fever which continued to increase
even after she was given Tylenol™ (acetaminophen). When this developed into
a grand-mal seizure, Sara was transported to intensive care by EMS - she
had turned blue. Whilst in the intensive care unit she continued to seizure
until her fever was brought under control.
At the end of several months of rehabilitation,
speech therapy as well as continuing in the special education pre-school
setting, Sara was again evaluated. The report described her as ‘. . . a 3
years and 4 months old child who has made immense strides and can tolerate
up to 10 minutes of one activity. She can maintain eye contact for several
seconds. She can follow one-step instructions such as “look at . . .”. She
imitated some sounds and could sign “me” and “more” with 80 percent accuracy.’
In summary, the evaluation stated: ‘Sara continues to be severely delayed/disordered
in her speech/language development. Since Sara exhibits some autistic tendencies,
a TEACCH referral is recommended.’
