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10 Week Post Residential Update: Behaviors

Tonight we celebrate 10 Weeks Post Residential!!! 


I have been promising an update for some time and have finally been able to sit down and do so.


I am sharing behavior information in hopes that it will help others and because Sunshine has consented. Reactive Attachment Disorder and mood disorders can be hard. 


A return from residential treatment, especially four placements in almost three years is anything but easy, even if visits have gone well.


There is a lot of adjusting, a lot of testing, and a lot of trauma to work through. 


No return will go perfectly. 


The goal is safety and slow improvement over time as everyone feels comfortable with each other and accepts the current arrangement.


10 Week Post Residential Update: Behaviors


10 Week Post Residential Update: Behaviors


Before I share Sunshine's behaviors from the past ten weeks, I want to share how she was doing in her last residential treatment center during the months of September and October.


September 2022 Behaviors in Residential


  • 254 Disruptions
  • 48 Physical Aggressions
  • 5 Elopements
  • 9 Lack of Safety Awareness Incidents
  • 9 Threats of Harm
  • 13 Self-Injurious Behaviors
  • 11-Other

October 2022 Behaviors in Residential


  • 197 Disruptions
  • 26 Physical Aggressions
  • 13 Elopements
  • 8 Threats of Harm
  • 4 Self-Injurious Behaviors
  • 3 Property Destruction


You may be wondering why in the world she was sent home. 


It was decided by her IEP team that her current residential placement was not meeting her needs. 


The current residential team was unwilling to work with our family and our local community professionals regarding what we know and has been documented to work for Sunshine.


It has been proven in multiple settings that ABA (incentives and reinforcers) only increases anxiety, causing significant behaviors, instead of decreasing them. The residential team kept insisting that this system be used.


Based on success at a previous residential treatment center with a personalized emotional regulation plan that met Sunshine's needs, AND an entire year of successful overnight visits with family in hotels and at home, the community wanted to give Sunshine a chance to return home and show she could handle it.


Below you will see a calendar of behaviors for each month so far. I have broken them down below the image, so you can see up close what is written under each date.


All of the days with no behaviors recorded, means there were ABSOLUTELY NO BEHAVIORS!!!



Post Residential Behavior Data: November 2022


November Behaviors


The initial transition home was definitely an easy one in regards to significant behaviors!


November 24, 2022

45 minutes (during mania episode)

  • Screaming
  • Kicked door
  • Head banging

November 30, 2022

45 minutes (during depressive episode)

  • Screaming
  • Moderate Aggression towards Mom



Post Residential Behaviors Calendar: December 2022


December Behaviors


I must admit, in December we were getting a little nervous as the aggression towards Mom and Dad was definitely increasing, but after we set the strict and firm boundaries, the aggression has stopped.



December 2, 2022

20 minutes (during depressive episode)

  • Screaming
  • Head banging
  • Biting hand

December 13, 2022

45 minutes (sickness triggered depressive episode)

  • Screaming
  • Severe aggression towards mom (left bruises on Mom's arm)
  • Head banging
  • Biting hand 

December 14, 2022

20 minutes (sickness triggered depressive episode)

  • Screaming
  • Moderate aggression towards mom
  • Head banging
  • Biting hand 

December 17, 2022

45 minutes (Testing limits)

  • Screaming
  • Moderate aggression towards mom
  • Head banging
  • Biting hand


Police were called to set the boundary that there would be no more aggression towards mom tolerated in home. Sunshine was calm with police.

December 21, 2022

20 minutes (during mania episode)


  • Screaming
  • Mild aggression towards Dad
  • Kicked van seats and van roof


December 26, 2022

30 minutes (during depressive episode)

  • Screaming
  • Mild aggression towards Dad
  • Head banging
  • Biting hand 



Post Residential Behaviors Calendar: January 2023

 

January Behaviors  


Though we still have a ways to go in January, including her manic and depressive episodes, we're feeling pretty confident about improvements that Sunshine is making.


There has been a lot of limit testing going on, but other than one scenario (which we're working to find a solution to), she has only ever tested a limit once, and then has understood exactly what's expected.


January 1, 2022

20 minutes (post-holiday crash/testing limits)


  • Screaming
  • Kicked door 


January 2, 2022

60 minutes (post-holiday crash/testing limits)


  • Screaming
  • Kicked door, wall, and bed 


If you'd like to read more details about this episode, you can read about it in the post below.


Internal Family Systems: A Child's Parts



January 2, 2022

45 minutes (post-holiday crash/testing limits)

  • Screaming
  • Kicked couch and table 


January 13, 2022

30 minutes, 4:00 PM (testing limits/big emotions)


  • Screaming
  • Kicked couch, wall, and window
  • Biting hand 


January 15, 2022

60 minutes, 9 AM (testing limits)

  • Screaming
  • Kicked furniture dressers, bed, and trunk in parents' room
  • Head banging, 
  • Biting hand 


If you'd like to read more details about this episode, you can read about it in the post below.


Reactive Attachment Disorder Fits: Did I Do Something Wrong?




January 15, 2022 

30 minutes 4:00 PM (testing limits)


  • Screaming
  • Kicked wall


Things that have Influenced Behaviors


Swimming three times a week started December 28, 2022 with the exception of weeks when we have been sick.


Swimming helps Sunshine stay regulated in such big ways!

Everyone in the family was extremely sick for two weeks in December before Christmas with high fevers, horrible coughs, runny noses, etc. Routines were not normal. 


Everyone in the family has been sick January 8th through the present with runny noses, coughs, chills, and muscle aches. Only one person had a fever this round. Thankfully routines have remained in full swing, but people are definitely grumpy.


The Best News


Sunshine expresses how happy she is to be home with her family on a daily basis. 


For a child with Reactive Attachment Disorder, this is huge. Her residential experience definitely helped her decide that she wants to be with her family.

Sunshine is using kind words, manners, and appropriate language except for during some behavior episodes. 


In residential, it was reported that she used foul language on a daily basis, directed towards others.

Sunshine has not had a single battle about food since being home. 


This was a HUGE issue in all of her residential placements and at home before she went to residential.

Sunshine has not had a single behavior related to peers or siblings. 


Her biggest struggle in residential and at home before residential was interactions with peers. There were screaming fits. There were physical fights. 


There have been times when Sunshine has wanted to kill family members and had a plan to do so. You can read about them in the posts below.


Call the Police!



This post shares our first experience with having to call the police to our home, which led to Sunshine's first psychiatric inpatient stay at age six.

Goodbye Sunshine


This post is about Sunshine's second and third psychiatric inpatient stays, which led to her placement in residential at age eight.


Fleeing for Safety



This post is about Sunshine's first attempt home after only six months of residential treatment during COVID-19.


Sunshine has only had one battle during learning time.  


Before residential, Sunshine was attending a private day program because behaviors were too severe to learn at home. In residential, she struggled significantly during her school day.

Sunshine is thriving with the use of Internal Family Systems Therapy with parents at home.


After seven therapists at home and in residential, we've finally found a therapy that works, and it's one that my husband and I have been using ourselves for over two years now.


Sunshine still has a long ways to go, but compared to how she was doing, she is doing amazing after ten weeks of being home. 


We hope and pray she continues to choose to be with her family and has the desire to put the work in to remain home with us.


For those who would like to continue to follow Sunshine's journey, be sure to subscribe to our free newsletter by clicking on the link below.



If you liked this post, you may also enjoy the resources below.
What Is Reactive Attachment Disorder I Hate My RAD Child My Child Wants to Kill Herself! Now What? Our Pediatric Mental Health Crisis What NOT to Do with a RAD Child How to Discipline a Child with Reactive Attachment Disorder Must Have Safety Resources When Parenting a Child with Reactive Attachment Disorder A Safety Plan for Mental Health

10 Week Post Residential Update: Behaviors

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