{"id":130,"date":"2021-02-25T23:54:23","date_gmt":"2021-02-25T23:54:23","guid":{"rendered":"http:\/\/fafasd.net\/?p=130"},"modified":"2021-02-25T23:54:23","modified_gmt":"2021-02-25T23:54:23","slug":"oppositional-behavior-and-fasd","status":"publish","type":"post","link":"https:\/\/fafasd.net\/index.php\/2021\/02\/25\/oppositional-behavior-and-fasd\/","title":{"rendered":"“Oppositional” Behavior and FASD"},"content":{"rendered":"

(First published on the Easy to Love but Hard to Raise blog (now private), by Adrienne Ehlert Bashista.) This was written when her son was about 10 years old.<\/em><\/p>\n

My child has a default setting, and it is NO.<\/p>\n

If I didn\u2019t know better, I\u2019d say he had ODD, or oppositional defiance disorder. Many experts \u2013 psychiatrists, psychologists, therapists, and others \u2013 have suggested he has ODD in the past. He certainly has all the characteristics \u2013 but in reality he has FASD, fetal alcohol spectrum disorder. What looks like ODD is a result of chronic frustration from living in a world that expects \u201ctypical\u201d behaviors from an atypical brain. Saying NO is what he does when confronted with people expecting more from him than he can actually do. Being angry and sad and frustrated are actually normal responses to chronic misunderstanding. So labeling him with ODD is not very useful as it doesn\u2019t lend understanding. It simply describes behaviors. It doesn\u2019t look at the WHYs, and I\u2019m not sure that it looks at the WHAT-TO-DOs. In my experience, understanding the WHYs is what drives the\u00a0WHAT-TO-DOs.<\/p>\n

So here are the WHYs:<\/p>\n

<\/p>\n

When I, and other people who train about FASD and the brain, talk about FASD\u00a0we often split up the behavioral symptoms of brain dysfunction into 3 different groups. This is based on research done by Ann Streissguth and others, and described by Diane Malbin, my mentor and trainer.\u00a0An excellent scholarly article on secondary characteristics, by Christie Petrenko and her colleagues, can be found here.<\/a><\/p>\n

First are the primary characteristics of FASD. These are directly related to brain differences and although they vary from person to person, they include slow processing, problems with memory, sensory differences, impulsivity, developmental lags, or dysmaturity, difficulty with language and communication, poor executive functioning, and difficulty with abstract thought. Each of these brain functions show themselves behaviorally. The person with slow processing may not be able to answer questions quickly, which might look like the person is ignoring the question, or \u2018not listening.\u2019 The person who is dysmature and who has language difficulties may be able to superfically engage in conversation at his\/her chronological age (due to mimicking or good expressive language skills), but may have little understanding of the content of the conversation, leading others to believe he\/she is \u201cgetting it\u201d when they are not. Later, when the person with FASD is supposed to remember the conversation or apply what he or she has learned and cannot, it is interpreted as deliberate and willful disobedience.<\/p>\n

We help the person with FASD by understanding brain differences, accommodating their very real physical disability (because the brain is part of the body, right?), and structuring their environment for success \u2013 just as we do for any other physical disability. We quit assigning motive for what they cannot do. We give them the benefit of the doubt.<\/p>\n

Secondary characteristics \u2013 like what looks like ODD \u2013 are behaviors that result when primary characteristics are misunderstood as being on purpose, intentional, or manipulative. If a person\u2019s needs aren\u2019t met, that person gets frustrated, angry, and shuts down. If this happens time and time again, and if that person is punished for things he or she simply cannot do, frustration and anger increase exponentially. This is a\u00a0normal<\/em><\/strong>\u00a0response<\/em>\u00a0to having one\u2019s needs be unmet.<\/p>\n

Tertiary characteristics of FASD are the very unhappy endings of chronic misunderstanding and frustration: jail, homelessness, addictions, and hospitalization.<\/p>\n

It\u2019s really important to understand FASD in this way \u2013 it\u2019s not a mish-mash of all the symptoms. It\u2019s not an inevitability that the person with FASD will become an addict or have to go to jail. It\u2019s primary differences in the brain, what happens when those differences aren\u2019t understood and needs aren\u2019t met, and what can happen when those needs aren\u2019t met over a long period of time that determine the outcomes.<\/p>\n

Let me explain, using my child, and all his NOs, as an example.<\/p>\n

    \n
  1. Primary characteristic: he is highly\u00a0impulsive<\/strong>\u00a0and so often says the first thing on his mind. Because he often can\u2019t do as asked, the first thing on his mind is often NO, whether or not he is able to meet the request.<\/li>\n
  2. Secondary characteristic: he is\u00a0fearful and anxious<\/strong>\u00a0about new things, and this expresses itself by a rejection of new things, leading to NO.<\/li>\n
  3. Primary characteristic: he has\u00a0trouble processing<\/strong>\u00a0situations and conversations rapidly. He uses NO as a place-holder, a way to buy himself time to understand what\u2019s being asked of him.<\/li>\n
  4. Primary characteristic: he\u2019s\u00a0dysmature<\/strong>, so while many children outgrow the NO at age 4 or so, he\u2019s really not there yet.<\/li>\n
  5. Secondary characteristic: when he\u2019s feeling most\u00a0frustrated<\/strong>, he combines the NOs with name-calling, the phrase, \u201cYou are mean,\u201d and sometimes crying and tantruming and throwing things to \u00a0communicate how he\u2019s feeling.<\/li>\n<\/ol>\n

    The primary characteristics are how his brain works. The secondary are the reactions to dissonance between expectation and reality. We can\u2019t change the primary characteristics, but we can change our OWN REACTIONS to the secondary and change his environment for better success.<\/p>\n

    Here\u2019s how this works in real life:<\/p>\n

    Saying NO started when he first began to talk, around 3 (notice that he was a late-talker, which lead to more frustration, which lead to more NOs) and although we\u2019ve had ups and downs over the past couple of years in terms of the level and intensity of his opposition, it pretty much continued unabated until he was about 9 years old.<\/p>\n

    What hasn\u2019t continued unabated has been our response to these NOs. At first we went with the flow. After all, saying NO is very normal behavior for toddlers and pre-schoolers, as are tantrums and screaming.<\/p>\n

    As he got older, and the NOs became more frequent, our next tactic was to be frustrated, to say NO back, to punish, to give consequences, to be angry and sad and frustrated\u2026and we did this for several years. A very LONG several years. It didn\u2019t work. It made it worse \u00a0The harder we pushed, the worse he felt, and the more frustrated he became \u2013 so the NOs only got louder and longer.<\/p>\n

    Eventually we (and when I say \u201cwe\u201d I really mean \u201cI,\u201d because for better or for worse Mama drives the child-rearing practices in our house) came to a place where we started to realize that there was more to the NOs than him simply being a super-brat. I really wish I could say that all along I believed in my child and knew there was more going on than him simply being \u201cbad,\u201d but this wasn\u2019t the case. It\u2019s only been a recent (in the past 2 years) development that I came to realize he truly, truly can\u2019t help this behavior (see #1-5, above.)<\/p>\n

    But even though I realized his behavior was beyond his control, that the NOs were not on purpose, that if I waited a beat \u2013 2 seconds or so \u2013 he would tell me what he really meant and thought \u2013 I STILL handled it wrong.<\/p>\n

    I talked. I talked and I talked and I talked. I talked to him about trust, and how he needed to mean what he said, and how people wouldn\u2019t like him if he was so negative and how hard it was for Daddy and I and his brother to know what he meant if he didn\u2019t say what he meant from the get-go, and blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah.<\/p>\n

    I\u2019m sure I sounded like the teacher in\u00a0Peanuts<\/em>. Because it did about as much good as that teacher does. Wah wah wah wah wah.<\/p>\n

    If a person\u2019s brain processes more slowly than the typical brain, and if there are particular difficulties in the area of auditory processing, talking is the LAST thing you want to do to get them to change.<\/p>\n

    It took me about a year to realize that although getting away from punishing him for saying NO was a good thing (and actually resulted in less NOs, believe it or not), talking about it, trying to be logical and providing reasons for why he wasn\u2019t being an effective communicator by saying NO all the time, didn\u2019t work. Not really. I mean, he heard what I said sometimes, and if you ask him in a calm moment how he\u2019s supposed to ask he can tell you, but it didn\u2019t really translate into the behavior we wanted.<\/p>\n

    That said, here\u2019s what HAS worked through better understanding of his brain:<\/p>\n

      \n
    • Giving him the benefit of the doubt.<\/strong>\u00a0When he says NO, we wait. We try not to assume that he truly means NO when he says NO. We actually assume otherwise. We ask a second time. We get clarification. We ask a 3rd\u00a0time. We make sure that NO means NO. Most of the time it doesn\u2019t.<\/li>\n
    • Taking him out of uncontrolled social situations (basically,\u00a0recognizing overwhelm and understanding the importance of environment<\/strong>). For us this included school. He was too overwhelmed with the other children, the social and academic expectations that he couldn\u2019t meet, and the constant frustration and disappointment he felt when comparing himself (or when others were comparing him) to others. He is less overwhelmed and we can concentrate on what really matters now.<\/li>\n
    • Stop talking so much<\/strong>\u00a0about how to act. Instead, we need need to give him space and an atmosphere where he can put what he knows into action.<\/li>\n
    • Recognizing dysmaturity<\/strong>\u00a0for what it is and waiting for him to mature at his own pace.<\/li>\n<\/ul>\n

      Now, my boy still says NO a lot. But he says it a lot less. And I\u2019m willing to bet that as the years go by he will say it even less than now.<\/p>\n

      I\u2019m not sure he\u2019ll ever be a glass-half-full kind of guy, but at least he won\u2019t break the glass before he\u2019s even tried the water.<\/p>\n","protected":false},"excerpt":{"rendered":"

      (First published on the Easy to Love but Hard to Raise blog (now private), by Adrienne Ehlert Bashista.) This was written when her son was about 10 years old. My child has a default setting, and it is NO. If<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6,5,3,7],"tags":[20,10,8,24,19],"_links":{"self":[{"href":"https:\/\/fafasd.net\/index.php\/wp-json\/wp\/v2\/posts\/130"}],"collection":[{"href":"https:\/\/fafasd.net\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/fafasd.net\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/fafasd.net\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/fafasd.net\/index.php\/wp-json\/wp\/v2\/comments?post=130"}],"version-history":[{"count":1,"href":"https:\/\/fafasd.net\/index.php\/wp-json\/wp\/v2\/posts\/130\/revisions"}],"predecessor-version":[{"id":131,"href":"https:\/\/fafasd.net\/index.php\/wp-json\/wp\/v2\/posts\/130\/revisions\/131"}],"wp:attachment":[{"href":"https:\/\/fafasd.net\/index.php\/wp-json\/wp\/v2\/media?parent=130"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/fafasd.net\/index.php\/wp-json\/wp\/v2\/categories?post=130"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/fafasd.net\/index.php\/wp-json\/wp\/v2\/tags?post=130"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}