Case of Developmental Expectation

Here’s a glimpse into the story about “Developmental Expectation.”

At 12 years of age,  Bobbi acted more like an eight-year-old, and that was on a good day.  It only took a few days in our residential facility for the staff to start noticing that Bobbi was most excellent at consuming all of their time, energy and patience.

When Bobbi’s peers were engaged in either work or play, enjoying the company of each other, Bobbi would endeavor to make everyone’s lives somewhat miserable.  She liked to spit on her finger and draw on the newly cleaned windows and mirrors.  Bobbi “accidentally” dropped food on the floor and dishes just didn’t bounce as well when Bobbi was in the kitchen.  Bobbi ignored pleas from her peers and orders from the staff.

And then Bobbi could suddenly offer a caring insight to a peer, or offer to help a staff member.  There was no rhyme or reason as to what Bobbi’s thinking was.  But the one thing everyone did know–Bobbi did not act her age.

She was rapidly self-disintegrating in our dorm.  Nobody wanted to be her friend.  If an item was missing, the first thought was, “Bobbi stole it.”  When the milk was left out on the counter all night, yep, Bobbi was the first person on everyone’s minds for her lack of responsible behavior.

“She knows what she’s doing.  She should have to pay the consequences,” was one of the major thoughts.

“She must have been abused,” was another.

“She needs meds,” was questioned.

“Has she always been this way?”

“Maybe she didn’t get enough oxygen when she was born.”

“Does she have to stay with us?”

All familiar thoughts and refrains when someone doesn’t ACT their age.

The morning that Bobbi decided to plug the toilets, was the morning that we decided that Bobbi needed us to stop complaining about her actions and actually HELP her.

We did the following:

  1. The staff and peers met with Bobbi and told her how much we wanted to help her be the very best Bobbi she could be.  That we knew she was really struggling to grow up.
  2. We DID NOT ask her why she was struggling.  She would let us know that when she was ready.
  3. We then set out an “old-fashioned” behavioral rewards plan:  but instead of rewarding her for tasks completed once a week (as would have been on a 12-year-old’s level), we checked her Behavior Rewards Plan every hour.  Giving Bobbi points for appropriate behaviors as well as tasks completed.  She received zero points for poor choices.
  4. Every behavior that was asked of Bobbi was based upon a typical developmental response from a 12 year-old.
  5. We had Bobbi help us build the plan, including her rewards.  She chose rewards that were often less than her age, but others were in keeping with a 12 year-old.
  6. We contacted the school and made sure that Bobbi’s Behavioral Reward HOURLY plan would be used at school.  Bobbi was also rewarded at school.
  7. And then we placed 12 year-old Bobbi in play therapy.  She was introduced to the play room in a non-judgmental way, encouraging her to use it in any way she chose.  She loved it.  She began with 4-year-old play.  Each time she came to the play room, she grew developmentally.
  8. As Bobbi’s behaviors became more consistent with making good choices and thus making strides into her developmental growth, we started to extend how often we checked her Behavioral Rewards card.  We encouraged Bobbi to seek out rewards that were more in line with pre-adolescent enjoyment.
  9. We knew we were making progress when her peers began to feel comfortable with her, not accusing her or making jokes about her.
  10. And then the day came when Bobbi turned to me in the play room and said, “I don’t think I need this anymore.”

I’m telling Bobbi’s story as an illustration of what kind of commitment it takes to help most children with a “spiraling-out-of-control” developmental delay.  Bobbi succeeded in growing up from her pre-school behaviors to pre-adolescent behaviors in about two months of consistent, concentrated effort on everyone’s part, including hers.

Yes, there are some children who suffer and struggle with developmental delays who are in need of neurological medications.  But most children do not need psychotropic or neurological medications to be able to achieve healthy developmental milestones.

I believe the major driving force behind our current 1 in 7 children being developmentally delayed is the need for the ability to give that struggling child access to more resources at school.  Wouldn’t it be wonderful if public schools could have school-wide environments that created and sustained “Developmental Expectation” without making it a medical diagnosis?

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