Hidden ADHD

So today’s topic came up because of this question – My brother, also an adoptee, had ADHD that was very obvious and came out behaviorally/externally. Therefore I was never tested/thought of having it because mine didn’t match my brothers. For years I lived thinking that my symptoms or experiences were just how the world works, but as I study more, I am seeing many ADHD symptoms that are just too hard to ignore. And maybe it isn’t ADHD, maybe it is related to dopamine levels that were affected through adoptee trauma and being born “addicted” to what my mother was using at the time. But I am wondering if other people have uncovered this or have experienced this, and how they went about handling it!

One adoptee shares – I have PTSD. The symptoms are similar. Adoption is trauma. I do less. I learned how to practice self care and regulate my nervous system. It got easier when I got away from the people who raised me. Therapy when needed.

Another adoptee writes – I suspect I have ADHD, and like you have a lot of symptoms. I’m working up the courage to get tested. I struggle with feeling safe with doctors, so haven’t gotten tested yet. The way I present is far different from my husband who was tested for ADHD as a child. She was asked – could you share some of your symptoms and how they are different than your husbands? She answers – he’s hyperactive and has no concept of time. I’m more of the zone out and dissociate. He’s a list guy and helps him focus. lists bore me. He forgets to text and call people whereas I lose things all the time.

Another adoptee notes – Women often go misdiagnosed or undiagnosed with ADHD (and autism). I wasn’t diagnosed until my 20’s with ADHD and suspect I’m autistic, too. A very ignorant doctor tried to tell me that if I got good grades in school, then I couldn’t have ADHD. That’s untrue. You can also have ADHD and not be the hyperactive type. There’s a hyperactive, an inattentive, and a mixed subtype. Typically, if your symptoms were not enough to aggravate/inconvenience others, especially in childhood, then you went undiagnosed.

Yet another adoptee shares – I used to just think that I had CPTSD from my adoption (which I very likely do have still), but after reconnecting with my birth family, found out that ADHD and autism are family traits (there is a genetic link to both of those). After doing a TON of research and taking the RAADS-R, it looks like I’m very likely AuDHD with a side of CPTSD/Adoption Trauma.

One more adoptee writes – Yes, diagnosed with ADHD at 38 and once I started meds, my autistic traits became more clear! And I do now know that I’ve always been this way, the two kinda cover for each other. My son is 6 and my mini-me, he hasn’t experienced any trauma in his life. We’re both neurodivergent.

Too Little Time To Succeed

Today’s story – I’m an adoptive parent of a 7 year old. “A” was taken into foster care at 3 months. She had visits with her mom for several months. Parental rights were terminated at about 18 months and they had their last visit. She was placed with me for adoption at 24 months. It took some time to get in contact with her mom, and we finally had our first visit when “A” was 3.5 years. A couple of missed visits, then COVID struck and slowed things down a lot. Thankfully, since she turned about 5.5, we’ve been spending time with her mom regularly, usually once every two weeks, and for the past eight months or so, I’ve usually left – so it’s been just them. We held birthday party jointly last spring, which was hard as we have very different values but also good and hopefully gets easier.

Increasingly, although I maybe always suspected, it’s clear to me that “A” shouldn’t have been removed from her mom. Basically, she didn’t know how to play Child Protective Services (CPS) games. And with a little more time and support, she could have parented. Definitely a case of a permanent solution being applied to a temporary problem. I do think she sometimes has made some unwise decisions, but so have I. I don’t think she poses any safety risk to “A”.

I’m increasingly wondering what’s really best for “A”. She is doing amazing in a lot of ways but has struggled with some challenging behaviors and as she’s getting older, it can no longer be dismissed as being on the normal spectrum of development. Of course, there are a lot of potential factors that we’re looking into, and I’m working to put in place sensory breaks and other accommodations at school, and I’m continuing to focus on building our attachment, but to some extent I wonder if these are just band-aids, if the real problem is being apart from her mom on a day-to-day basis. And if she doesn’t really need to be apart from her….? I’d appreciate responses from Adoptees – especially if you had a very open adoption – or first families.

While not the role she asked for – I did think this was an important point from a commenter. Just wanted to note that indeed it may not “solve” all the school problems. Maybe nothing ever will. Things will hopefully get better, absolutely. I just worry about framing any decision as possibly “solving” any “problem” behaviors for good. Sometimes expectations at school are in direct opposition to a child’s needs to thrive in an environment. Don’t let “solving her school problems” be a litmus test for your decision making.

Another not from the role but probably good advice – It sounds like you’re on the right track with nourishing a relationship between them. I’d include First Mom as much as possible in meetings and making decisions, such as IEP/school conferences and medical visits. If she’s included and reunification or guardianship becomes a possibility, she’ll be able to make informed decisions and it will be a much smoother transition for them.

Finally, from an adoptee – I had an open adoption and both me and my biological mom are neurodivergent. I also am a Board Certified Behavior Analyst (BCBA) and past special education teacher. I would get “A” assessed by a specialist, not a MD as they often misdiagnose (it happened to me). Once there is a confirmed diagnosis, you can start the process of getting support such as IEP, OT, SLP, School Psychologist and there may be a BCBA in the school district as I saw you mentioned “challenging behaviors”. (NOTE: not all children need any of the above therapies to succeed. Case by case basis solely). If insurance is an issue (you can receive in home or clinic support outside of school, if needed), stick to school services. I do believe a lot of my behaviors growing up were related to my adoption trauma but also, I can look back and easily see all my diagnoses presented before I was diagnosed. Both contributed. I wish I had gotten diagnosed as a child to receive support sooner. Everything you’re doing seems to be benefitting “A”. I would ask mom how you can better support her and keep her definitely in the loop about getting “A” evaluated. There could be other diagnoses in the family you don’t know about. I do believe her adoption trauma has contributed and after working with children, teens and adults from 18 months to 19 years of age from all backgrounds I’ve realized, kids especially may not vocally be able to tell you what’s going on or how they feel, but their actions/behavior tell you. They can feel it inside, just may not be able to express it yet where you would understand. That was 100% me growing up. I hope this helps.

From someone else regarding laws surrounding reunification of a youth who has already been adopted – if a youth has been involuntarily relinquished for adoption, meaning CPS convinced a judge to terminate parental rights (TPR), it will be harder than if the parent relinquished voluntarily. But not impossible. For her mom to adopt her child back, she would need to pass an adoptive homestudy in your jurisdiction. Some jurisdictions disqualify a homestudy, if the adult has had a termination of parental rights, some don’t. If, she would have to make a very good case that the reasons leading to TPR are false or no longer apply, which typically means outside documentation (proof of steady employment, steady housing, AA attendance for the last 5 years, etc.) If “A” is staying with mom for any extended time periods, you can get an educational and/or medical power of attorney done that lets Mum make emergency decisions. (Note that there is a small but present risk of CPS involvement, if you do this, so you may want to contact a lawyer in your jurisdictions with all the details of the case.)

One adoptive parent shared – I know it is hard and my daughter’s mom is similar to yours. I learned what I must do and asked our daughter if she would like to return to her mom ? If I had asked when we first started access, when our daughter was 6, I know she would have wanted to go home. Now she is 15 and has opted for increased access, while remaining with me. I know that it is hard to fathom letting go but putting the child first is always the right thing to do.

From an adoptee – Best for “A” is access to her mom. Obviously, safe access and led by A at her pace. The openness is great, but I would also add therapy. Access to therapy while young is so helpful. It will also help you as you navigate the future.

From a mom who lost her child – I couldn’t figure out how to play CPS games, and my PSAT scores were in the 99th percentile. I didn’t even study until I got to college, because I was used to being able to succeed with minimal effort. With CPS, there wasn’t any set rules, or consistency, like the whole thing was set up to make parents just give up. I fought until I was TPR’d, but I can understand why a lot of parents just get overwhelmed and see the goals as impossible. CPS will just keep setting up new goals, or stall for time, then claim they can’t return the child because all the goals weren’t completed in time.

The no set rules and consistency is so on point. I have watched CPS change requirements and not notify parents. I have seen the parent doing the work get punished while the parent not complying with court orders gets praise. The more you see the system the more you see it is set up to take those children and not give them back. It is appalling AND they can lie without consequence.

An adoptee and reunified mom wrote – The thing you can’t say wouldn’t solve all the problems. The trauma already happened. But it might mitigate them. I’m not a child development specialist, so I really can’t be certain, but I know that reunification helped my child. And reunion, even this late, is helping me with my own issues.

A therapist with years working the system said – live close and co-parent. Look to each person’s strengths and build on those. Consider relating like separated parents, figuring out who does what. If it seems that you are in a better position to support her school needs, then take the lead on that but include mom. Build up her capacity to do it.

An adoptive parent brings up an interesting, sometimes overlooked, issue – So is there a first dad in the picture? It could complicate things. For us one complication is the natural father who lives in a different country is against it. He only wanted us to adopt, not for first mom to get the kids back. So we don’t know how that will look in the future. Also this, there is no magic pill. Leaving the home the adoptees have known for years will be traumatic as well.

What’s In A Name ?

A major topic for reform in adoption is in regard to the adoptee’s name. Today’s story is complicated and long and so I’ll try to summarize it. There was an oops when bi racial boy/girl twins were born to supposedly white biological parents. When they were born, their mom put her husband’s last name on their birth certificate. However, it was determined that he was not in fact their dad. So, the twins last name was changed to their mom’s maiden name. For rather obvious reasons, her husband did not wish to parent these children and so they were put up for adoption.

They are now 7-1/2 years old and their adoption will most likely be finalized in the next couple of months. The soon to be adoptive parents are in contact with these twins older half siblings. One of the twins is the only one of all the siblings without a double letter in their name but they did not want it changed. The issue of what their last name will be has been handled delicately. One twin wanted to keep their last name but add the adoptive parents’ last name, the other twin just wanted the adoptive parents’ last name. Recently, one twin asked, “since the adoption is coming up, can I change my name?”

This is the same child that didn’t want to change the spelling of their first name, now they want to change the name completely. When the kids (both the soon to be adoptive parent’s biological children and these twins) play dress up, they have alter egos. They go by their alter ego names while playing pretend. The twins will even go by their alter ego name when they change their hair style from natural to braids, twist, finger curls, etc. for a day or so. This child is asking to change their name to their alter ego name and they said, “you can spell it anyway you want.”

Almost every child, at some point in their childhood, will go through a phase of trying a different name. So the almost adoptive parents said it takes a judge to change your name, no matter the reason. There are situations where names are changed – when you get married and you can change your last name, if you correct your gender you can change all of your names, at adoption names are often changed and you can keep all of the names your first family gave you or change parts of your name, and at the age you are grown up if you just really dislike your name, you can change it then.

Another adoptive parents said – I wish no one brought up name change at adoption. It makes it seem like something that should happen, and I no longer think it should. I also think it’s a lot to ask a kid to make a decision about this, especially a kid with adoption related trauma.

A domestic infant adoptee said – I think giving a kid the opportunity to make a decision about their huge upcoming life shift that is completely out of their control, gives them a tiny bit of control back when things are so rocky. However I still believe the first name change can happen as a nickname, let her go by that but let her choose her last name for the adoption finalization. Then, when she is older, if she has kept that nickname for years, then as a teenager let her consider changing it legally.

Another adoptive parent shared – In our case, I screwed it up in the worst way. We changed all her names with her “choosing” from several names we were considering. But keeping it the same wasn’t presented as an equal choice. She was 4 years old at the time. She is 8 years old now and sometimes she wants to change back, sometimes she wants a friend’s name, sometimes she’s happy with what it is. We are now in reunion with her birth family, through a relative who adopted her younger siblings when they were born and we have discussed the name changes we made, our reasoning, and how we feel now. Both of us independently decided that we will support any changes the kids want, when they are adults but we will pay the court costs. I don’t think there are any right answers but my main regret is that keeping the name at birth was not presented as an option. I’ve heard adoptees say that with so much taken away from them, their name should remain the same.

Another adoptee said – I’m a non-binary trans person who has changed the name they go by as an adult. Let them go by the name they want to legally change it to – immediately. Start calling them by that name. Don’t give the legal name change a deadline (the legal adoption finalization date). These are two distinctly different things and while they are connected, each needs its own timeline. You can help them by discussing if they like the name. If they go by it for a long period of time, then you can discuss legally changing their name. I recommend this because of their young age and the already overwhelming situation of the adoption being finalized. Names are a GIFT, and if that gift no longer works for them, they can give it back and find one that meets their needs now. Changing the name during adoption seems to layer on trauma but for an older trans person I think it removes trauma.

Yet another adoptee shares – I was different because I’m neurodivergent. I wanted to change my name to fit in, rather than have a name no one connected to. When I grew up, I changed my name. Always Always go with what the kid wants. It just doesn’t have to be legally changed until they’re older and had a long time to think about it. Kids are still discovering themselves.

Autism and Foster Care

Children with autism are more likely to end up in the foster care system. Long- and short-term outcomes for children in foster care are not good: Children who spend any amount of time in foster homes are less likely than their peers to graduate from high school and more likely to end up homeless, in the criminal justice system or in long-term residential care. Foster care may be an even less desirable place for children with autism, given their special needs. Although foster parents may receive some specialized training, it is generally not nearly enough to help them adequately care for these children.

7.3 percent of Medicaid-enrolled children with autism were in foster care in a 2008 study. This is well above twice the proportion of all Medicaid-enrolled children in foster care. The prevalence of children with autism in foster care started out at 7.5 percent in 2001. It climbed to 10.5 percent in 2005 and then declined to 9.1 percent in 2007. Children with autism were 2.4 times more likely to enter foster care than a typical child.

Raising a child with autism is stressful for families, as the condition is unusually difficult to manage effectively. Some parents may simply not have the skills and resources to do so. This may result in neglect or abuse — and placement in foster care. Alternatively, families may voluntarily place children with autism in foster care because they can’t handle the children’s behavioral problems. Third, parents may relinquish custody so that their children can obtain Medicaid-funded or residential care that they otherwise cannot afford.

I will always be for family preservation. To lower the chances that a child with autism will land in foster care, clinicians working with these families should talk openly about the stresses of raising a child on the spectrum. They should ask how that stress is manifesting in the family, and assist the family members in getting the support they need. All US states should offer home visits from professionals or short-term breaks for parents of children with autism. (Only a handful currently do.) Home visits and respite services have been shown to lower the chances of psychiatric hospitalization among children with autism, and also may reduce the risk of foster care placement.

Foster care arrangements can cost between $30,000 and $50,000 in taxpayer funds per child per year. That money could be more wisely spent supporting the needs of these families. Society has an ethical obligation to help families care for their children with autism. We can and must do better to help these most vulnerable children and their families.

Thanks to David Mandell and his essay in LINK> Spectrum News for today’s blog. I started with an interest in how neurodivergent issues relate to foster care and a google search ended up with that essay.