Chapter 2: Hints of trouble

Date: 2007-12-03
Source: freep.com

Chapter 2: Hints of trouble

As his behavior worsens, his foster mother is on edge

BY JACK KRESNAK • FREE PRESS STAFF WRITER • December 3, 2007

Ricky Holland lasted only nine days in his first foster home. His foster mother found him trying to fondle a younger boy, and because she operated a day care center in the home, Ricky had to go.

The 3-year-old landed with Tim and Lisa Holland on Oct. 2, 2000. He was their first foster child and they thought he was a gem. But a few weeks later, Tim walked in on something disturbing.

Another foster child who had been placed with them, a 6-year-old boy, was on top of a naked Ricky. Ricky wasn't protesting. It was another instance of sexually tinged behavior, often a sign of an abused child. Lisa called Child Protective Services.

The Hollands weren't found to be at fault. They met with caseworkers to discuss safety measures and installed a monitor and alarms on the boys' bedroom doors. The 6-year-old soon was moved to a different foster home.

One form of discipline: No dinner

Three more foster children -- siblings 7, 4 and 2 -- arrived at the Hollands' in early January. Teresa and Darren Bloodworth had lost custody of the kids temporarily because their house was dirty and needed repairs to remove lead paint.

Lisa Holland, who by then had a part-time job at a Rite Aid, quit to be a stay-at-home mom.

The oldest sibling, Teresa May Bloodworth, now 13, said she often arrived home from school and found Lisa watching television while Ricky and her 4-year-old brother, Dallas, were locked in their room, presumably for misbehaving.

Teresa May said Lisa used other forms of discipline, including a version of time-out in which she'd have the kids hold pennies against the wall with their noses. A penny had to stay in place for a minute for each year of the child's age. If it fell, the clock started over.

Two or three times, Lisa sent Ricky and Dallas to bed without dinner, Teresa May said. She said she fixed macaroni and cheese with chopped-up hot dogs for the boys after Lisa fell asleep, carefully relocking their bedroom door afterward and cleaning up the dishes.

Tim later said he took over child-care duties when he came home from work. Teresa May remembers that Tim was always nice to her and took her out to dinner with the other kids for her birthday.

Lisa Holland's complaints grow

It wasn't long after Ricky arrived in the Hollands' home that Lisa's complaints about him to his foster care worker began to grow: He was hyper, aggressive with other children, sneaky, constantly getting into things and putting himself and others in danger with his actions.

She insisted she needed a higher difficulty-of-care subsidy for him. So the caseworker at the Jackson County Department of Human Services, Theresa Bronsberg, arranged for an evaluation by child psychologist Jerel Del Dotto of Birmingham, who worked two days a week at Foote Hospital in Jackson.

After tests, Del Dotto decided that Ricky's problems fell into a catchall category -- disruptive behavior disorder -- but said he didn't think further medical or psychological intervention was needed. He thought the boy could be managed with proper parenting. Lisa didn't agree with his diagnosis. She also complained to Bronsberg that Ricky was wandering the house at night and urinating in spots, and being disruptive at the Head Start program he attended.

At the school, Ricky was viewed as a normal 3-year-old who had flashes of defiance. Tests showed his basic skills and emotional development were typical for his age.

And Bronsberg noted only one weakness in Lisa's parenting skills: She was allowing Ricky to have too much control. Overall, Bronsberg told her superiors, Ricky and the Hollands were coming together as a family.

Therapist says Ricky needs TLC

After observing him for 10 months, Susan Honeck, Ricky's therapist at Catholic Charities of Jackson, concluded that Ricky was suffering from reactive attachment disorder caused by the separation from his birth mother.

Once, while playing with two plastic horses during a counseling session, Ricky said, "The little horse is going to die if it can't be with its mother."

Honeck thought he needed a soft touch and urged Lisa to "touch Ricky on the shoulder or to gently touch his cheeks to get his attention to focus on her when speaking to him." But once, Honeck observed Lisa pinching Ricky's cheeks with one hand hard enough to pucker his lips, to force him to look at her.

"It was not a loving touch," said Honeck, who thought Lisa always seemed overwhelmed by Ricky.

Honeck also told Bronsberg that Ricky needed special attention, "in a household where he had one-on-one contact and was the only child." But her advice made little impression at the Jackson County DHS. The Bloodworth children left in April 2001, but that July, a new foster child -- a 4-month-old boy -- arrived at the Hollands'.

The next month during a visit at the DHS office, Ricky's mother, Casey Gann, found a bruise on his buttock. Ricky told a protective services investigator that he'd fallen on a toy. Lisa Holland said she didn't know how he came to be bruised, but that he did play aggressively with toys. Child Protective Services decided there wasn't enough evidence to open a formal investigation.

Ricky starts getting medication

By September 2001, Lisa was asking for a new psychological assessment of Ricky. Bronsberg arranged for an appointment with Dr. Aurif Abedi, a child psychiatrist at Foote Hospital.

After the first session, based on his observations and others' previous assessments, Abedi diagnosed the boy with attention deficit hyperactivity disorder -- the diagnosis Lisa had sought for months -- and reactive attachment disorder, the bonding problem that Honeck detected.

Abedi put Ricky, who had just turned 4, on Ritalin, a stimulant often prescribed for hyperactive school-age children to help them focus better. When preschool children are prescribed Ritalin, experts say, it's generally because the children are disturbed and other therapies haven't helped.

Abedi advised the Hollands to keep an eye on Ricky's moods and continue his weekly counseling with Honeck.

Through the fall, Ricky's behavior worsened.

"Ricky's developmental accomplishments regressed to their previous levels of defecating in his pants and on his bed," Abedi wrote at one point, reflecting what Lisa reported to him and the DHS, and documentation she provided from the Head Start school.

"His behavior at school was again aggressive and violent with the other children. ... The skills Ricky was developing are being undone, and his emotional state is currently very fragile."

In a recent interview, Abedi recalled that during one visit, he suggested Ricky might need hospitalization. Tim Holland asked him whether there was another option. Abedi prescribed a mood stabilizer for Ricky.

"We made that change and it worked for him," Abedi said. The doctor, who said he sees 60 to 80 children a week, said he spent perhaps 20 minutes with Ricky during visits and had to rely on what his caregivers told him.

The Holland family "came to me and looked like a perfectly normal, average middle-class family," Abedi said. "Looking back on that case, it all comes down to: Were they really telling me what was going on?

"God knows what was going on in that house."

Contact JACK KRESNAK at 313-223-4544 or jkresnak@freepress.com.

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