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Hesitant to Bond
Speake’s situation is not isolated, according to Susan Resko, director of the National Child and Adolescent Bipolar Foundation (CABF). She wrote in a recent blog that some children with severe mental-health needs are too ill to live in a traditional family setting. Residential treatment costs more than most American families earn in a year, and there is a severe shortage of treatment facilities that accept very young children. “We know painfully well how a child’s psychiatric illness can tear apart the fabric of even the most loving families,” says Resko.
CABF recently surveyed its members to learn if parents who were faced with this dilemma were willing to be interviewed on national TV. Thirty-four parents responded affirmatively. “Many of my friends and acquaintances with neurotypical children commented how unfathomable it is that families are faced with this ‘choice,’” Resko writes.
In the wake of caustic online comments that followed the September 2010 publication of a similar family’s story in the Chicago Tribune, Resko was quoted as saying, “There would be a national outcry if families were forced to relinquish custody of a child with cancer in order to receive treatment. Yet, when it involves mental illness, we still look for reasons to blame. It’s high time we as a nation address the shameful way we treat children with mental illness and their families.”
Speake’s two adopted sons are both Emily’s biological brothers, whom Speake has also adopted. They were all born from the same drug-addicted mother. “All three were born with heroin and cocaine in their systems. Emily’s situation was the worst—she had black-tar heroin in her system and spent 23 days in University Hospital withdrawing from that,” says Speake. Today, Emily shows multiple signs and symptoms of reactive-attachment disorder, which often occur “with kids who have been in and out of orphanages and haven’t bonded,” Speake explains. “The confusion over that causes people to ask me, ‘Haven’t you had her since birth?’ If she has reactive-detachment disorder, it is because she spent the first six months of her life withdrawing from heroin. The physical withdrawal is so intense that they can’t emotionally bond.”
Having children was a long-sought goal that Speake once thought was beyond her reach. She was married at 19 for one year and had no children. In her second marriage, she gave birth to one now-grown daughter, April. After that marriage ended in divorce, she still longed for more children. Yet, when she suffered a miscarriage during her third marriage, her husband responded with, “I haven’t been honest with you. I don’t want a baby, and I never will. I’m glad you lost it.” When she didn’t remarry or have another child, Speake decided to pursue “legal-risk” foster care, where children are not legally free for adoption until birth parents terminate their rights.
Julien Smith, Ph.D., is a pediatric neuropsychologist in Salt Lake City who has evaluated children born with various addictions. “As our brain begins to develop early in gestation,” she says, “even before a woman knows she is pregnant, the use of substances or even poor prenatal care can impact that development. Even prior to conception, the health and general behavior of the mother can affect development. The brain really starts developing early in conception—about Day 3—when the neurons in the brain are actually starting to organize themselves and get in place to be prepared to do their future task or activity,” she says.
“The experiences in gestation and any potential toxin in gestation can impact the organizational framework of the developing brain. During gestation, when things are chemically disrupted or disturbed by trauma, then that neurological development and the diversification and specialization of neurons is then altered chemically, functionally and structurally. Those abnormalities have lasting effects on brain area. Any time you are exposing a fetus to a toxin that potentially impacts neurodevelopment, there is a risk factor for inappropriate development.”
She adds, “While we clearly know toxins aren’t good for a developing fetus, it’s not the only piece of the puzzle. What are the genetics that went into the birth mother’s own disorder? Was something going on psychiatrically? There are so many pieces of the puzzle when interpreting developmental disabilities. A combination of bad genetics, bad behavior and toxins can impact the child’s development from the moment they are conceived. You get a neurological system that didn’t develop appropriately from the outset.”
Regarding Emily’s current situation, Smith says. “These challenges are the nature of our system. We don’t adequately provide for the least among ourselves. There are good outcomes, but it’s not like these kids get cured.”
She received a call from a homeless shelter looking for someone with a medical background to care for a drug-addicted newborn. She took Emily’s older brother home first at 11 days old, with the understanding that he was not adoptable. Social workers told Speake that the boy would stay in her home only a month before entering a special drug-addiction rehab program with his mother.
“I would think he might be leaving any day, and as much as I wanted him to become mine, I tried not to get too bonded.” Speake’s emotions warred as months passed and the boy stayed in her home. “Some months there would be visits, and other times the mother’s drug test would come back ‘dirty’ and she couldn’t see him. It was a hard emotional time.” When his mother never completed rehab, Speake continued to care for him. “We ended up back in court and the state wanted to take him from me and put him in a two-parent home. We had already bonded. The Foster Care Review Board ultimately ruled that there was no guarantee that a two-parent home would stay a two-parent home.”
Foster Parenting vs. Adoption
Foster children often come from at-risk backgrounds, says Mike Hamblin, Utah Foster Care Foundation director of foster/adoptive family recruitment. “Children that are in foster care are typically there due to a background of abuse and neglect.” In Utah, there are 2,600 children in foster care and only 1,400 families providing care.
“Foster care is seen as almost a volunteer labor of love,” says Hamblin. “While there is a basic reimbursement for parents who care for children in foster care, it’s a fairly minimal amount,” requiring some foster parents to fork out their own money for their children to participate in extracurricular activities. On top of that, with the poor economy, the reimbursement rates paid to parents for providing foster care have been reduced each of the past two years.
At the hearing where the birth mother of Speake’s children ultimately relinquished the oldest boy, Speake recalls gazing at the birth mother, a pale dark-haired woman who sat alone with her attorney on the other side of the courtroom. “My heart went out to this woman who was never able to give up cocaine and heroin so that she could go into rehab.” After the hearing, “I just had to hug her. We hugged each other and both broke out sobbing,” Speake remembers. “It was like we were at a funeral—one of the most heart-wrenching things I have ever experienced.”
During December 1998, Speake received calls from DCFS, asking that since she had kept her foster license active, if she could foster Emily. Again, she was told that she wouldn’t have this baby long before the mother entered drug rehab. “They said that this time, there was a father involved and Dad would be getting to see the baby.” Emily’s birth parents visited her just twice in the first seven months. Because the birth mother never completed drug rehab, Emily remained with Speake. To her surprise, she received another call five years later about a third sibling, a son from the same mother, whom she also later adopted. “I feel that it was in God’s hands. I thought I wouldn’t get a baby. Now I have three, and I am trying to keep them together.”
She also thinks it points to the fact there aren’t enough homes or people willing to step forward and do this kind of thing. At the time she adopted her children, had another parent asked if they should adopt instead of remaining a foster parent, “back then, I would have told her to go for it. Now, knowing about the issues that have come up, I probably wouldn’t be so sure.”
She still has no idea how her and Emily’s futures will play out. “Other than the fact that she and the boys are safe, I don’t feel that we have made a lot of progress.” At the one parent meeting she was invited to attend on Feb. 8, Speake says no one could tell her who Emily’s teacher was or how her grades were or provide school pictures. Up until the e-mails she received on Feb. 16, “I’ve gotten no direction, no guidance and no plan for the kind of therapy for Emily.”
Speake recently met with a foster mom who has cared for a little girl, now 6, for several years. “She says that my experience is the reason why she won’t adopt this girl,” says Speake. “She can’t afford to lose all the help she is getting. Why will they give a foster mom all of this money and support—over $2,500 month—when they won’t give that to me? Isn’t the goal a permanent home?”
Sollis says it is unfortunate that there are families who won’t adopt strictly because they will lose foster-care payments. When Speake recently wrote a letter requesting a different foster home for her daughter, she expressed concern about Emily’s bed-wetting episodes in the foster home, possibly due to nocturnal seizures that Emily was known to have. “This is a safety issue and the fact that Emily doesn’t remember [why she wet the bed] is a red flag that she could be having seizures in her sleep, losing bladder control and then not remembering in the morning,” Speake explains. “I am fully aware, probably more than anyone, how difficult Emily’s behavior can be, but I feel her needs still need to be addressed and provided for.”
During almost every visit, Emily asks Speake, “Can you make them let me come home? Why can’t I come home?”
Would Speake want Emily to live at home again? “That’s a tough one,” Speake admits, “but if we could get the right help and it is safe—absolutely. My dream would be for her to get the help that she needs so that she can come back home and be a part of our family. That would be the family life I have always wanted,” she says.%uFFFD