The Boy Who Was Raised as a Dog (33 page)

“I think Peter is really a very lucky boy,” I began, “You are wonderful parents. And he has shown remarkable progress over the last four years.” I paused for a moment to let that sink in. Then, I added, “Your efforts are heroic. You must be exhausted.” Amy started to cry. Her husband tenderly put his arm around her. I got some tissue and handed it to her. She wiped her eyes.

I began to tell them what I thought, asking them to interrupt if I said anything that they thought wasn't accurate or didn't make sense. I related Peter's history as I understood it, recounting the details of the orphanage and the list of developmental delays he had experienced.

Then I asked if I was right in suspecting that when Peter became upset, all of his developmental progress would seem to disappear and he would act in primitive, almost frightening ways. Perhaps he'd lie on the floor in the fetal position, moaning and rocking, or perhaps he'd let out unearthly
screams. I added that I thought that once he started to get stirred up or overwhelmed he probably reached a “point of no return,” and that he seemed to regress before slowly coming back to himself. They nodded. That's when I explained how changes in our emotional state can affect how we learn. Skills that we've mastered like comprehension of certain concepts or even use of language itself may dissipate when we get “worked up.” I talked about how new or frightening situations would be stressful to a child like Peter and would likely prompt this kind of regression.

Wrapping up what we'd learned from the evaluation, I said, “So, I think we have a pretty good idea about Peter's problems and how he ended up with them. We also know some of his strengths—not all, but some. The key now is whether we can use what we know to help him.” I paused, struggling to strike a balance between hope and caution.

“Let me take a moment and talk with you about how the brain develops,” I began, “I think if you understand this a little bit more you will feel better about the progress that Peter has made, and I think you will better understand why progress now seems so slow.” As I spoke, my thoughts about the theory and practice I'd been working on for so many years seemed to crystallize for the first time as a coherent whole.

I drew several charts on a blank piece of paper. The first (See Appendix,
Figure 1
) showed a simple comparison of the growth of the brain relative to the growth of the rest of the body, making the point that while the body doesn't reach its adult height and weight until adolescence, the brain's growth follows a much different path. By age three it has reached 85 percent of its full adult size.

“The human brain grows most rapidly early in life,” I explained, “In fact, the majority of brain growth takes place in the first three years of life.” I wanted to help them understand the full significance of the fact that Peter had been in a sterile, neglectful institution during that critical period when the brain is rapidly organizing itself.

Then I drew a pyramid and turned the page upside down (See Appendix,
Figure 2
). “The brain is organized from the bottom to the top,” I said. “The top part here,” I noted as I pointed to the wide base of the
upside-down pyramid, “is the cortex, the most complex part of the brain, responsible for our ability to think and for integrating many of our functions.” I also described how some of the lower regions work, how the central emotional areas allow us to make social connections and control our stress and how the core brainstem areas drive the stress response itself. I explained how these regions “awaken” sequentially during development, starting from the innermost brainstem and moving out toward the cortex as the child grows. I discussed how the development of higher, more complex brain regions relies on proper organization of the lower, simpler areas. I explained how deprivation could affect these regions and cause the wide variations in their son's behavior.

“The key is to parent Peter where he is developmentally, not where he is chronologically,” I said.

Jason nodded, beginning to understand what I was saying.

“Which is a very difficult thing to do, right?”

Now, both parents nodded.

“The challenge is that, in one moment, you will need to have expectations and provide experiences that are appropriate for a five-year-old, for example, when you are teaching him a specific cognitive concept. Ten minutes later, however, the expectation and challenges will have to match those for a younger child, for example, when you are trying to teach him to interact socially. He is, developmentally, a moving target. This is why parenting these children is such a frustrating experience. One moment you are doing the correct thing and the next, you are out of sync.”

Amy and Jason had experienced this dichotomy many times, but until this conversation they hadn't been able to articulate it. My explanations helped them enormously, immediately reducing their conflict over “babying” Peter and helping Jason not worry when his wife engaged in it. Now, in fact, he could allow himself to do it as well. Amy, however, could also see from what we'd taught her that there were times when Jason's more demanding parenting style would be useful.

But explanations alone would not be enough. The core challenges of parenting Peter would remain the same—and it would be close to
impossible for either parent to be attuned to him always or even most of the time without more support. Both parents were spent, emotionally and physically. We would need to help them get some respite care. We suggested bolstering their social network, taking time for themselves as a couple and doing things they enjoyed so that they could “recharge their batteries” for their time with Peter.

Amy and Jason were open to all of our suggestions. Since they did not live near our clinic, we had to work with and through their local providers. Fortunately, most of the pieces of a good clinical team were in place. Peter had an excellent speech therapist, occupational therapist, master's level therapist and an understanding pediatrician. We had talked with all of them. We wanted to add therapeutic massage and a music and movement class to his routine, which had been useful for other children who suffered early neglect, such as Connor.

But what I thought, at first, would be just another piece of the puzzle turned out to be the most important element: Peter's school and, especially, his classmates. As I looked over his history, I suddenly recognized that most of Peter's progress had come in the first three years after he came to the United States: when he spent his time alone with his parents, or with adults, or one or two peers selected by them.

When he began attending kindergarten, however, his progress had ceased and his behavior problems had intensified. His mother had intuitively understood that he was chronologically six but behaviorally two, but his classmates couldn't comprehend why he behaved so strangely. Even his teacher didn't know how to handle him, despite having been told of his background. Peter would grab toys from other children without asking, missing the social cues the other kindergartners understood about when it was OK to take something and when it wasn't. He didn't understand when he should share his things and when to keep them to himself, when he should speak and when he should be quiet. At circle time he'd suddenly get up and slip into the teacher's lap or begin to wander around without realizing he wasn't supposed to. And he'd sometimes shriek and have his terrifying tantrums.

As a result the other children began to fear and marginalize him. His oddly accented English didn't help. His classmates viewed him as a strange and frightening boy. He'd done well in the sheltered world of his adoptive home, with one-on-one relationships with adults who knew and loved him. But the complex social world of kindergarten, with its varying peer and teacher relationships to negotiate, was beyond him.

Instead of the patient, nurturing, loving responses he got at home, at kindergarten his behavior was met with suspicion and, often, outright rejection. The classroom filled with noisy children and loud toys and frequent movement was overwhelming to him. Where once he understood what was expected of him and was treated gently if he wasn't able to do it, now he couldn't figure out what was going on. No matter how many hours of healthy positive experiences Peter had each week, the hours when he was marginalized or teased could easily overshadow them.

Peter had no real friends and preferred to play with much younger children; he felt most comfortable with three- or four-year-olds. His own classmates didn't know what to make of the boy who talked funny and often acted like a baby. In many situations children can be kind and nurturing to someone who appears to be younger and more vulnerable. But Peter frightened them.

The behavior of his classmates was predictable. What was happening was a small version of what happens all across the planet in various forms every day. Human beings fear what they don't understand. The unknown scares us. When we meet people who look or act in unfamiliar or strange ways, our initial response is to keep them at arm's length. At times we make ourselves feel superior, smarter or more competent by dehumanizing or degrading those who are different. The roots of so many of our species's ugliest behaviors—racism, ageism, misogyny, anti-Semitism, to name just a few—are in this basic brain-mediated response to perceived threat. We tend to fear what we do not understand, and fear can so easily twist into hate or even violence because it can suppress the rational parts of our brain.

Faced with Peter's growing ostracism and social rejection, Amy and Jason wanted to know what to do: should they hold him back in
kindergarten, hoping he'd learn more socially the second time around? Yet his cognitive abilities were clearly on grade level for first grade, perhaps higher.

Peter was intellectually advanced, but socially clueless. I realized that if he was going to catch up, he was going to need the help of his peers. It seemed to me that we might as well try letting him start first grade. When I had worked with adolescents, some of them had allowed me to talk with their classmates about their traumatic experiences and the effect it had on their brain. A bit of understanding had gone a long way in helping improve their social lives. But could this work with first graders? And would Peter find it acceptable?

I knew that I would be in his hometown several weeks after his evaluation and could talk to his classmates at that time. I went back to explore this possibility with Peter. As we were coloring, I asked, “Peter, do you remember living in Russia?”

He stopped and looked at me for a moment. I kept slowly coloring, not looking back at him. The pace of his coloring slowed. I was just about to ask again when he took a new sheet of paper and drew a big blue circle around the entire page.

“This is Russia.” He held the page up to me. He placed the paper back on the floor, took a color and made one tiny, delicate, almost invisible dot. “And this is Peter.” I looked at him; he was clearly sad. He was eloquently expressing how he felt at the orphanage, where he'd been special to no one, just one of dozens of anonymous babies.

I smiled sympathetically at him, then raised my eyebrows and said, “But that isn't Peter anymore, is it?” He shook his head no, and smiled back.

“Peter, I was thinking that I would come to your first grade class to visit.” I wasn't sure he would understand, but I wanted him to know what I wanted to do and why.

“OK.”

“You know how we have talked about how your brain is growing and changing? I was wondering if you would mind if I talked to your class
about the brain. And maybe a little about the way you lived before you came to live with your parents?”

“OK,” he said, thoughtfully, adding, “Will you bring the pictures?”

“Which pictures?”

“The pictures of my brain.”

“Sure. You won't mind if I show pictures of your brain to your class?”

“No. My brain is cool.”

“You know, Peter, you are so right. Your brain is cool.” And so, with his permission and with that of his parents and his school, I decided to see if I could make first graders into a new community of “therapists” for Peter.

I addressed his first grade class at the beginning of the school year. “I'm Peter's friend,” I said. “I study the brain and Peter asked me to come from Houston to tell you some of the things about the brain that I taught him.” I had Peter come up to the front of the class and serve as my assistant.

I told the first graders about the brain, and about how in some ways, it acts like a muscle. I talked about how they were exercising their “ABC” muscles in school and about the importance of repetition. I described how they had many other similar kinds of “muscles” in their brains that also needed certain kinds of attention in order to grow big and strong. I talked about how the brain develops and what makes everyone's brain work, emphasizing how the brain changes.

“Remember, Peter, when we were talking about how it takes a lot of practice to learn anything new? That is because the brain changes when you use it, use it, use it.”

I looked at the children and then back at Peter, “Right, Peter?” He smiled and nodded. “And that is why your teacher keeps having you practice writing again and again; and practice your letters again and again and again.”

I showed some slides; I brought a model of the brain and Peter passed it around. I answered questions. What part of the brain makes you talk? What color is the brain? Does the brain keep videos of your life?

I told the children how important it was for a developing baby's brain to get stimulation from talk and touch and human interactions. I told them the same things that I told parents, judges, pediatricians and my own staff, just with fewer big words.

Then I talked a little bit about how different children grow up in different homes. How Japanese children learn Japanese; how in some cultures mothers carry their babies around all day long during their first year of life. How some children don't get as much touch or talk or love early in life, and how that can change the brain. They were having fun. We laughed.