47. They may urinate or defecate in their clothes.
This is usually a serious problem sometimes caused by medical problems but more often by emotional troubles. Keep in mind that a child ten or twelve-years-old sometimes might have an accident. Even so, it is unlikely for children that old. If you see the sign in your foster child, a physical examination is necessary. A real physical problem may be the cause.
Here are a couple of things to know. Even if the problem is emotional, it can become physical if it goes on too long. Not regularly going to the bathroom causes physical problems. This means he needs medical care for the problem along with counseling. Also, there is not much you can do to help except calmly have him clean himself each time he has trouble. Making any more of it will only make the problem worse.
48. They may cut and hurt themselves on purpose.
Your foster child might cut or hurt himself and really just be fooling around; but it is unlikely. Even then, it will happen once or twice and stop. If the cut or injury is more than minor or if the behavior keeps happening, the child has a problem.
Talking to him about the problem and listening for other signs of trouble will help. This is a very serious problem. If it happens more than once or twice, he needs a mental health evaluation. Also look very closely for other signs you may have overlooked and do not accept the explanation that he is doing it for attention. It is much more serious than that.
49. They may have a strong interest in fire, watching fires, setting fires, and doing things with fire.
A child might like to build fires and watch a fire burning. At the same time, he understands the danger and is careful. Also, fire is not something he thinks about much.
A child who has a problem with fire has a much different set of thoughts and feelings about fire. He thinks a lot about it. He looks for chances to set fires, to watch fires, and to do things with fire.
Before ten or so, your foster child’s playing with matches or lighters may cause a fire or get you concerned in other ways. Usually this is a behavior problem and not a sign of mental illness. By ten to twelve, it is more than a behavior problem, although a simple accident can still happen.
If the child has a problem with fire, some effort to keep matches and lighters away from him is a good idea. Even taking time to teach him safe use of matches and fire cannot hurt and has helped some children. Also, talking with a fireman might have some educational value. These activities should not be used to frighten or scare the child. It is likely he has other problems that may be less easy to see.
Here is the important point. Getting angry with him or punishing him are likely only to make the problem worse. Talking is important as is a warm, safe family environment. Even when they are there for him, professional help is important.
50. They may hear voices and see things others do not hear and cannot see.
When your foster child has this sign, it is called hallucinating. The problem is most likely not a sign of mental illness. Hallucinations can be caused by high fevers or by drugs or some type of poison. Always consider these possibilities first. They mean she needs medical attention right now. Also, she may tell you about things that may seem like hallucinations when they are really dreams. At other times, it just seems to her like something odd happened when it did not. Any of these causes do not last long and do not come back up. Even at that, don’t just brush them off as unimportant. Watch for other signs.
Here is the important point. If the hallucinations are a sign of mental illness, they will happen from time-to-time. Also, the child believes they are real. Usually, she will tell you about them, especially if you ask if she is still hearing the voices or seeing the visions. If not, you can likely tell by watching her. You will see she is watching the visions or listening to the voices.
Two additional points are important. First, this sign does not mean the child is dangerous. She probably is no more dangerous than other children. Second, she is seriously mentally ill. Helping her will take long-term professional treatment. An important part of her treatment is getting to live in your home and having you and your family to care about her.
Consider this example.
Barbara tried to think about the question her doctor just asked and then said, “What? I don’t know what is wrong with me. I don’t think I heard what you said.” She got up and started walking around the office as she continued, “I just feel weird. It is like laughing and crying at the same time. It is like someone else is controlling me and playing tricks.”
Sue, another girl in the group, said, “You should see her at school. I don’t know what her problem is but she sure isn’t normal. She isn’t anything like she used to be.”
The doctor asked Sue to talk some more about what she had observed. She went on to describe the changes in Barbara. “It is like she gets really high and nothing bothers her. The next time you see her, she is really down and will hardly talk.”
Later Barbara was again talking. “I get so afraid I cannot stand it. It’s like someone is talking to me, telling me these awful, bad things are going to happen. It says really bad things to me.” She turned to face the wall and continued, “I know. I know what’s going to happen. No. I will.” She then went back to her chair and refused to talk anymore.