Bear in mind Dr. T's answers are the best I can remember and are coming through the filter of my brain, but it's what we have to work with.
Q: Yesterday Cadi had some pretty bad behavior but couldn't seem to understand that her behavior was tied to the consequence of losing privileges which she was indignant and angry about. The phrase "Everything I do you blame on me" sums up her attitude and the extent of her understanding of the situation. It seems like she is missing some important connections here. What do you think this is coming from?
A: There are some areas in which Acadia is developmentally immature, and other areas where she is on target, or close to target for her age. This is one of those areas where she seems to be immature. You would expect this kind of thinking and behavior from a four year old, but not a 9 year old. Acadia has a social deficit or immaturity in her understanding of responsibility for her actions.
Q: You have mentioned anxiety as a probable cause for Cadi's anger, irritability, and oppositionality. In your experience with other kids, have you seen anxiety present this way?
A: Yes, often. I can relate it to being like a timid animal. When you first approach it, it will run. If you get closer, it will freeze. If you try to touch it, or force it to do something, it will fight. When Acadia is faced with something she is being asked to do, she is not saying, no, I can't do that because it's too hard or too scary for me. She struggles with that capability to express intense feelings with words when she is in the middle of them. She is just fighting, desperately.
Q: We've talked about Acadia having a developmental language problem in not being able to express things using language. What about the times that she has talked about her feelings, such as in a therapy session where she is motivated with candy?
A: The fact that she has to be motivated by a piece of candy for each sentence, actually demonstrates that this is a problem. Food is a very base level motivator, we use food to train animals to do what we want them to. A 9 year old should be able to volunteer at least some basic information about their day or their week, and then maybe work towards more expressing more personal feelings, but shouldn't have to have such a base level motivator to use language.
Check the Care Page for more about Cadi's status, meds and our plans.