Final Post

            Casey and John never married due to John’s immature reaction to finding out Casey was pregnant. His emotional immaturity caused him to distance himself from Casey. John felt totally overwhelmed at the prospect of marriage and raising a child. As much as he liked Casey, he was scared and could not deal with that kind of responsibility. John subsequently moved into a different group home. Casey gave birth to a 6.2oz baby boy named Matthew. Casey was adamant about keeping her baby and rejected the idea of giving him up for adoption. Given Sarah’s feelings of regret after giving up her son for adoption, she offered to help Casey raise Matthew. At least this time her financial situation made it possible to provide for a child. In a way, Sarah was making up for what she couldn’t have given her own son. Matthew grew up in Sarah’s home, and Casey spent time with him after work and on weekends. Sarah had arranged for child care while she was at work.  During the time they were together, Sarah taught Casey how to care for Matthew. Casey would return to the group home after putting Matthew to bed. On occasion, Casey would spend the weekend with her mother and Matthew. Casey continued to work but had to get another job at a different restaurant when the first one closed.

            Casey’s experiences as a mother promoted an increase in her emotional maturity. She was less self centered and demonstrated concern and empathy for others. She had learned to cook and kept herself and her living area neat and clean. Although Casey’s mental age was far below her chronological age of 40, she had made significant gains both socially and emotionally. Casey had become a productive member of society. She had succeeded in holding down a job and was able to use functional academics in her daily life. She had reached the level of functioning which professionals strive for when working with people like Casey.  With Sarah’s help, she was able to raise her child. Casey was able to provide Matthew with love and attend to many of his physical needs, but lacked the intellectual abilities to stimulate him mentally as he grew older. It was Sarah who had to supplement the mental stimulation that Casey could not provide to Matthew.  In addition, Matthew was enrolled in a nursery school program for added stimulation and socialization with peers. The first five years are crucial to the development of a child’s brain.

            Sarah was almost 60 and still employed as a dental hygienist. She often thought about her son and wondered if she’d ever see him. Casey’s son helped to fill the void left after giving her son up for adoption. Sarah never stopped sending cards and gifts for his birthday and holidays. The adoptive parents continued sending pictures but not as often or as many since he became a teenager. When Sarah turned 65, she received a long awaited communication from her son who had asked to meet with her. Sarah was thrilled and extremely nervous about meeting him. When the day came, her son appeared at her door with flowers. Sarah took the flowers in one hand, hugged him, kissed him and proceeded to cry. He returned the hug and kisses as the tears rolled down his face. They talked for hours. Sarah explained the circumstances surrounding his birth and her reasons for giving him up for adoption. She told him about his father, his sister, and his nephew. Casey and Matthew came over and got to meet him as well.  He had been given the name Brian, and was attending graduate school in order to get an MBA. He spoke lovingly about his adoptive parents. Speaking with Sarah and meeting Casey helped Brian better understand what led to his being put up for adoption. He was grateful to Sarah for all the cards and gifts as well as making it easy for him to find her. As Brian left, he agreed to keep in touch and gave a big hug to Sarah, Casey, and Matthew.        

Casey had turned 50 when she was diagnosed with breast cancer. Matthew was now 15 and attending high school. He was a bright boy and understood about his mother’s disability. He was quite upset when he learned that Casey had cancer.  Sarah was devastated when she found out. Casey had to have a mastectomy and underwent chemotherapy. During this time, Casey stayed with her mother. Sarah was retired and collecting social security. She also had an annuity from a 401K that she started when she began working for the dentist. Casey had Medicaid and received SSI given her disability. Casey also saved money from her salary at the restaurants at which she worked. Casey’s illness was affecting her attendance at work. She had used her sick leave for her surgery, but the time she missed because of the side effects from the chemo was deducted from her pay.  Casey was able to manage with Sarah’s help. Matthew had a part time job and was also able to contribute financially.

After Casey finished chemo, she was back to work on a consistent basis and no longer needed to stay with Sarah. Matthew graduated high school and received a full tuition scholarship based on need and academic performance. Casey was back in the group home and feeling more like herself. Cancer patients’ survival rate increases if they remain cancer free for at least 5 years.  Percentages change, depending on the stage of cancer at diagnosis. Casey’s was stage 2 so her chances were 93%. When Casey was 56, Matthew graduated college. She and Sarah were attending the graduation exercises. It was a proud and joyous day for Casey and Sarah. During the graduation exercises, Casey complained of a deep chest pain. They said nothing to Matthew in an effort not to ruin his day. The next day, Casey saw her doctor who recommended a chest x-ray. When the results came back, they were inconclusive, so Casey was sent for a CAT scan.  Once the results were in, the news wasn’t good. The cancer had metastasized to her breast bone. Sarah and Casey wept. The prognosis was not good. The doctor recommended radiation therapy to shrink the tumor in the bone and suggested another treatment of chemotherapy. He felt this was the only option at this point, if there was to be any hope of arresting Casey’s cancer.

http://www.cancer.org/cancer/breastcancer/overviewguide/breast-cancer-overview-survival-rates

http://www.specialeducationadvisor.com/thinking-about-the-future-your-childs-special-education-teacher-should-be/#more-10210

http://www.buzzle.com/articles/brain-development-in-children.html

July 15 Post Nine

Casey’s high school assisted in her transition upon aging out of special education services. Her behavioral and academic functioning posed problems with job placement within the community. The school recommended a group home with supervision and was willing to assist in finding an unskilled job, but expressed reservations due to Casey’s tantrums and inappropriate social behavior with men. People with disabilities who demonstrate behavioral issues find it difficult holding down jobs for any great length of time. If Casey is to succeed on a job, her behavioral issues must be under control. Her inappropriate behavior with men could pose the problem of being taken advantage of and the potential for an unwanted pregnancy in the future. The school took both these issues into consideration when recommending a group home with supervision. Casey’s proficiency with daily living skills would serve her well in maintaining herself in the home as well as making her eligible for a job that involved cleaning skills. Fast food restaurants, diners, and other casual eating places, always need unskilled individuals for clearing, and washing tables, as well as sweeping and washing floors.

            Sarah had been feeling stressed about Casey, and the reactions of Jacob and Fred to her pregnancy. Fred never wanted a baby and was against abortion. He wanted nothing to do with the baby, and was out of the picture shortly after finding out about the pregnancy. Jacob was angry that Sarah was not sexually responsible and was about to have another baby when she was already struggling to support and care for Casey. To make matters worse, Sarah had been experiencing morning sickness which affected her ability getting through her day to day tasks. Adding to her stress was word from the group home that they had an opening for Casey, which meant that Sarah faced the task of preparing Casey for the transition. Fortunately, the staff at the home offered suggestions and invited them to visit. Sarah talked to Casey and called Jacob in preparation for their visit. She felt that Jacob would want to be a part of this decision.

            The visit went very well. Casey loved the home and had a positive experience with one of the people in the home. Sarah and Jacob had an opportunity to talk, and Jacob felt the home would be beneficial for Casey to develop some independence. He also felt the timing couldn’t have been better, given Sarah’s pregnancy. Sarah chose to wait to tell Casey about the pregnancy until after Casey had made the transition into the group home. Surprisingly, Casey made the transition better than anticipated. The staff at the home was extremely helpful in making the transition go smoothly. They were also actively assisting Casey with finding a job. A local restaurant was seeking someone to clear and wash tables, as well as sweep and wash floors. They were made aware of Casey’s disability and were still willing to give her a chance.

            Casey had not had a temper tantrum since entering the group home. Inappropriate touching behaviors had diminished with consistent negative reinforcement from the staff. They used frequent reminders, verbal corrections and loss of privileges for inappropriate behaviors. Casey was rewarded for appropriate behaviors with added privileges.  If Casey continued with this progress, the staff was optimistic for her success.

            With Casey settled in the group home and working at the restaurant, Sarah had time to deal with her own situation. She was in no position financially to provide for a baby, especially as a single parent. Fred had left and wasn’t assuming any responsibility for the baby. She and Jacob had divorced, so his relationship focused primarily on Casey. Sarah shared Fred’s feeling about abortion, so abortion was not an option. That left Sarah with giving the baby up for adoption. As much as she hated the idea, it was the best decision for her and the baby. Sarah worried about what effect it would have on Casey, and wished she could have avoided telling her anything. Sarah eventually told Casey, who did not react strongly to Sarah’s news. Casey had been living and working independently, and her low intellectual functioning made it hard for her to fully comprehend the concept of adoption.

            Sarah gave birth to a 6.5lb baby boy and struggled with the idea of giving him up. Sarah had to face the reality of her decision. The one factor that helped Sarah make her decision was that the adoptive parents had agreed to an open adoption. This meant that the family would maintain contact with Sarah through letters and pictures, and her son would know who his birth mother was, and have access to her information should he wish to make contact with her in the future.

            Casey’s living and work situation had served to increase her emotional maturity, and the supervision provided in her group home helped in decreasing maladaptive behaviors. Living in a group home provided a sense of family and consistent opportunities for social interaction with staff and members of the group home. Over the years she achieved a sense of independence, and responsibility for herself and her home. The functional life skills she was taught in school had been used on a daily basis, whether it was at home, work or in the community.

            Sarah had been able to return to school part time, and earned an Associate’s degree which provided the training that she needed to work as a dental hygienist. Sarah was able to find a job that was a 20 minute train ride from her apartment. She started with a salary of $40,000 a year with excellent health benefits. She earned enough to move into a nicer apartment and saved enough to buy a used car, so she could drive to work and get together with Casey more often. She heard regularly from the adoptive parents and had made a scrapbook with pictures of her son’s growth through the years. Sarah sent him presents on his birthday and holidays. Having this job and new apartment saddened Sarah, for she thought, if only she could have kept her son.

            Casey had been seeing one of the group members who had sustained a brain injury as a child. His name was John and he too suffered from intellectual deficits. They had been dating for over a year and Casey, now 34, recently learned she was pregnant. In a recent dinner with her mother, Casey told Sarah that she was pregnant. Sarah listened with disbelief. Casey wanted to keep the baby. As Sarah listened, it brought back memories and feelings of her situation years before. Only this time, the baby would be born to two intellectually disabled parents. The etiology was not genetic, so Casey’s baby could be born normal and healthy. Sarah was filled with a wide range of emotions and was strongly ambivalent about Casey keeping the baby or giving it up for adoption.  What did Casey know about parenting? How could she afford to keep and raise this child? These and many other questions ran through Sarah’s mind.

Questions:

1.     How successful are marriages among adults with intellectual disabilities?

2.     Can intellectually disabled parents successfully raise a child?

3.     What are some of the problems associated with children who are raised by parents with intellectual disabilities?

Decision Point:

Does Sarah help Casey to keep her baby or give it up for adoption?

http://www.iheartadoption.org/open-adoption/about-open-adoption

http://en.wikipedia.org/wiki/Mental_retardation#Epidemiology http://www.researchgate.net/publication/15226208_Parenting_education_for_parents_with_intellectual_disabilities_a_review_of_outcome_studies

July 11 Post 8

Since Sarah cannot pay the cost to fix her car, nor buy a new car, she has been taking the metro. Because Casey has a disability, she is able to get a discount. it is $1.75 for her to ride the metro (Metro, 2014). There is also a deal for people with disabilities where they get a discounted price on the metro ticket so this could work in Casey’s benefit. However, one day on the metro, a man started to make fun of Casey. This is because her appearance is different because of FAS. She has many facial abnormalities, including smaller eye openings and flattened cheekbones. She also has poor coordination and as soon as the metro started to go , she wasn’t holding on, so she fell over.

Casey’s class that she entered into high school with has graduated, but since she has a disability, she is able to stay in the school system until she is 18.  Now that she is older they are working more on life skills, since she has competed most of the academic curriculum. Every week she travels with her class to a local community center where they have certain jobs such as cleaning the pool, vacuum the carpets, and clean the railings. Sarah is upset that they are making her do these types of jobs because she thinks she is capable of so much more.

Casey has continued playing soccer and her skills have greatly improved. She is learning the concept of group sports. They offer lessons such as "win as a team, lose as a team," which focus on overcoming individual mistakes or spinning one person's standout performance as just part of a team effort. In a team sport, a young athlete may move into or out of a specific role on the team as their skills develop or diminish in relation to their peers. When that happens, the athlete must learn to adapt to that different role. They remain a member of the team, though, and the culture of team sports encourages the athlete and his or her teammates to accept and make the most of those changes (Sampsell, 2012).

After months of court dates, the court decides to rule that Sarah and Jacob have joint legal custody. Joint legal custody is when both parents retain joint responsibility for the care and control of the child and joint authority to make decisions concerning the child, even though the child's primary residence may be with only one parent (Judicial System, 2014). Since Jacob is a part of Casey’s life and tries to provide for her as much as possible, it is fair that he gets to see her just as often as Sarah does. However, since Sarah is the main provider to Casey and pays for a lot of her expenses, Casey will live with Sarah and Jacob will visit when he wants to. This will hopefully help Casey transition into her parents getting divorced that way one of her parents aren’t taken away all of a sudden and she can never see them. 

Sarah and Jacob are concerned with what to do with Casey after she graduates high school. She is approaching her 22^nd birthday meaning she won’t be able to be a part of the public school system. Her parents are exploring other options such as a college career, working, or an independent living facility.

Sarah has been very stressed and has now just found out that she is pregnant with Fred’s baby. Sarah is very concerned how Fred will react because he has said that he doesn’t want to have children. They have also only been dating for sixth months and Sarah can’t imagine having to care for another child since Casey requires so much of her attention already. She is also concerned with how Casey will react to having another child in the house. Sarah is also hesitant to tell Jacob because she knows that he will be furious.

1)    Do you think it is ethical to have the special education classes do custodial work at local centers?

2)    What are some other options that Sarah and Jacob could look into for Casey after high school?

3)    Do you think 21 is a proper age for teenagers with disabilities to age out of the school system?

Decision Point: How do Jacob and Fred react to the news that Sarah is pregnant?

Sampsell, S. (2012, July 11). Team Sports vs. Individual Sports | Kid Sports Magazine. Pittburgh Sports Report. Retrieved July 9, 2014, from http://www.kidsportsmagazine.com/PSR/node/4619

Lynchburg Juvenile and Domestic Relations District Court: Custody, Visitation and Support. (2014, November 3). Custody, Visitation and Support. Retrieved July 9, 2014, from http://www.courts.state.va.us/courts/jdr/Lynchburg/custody.html

July 8 Post Seven

Casey is about to enter high school. She has had a rough summer because she keeps transitioning from her Mom, Sarah’s house, to her Dad, Jacob’s house. Sarah and Casey live in government housing. Sarah has gotten rental assistance from the Salvation Army and is in the process of qualifying for government housing.  Sarah and Casey are getting used to living independently. However, since Sarah doesn’t receive too much income, they are living in a one bedroom apartment. Casey is not sleeping well, which means Sarah does not get much sleep either. This also limits Sarah’s privacy because she is now living in a one bedroom place with a teenage girl (Housing, 2014).

As Sarah is driving to work, her car breaks down. Sarah has to get the car towed and this costs her a major chunk of money. She is also informed that the care is going to cost $2,000 to be repaired and she does not have the money to currently pay for it. Sarah is now stuck in a dilemma because she can’t afford the fix the car, yet she needs a way to commute to work and to take Casey to where she needs to go.

Jacob has been looking into how Fetal Alcohol Syndrome may affect Casey in her teenage years. Casey is also now approaching puberty and is not aware of appropriate boundaries with males. She tries to hug every male that walks in her path, whether she knows them or not. This really concerns Jacob because he wants to make sure she is safe and not hugging random strangers that could potentially take advantage of her. Casey is now displaying many signs of anxiety and depression. There is medication that may be helpful but Jacob wants to resort to medication as a last option. So he looks into having her talk with the high school counselor on a daily basis in order to assist with her anxiety. However, he has not seen much progress (FASD, 2014).

Casey is now participating in a Special Olympics soccer team. She loves to run but doesn’t quite understand the concept of having teammates and having to work together. She lacks a lot of fine motor skills which make the coordination of running , and kicking, and throwing the ball in very complicated for her. She also can’t sustain this type of activity for very long and she doesn’t retain the muscle memory so each practice she is relearning the skills from the last time. Although this is physically tiring for her, she is getting exercise and she is having a social outlet.

Sarah is now hanging out with her new boyfriend, Fred, quite often. Fred has been introduced to Casey but this has only confused Casey even more. She has begun calling him Dad and when Jacob found this out, he was very upset. Casey no longer wants to go to Jacob’s house because in her mind , Fred is her “new” Dad. This is really confusing for her and this is now causing a ton of stress between Sarah and Jacob. Jacob is tired of this and wants to see his daughter for his fair amount of time each week. But now Casey is refusing to go to his place. Jacob suddenly files for divorce which is a shock to Sarah.  Divorce affects everyone involved, but it is often the most difficult for children with disabilities. When custody determinations or modifications involve children with disabilities, the decisions regarding the “best interests of the child” may be even more because all children are unique and may respond differently to divorce. Because of this, Jacob’s lawyers had to become familiar with the characteristics of Fetal Alcohol Syndrome. His lawyer is focusing on visitation agreements and transitions between homes, educational decision making, health and medical care, and social and recreational opportunities (Parents 2008). Being concerned parents, both Jacob and Sarah want what is best for their daughter but right now they are not able to solve this issue on their own, so now the court is involved.

1)    Since Sarah does not currently have a car, what would be an effective alternative for the time being? (rent a car, borrow her parents car, public transportation, etc?)

2)    How can Jacob reinforce appropriate boundaries for Casey?

3)    Should Casey continue participating in a team sport or should she switch to an individual sport such as swimming?

Decision Point: What does the court decide in terms of custody?

Living with FASD. (2014). National Organization on Fetal Alcohol Syndrome. Retrieved 2014, from http://www.nofas.org/living-with-fasd/

Local Renting Information. (2014). U.S. Department of Housing and Urban Development (HUD). Retrieved from http://portal.hud.gov/hudportal/HUD?src=/topics/rental_assistance/local

Special Education. (2013). Teaching Students with Fetal Alcohol Syndrome/BC Ministry of Education. Retrieved from http://www.bced.gov.bc.ca/specialed/fas/motskil.htm

When Parents of Children with Disabilities Divorce. (2008). When Parents of Children with Disabilities Divorce. Retrived from https://www.americanbar.org/newsletter/publications/gp_solo_magazine_home/gp_solo_magazine_index/parentsdivorce.html