12 y/o Daughter Out of Control

Discussion in 'General Parenting' started by ABS, Jan 27, 2012.

  1. ABS

    ABS New Member

    Hello all :)

    As a quick little background, my daughter is actually my step-daughter. Her mother walked out when she was 18 months and relinquished her rights (she doesn't know her). I came in the picture when she was four and her father and I have raised her together since then. She has always had traits that weren't quite normal but we shrugged most of them off. When she was younger she had issues in school with following directions, staying quiet, following through, organization and impulse control. She also has issues sharing attention. When she was younger these traits would come in waves. We'd have one or two bad months and then things would calm down. She was a straight A student and generally a delight at home (though exhausting :) ).

    When she was in the fourth grade, she started a down phase and hasn't come up since (now in 6th grade). She's gotten far worse than ever before. She's failing all but one of her classes, is constantly in trouble and has moved her way through her school's discipline step system faster than anyone else (is close to being expelled), she was once in gifted classes and has been removed because of conduct, she's very angry and lashes out at teachers and friends (she called her teacher a b*tch two weeks ago), has purposefully hurt our dog "just to see what happens", she bullies other kids (suspended from the bus twice this year), is very disrespectful at home and screams, tells us no and has temper tantrums, her hygiene has to be micromanaged or she won't brush her teeth and take a shower, she has issues with repetitive sounds (fans clicking/dishwashers, etc) to the point of breakdowns, doesn't seem to learn from mistakes and repeats them, steals and lies from us and others and is just quickly falling to rock bottom (if we aren't there already). We tried multiple different rewards/punishments and nothing has curbed the behaviors. We've also tried getting her involved with various sports/activities and she been removed from them.

    We eventually realized something may be going on medically so we began seeing a psychiatrist who started her on vyvanse for ADHD which was a complete nightmare. While on it her anger issues went through the roof - screaming, throwing objects, refusing to move (sat outside in the dirt for 6 hours straight), etc. She was taken off of vyvanse and put on Paxil to help with the anxiety and has also been seeing a counselor (though it doesnt seem very helpful). Her school psychologist also got involved and for the past three months she has been undergoing various testing and we find out on the 14th their results and eligibility for an IEP/assistance.

    Basically I don't know what to do. I feel like we're going through all the right steps but nothing is changing - her behavior is only getting worse. Her behavior is very hard for me to accept because I was a straight A, goody-two-shoes kid who would have been crushed to disappoint a teacher. I've never been wrote up in my entire like whereas my step-daughter has been wrote up twice in the past two weeks! I know she can't control some of her behaviors but I feel like the drugs are only a tool, she has to try and help control herself some as well. I don't really know how to punish her because nothing seems to effect her. Her dad works nights so I am the one responsible for managing her the majority of the time. She's very close to being expelled, will more than likely have to repeat sixth grade, has no friends, is nightmare at home and now Im beginning to worry about her sister's (half-sister who is a toddler) safety because of her violence. No one around seems to understand and judges us as parents but I'd love for them to tell me what to do because I've tried it all and nothing has worked. My husband is a foster child and my parents are out of the picture so we're doing this alone and have no support outside of each other.

    I'm sorry for the length but I just don't know what else to do. I feel like Im beginning to breakdown and am having issues controlling my own anger at the situation (and Im normally a very calm person). It's just so frustrating and helpless feeling.
  2. TeDo

    TeDo Guest

    There is definitely something more than ADHD going on. It sounds like she's feeling very misunderstood and frustrated to me. You really should read the books The Explosive Child by Ross Greene and What Your Explosive Child Is Trying To Tell You by Dr. Doug Riley. I think you'll find a lot of help in them. They have helped me a LOT in understanding and communicating with difficult child 1. You also REALLY need to have her evaluated by a neuropsychologist. They assess behaviors as they relate to brain functioning. In many cases, talk therapy won't work very well, as you've said. There are also medications that, if given for an incorrect diagnosis, can make things MUCH worse. We've lived through that part with HORRIBLE results. You need to find out the WHY to her behavior. Without knowing that, you can't really fix the problem.

    Glad you found us but am so very sorry you needed to. Stick around and you'll find a lot of help and support here.
  3. buddy

    buddy New Member

    Hi there, no worries about the length! You did great. Sorry she is having such a rough time and sorry for you too....

    It really is sad to say this but your story is not uncommon. Kids who have "issues" then really fall apart in grades three thru five when language and social communication demands along with many other developmental issues increase. It does sound like more than adhd is going on. Has she ever had an Occupational Therapist (OT) evaluation. Her sensitivities may mean her ability to integrate incoming sounds (or sights, touches, tastes, smells) may be not working well. The Occupational Therapist (OT) in a school may have done a sensory profile, do you remember filling one out? If not, it may be like many places where they dont really go looking for it in the schools. It would be well worth the time and effort to seek a private Occupational Therapy evaluation.

    She can nto be expelled as a child with a suspected disability. You have rights due to the evaluation and potential IEP being developed. They can say she needs a change of placement but that is putting the cart before the horse. The law says she needs to be in the least restrictive environment, so until they actually try supports and accommodations and show that it is not doable, AND you agree with that... then they can't move her. Dont let them tell you different unless they are offering something you are really comfortable with. They need to have done (or if not yet, the need to) an FBA ... a functional behavioral assessment along with all of the other testing. Then they need to develop a behavior program designed to develop skills that are missing. Skills to help her socially and to do her school work. It must be a Positive Behavioral Intervention Plan. (mandated by law) This is along with goals and objectives to teach skills in her IEP.

    Along with that, many of us have our kids evaluated by a neuropsychologist. You may want to wait to see if you think your school did a good enough job and what they say is helpful.

    I can tell you that you are not alone in the anger thing! I actually just tonight had such a huge impulse to punch my son back (he did a fake punch at me on his way out and it just made me angry and I would not hit him but that urge to want to do it back/that feeling inside...I didn't like it. In fact he is down stairs saying I am a fu**ing a**hole right at this moment....the rest of the day has been fine but he did the first when transitioning out of the house with his Integrated Listening Systems (ILS) worker and now he just came back and is settling in--I am giving him some space, smile)

    by the way, he has called every teacher he has INCLUDING THE PRINCIPAL either a b word or an n word or the words he is saying to me now.... He has a brain injury that causes it but still, there are many who do not understand. and it is embarrassing many times. I can really understand the frustration, but I push on each day knowing it is not his responsibility to figure this out... he has to try to some degree, but we have to make the environment positive and supportive for him to do so. HUGS to you, it is wonderful you have taken on her care.
  4. ABS

    ABS New Member

    Thank you for the welcome :). I hadn't heard of a a neuropsychologist until now. I thought the psychiatrist was where you went for diagnosis but to be honest we haven't been very happy with ours. He didn't do any testing but rather listen to us explain her behavior and five minutes later gave us the prescription for vyvanse. When vyvanse didnt work he put her on paxil but it just feels like a lot of trial and errors with medication and no explanations. I just found that our local Children's Hospital here in Atlanta has a neuropsychology department and in the morning we'll see about insurance and how all that works.

    I don't expect her to be perfect and I do expect challenges but I guess I would just like some direction on how to proceed. She's turning 13 this year and I feel like if we don't get some control over it soon then it will be too late.
  5. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    See a neuropsychologist. There is a heck of a lot more than ADHD going on and sounds like psychiatrist is just guessing about medications and seeing if anything works. This is common, but it usually is not a solution. Often the drugs just make things worse.

    Before you came into the picture, did your stepdaughter have a chaotic life with different caregivers? Did birthmother ever drink or use illegal substances when she was pregnant? Are there any psychiatric disorders or substance abuse on either side of her genetic family tree? Lots of things are inherited, whether or not the child ever sees the parent. Do you have any other children? If so, how does she interact with them?

    You may want to do a signature like I did below to give us an overview of the family. The more you tell us, the more we can try to help.

    Welcome to the board...but very sorry you had to be here :/
  6. ABS

    ABS New Member

    I just saw your response and I am so grateful I'm not the only one that has thought about smacking the **** out of their child. It sounds horrible and it is but there have been more than one time when I've told her to go to her room because I was about to lose it, she refused and I had to literally run away from her or else the police would need to be called. It's hard to wrap your mind around the fact that this is a type of disability. My brother has many birth defects and physical disabilities and those, in a way, are almost easier. You know what you're dealing with, can understand it and people "see" that there's something wrong. With my daughter they just automatically assume we're failing at parenting and to be honest, there are many times I doubt our parenting abilities as well.

    With regards to the expulsion and the IEP, it feels like there isn't much communication between those doing the disciplining and those with special education. We have a meeting that brings both groups together on the 14th so I'm hoping we'll get more understanding there. I can understand how its hard for the assistance principal (the one threatening expulsion) to understand that our daughter isn't just a bad kid because I struggle with it too. Oh and they did do a specific test with regards to the sound/sensory issues. She doesn't have issues with touch/taste but any sound or sight of something repetitive sends her spiraling.

    If I might ask, how do you punish/reward? We try and pick our battles but we try and be firm with regards to her acting violently towards other and the bullying (she sent a boy home in tears after weeks of her bullying him about his sexual orientation! I have many friends who are gay and she has been raised around them so that was a complete shock). We haven't found any punishment that deters her behavior nor any rewards that inspire her.
  7. TeDo

    TeDo Guest

    Be prepared for a long waiting list (maybe months) if they are good at what they do. You might need a referral from a primary physician, depending on insurance. Our Medicaid footed the whole bill and I didn't need a referral. I am glad you have access to one.

    As for the psychiatrist, dump him/her. Find a reputable Child Psychiatrist. Many, if not most, psychiatrists are for medication management. That is not uncommon. The diagnosis'ing is sometimes done by psychologists. The neuropsychologist will be the one doing that in your case. If your insurance doesn't cover it and you can't afford it, try to find a reputable PhD level Child Psychologist. No professional can diagnosis based solely on 5-15 minute interviews.

    medications ARE a trial and error process regardless of diagnosis. Everyone reacts differently to medications so there is no "one size fits all". Be prepared for more of that but if you get an accurate diagnosis, it narrows the types of trials.

    You are doing a great job trying to help her. That is what will make the difference. {{{{HUGS}}}} to you all.
  8. ABS

    ABS New Member

    MidwestMom, her first four years weren't ideal as her dad was a single parent trying to make it work. He worked full time and was going to school so she did have several caregivers. He only dated one woman where they lived together (for about a year) during those four years. She doesn't remember the woman but does remember her daughter who was about her age.

    Her birthmother DID do drugs/smoked while pregnant though the true extent isn't known. She disappeared quite a bit and when she decided to walk away for good, my husband decided to raise her alone and took the measures to get her rights terminated.

    As far as genetic conditions we have sketchy details on both sides. There were a lot of addiction issues on birth mother's side but the full extent isn't known. My husband does have anxiety and impulse control issues and is on lexapro. His mother has severe bipolar and addiction issues. Because his parents gave him and his sisters up, the details of his parents are sketchy as well.

    We have one child together who is 13 months old. My oldest daughter relates great with her though she gets easily frustrated. She truly loves her sister and has made the comment "I hate everything in this world....except *youngest daughter*". She does have issues sharing attention but we try and make sure she gets one on one time (like going shopping, yogurt, etc) without the toddler. We are also 10 wks pregnant at this moment.

    TeDo, I updated my signature but I didn't know what to put. So many confusing abbreviations to learn. And from what I learned about the neuropsychology department so far is that we'll need to go through our medical doctor first. So we'll start that route.

    Thank you all for the warm welcome and advice. I have gained more confidence in the past half hour than I have had in months. Friends can't relate and doctors/counselors/teachers all have different and confusing advice, most of which isn't helpful.
  9. mazdamama

    mazdamama New Member

    You have gotten some great advice already from the wonderful women here but I did want to add that when my 11yr old son began puberty things got ALOT WORSE. At her age I can only assume that she is also going through puberty/ Most likely has some reactive attachement disorder in there also. These so called mothers that leave their children at early ages don't realize (or don't care) that babies learn from the day they are born. They are aware of what is going on and it gets put in a part of their brain and stays there until they have the words to go with the action they recall. My son is currently in a residential treatment center and getting the help he needs to get over the feelings of anger and depression that bio mom had tried to drown him at an early age. He was less then 18 months old when it happened and I was not aware of it. At age 3 I started having anger problems with him and when I asked who he was so mad at he said "Mommy, do you remember Mama Rae?" and I told him I did ...he then said "she scare me so bad mommy, she hold my head under the water in the bathtub". I simply told him she was wrong to do that but took him in to two different therapists to find out if his memory at such a young age could be accurate. They both used play theraphy with him and said he was recalling an event that had happened before he had the words for it. Along with his other diagnosis's he has PTSD because of it. She later admitted to me in a letter that she had done this as well as some other things that she would not tell me.

    Something is going on and you need the right diagnosis to get her the help she needs but I did want to bring the puberty issue up.
  10. susiestar

    susiestar Roll With It

    I totally agree with what TeDo said. It just seems like there is a LOT going on with your daughter. In addition to the neuropsychologist evaluation, which should be 8-12 HOURS broken up into several appointments, you also need Occupational Therapist (OT) and Speech Language Pathologist (SLP) evaluations for sensory problems and for auditory problems. We were told by an Occupational Therapist (OT) that sensory stuff has to be treated early, but I don't believe it and I would encourage you to PUSH to get them to at least try. WHY? because I, at over 35yo, saw HUGE improvements in MY sensory problems when we learned about what they were and I did the brushing therapy to myself. The Occupational Therapist (OT) said it wouldn't hurt if done properly (done improperly it can cause HUGE problems so you MUST learn it from an Occupational Therapist (OT)) and it also helped my older kids. The results were not as dramatic, but if it helped me it can help anyone. Just in my humble opinion of course.

    You also need to figure out what happened in those early months. Did her mother abuse or neglect her? Use drugs/alcohol while pregnant or nursing? Those thing can cause HUGE problems iwth attachment. You should also explore attachment disorders - they are a spectrum so there is a lot more than Reactive Attachment Disorder (RAD) that could be the problem. Those issues need to be addressed by an attachment therapist.

    As for school, why has she not been given an IEP before this? I know I sound jaded, but PLEASE be aware that the school's motivation is to blame you and to NOT provide accommodations. Those cost money and sadly that is the bottom line in many areas. PLEASE educate yourself on the IEP process, get private evaluations if at all possible (school evaluations look at school issues, private evaluations are FAR more complete and do NOT have the pressure to minimize problems that some schools place on the people doing their evaluations - I know, jaded and cynical but also been there done that.).

    The sp ed 101 forum and archives on this board are PACKED with help and you also should check out Wrightslaw. They publish books on sp ed law and have a great website that I don't know the name of but is probably wrightslaw.com or something similar. I hope that doesn't send you to a porn site like the whitehouse site does (not the .gov site, the .com one - we have a middle school that let it through the webnanny a few yrs ago, lol). Anyway, learn the sp ed law, and get an advocate to help you fight for her rights. As they are doing the IEP evaluation, they CANNOT expel her for behaviors that are manifestations of her disability. If they deny the IEP, then they can. That is why you fight for an IEP. She has the right to FAPE in LRE - free and appropriate public education in the least restrictive environment. If she has an IEP and is suspended for 10 days then a placement hearing must be held.

    Be aware that YOU (or actually your husband unless you adopted difficult child) is a member of the IEP team with the SAME rights and responsibilities as ANY other member of the team. YOU can call and IEP meeting if there are problems. YOU can reject the IEP until they meet her needs. YOU have a say. This is SO important. You can also get a parent advocate and I STRONGLY recommend it. The fact that she is capable of gifted level work and is not working to that level means that she needs supports and has some unidentified problem. PERIOD. THEY KNOW IT because it is common sense and is also part of their JOB. But they have waited this long to do anything, which makes me very untrusting of them. You can usually find a parent advocate through the state board of education/dept of education - same thing but different name in some states. They are FREE to parents. You also may find some help from various adhd sites (chadd is the one I am thinkng of - they have a magazine and they have a lot of suggestions for help at school and with IEPs etc.... on their website. I don't know the website addy though. )

    The books TeDo suggested are going to be lifesavers. They will seem counter-intuitive but they WORK. Doug Riley posts here and was a member here and knew what we thought before he wrote his book. He pops in now and then. Ross Greene's book is AMAZING because no matter what the diagnosis, the method works. it just does, even though it seems like you are ignoring a LOT. Reality is that it will make progress and little else seems to work for more than a couple of weeks for most of us.

    I hope some of this helps. Welcome to our family and (((((hugs)))))
  11. InsaneCdn

    InsaneCdn Well-Known Member

    I'm not being trivial here - this is all deadly serious. But... she is "only" 13. That is to say, you DO still have time to make a huge difference. (at 17, there's way fewer options left)

    You'll need to borrow a warrior mom suit, if you haven't built your own already... and dig into the wealth of info that the old hands around here have collected...

    Just wanted you to know there IS still hope.
  12. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Ok. Not going to quibble too much, however not all children who's birthmothers leave them have attachment issues. It's just not true. It depends on whether or not they have a consistent, loving caregiver, not whether or not bio. mom was there. Yes, they will feel that they were "bad" and wonder w hy she left, once they are old enough to understand. No, they don't all have trouble attaching. This child may or MAY NOT have attachment issues, depending on how much consistent caregiving she had by the poster.

    Just don't want parents of adopted kids or single fathers to think it is inevitable. And we were also told that Reactive Attachment Disorder (RAD) or attachment should be considered AFTER everything else has been ruled out, unless it is an obvious issue such as the child having been tossed around for five years. I have adopted six kids (one is no longer with us). The older adopted kids have serious attachment issues. The three who are still with us have secure attachment.

    It is never a good thing, in a child's mind, to have a parent reject him/her. But that does not necessarily lead to attachment issues. I just wanted to counter that post. I know a lot of lurkers are here. Ok, off the soap box :)
  13. mazdamama

    mazdamama New Member

    You are right about the Reactive Attachment Disorder (RAD). I know that neither of the two boys that were my grandsons but are my sons now have ever ben diagnosis'd with Reactive Attachment Disorder (RAD) although the PITA therapist Daniel used to have tried to pin that on him. The boys bonded with me rather then the bio mom and even called me Mommy from the time they could talk. Both bios called me Mom and they thought it was my name...lol...now it legally is.
    I fo belong to a grandparent raising grandchildren group and there are alot of children there that have been diagnosis'd Reactive Attachment Disorder (RAD) because of what the bios put the children through before they wind up with the grandparents. Some children are just more sensitive about issues then others but all children need love.
  14. buddy

    buddy New Member

    It also depends on that intangible thing we call resilience. Some people can go through horrific experiences and come out normal or even stronger and more sensitive. It is just so hard to see....

    Have to go by what the child is doing, experiencing, and what you have tried. For anyone, it is important to do what you can do to bond especially if there is an at risk situation. Once you go through years of trying all you can, and you see they are doing things that show treatment resistant behaviors that fall on that Attachment Disorder spectrum, then I would look for a specialist, no matter what you call it. It is just too specialized and important to not look into in my humble opinion and I live it so I get that is NOT easily done.
  15. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Well, I will disagree. It is useless to go through attachment therapy if there are no attachment problems and attachment disorder looks a lot like autism (we were told all this at Mayo). I think it's becoming overdiagnosed. There is a difference between being sad that you do not know your birthmother, once you are old enough to understand, and to be unable to attach to people.

    I like the advice I was given: If t here is sufficient cause to suspect attachment disorder, still look for everything else first. If Father or grandma was there to nurther and love child in early years, there is no reason to suspect attachment disorder. My unattached kids were obviously unattached. But they lived in chaotic situations for, respectively, six years (orphanage life) and eleven years (foster care). The latter child lived with five different families before coming to ours.

    So...just posting again for those who lurk and may think, "OMG! I got divorced! Must be attachment disorder!" Can cause a lot of guilt.
  16. buddy

    buddy New Member

    Are you disagreeing with me??? I again thought I was agreeing with you, lol.

    I said it is good to do BONDING parenting... attachment parenting... with any kid period and any kid who is at risk especially. NOT attachment THERAPY. Holding a child who is adopted, for Q I didn't push potty training even though the foster mom had started (he was 2) and I did more caretaking of him... I fed him more often than I did for my other two year old kids I cared for, things that adoption specialists tell you to do...not letting him be passed around etc.

    I said, if after you have tried many therapies (like for Autism Spectrum Disorders (ASD), and the other options...) and you see symptoms of attachment disorder -obsession with fire, hurting animals and people and not caring at all, in combination with a break in normal bonding opportunity whether due to pain or loss of a parental attention thru illness or their leaving or foster care or whatever----(which of course needs a professional specialized evaluation) then it would be important to go to that option....VERY important.
  17. ABS

    ABS New Member

    My replies are being blocked and have to be approved. Not sure if this one will get through but didn't want yall to think I wasn't reading and responding to your wonderful comments. Hopefully they get approved soon :)

    EDIT: It made it through! But I guess my other comments from last night are still in a queue somewhere.

    I won't try and retype everything I said last night but the shorten version is:

    History of mental illness: Yes, father has anxiety and impulse control issues that he's just recently been diagnosed with when we started this journey with our daughter. Biological mom has substance abuse issues though we don't know anything beyond that. Fraternal grandmother is bipolar and also has substance abuse issue. Biological mom DID use drugs/smoke during pregnancy though the full extent isn't known. Daughter hasn't shown any physical issues from it but we really don't know what damage it caused mentally.

    IEP/Expulsion: The team doing the IEP and the people threatening expulsion don't communicate. We're bringing both groups as well as others together on the 14th so that one hand knows what the other hand is doing.

    Attachment issues: To be honest I really have no idea and it hasn't been brought up by any of the mental health professionals that we've been working with. Her mother began leaving for days at a time shortly after my daughter's birth. My husband was there taking care of her from the beginning. We don't hide details about her biological mom but we also do not talk negatively about her. She knows the full situation and has been told that if she wishes to seek her out then I will help her find her, once she's of age. She states she doesn't ever want to see her and doesn't talk about her. I'm sure she does wonder why her mom would leave (especially since we found out last year that she's went on to have more children once she was released from prison) but she acts like she doesn't care.

    Signature: I wasn't sure what to put (all these abbreviations are confusing) but I did add one.

    Sister: She gets along great with her sister and often states she "hates everything in this world except her sister". She does have issues sharing attention because she was an only child for so long but we try and curb that with special days devoted completely to her.

    Sensory issues: We have brought this up but were told that it's related to the ADHD and that classic sensory disorders exhibit their symptoms far earlier. She just started having issues with repetitive sights/noises this summer. Hoping to be able to see a neuropsychologist to get a better idea of what it is truly going on.

    I think that addressed the major questions but wanted to add that you ladies/gentlemen have given me more hope in the past twenty-four hours then I've had in a year. Mental health isn't something talked about amongst my friends/family and this whole process is quite foreign to us. For the longest time we thought and were told that we weren't doing enough at home as far as structure/rewards/punishments/etc. We had no idea there could be a deeper issue until we began pushing for it last year. Thank you all for advice. It's a lot to go through but it's very helpful.
    Last edited: Jan 28, 2012
  18. buddy

    buddy New Member

    NO worries, you mean you are getting that message to write in the numbers and letters to allow it go go through??? mine did that too here... and on another thread... seems more easily tripped lately (for me)
  19. ABS

    ABS New Member

    After my second reply last night I got a page that said something in my reply had triggered "something" and that they would have to be manually approved by a moderator. I didn't say anything horrible/racist/sexual so I'm not sure what it could be but each reply after that sent me to the same page. I eventually just headed to bed and when I tried this morning it worked. Who knows with these things....the internet is fickle :)
  20. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Buddy, no, I agree with you.

    Just that lately Reactive Attachment Disorder (RAD) has come up so much I'm afraid that people will think an unstable attachment happens just because a child is adopted or just because there is a divorce. I was just trying to basically reassure the lurkers that this is NOT a fact.

    TO poster, if your HUSBAND was there consistently for his daughter, that is enough. However, if birthmother was a substance abuser, did she drink alcohol or abuse other drugs while pregnant? If she did, that can cause organic brain damage in any child and it would explain a lot of her behavior. Have you ever had a talk with husband about that? Did birthmother take care of herself during the pregnancy? I was told even smoking cigarettes can cause a smaller child and a higher percentage of learning disabilities. There is a fetal alcohol spectrum...and this is NOT behavioral, it is organic. But it presents as behavioral.

    Also, as an adoptive mom I know so many grown adopted kids who have met their birthparents and this is unofficial, but the parents swear that their children are more like their birthparent than them, even if they never met them. Heredity is a big deal! Most in our adoptive support group (which does NOT mean anybody outside of this group) feels that nature always trumps nurture, although the nurture is certainly helpful to the child. Again, though, these are just the parents in my particular support group and does not reflect the opinions of any other parents.