Problem:
Kara, age 5, has been living with her dad, Shane, on a working sheep farm. Kara's mom, Leah, has been in and out of Kara's life since she was 2 weeks old. Shortly after Kara's birth, Leah was involved in a car accident and did not see Kara for many weeks while she was recovering. In the last 3 weeks, Leah has just finished a year-long jail sentence in a different part of the state and has come to live with Kara and Shane. This is the first time since Kara was an infant that they have all lived together.
The family recognizes this new living situation is still a "work in progress." Leah has a traumatic brain injury that makes her "have to think a little harder" sometimes. Kara states that her mom is "sometimes kinda silly, and other times kinda dumb." Leah admits that she does have a hard time making decisions and choices when it is outside of the daily routine or plan that she and Shane created. For example, one day early last week Kara's school called for an early pick-up due to a fever, and it took Leah over 3 hours (and many phone calls from the school) to contact Shane, who was in the barn just 50 feet away.
In the beginning, Kara was shy around Leah and would go to Shane for anything she needed. This quickly escalated to outright hostility towards Leah. When Leah tried to talk to Kara to try to get to know her, Kara would respond back by saying things like, "leave me alone, you're stupid!' or "You're a poopy head!" When Leah is standing in her way, Kara will try to push her out of the way or punch her in the arm. If Kara tries to discipline her for this unacceptable behavior, Kara will resist and lash out to try to hit any piece of Leah she can connect with. At first, Kara would respond to Shane if he caught her behaving this way and she would stop. Now, Shane has been unable to manage her anger and physical behavior towards Leah, leading to Kara often being sent to her room for hours until she can respect her mom.
Kara attends kindergarten. School staff report that she is a curious learner and is dramatic in her play. They have noted that since Leah joined the family, Kara's ability to manage frustration has decreased drastically. She will be playing calmly alone or with peers, and then suddenly pull away from others and begin crying. Any change -- to the daily schedule, a fire drill, a snack isn't available, -- leads to emotional outbursts which result in Kara going into the coatroom and crying which disrupts the class. Kara is not aggressive towards others during these episodes and continues to have friends and be well-liked by the other kids. School and parents say that Kara has been getting more emotional and often seems sad.
At home, in addition to her aggressive behavior towards Leah, parents have noticed that Kara has begun to behave like a younger child. Though previously independent in toileting, now she has occasional accidents. She also pleads with her father to feed her, and when he tells her she is a "big girl" and can feed herself, she will only use her hands. Leah isn't sure what to do, and gets confused when Kara "acts like a baby." Kara states that she doesn't like her mom living with them, telling her what to do and "messing it all up." She is upset at Shane for bringing her mom to live with them and wishes mom would leave. Kara thinks that if she acts up bad enough, her dad will tell her mom to go and it will be just the two of them again. However, Shane is committed to Leah getting well, and Kara's behavior is becoming so problematic that he doesn't know how the three of them can get along and be a family again.
Leah feels hurt that Kara hasn't warmed up to her and she finds herself treating Kara more harshly than she should, such as swatting Kara's bottom when she doesn't listen. She and Shane know that they need help with Kara, but they do not trust "the system." Leah doesn't like to be told what to do. When she was in jail, they made her take parenting classes, but she slept through them instead. Shane is worried that too many providers in and out of the house will increase issues for Leah. Shane states he isn't sure what this help might look like, as he has asked for formal help with Leah throughout the years and was met with a lot of assumptions and barriers, and he wonders why it would be any different with getting Kara help. Parents are thinking that they may need to find Kara someplace where she can learn to calm down and behave, and then she can come home when her behavior improves.
Kara loves to sing and she is often heard humming or singing softly to herself in school when she is not in class. Her family believes she could be on the radio and beyond with her voice. Kara reports that she has always been able to sing, and she sometimes sings to calm herself down when she is upset. Since her mom came to live with them, Kara has been singing more because her mom upsets her so much. She wants to sing on TV so she "can get lots of money so my daddy doesn't have to work all the time." Need Assignment Help?
Domain
- 1 family functioning
- 2 living situation
- 3 social and emotional functioning
- 4 sleep
- 5 play
- 6 preschool/childcare behavior
- 7 preschool/childcare attendance
- 8 preschool/childcare achievement
- 9 learning ability
- 10 medical/physical
- 11 adjustment to trauma