Helping Madeline Thrive

Madeline*, 7, is an outgoing kid who loves bird watching and running around the playground. “She recognizes many species and especially loves cardinals, woodpeckers, hawks and herons,” says her mom, Linda*. But life for Madeline and her family hasn’t always had room for so much enjoyment.  

At 4, Madeline’s repetitive speech patterns led her family to Children’s National for an evaluation with a speech pathologist. Mention of significant delays in her toilet training caught the care provider’s attention as a possible sign of a bigger problem. The toileting issues also had created other difficulties. In pre-K, Madeline’s school staff frequently called her parents to come and manage toileting accidents. A summer camp expelled her. Madeline’s parents debated if one of them should quit their job to stay home with her. “Our lives had become a nightmare focused on this problem,” Linda says. “We realized that patience and persistence weren’t going to help. Care from Children’s National changed everything.” 

Wraparound services included therapy with Amanda Hastings, PsyD, director of behavioral development in our Early Childhood Behavioral Health Program. Dr. Hastings also helped Madeline’s parents build confidence — and the right vocabulary — to advocate for their daughter within the school system. “Dr. Hastings’ interventions and empathetic, effective treatment skills took away the constant stress and gave our kid the opportunity to thrive. She taught us how to help our child manage a poorly understood and stigmatized condition. It’s hard to think of where we would be without her.”  

Dr. Hastings referred the family to the hospital’s gastroenterology team to investigate potential related medical issues. A few months later, Madeline’s team diagnosed her with autism, ADHD, mixed expressive-receptive language disorder and an elimination disorder known to cause psychological distress. Along the way, clinical social worker Jennifer Floran, LICSW, connected Madeline’s parents to a support group. 

A year after she came into our care, Madeline no longer showed signs of a toileting disorder. “This made her eligible for any type of camp or educational placement the family considered,” says Dr. Hastings, who also suggested a school for Madeline that specializes in children who are both intellectually bright and neurodiverse. 

“Now Madeline goes to a school where people see her and appreciate her as opposed to tolerating her,” Linda says. “Children’s National offers unparalleled care. I wish there were 100 Jennifer Florans, 100 Amanda Hastingses and 100 Leandra Godoys so they could reach more children. Early intervention matters tremendously.”  

*Names have been changed for privacy.