My sister- in -law adopted two boys at the age of 18 months. They are now going to be three. She has started them in a two morning a week fun-type school. She is a teacher and will be going back to school in a few weeks and wants the boys to be able to adjust to her being gone and to being in school. One of the boys loves it and the other one gets hysterical and she has to take him home. He cries himself to the point where he can hardly catch is breath. My sister- in -law says he is spoiled and needs to be punished. I strongly disagree. What help can I give her? Thanks so much.

Nancy

It is hard to answer the question without a little more knowledge. What will happen for child care when mom returns to work? How many hours will she be working? What do the boys know about her going back to work and what will happen to them when she goes back to work? What will the schedule look like?

Sometimes it is helpful to try to see the world from different points of view. From the point of view of the "happy twin" it seems like he likes the preschool and is comfortable and sees it as an adventure. The "unhappy twin" clearly does not see this as a fun adventure but as somehow frightening (for whatever reason). Every child deals with separation and transitions differently. I clearly do not see crying as a behavior that is "bad" or will resolve easily with punishment. Not all three year olds handle separation easily. For many children it is developmentally NORMAL to be well attached to their parent. I found in my clinical practice that some (not all!) adoptive kids have a little more difficulty with separation than non-adoptive kids. From the positive point of view (and I think this is very important) the child has clearly bonded and attached well to Mom. That is quite an accomplishment for children who are adopted after the first six months and is VERY valuable for them as human beings. The problem now is that the child wants to be attached and the Mom needs/ wants to go to work.

Like any difficult transition for preschool children this one will need time (not punishment) to solve. It may help the Mom to see it from its positive point of view (how successful she has been in bonding with her adoptive child). Here are a few other suggestions that could be tried over a two week period.

1. Give the child as much choice about school as possible. "We are bringing your brother to school and you may stay if you are ready". or "We are bringing your brother to school and I will stay for 20 minutes. You can stay with me there for 20 minutes and come home, or you can choose to stay longer". This is not a suggestion for "weaning" as weaning may not work at all here,(especially with a child who may have some significant abandonment issues/memories) but just a way to help the child feel more in control and more safe which may help them make the transition on their own. Children (and adults) do better when they feel better.

2. Make sure the child really knows what will happen (to help them feel safe).Sitting down the night before and making a picture map of what will happen during the day (including all choices about school) can be a useful tool. This does not need to take a long time and is fun to do with 3 year olds. Take out a big sheet of paper (construction paper will work). Start by talking about making a picture of what tomorrow will look like (from the kids point of view). How does the day start? (getting out of bed). Should we draw a bed?

Then what happens? (eat breakfast, get dressed) Draw a symbol that the kid will recognize. Then what happens ?(this is where prompting may be necessary... we will go to preschool and you can stay or come with me). (again a picture) Then while your brother (and you if you choose) are at preschool I will (go grocery shopping or other). Then I will pick your brother (and you if you choose to stay) up at preschool and we will ____

Continue listing activities, drawing pictures until tuck in time. (maybe even leave time to make another map tomorrow).

The next day have the child bring the map with him and see if is what happens.If the child is really into this the Mom may need to warn him that sometimes plans change and you have to change the map (but that she would never change the map so that the children would be left at the preschool).

3. At a time totally separate from preschool, talk to the child to see if he can identify what is happening that makes him cry. Does he recognize any feelings?(he may or may not.

Lastly.... (and as a parent I always find this the hardest) what is really happening for Mom?. Is she really eager to get back to work and the kids now seem to be getting in the way of her dreams? Is she ambivalent about going back to work and this screaming is really stressing her because it is adding to her own confused feelings? Does she have any memories as a child of having strong feelings that were hard to share with adults? Sometimes a little self reflection can lead to insight and often with that reflection, mothers find that in their heart they have the wisdom and strength to do what will work in the situation and for the long term benefit of their relationship with their child.

Finally a word on punishment. Behavior modification or punishment (making an experience unpleasant so that someone might choose not to do it again) may change the outward behavior. It will not improve the relationship between the Mom and the child. It will not promote the childs understanding of themselves or the situation. It will not give him strength to deal with similar situations (we all deal with separation issues regularly) in the future. It is unlikely to lead to a positive soluion.

I realize these may be more questions than answers, but it is part of the problem of answering questions by e-mail.

Jody McVittie M.D.