I'm gathering information for My friend
My friend Sara* (* is name changed) has had residential custody of her stepdaughter, Jane* since she was 3 months old. Lily*, Janes' biological mother, lost custody when she was 3 months old. Jane is now 6 and displays a variety of behavioral and emotional problems due Lily's drug use while pregnant. Jane has been in a loving, caring, 'safe' environment since 3 months old, and is being treated for her disorders with counseling and medication, yet continues to have problems. The 'trigger' for the most recent problems is the re-appearance of Lily in her life via court-ordered visitation.
Lily abused alcohol and a variety of hardcore drugs before and during pregnancy and Jane was born a month early. She had no problem informing Sara she went into labor while smoking marajuana, Jane was born 'high'.
Janes' physical problems include severe acid reflux. She is on a restricted diet, (no fried foods, carbonated drinks, etc.)and cannot eat or drink (even water) 2 hours before bedtime. She will vomit in her sleep and before this was diagnosed, almost choked to death on several occasions. Jane also has a sensory disorder; oral fixation and 'mouthing' are calming and is treated rather simply with a piece of gum. Deep tissue massage and 'bear hugs' have a positive effect on mood and behavior.
Emotional problems are extreme when Jane is not medicated. She has ADHD and ODD. The ADHD is treated with ritalin and all artificial food additives have been eliminated from her diet, as well as artificial sweeteners. High fructose corn syrup intake is extremely limited. Her ADHD is under control, and her academic performance has been 'caught up' with therapy at school and Sara's tutoring at home. She is on level and even above her peers in school.
Most children 'learn' aggressive behavior, for Jane it seems to be instinct. She has outbursts of unprovoked violence, usually against her younger sister. This behavior is disturbing because she has NOT been exposed to it in her home or on TV, and it began to manifest at 11 months of age. She has attempted to kill her sister on several occasions by differing methods including strangulation, blows to the head and face, and in one instance she smashed a ceramic dish to stab her with the shards. Jane is on two different anti-psychotic medications as well as the ritalin.
Early last spring, Lily sued for custody/visitation of Jane and set a sad chain of events in motion. Lily had not had any contact with Jane for nearly 3 years, and Jane was doing very well. She was off the stronger anti-psychotic, (the other is more of a mood/brain chemistry moderator)doing well in kindergarten, and all around a happy, normal child. Within two weeks of knowing she HAD to see Lily, by court order, she tried to kill her sister with the broken dish. Visitations were supervised (by Sara at her house)on Saturdays from 2pm to 4pm. Lily showed up to 4 out of the six between the 1st and 2nd court dates, was late for those anywhere from 45min to 3hours and has not seen Jane since June 2, its October 16 as I write this.
On June 2, Sara took Jane to see Lily at a family cookout where Lily admitted to being high on extasy, (a hardcore drug)because she couldn't handle Jane being there. Sara has not allowed Lily to see or talk to Jane since. Lily and her boyfriend came for one subsequent visit; Jane was at soccer practice and was to return home within 10-15min. Lily said "Tell my baby I love her and I will call her later." Sara asked why she couldn't wait for Jane to come home. An argument ensued that ended with Lily and her boyfriend threatening to beat-up and kill Sara. The woman is out of her mind.
Lily would call Jane and say to her "Be good
for Sara or I won't come see you on Saturday" Jane would deliberately and severely misbehave in order to be punished. She eventually admitted her rationale to Sara "If I'm punished, I can't have any visitors, so that means Lily can't come see me right?" This was after she killed her goldfish by squishing it and gouging it with her fingernail.
After the visitation, Sara and her girls were supposed to have a play-date with me and my daughter and Jane said "I will 'trade' not seeing Liz* and Katie* so that I don't have to see Lily." Her anxiety over Lily also manifested physically in that Jane would throw up after eating, lose control of her bladder and even her bowels in public. Part of it stems from Lily insisting to be called Mommy, and telling her, things such as 'as soon as I get on track, you're going to come live with me, won't that be fun?' Making promises to call and show up to the visitations and failing to follow through, and other behaviors that would stress a 'normal' child, let alone a child with issues such as Jane.
Jane has begun lashing out at Sara. Saying things such as "Mommy, I don't think I love you anymore." At a restaurant, misbehaving and asking to go potty, just so that her mother couldn't eat her meal. Lying to her parents in order to start fights between Sara and her husband (who has multiple sclerosis). Misbehaving, knowing full well she will be grounded, just to make her mother and father mad. On the contrary, she is PERFECTLY well behaved at school.
This description has made Jane seem like a Demon-Child, and it's sad because it's not her fault. She responds very well to the medication, which confirms neurochemical imbalance. She does well with counseling, and is for the most part, a bright, happy, loving little girl whose parents do whatever they can for her. Sara and her husband have promised Jane they will do everything in their power to keep Lily away, and things have improved. The issue lies in the continued 'misbehavior' which I feel is due to stunted cerebral development directly related to Lily's drug and alcohol abuse.
Sara is working on getting full parental rights to Jane and officially adopting her so that she and her husband can do more to protect Jane from further emotional damage.
After all that background information, My questions are as follows, I'm in school for medicine, but I have not yet studied pediatric psychology or neurophysiology. I am not yet a doctor and cannot diagnose or give medical advice. The little I do know leads me to think Jane needs more aggressive therapy and treatment. Her counselor is more along the lines of a social worker. Her doctor is currently content with dispensing medications.
1. The effects of long-term drug therapy on female puberty and adolescence from parents who have experienced it. Jane is 6 and her parents and I worry that with the extreme hormonal changes of maturation, her condition will deteriorate.
2. The lack of impulse control that leads to the violent aggression has existed since infancy, Is there a physiological treatment that will help brain development when combined with her medication?
3. Would a study of her brain waves during varying emotional states and an MRI depicting cerebral development aid in diagnosis and treatment of Janes' disorders? Has anyone done this and has it helped discover whats going on?
4. What is the true prognosis for a child in this situation?
Thank you for taking the time to read and answer my questions. Sara and her husband are like family to me and I love Jane and her sister like they were my own. I'm distressed watching them suffer because of Lily's mistakes. Please e-mail me if have any information that can help us.
Use subject heading "Helping Jane"