At home Sara spun in circles; she pushed buttons
on the T.V., VCR, and microwave; she flipped light switches on and off every
time she encountered them; she ran from place to place; she tripped on the
hearth and the steps; she fell down but did not cry; she patted the faces
of everyone she came into contact with, harder and harder until we stopped
her by holding her wrists; she pulled away, she rocked back and forth, she
screamed, scratched our hands and wrestled when being restrained, using every
ounce of energy she could manage from her 38 pound body .
Once we were home with her it was a struggle to keep my eyes on
Sara and get the car unloaded. My husband sighed and rolled his eyes in a
look of despair. Sara was in a frenzy. She didn’t stop moving, spinning in
circles, running into things, tripping over the door step, pushing the buttons,
rubbing the walls and flipping the light switches in every room. I tried
to hold her and she wriggled, wrestled, banged her head into my chin. I turned
her and tried to hold her to me and she buried her chin in my shoulder. I
sat her down and she ran, spun; I followed and watched. “Stop, stop Sara,”
I requested but there was no indication she heard my words; there were only
guttural sounds and maniacal laughter.
We had dinner. Sara was sat on a tall step-stool. Her plate was
fixed and the food was cut into pieces and allowed to cool. We said the blessing.
I peeked at her through squinted eyes. First she sat looking away and then
she reached out and put her fingers into the glass of tea. She rubbed her
thumb across her fingers and felt the cool liquid, then she quickly touched
her fingers to her lips. Her tongue came out and she licked her lips and
then she spat, waited and then picked up the glass. I watched as she took
a small sip and again she spat out the beverage. She waited a second and
then drank. The food was touched and then her fingers were touched to her
lips. She finally picked up a piece of food and put it in her mouth and then
took it back out, waited, then returned the food to her mouth and swallowed.
No chewing. She got up and went to Erika’s plate. She reached and got a piece
of Erika’s food, put it in her mouth and swallowed. I got up and returned
her to her own chair. Later, I described her weird eating behavior to my (foster)
brother David and he said it reminded him of survival training in the military.
Upon placing her in bed, the raging began - screaming, kicking, scratching
the wall, scratching herself, scratching me. I placed one arm across her
legs and one across her chest. I talked calmly to her, I told her no one would
get into her bed with her. I stayed kneeled on the floor until she finally
slept, 2 or 3 hours after we went upstairs. She slept with her eyes open.
The night rages lasted for 2 weeks. Of course we did not know they
were going to end, so we made preparations for B.J. and Erika to spend the
week of July 4th with Bud’s aunt and uncle, 4 hours away. It was early summer
and I am still thankful we had the whole summer to work with her before school
Our goals for Sara now were language development, interactive play and
developing enough skills to pass DIAL screening for placement in a regular
kindergarten. Our approach was to talk to her in plain complete short sentences
about everything we did. For example I would say: “I am going to set the
table”; “I am opening the silverware drawer”; “I am getting out the forks,
the spoons, and the knives”; “I’m putting them on the table - a fork, knife,
and spoon at Sara’s place;” etc.
We asked Sara questions, and answered for her with the response
we would expect from a young child, for example: “Would you like a banana,
Sara? . . . yes, please”. After a week, we added the trick of answering for
Sara with the ‘wrong’ response, such as: “Would you like a brownie Sara?
. . . no, Sara does not want a brownie”. She protested loudly: “Want one,
want one.” We asked her to repeat after us: “Yes, Sara wants a brownie.” She
complied with “Sara wants”.
I made alphabet cards, number cards, dot-to-dot pictures and dot-to-dot
words. She would give us her attention for minutes at a time, and we made
full use of every alert moment. We sat for hours trying to get her to push
a ball: “Come on Sara - roll the ball to B.J.” We played for hours until,
finally, she reached out and touched the ball. Praise, hugs, claps and cheers
were her reward for these simple acts of compliance. This work was stressful
for B.J. and Erika, so they received exaggerated rewards too - trips to
the movies or ball-park, shopping with aunts, uncles, grandparents, friends
and neighbors. We would pay for whole group outings in return for B.J. and
Erika’s respite from home. They too were greatly pleased with Sara’s progress,
although her behavior in public was still outrageous - she would run if
she got the chance, mashed cash register buttons and reached for fire alarms.
When she passed elderly men, she would reach for their genitals; in restaurants
she would lift her shirt or dress and slide under the tables.
I started out early one morning to try to get her behavior to a
manageable level. I told her what reward she would get for acceptable behavior
and held her hand until we reached the desired reward. “Sara, I will buy
you this toy if you stay with me and keep your hands to yourself. Look with
your eyes not your hands.” She laughed and ran, knocking the wigs off mannequins,
hiding under clothes racks: no reward. Next stop she was offered a pretty
shirt: no reward. Next stop, she chose a bracelet and carried it through
the store without running or causing mayhem. Success! That afternoon we went
from store to restaurant to video store to grocery store and by late afternoon
Sara was exhausted, her stubbornness subsided. She now held my hand and walked
quietly beside me, listening for what new treasures she might get for her