SLEEPLESS IN FOSTERING

A reader named Ally asks;

"Do you have any experiences with foster kids diagnosed with PTSD that dont sleep well, and if they do sleep, are awake super early, 4-5am waking everyone in the house up to show she is awake and leaving EVERYONE exhausted".

Interesting question, due in no small measure to the fact that it got me wondering how many foster children have undiagnosed PTSD in some measure...

Probably so many it would bring down the system. So Ally's placement must be a particularly profound case.

I'm assuming here that PTSD refers to post traumatic stress disorder.* 

Poor child must have been through something seriously distressing. And is still going through something seriously distressing, namely re-living whatever the traumas were over and over.

I haven't had any experience with children who've been clinically diagnosed with PTSD, my first thought is that whichever professional made the diagnosis would be your first port of call with the sleep issue. A diagnosis of PTSD is obviously serious; you hear of firefighters and suchlike receiving counselling and medication to deal with experiences. PTSD in a child is a major thing. 

Sleeplessness for foster parents is no minor matter either.

First off I want to say to Ally that you must be held in huge esteem by your social workers if they chose you to help this child's repair and recovery. Think about it Ally, you must be one helluva foster parent, good on you.
That's no comfort to you though, especially at 4.00am, but the child wants and needs to be with you. You, your whole household, represents the love, warmth, friendship and security she craves, and she wants it all around her from the minute she wakes.

Getting children to go to sleep? Can be a devil of a job.

You can make a child up wake up, but you can't make them go to sleep. You can crowbar them into bed, but if they have distressed minds, why try? Most of the foster children I've had were dead set against bedtime, many because they dreaded the loneliness of a strange bedroom in a strange house. Many's the time I've allowed a child to stay 'up' with us on the sofa in their pyjamas and dressing gown under a blanket until they are proper drowsy. Depends what's on the TV as to whether it's on or off. If it's off I'm either in a book or on my ipad. Best of all is if I pretend I'm nodding off. Sometimes I don't have to pretend too hard. Had one child who used to synchronise their gentle breathing with mine and that was when I knew they were ready to go upstairs.

Long bike rides at the weekend helped; children don't run around in the fresh air like they used to.

Let's talk about the early waking and wanting everybody else to be awake.

Our very first foster child was a bad sleeper and an early waker-upper of myself. Partly my fault. On his first night I made a rookie mistake, I told him if he woke up in the night and felt scared he could tap on my bedroom door and I'd be there for him. So he did, at 2.30am. And a promise is a promise. It became routine, and once it got in the groove it proved really hard to undo. Turned out he had always been a poor sleeper all his life.

We did undo it in the end, it took about 3 months to start improving and another 3 before it was just a bad memory. I'm not saying Ally is in for a long haul; every foster child is unique; what happened with this child was that with time and effort he began to feel more and more secure and trusting, and as he did so he started sleeping better.

Time heals, but lacking a Tardis to fast forward we decided to try various things to speed the process up.

First off we put a clock in his room and agreed he could get up at a certain time and was rewarded every time he did. We started with 'soft targets' and gradually moved the time forward until it got to an acceptable 6.00am. We made a game of it; I bet him he couldn't stay quiet in bed until such and such a time and he kept beating me. He was the 'winner'. No matter that I had to buy a digital clock (easier to learn than one with hands). I had to teach him how to tell the time before this one began to kick in, and it was a struggle at first, but I'll never forget the first time it fully worked, we all felt good, especially the child.

We put food in his room. Many children coming into care have suffered neglect with food. Not just poor diet, but being denied food as punishment or because the adults simply can't be bothered, or forgot, or were too drunk or high to even make beans on toast. And the children are often barred from using the larder or the fridge on pain of punishment. That's if there's anything in them to be going on with...

Food is right up there on dear old Maslow's hierarchy of needs, third in fact, behind air and water. Not just the eating of it, but the comfort that it's available. So we put a bowl of apples and bananas in his room and said they were his and he could eat them whenever he wanted to. We started making a snackbox with his favourite nibbles and putting it in his bedroom every night and telling him it was his and he could snack away if he woke up. He didn't seem that fussed about the snackbox because it hardly ever got eaten, so we stopped it only for him to complain. Turned out he needed the security of available food more than he needed to eat it.

We got to the bottom of his jitters. We found out, thanks to a chance remark by a social worker, that before he came into care he used to be locked into his bedroom every night so his mother could go to the pub. We called the social worker who had overseen his coming into care. She'd been to the house, she described the scene. His bedroom door had no ordinary door-lock with a little key in it. It had a huge steel hasp screwed onto the outside of the door with a thick gunmetal staple on the door frame to take an industrial padlock. Horrific! To this child his bedroom was a dungeon. So the lesson learned is to find out everything you can about the child; ask social workers questions about everything they know about the child's experiences, ask them to dig out everything they can because it's possible that somewhere in all the awful history is a detail you can use. What did we do for this child? We took his bedroom door off. Yep. Drastic, I know, but it was just six screws. We talked to social workers first about it, it was agreed. I'll never be sure how much it helped - we had to be careful with privacy etc - but it definitely contributed.

We couldn't stop him waking up early, only peace of mind would do that. He had nightmares he didn't or couldn't recall and they were probably what woke him up. Once awake he didn't dare go back to sleep for fear of more bad dreams. We couldn't stop him waking up, couldn't stop the dreams, couldn't make him go back to sleep, but we could help him feel comfortable with just himself for company.

We put things to do in his bedroom. I lent him an ipad so he could play games with headphones on when he woke up (and I was able to monitor his usage by checking history when he was at school). It helped. He started to get used to being alone in the wee hours.

Lighting was important. We left the landing light on and a night light in his room. We kept checking to make sure the lighting didn't make any strange shapes out of shadows. We left the bathroom light on, in case he needed to go and didn't have to encounter any darkness anywhere. 

As he got to know our house better we tried something a bit daring and it worked, maybe the best thing we tried; we told him that we thought he was clever enough to creep all the way downstairs and play on the X Box with headphones on without waking anyone up. We made a game of it, a challenge. We sussed out which stairs creaked and how climb down without stepping on them. We had fun practising during the day; I'd sit at the kitchen table with my eyes closed and he'd have to start in his bedroom and get into the living room without me hearing a sound. The child was a mature ten years of age by the way (this tactic is not for younger ones, obviously). Being awake and having the run of downstairs made him feel grown-up. Was it a risk? We talked it through with social workers, the joke was that if he grew up to be the world's best cat burglar we'd go down as his accomplices. We gave it a go. He was fine. It worked until the time a spider galloped across the living room floor...

Not all the above are appropriate for all children of course. Always run ideas past your social worker. The key thing is to keep trying to find things that help. Try your own ideas out, anything that might improve things.

Naturally we didn't buy fizzy drinks or any food that might trigger 'blue sweet syndrome'.

We (my partner and I) took it in turns to be 'it', when he needed someone to be awake. As things improved we both got used to dozing in and out of sleep once he was on the move. When he was at school I had regular afternoon naps, but they never made up for a poor night's sleep.

Being awake with a demanding child when the rest of the world is fast asleep is one of the loneliest places. But...

We got there in the end, and now it's a distant memory, but many thanks to Ally for reminding me about what started out very demanding but ended up a very satisfying fostering experience.

Funny thing, one's memory with parenting. When my first baby was born I swore loudly and frequently (43 hours labour) that I would never put myself through it again. Apparently it was ten weeks after the birth that I announced I wanted another...

Fostering's a bit like that. I'd forgotten the hardships of having a sleepless foster child until Ally asked. When the lad left us I was straight on the phone to Blue Sky asking for another placement. 

Didn't take me ten minutes, never mind about ten weeks...

* ps I'm cautious with bunches of initial letters, they're everywhere. A friend visited recently, a petrol-head. He was getting into his car to go and said something spookily insightful so I said;

"Your ESP is working well."

And he replied; "Actually I've just had it tweaked."

I replied "Tweaked?"

Turns out ESP can refer to a car's Electronic Stability Programme. 
Unless, my friend went on, I was referring to his Electric Submersible Power motor which is a two-pole squirrel cage induction device...

Anyhoo from that conversation on I make sure everyone's agreed on what initials stand for.