When a Host Child Has New, Psychological Challenges

by cv harquail on April 29, 2017

Every host parent of a child with special needs or unique needs knows to look for an au pair who’s ready to handle these sorts of challenges.

But, life being what it is, these challenges can show up *after* you’ve matched, and while the au pair is happily placed in your home.

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Many au pairs are able and willing to do whatever it takes to support their host kids and host families — and that’s not a concern on this situation. Instead, EasternHostMom wonders what her responsibility is to her AP Agency.

  • What can you expect of an au pair and their ability to work effectively with a new situation?
    And —
  • What does this Host Mom need to say to the Area Direction/ Local counselor?
    What else should she be thinking about now?

Here’s her situation:

We are currently hosting our third Au Pair, who has 4 months left with us. She rematched with us after spending her first 4 months with another family.

My husband and I have a pre-k child, who gets most of her time, and a pre-teen girl. When our AP began with us, there were no behavioral or mental issues with the kids. But in the last couple of months, our daughter has had trouble controlling her mood and emotions. Adding to that situation, she also just “came into her womanhood.” DD started seeing a psychotherapist about 6-weeks ago, since we are determined to give her the right tools and solutions for this challenging problem.

The talk therapy is helping, but one day this week, DD was inconsolable and tried hurting herself while AP was there with both kids. She was finally able to calm down, and has been back to her normal self since, but is still a risk. Psychotherapist is having her assessed by a psychiatrist in the coming days and has put a plan in place to limit DD’s access to dangerous items in the home and to make sure she is never alone.

I have been very clear and open to AP as these things has developed. She understood why DD started seeing the therapist and I have shared with her everything the therapist has said about how we can help DD cope and stay safe.  

AP is being informed as things change and is being given information on how to handle these changes. We gave her the detailed email our DD’s therapist wrote for us about how to proceed. However, I understand that to care for someone else’s child when they are gong through something like this is stressful. To be clear, AP has not said anything to me about this situation being beyond her comfort level.

Our question is more about our obligation to the agency and not so much about our AP directly. What and how much do I need to tell our AD? I want to be respectful of the agency’s right to know when AP’s are dealing with special needs. I admit that DD is not the same child she was when I wrote about her on our family profile.

I would love to hear what anyone else has to say about this. And, to be clear, DD does not have a definitive diagnosis as of yet, but I am in the process of getting the psychiatric screening.

Image: The Road Ahead, Alex de Haag on Flickr

{ 11 comments… read them below or add one }

Taking a Computer Lunch April 30, 2017 at 10:08 pm

I’ve been there – middle school and adolescence brings on a host of problems – more common than you would think. Child #2 went through a bad year after his grandfather died followed by his older sister having been on life support in ICU. We were already a “special needs willing” family, but we were not prepared for how long it took him to regain emotional stability (and his psychologist and child #1’s psychiatrist definitely under-estimated it). We had a so-so AP that year, which led to DH and I scheduling some early date nights! For us, self-injury was not an issue.

My advice – err on the side of frankness with your AP, especially if she’s rock solid and someone you want to keep for her last four months. Tell her you are not totally sure what’s going on, answer any questions she might have, and enlist her help in keeping your child safe. In my experience, AP’s who are told they are needed, rise to the occasion.

You may be able to skate through the next four months without having a conversation with your AD (LCC for some agencies) – but my advice – list your child as having special needs for future matches. Your child needs as much stability as you are able to muster, so matching with an au pair who is aware of the situation up front will save you a heart-breaking rematch. We listed child #2 as having special needs while undergoing therapy – child #1 has always had – and always have special needs while she is alive (now on nursing since she is too old for au pair care).

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Should be working May 1, 2017 at 12:40 am

Our teen developed anorexia 2 yrs ago, and refeeding evoked violent outbursts, some self-harm attempts, and required intense parental involvement and vigilance. [Thanks to the Maudsley/FBT treatment protocol, and aroundthedinnertable.org, she is back in a really great place. I’m happy to share more about that for anyone in need of advice.]

I took all responsibility for our daughter for all of this (including family leave from work for months). The AP continued to do simple things for the teen, and normal things like grocery shopping, but I could not expect her to keep my out-of-control teen safe nor was it fair to ask her to do any of the miserable work I had to do. I also told the AP that I would understand if she chose to rematch–heck, *I* fantasized about some kind of parental rematch for myself! The AP stayed, did a good job with younger kid (who was deprived of normal parental attention for quite a while), and prudently made more of her life outside our house.

Your AP has not complained, but you might consider why she is in the program. If she is from tight economic circumstances, she cannot afford to risk rematch with a 2-week window. If it were me, I might ask the AP if she would prefer to rematch BUT offer her the chance to stay with us until she finds a match, if the agency lets that situation happen.

Meanwhile I think you are doing a great job of keeping her informed and I agree with TaCL that you should support her as best you can in this time of uncertainty. I would not make her responsible for keeping your daughter safe, that’s too much to put on an AP.

If you genuinely feel the AP is sincere in wanting to stay and you are fair with her, I would not tell the AD at this time. But for your next match it would be something to consider. I did not list our teen as special needs as we sought our next match, but in matching brought up with AP candidates what was going on and explained in detail.

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AuPair Paris May 1, 2017 at 11:56 am

How did your Au Pair get along with your daughter before this? I have, admittedly, gone from Au Pairing, to mental health work, to working with troubled children, but I can’t imagine she’d be likely to want to abandon a child she’d grown fond of because of this. I think you’re right that it’s important to be open and honest while your daughter is going through these problems (for your daughter’s own safety too!). I think it could also help to encourage your au pair to take care of herself. Remind her that when she’s off, she’s off. She doesn’t need to spend all her free time thinking about it; she can care just as much about your daughter, and still have free time when she’s laughing and having fun. (I’d say the same to you, but it’s much harder for parents!). Remind her to enjoy herself, and to continue her activities – and if she’s good with your daughter, and goes above and beyond, thank her for it. But I wouldn’t assume that she wants or needs to go elsewhere.

If you maintain this openness in your search for your next au pair, I should think all will be well there too.

One thing: I have been in a situation recently where a child under my care has harmed herself. I could not have done anything about it. It was in the bathroom, she was not gone for a long time, there were no immediate warning signs (and I’m trained to spot them…). I knew I had done everything in my power, but I still feel horribly guilty about it. Please reassure your au pair that this is not her fault and that you don’t blame her (assuming that’s true).

You sound like a great advocate for your daughter. I hope she gets well soon, and has all the support she needs.

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Schnitzelpizza May 4, 2017 at 5:30 am

“Please reassure your au pair that this is not her fault and that you don’t blame her”

This.

OP, also make sure that your AP has the necessary tools if your child harms herself when your AP is alone with her. Limiting access to dangerous items is great until you notice which items can be dangerous and how creative someone can become if they feel the need to harm themselves.

Make sure that your AP knows how to react in such a situation and even if you think she does know write it down and tape it somewhere easily accessible (back of AP’s bedroom door, inside the kitchen cabinet where you keep your first aid supplies etc.). If your child harms herself who do you want your AP to call? What should she do if there is blood and possibly lots of it? If she has to call an ambulance does she have all the necessary information concerning medication your daughter is on or allergies your daughter has?
You don’t want your AP panicking and making wrong choices or worse, freezing and not being able to make choices at all. No matter how happy you are with your current AP this is a new situation for all of you and you want to make sure that everybody knows what to do and how to behave in case of an emergency (especially a young foreigner who is hired to care for your children).

I agree with AuPair Paris – you sound like a great advocate for your daughter and with everything you are doing to help her heal I hope she gets well soon.

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NJ Mom May 3, 2017 at 10:02 am

We don’t have experience with this so feel free to dismiss any of this.

It sounds like what you’re doing now sounds reasonable. Keep communication open with AP, check in on her, and also let her know to please speak up if she’s uncomfortable or wants to consider rematch to give both parties plenty of time. I would stay very close by if AP is supervising DD so you can get home quickly in the event of an emergency.

For the next AP, perhaps having more overlap for transition would be prudent so new AP is not overwhelmed from the start and current AP can train new AP. Also, your other child can get some extra attention and have a more gradual transition. I would definitely update your profile to indicate generally that your DD is going through some challenges, and go into the details when you’re speaking with candidates (since it’s still early, and you don’t have a diagnosis yet). I would let your matching person know what is going on so that they can assist better in finding the next AP (and I’m sure they seen many of these situations).

For the AD, I would say it depends on how involved/helpful the AD is. One LCC we had hardly did anything, so I wouldn’t have said anything to her. Another LCC was much more involved, so I would let her know the situation so that she can more knowledgeably check in with AP to give you advice on what the best role for AP is with DD.

If you plan on having the caregiver supervise and assist with DD, I would seriously consider looking for someone experienced until DD is more stable. Or perhaps AP for Pre-K child, and part-time professional for DD. Having someone you can leave DD with can give you a a chance to recharge or spend some quality time with your other child.

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WestMom May 4, 2017 at 10:35 pm

We have been there too.

DD10 developed severe anxiety and OCD very suddenly, after an illness in 4th grade. Within a few weeks, she went into complete school refusal.

At the time, AP3 had been with us for 3 months. We basically isolated AP from the situation and took the complete burden of the situation. This meant that at some point I had to take a leave of absence from work to homeschool my child and take her to intensive therapy. I did not think it was right to have AP be responsible for any of that care.

Later in the year, once things stabilized and progress was made, we involved AP in driving our DD to school in the morning (she could not take the bus). We only did this once we felt that AP’s duty were back to normal transportation needs and there was not going to be any psychiatric or therapeutic help needed. That being said, AP was a trooper, super empathetic and would have probably been willing to help more during this rough spot.

Fast forward to the following year. We switched our daughter to a school with better suited services, and found a great AP who was also a trained social worker and although we did not list our DD as special needs (I personally don’t think that’s what APs expect when we tick the box ‘special needs’), we disclosed the situation in detail during the interview process. We matched with 2 more social workers after that. I specifically and carefully looked for candidates with that kind of experience in case our DD had a flare up (which did happen again a few times, including one hospitalization after expressing suicidal thoughts).

My advice would be to shelter this AP as much as possible from this situation. She did not sign up for this. And if you plan to stick with the program next year, consider how you will screen for someone who has the fortitude to help with these types of situations in the future and disclose as much as you can (once you think it might be the right person).

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Should be working May 5, 2017 at 12:37 am

WestMom, good advice. OT I am curious if your child was diagnosed with PANDAS.

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WestMom May 5, 2017 at 7:16 am

Yes, and after a few months of running around with no clear guidance, that’s the diagnostic we finally followed and treated. Now after 5 years, although I have no doubt that a physical illness triggered a mental illness for my child, I feel a bit more pragmatic about traditional approaches to treating mental illness (as opposed to somewhat scary PANDAS treatments). Have you had to deal with this yourself? Feel free to drop me a note if you want to catch up offline: couchandmore -at- gmail -dot- com.

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Should be working May 5, 2017 at 1:45 pm

There was a question as to whether my child’s anorexia (which is arguably on the OCD spectrum) was triggered by PANDAS following illness, yes, and I believe it was. But whether or not PANDAS was the trigger, once the anorexia kicked in then the evidence-based treatment for anorexia was what was needed. That treatment, known as Maudsley/FBT, has a LOT in common with OCD treatment. The main difference is that exposure can’t happen very slowly because it’s food and eating that are at stake.

I’ll send you a private message.

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Should be working May 5, 2017 at 1:56 pm

Geez, I was searching this blog after reading WestMom’s answer here…and found a beautiful post dedicated to me and my family’s misery back when my daughter got sick. Nice advice and warm support were given! I guess I have blocked out a lot of that hellish time in my memory, I didn’t have any recollection of that post!! Let me very belatedly say how grateful I am for the nice posts and overall community here. It was a miserable time and now things are SO much better.

Taking a Computer Lunch May 6, 2017 at 9:36 pm

I’m glad that pre-disclosure worked for you, but parents – you never know what will trigger “special needs” for APs. I have a friend who lost an AP to rematch because she failed to disclose that a child had a rescue inhaler – even though she rarely used it. The AP was a preschool teacher who had lost a student to an asthma attack.

Just like you might choose not to match with an AP with a variety of dietary preferences, allergies, or pre-existing conditions, so might an AP choose not to match with your family “if only she had known.” Special needs is not just mental retardation, physical disability, or a child’s medical condition – it takes a special au pair to work with children who have autism, mental illness, or any condition – no matter how mild – that falls outside the rubric of basic childcare. Match for success, which includes being up front – but in my experience also calls for including your outgoing au pair in the matching process. Your incoming AP wants to know that you, the HP, will have her back and provide the support that will ensure a successful year – and give her the necessary down time to recharge her batteries.

When child #2 developed an anxiety disorder, DH and I so wanted it to be temporary that we downplayed it – to the detriment to everyone, including an immature AP who should not have been caring for The Camel, might less her anxious younger sister (and we were only eligible to match with ‘special needs willing’ APs!). It was a mistake we made only once.

Child #2 still has relapses during times of stress, but now cares for her older sister routinely, including changing diapers and giving tube feedings – essential in our “post AP” lives!

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