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Originally published by Scary Mommy as Developmental Trauma Absolutely Destroyed My Family
My husband and I jumped in heart first when we adopted out of foster care. Devon was three with big brown eyes and a shy smile. His two-year-old half-sister, Kayla, was spunky with freckles and gobs of curls. We already had two young sons and I eagerly imagined a lifetime of annual family photos, beach vacations, holidays, and birthday parties.
Early on we learned that Devon and Kayla had been neglected and abused, and they’d been in multiple foster homes. Because of this, they both were anxious and inconsolable at bedtime. Devon squirreled food away under his bed and sometimes gorged until he threw up. He was aggressive, played with his feces, and urinated in odd places around the house.
These behaviors concerned us, but in our pre-adoption training we were told they were completely “typical” for foster kids and there was nothing the love of a “forever family” couldn’t heal.
Over the next few years we went on the beach vacations I’d dreamed of and the kids had birthday parties at Chuck E Cheese. They played soccer and learned to swim and ride bikes. Kayla settled in, but Devon continued to struggle. I tried many different parenting strategies, but he wasn’t motivated by rewards or deterred by consequences. Two years after the adoption, our family grew once again with the birth of our youngest son Brandon.
Devon started kindergarten and enjoyed the first few weeks with his Blue’s Clues backpack and matching lunch box, but then the calls home began. One day he pulled the fire alarm. Another time he ran out of the school and an assistant principal had to chase him away from the busy road. He often refused to do his homework, especially if I told him to. Once he became so angry he pulled his bedroom door off the hinges. He was six.
It was clear something was seriously wrong, but I had no idea what it was or what to do about it.
By the age of eight, Devon’s tantrums lasted two or three hours at a time. He’d smile at me and say, “I feel like having a fit.” And then he would. He knocked holes in walls, broke toys, and chased his siblings with a baseball bat. I tried to be patient, but it seemed impossible. Sometimes he’d kick my head or try to climb out the van window while I was driving.
Adding to my frustration, Devon was adept at hiding his behavior from my husband. When he heard the garage door open, and realized Dad was home from work, he’d snap off his tantrums like a light switch. As a result, my husband thought I was overly sensitive or overreacting. When I reached out for help – to teachers, family, friends, therapists – they too assumed this was a parenting problem.
Sometimes I wondered if they were right. There were times I lost my temper, said things I shouldn’t have, and overreacted. I grappled with guilt, shame, disappointment, and anger.
Tired of being blamed, I plastered on a smile in public and hid behind closed doors. I grew more isolated and lonely. I developed a sleep disorder, was hyper-vigilant, and constantly on edge. In retrospect, I realize Devon’s tantrums had, by this time, morphed into rages. This created an environment of toxic stress for his siblings, and though I didn’t yet know it, I’d developed PTSD. I was so busy just surviving, I had little insight into how dire the situation had become.
Then, one afternoon, Devon angrily karate chopped little Brandon in the throat. Moments later he pushed him down the stairs. One giant shove from behind. Brandon wasn’t seriously hurt but it was the wake-up call I needed.
I began to take Devon to the mental health emergency room whenever he became unsafe. I had no idea what else to do. The first time I signed him into the psych ward, my heart pinched. This wasn’t the adoption happily ever after I’d imagined for us. Still, I was optimistic we were on our way to getting help.
The ER psychiatrist started Devon on medications. They didn’t seem to help. After several visits and one admission, the hospital referred us for intensive outpatient services.
Devon began to receive 15 hours of treatment and therapy a week. The treatment team helped me create a safety plan for Devon’s brothers and sister. They would run upstairs and lock themselves in my bedroom whenever he became physically aggressive. For everyone’s safety, they coached me to restrain him in what I called a “bear hug.” I was terrified, exhausted, and heartbroken all at once.
A few days into fifth grade, Devon punched his teacher in the stomach. He plucked out his eyelashes and wrapped a belt around his neck. That’s when his therapist sat me down to explain that Devon needed to be in a residential treatment program.
I balked. We just needed more therapy or different medications, didn’t we? There must be something else we could try…
She shook her head and insisted. His behavior was dangerous and the months of outpatient services he’d been receiving weren’t helping.
Devon was admitted to his first residential psychiatric facility when he was only 10 years old and we expected him to return home, much better, after a few months of intensive treatment. But while there he broke a staff person’s thumb. He caused thousands of dollars of property damage. He vomited and urinated on staff, and stabbed other residents – kids like himself – with pencils. He tried to strangle himself with his shirt.
As this continued for months, and then years, I was confused. Devon was receiving countless hours of therapy. Why wasn’t he getting better? Why weren’t his medications helping? It didn’t make sense.
I began to do my own research and learned about developmental trauma – the effect chronic abuse and neglect can have on young children. These kids perceive the world as unsafe and unpredictable and can go into fight-or-flight mode in even minimally threatening situations. Trauma can also disrupt their brain development. They may feel the loss of their birth mother so acutely they begin to unconsciously view any new mother figure as the enemy.
Suddenly Devon’s behaviors made more sense – his impulsivity, emotional and behavioral dysregulation, desperate need for control, and targeting of me. It was such a relief. Now that I knew what was wrong, I was hopeful Devon could finally get help.
Though the therapists agreed Devon had developmental trauma, their treatment approach didn’t change. They simply slapped on more diagnoses and tweaked his cocktail of drugs. They continued with the same ineffective therapies.
I was at a loss for a way forward. I thought back to the three-year-old little boy who we believed only needed was the love of a forever family. By then I’d realized love couldn’t heal developmental trauma any more than it could cure leukemia or set a broken bone. And the mental health system clearly had no solutions. Devon’s condition was getting worse in the treatment facilities. But what else could we do? With the safety of his younger siblings to think of, Devon was too dangerous to live at home.
Today Devon is 17 and has been in a parade of group homes, psych wards, and treatment centers. We visit him regularly, but he’s not stable or safe enough to move home. He’s been on numerous antipsychotic drugs and has received an alphabet soup of diagnoses: ODD, ADHD, CD, RAD, PTSD, DMDD, and more. He’s proven to be extremely resistant to traditional therapy, a hallmark of developmental trauma. With each new placement he’s grown more dangerous and violent. He’ll soon turn 18 and age out of the treatment centers as an angry young man.
I am angry too.
Ineffective treatment has snuffed out Devon’s once bright future and our family has been broken. Hundreds of thousands of children suffer developmental trauma, yet the mental health system has no answers. I recently heard leading trauma researcher Bessel van der Kolk speak at a conference and he confirmed what I learned the hard way: We have a long way to go in the work to develop effective treatments for developmental trauma.
How is this possible? Why isn’t the public outraged? I’m convinced it’s because our stories aren’t being told. We talk freely about the challenges families face when their child has leukemia or other physical illness. But there’s a taboo around mental health struggles.
Yet, there are thousands of families with stories virtually identical to Devon’s, and to mine. Like me, these families receive little support. Gaslighted, blamed, and shamed into silence, they’ve gone underground into private and secret online support groups. Their suffering is treated like a dirty little secret instead of the national crisis – the tragedy – it is.
Realizing this has only cemented my commitment and determination to raise my voice louder and to use my blog to call for increased funding and new research for treatments for developmental trauma. I am speaking out not only for Devon and my family, but for the thousands of families and children who have no voice.
Developmental trauma shouldn’t be a life sentence for any child or family.
Published by Fostering Families Magazine (May/June 2019)
Three-year-old Devon, whose name has been changed to protect his privacy, had big, chocolate brown eyes and was eager to please. His sister Kayla, 2, was feisty, with gobs of curly hair and dimples. During our pre-adoption waiting period, Kayla screamed for hours on end, seemingly for no reason at all, and couldn’t be consoled. I found Devon elbow deep in the toilet playing with his feces. At mealtime, he’d eat fast and furious then throw up all over the table. Once, I found Kayla hiding in the pantry and clutching a jar of peanut butter.
Despite all this, my husband and I jumped heart-first into the adoption. We understood these behaviors weren’t uncommon for foster kids. We believed all Devon and Kayla needed to heal was the love of a forever family.
Unfortunately, it wasn’t so simple.
By referring to these concerning behaviors as “normal for foster kids,” it’s easy to lose sight of the why behind them. For example, Kayla was frequently left alone in her crib for hours as a baby. When she cried because she was hungry or wet, no one came. These experiences etched an innate sense of insecurity on her psyche.
Devon lost his birth mother at 6 months when he was removed from her care and her parental rights were eventually terminated. His mind couldn’t understand, but his body absorbed the loss.
Leading trauma expert Bessel A. van der Kolk uses the expression, “The body keeps the score,” to illustrate how the body remembers trauma with tragic, long-term impacts for kids like Kayla and Devon – even if they find a loving forever family.
What is Developmental Trauma?
Developmental trauma occurs when a child experiences chronic abuse or neglect before the age of 5. These are the years when the brain is developing rapidly and is particularly vulnerable.
Trauma may disrupt a child’s sequential brain development, according to psychiatrist Dr. Bruce Perry. This can cause, for example, impaired cause-and-effect thinking and poor self-regulation. Their behaviors, emotions, and thinking are developmentally immature because they’re literally “stuck” at earlier developmental levels.
Also, when a child experiences frequent activation of their fight-or-flight response due to abuse, their brains can be overexposed to the stress hormone cortisol. As a result, their fight-or-flight pathway may activate in even minimally threatening situations. Forrest Lien, executive director for the Institute for Attachment and Child Development, explains: “These children live in constant ‘survival mode’. They are hyper vigilant, do not trust others, and feel the need to control their environment at all times to feel safe. Therefore, they do not allow adults to parent them and cannot have healthy relationships.”
Developmental trauma affects each child uniquely and its impact varies in symptoms and severity. The symptoms can include attachment difficulty, self-esteem problems, anxiety, sleeplessness and a lack of impulse control.
Kayla has overcome a math learning disability, has close friends, and is a creative and independent 15-year-old. However, the trauma symptoms haven’t disappeared entirely. She still sleeps on the floor instead of in her bed, and won’t eat in front of non-family members.
Devon, unlike his sister, falls on the moderate to severe end of the spectrum for developmental trauma. Now 17, he lives in a psychiatric treatment facility. He’s physically aggressive and has no close friendships. He has pending criminal charges for assault and is on track to turn 18 with an 8th grade education.
Early Intervention is Key
Like many foster and adoptive parents, I was unfamiliar with developmental trauma and didn’t know the warning signs. I only realized we needed professional help when Devon, at 9, karate chopped his adoptive little brother in the throat and pushed him down the stairs. Regretfully, those early missteps and missed opportunities exacerbated his condition.
To determine if your child needs professional intervention watch for:
- Behaviors that don’t respond to discipline (particularly therapeutic parenting methods)
- Tantrums that last far past the terrible twos and threes
- Persistent struggles severe enough to interfere with home life, school, or friendships
- Feeling frightened for the safety of the child, yourself, or other children in the home
Trust your instincts and err on the side of caution. There’s no harm in getting a professional evaluation, while the cost of not getting help early can be devastating. If you delay, your child may turn to unhealthy coping mechanisms including drugs, promiscuity, and self-harming.
Untreated developmental trauma can result in behaviors that cause kids to be expelled from school, institutionalized, or face criminal charges. Other siblings in the home are at high risk for primary and secondary trauma. Parents, especially mothers, may develop PTSD.
This doesn’t have to happen. Your child’s future isn’t yet written. Early intervention can change their trajectory academically, vocationally, legally and relationally.
How to get help
The best place to start is with your child’s pediatrician – but be wary of the ADHD diagnosis they might dole out at first. While developmental trauma may cause attention deficits and poor impulse control, an ADHD diagnosis doesn’t tell the full story. Also, the stimulant medications prescribed for ADHD can exacerbate symptoms. Instead, ask for a referral to a psychiatrist for a comprehensive psychological evaluation and diagnosis.
Developmental trauma doesn’t currently map to any single diagnoses. As a result, your child will likely be given multiple diagnoses to fully cover their symptoms. These may include:
- Post Traumatic Stress Disorder (PTSD)
- Anxiety Disorder
- Reactive Attachment Disorder (RAD)
- Oppositional Defiant Disorder (OD)
- Sensory Processing Disorder
- Developmental Delays
- Learning Disabilities
For a child with developmental trauma, these diagnoses are interconnected and need to be addressed in the context of the underlying trauma. For example, PTSD-like symptoms caused by developmental trauma requires different treatment than PTSD caused by combat according to Dr. van der Kolk.
This is why it’s critical to engage clinicians who have experience working with traumatized children, foster kids, and adopted kids. Work with a psychiatrist to explore medication choices. Get an Individualized Education Plan (IEP) in place at school to ensure your child receives the services and supports to be successful.
Unfortunately, there are no quick or easy fixes to developmental trauma, but there is hope with early intervention.
Love is critical, but it’s not enough
Raising a child with developmental trauma can be incredibly difficult and isolating. The more you understand your child’s trauma history, and learn about the science of trauma and therapeutic parenting, the better equipped you will be to help your child heal. Join a local or online parents support group (I recommend, The Underground World of RAD or Attach Families Support Group), prioritize your self-care, and consider seeing a therapist if you begin to feel overwhelmed.
“Love and time will not erase the effects of early trauma,” says Lien. “The best first step is to secure the child in a healthy family but that is only the beginning.”
Children who have experienced developmental trauma desperately need the love of a forever family, but love alone isn’t enough. Get professional help early, before the behaviors and emotions grow too big and overwhelming."Love and time will not erase the effects of early trauma. The best first step is to secure the child in a healthy family but that is only the beginning.” – Forrest Lien, executive director @InstituteAttach Click To Tweet
Published by Adoptive Families May 2018 Issue
Sarrah laughed a little too loudly, running her fingers through her long, fluorescent blue and pink hair. The only flaw on her heart-shaped face was a pale scar to one side of her mouth, like a hairline crack in porcelain. There we were, sitting across from each other in a booth at Chili’s Bar & Grill with our children—hers by birth, mine by adoption.
Sarrah was seeing them for the first time in more than a decade. Devon was 12 with light brown skin. And, now that he was sitting next to her, I could see he had her easy smile. Kayla, 11, fidgeted in the seat next to me, pulling at the strings of her ripped jeans. She cast shy looks my way.
My husband and I adopted Devon and Kayla from foster care when they were toddlers. Because it was a closed adoption, they received new birth certificates and social security numbers to permanently sever the relationship with their birth mother, Sarrah.
When Kayla was five, her curiosity was piqued about her birth mother. I’d patted my growing baby bump and told her and her brother that they were once in Sarrah’s belly, like the baby in mine. “What does JSarrah look like? Where does she live?” Kayla had asked.
I wasn’t sure, so I’d pulled out and read through the adoption case files. When Devon was born, Sarrah was 17 and a foster child herself. He was an infant when she left him sleeping in a motel room to meet a friend in the parking lot. Another guest heard his cries and called 911. Devon was unharmed and his diaper was still dry, but Sarrah was arrested for child abandonment. With no one to bail her out, she was in jail for a month before the charges were dropped. By that time, Devon was in foster care. Kayla was born a few months later, and, since Devon was already in foster care, social services took her too. Eventually Sarrah’s parental rights were terminated.
I told Kayla and Devon their mom was poor and had no family to help her. She loved them and wanted them to be taken care of and that’s why we became their parents. I framed a small photo—a carefully cropped mugshot—of Sarrah for each of them. Kayla, especially, treasured hers.
I kept tabs on Sarrah throughout the years in case Devon and Kayla wanted to contact her when they became adults. Several years ago, while she was serving time for check fraud, I sent her a Christmas card with pictures of the kids. Separated by hundreds of miles and thick prison walls, I didn’t want her to know where we lived, so I sent the letter through a relative.
A couple weeks later I received her forwarded reply. Sarrah’s curly script was embellished with doodled hearts and flowers. “I was so surprised to get this! I will always treasure these pictures. Thank you for taking such good care of my babies when I could not take care of them myself. ”
I read and reread the three-page letter braced for bitterness to slice me like a paper cut. Finding none, I was haunted by the suspicion that the real crime that cost Sarrah her children was being poor. After all, it’s not unheard of for parents to leave kids unattended in a hotel room—running to the lobby, grabbing something out of their car, switching a load of laundry—and they don’t get charged with child abandonment. They don’t lose their children forever.
After being released on parole, Sarrah joined Facebook. She had a penchant for duck-face selfies and over-the-shoulder poses that showed off her Kardashian-esque bottom. She called her boyfriend—a tall, handsome black man with an ankle monitor—her king. She was his queen. Many pictures showed “Coogie” tattooed across her chest, a term I could only find in the online Urban Dictionary: “A cool ass mutha f–er. A cool gangsta.”
Sarrah couldn’t have been more different from me, a conservative, suburban mom. Still, unable to resist dipping my toes in to test the water, I set up a new Facebook account and sent Sarrah a friend request. Seconds later she accepted. Over several months I uploaded hundreds of photos of Devon and Kayla. Sarrah giddily shared them with her Facebook friends, many of whom commented that the kids looked just like her. I noticed it too.
Sarrah and I messaged regularly. She told me about her job assembling furniture and living with her boyfriend in his mother’s house. She was especially proud to have earned her GED and cosmetology license in prison.
When I trusted her to Devon and Kayla, she sent a picture of their initials tattooed on her ankles. “You see? I’ve never forgotten you! I went through a lot when I was younger. I was living on the streets. I’m so sorry. I know you might be angry with me, and that’s OK, but can we be friends? I love you and always will.”
Devon was ambivalent about the relationship, but Sarrah and Kayla swapped emoji stories and pictures of their hairstyles and outfits nearly every morning. Some afternoons they would bike, dance to the radio, or play with the puppy together—courtesy of FaceTime.
Sarrah was seeing a court-ordered therapist, taking medication for her bipolar disorder, and submitting to regular drug testing. I was rooting for Sarrah but worried whether she could keep her life on track once off parole. This felt like a once in a lifetime opportunity for Devon and Kayla, so I booked her a flight to visit.
At the airport, Kayla cradled a Grande Caramel Frappuccino with whipped cream and a drizzle of caramel sauce—Sarrah’s favorite. With her fluorescent hair and bright pink jeans, we had no problem picking her out of the crowd at baggage claim. Kayla snuck up behind her, so close that when Sarrah spun around squealing, she nearly dropped the Frappuccino. Teetering on black, stiletto boots Sarrah kissed Kayla and Devon’s cheeks and pulled them into an awkward hug. Devon eagerly took the handle of her suitcase, leading the way to the exit, and Sarrah cooed at his chivalry.
Kayla climbed up on a large concrete block to give her a better vantage point, and therefore a better likelihood of seeing the shuttle before her brother. She hugged herself to keep warm. “Why didn’t you wear a coat, you silly goose?” Sarrah peeled off her thick coat and put it on Kayla, then wrapped her arms around herself against the cold.
Once in the parking garage the kids trotted ahead of us. Sarrah whispered that she hadn’t smoked for hours—since she left Colorado. “Would it be all right to have a cigarette real quick?” she asked.
“Of course. It’s fine.” I hoped my smile conveyed my sincerity. This weekend promised to be stressful enough without Sarrah having nicotine withdrawal. While she hid out of view behind other cars, I loaded the kids into my minivan.
“Doesn’t she know that’s bad for her?” Kayla blurted. “Doesn’t she know she’ll get lung cancer?”
I hushed her. Sarrah was our guest and we would let her be comfortable.
At Chili’s Kayla squirmed in her seat next to me, shrugging shyly whenever Sarrah asked her a question. Devon was chirpy, eager to capture and hold Sarrah’s full attention. He told her he liked bowling, video games, soccer, LEGOs, and dogs. His favorite color was green and his best friend was named Bobby.
“So, let me tell you what my boyfriend and I do—we pick each other’s noses.” Sarrah mimed the motion. “Then we make the other person eat it. Isn’t that funny?” She hooted with laughter and the kids thought she, if not the story, was hilarious. Me, not so much.
Devon nibbled on a chip and Sarrah exclaimed, “You need more cheese than that! You’re not worried about double dipping are you? Don’t be silly!” Dunking her half eaten chip into the queso Sarrah levered the whole thing into her mouth. She looked around the table, chomping enthusiastically. Then, pausing, she slowly lifted a hand to cover her mouth. “Oh,” she mumbled. “You don’t double dip, do you.”
“Don’t worry about it.” I waved my hand, permission for Devon and Kayla to double dip as well.
Sarrah’s face flushed. “I’m so embarrassed. I’m just so different than ya’ll.”
It was true. I held down a professional job and owned a house and two cars. I had student loans and no criminal record. While Sarrah spent her evenings partying, I spent mine packing school lunches and helping with homework. She double dipped. I did not.
As we left the restaurant I touched Sarrah’s arm. “You and I are different, but I’m glad we are. The kids have a special relationship with you that they can’t have with me. I’m so happy you’re here.” Beaming she gave me a quick hug.
Later that night, I supervised showers and teeth brushing, then Sarrah tucked Devon and Kayla into bed. She kissed them each good night, told them she loved them, and blew more kisses from the door.
The next day we went bowling and out for lunch. She gave Devon and Kayla piggy back rides and pushed them on the swings at the playground. That evening we had hot chocolate and popcorn. Devon and Kayla pulled out our scrapbooks and showed Sarrah pictures of themselves and scanned copies for her of their artwork and school work from over the years.
I asked Sarrah to tell us Devon and Kayla’s birth stories. Pulling Devon onto her lap, and with Kayla curled up next to her on the couch, Sarrah told us that Devon was her Valentine, born on February 14. Her foster mother, Teresa, had been there for the birth. Devon had soft brown eyes and all she wanted to do was hold him.
When Sarrah was pregnant with Kayla she’d had no friends to take her to the hospital. Kayla came out with a pouf of curly hair. All the nurses said she was the prettiest baby girl they’d ever seen. “You were so cute!” Sarrah tickled Kayla’s side until they both giggled and rolled off onto the floor.
Before we went to bed, Sarrah drew a thick tree trunk and the outline of a wide leaf canopy on a piece of paper. She wrote in the names of Devon and Kayla’s grandparents, aunts, uncles, and cousins. She noted that her mother, Debbie, had died from colon cancer. Aunt Darlene had breast cancer and Sarrah’s half sister, Katie, had cerebral palsy. I was touched by this simple family tree and the kids’ birth stories, gifts most adopted children never have.
On Sunday evening Kayla lay on the kitchen counter and Sarrah cradled her head in the sink. She massaged in shampoo and conditioner, stopping several times to gently kiss Kayla’s forehead. Sarrah blow dried and flat ironed Kayla’s hair in the playroom while they watched cartoons together. Devon had gone to bed long before and Kayla fell asleep with her head on Sarrah’s lap.
“I never abandoned Devon,” Sarrah told me. “I went to the parking lot for just a few minutes to meet a guy friend who was going to give me some money. This girl who stayed in the motel too was upset because he was her ex-boyfriend, so she called the cops on me.”
Sarrah had no family; she was 16 when her mother signed her over to social services. “I wasn’t a good kid. I know that. I stole from my mom and ran away a lot. She and her husband didn’t want me back. See this scar?” She leaned toward me and pointed to the tiny scar I’d noticed beside her mouth. “One time I got into a fight with another girl at a group home and she stabbed me in the arm and face.”
After a long silence I asked, “What happened with Kayla?”
“The social worker took her right after she was born. I’m not gonna lie to you,” she said. “I left the hospital and I sat on the curb outside. I had nowhere to go, no one to call for a ride. I just gave up. I knew I would never be able to get them back living on the street.” The despair and regret on her face made my stomach churn with nausea. I was deeply disturbed. That wasn’t how things were supposed to work.
The next morning we dropped the kids off at school before I took Sarrah to the airport. After hugs, kisses, cheek pinching, and giggling we waved goodbye. Before Sarrah entered the security line we hugged. I knew I’d always see Sarrah’s beautiful face reflected in Devon’s smile and Kayla’s dimples. We promised to do another visit soon, but that never happened.
As I’d feared, with the weight of a felony tethering her, Sarrah struggled to keep her head above the water when she got off parole a few months later. She struggled to find jobs and housing. Without health insurance, she stopped seeing her therapist and taking her bipolar medications.
On Christmas Eve I called Sarrah so Devon and Kayla could say Merry Christmas. No answer. No call back. She hadn’t posted on Facebook since December 21. By January, I was very concerned and scoured the Internet. I knew to start with arrest records. Sure enough, Sarrah had gotten tangled up with a gang and was arrested trying to use stolen checks. Charged with three felonies, she faced a decade or more of prison time.
Several days later, I penned the address of the jail onto an envelope and added Sarrah’s inmate number. Before sealing the envelope, I slid in pictures from her weekend visit. Later I would make a small deposit to her commissary account. When I put the envelope in the mailbox and raised the flag, I knew this would be only the first of many letters.
As I walked back inside the house, Kayla was already putting her shoes on, excited to go. She had a salon appointment to get a purple streak in her hair.