Category: Family and Friends

Documentary exploring the school-to-prison pipeline

The PBS documentary, The Kids We Lose, explores how discipline techniques in schools feed the school-to-prison pipeline. It effectively argues for ending punitive practices in schools, but where are the viable and realistic solutions?

One strength of the film is showing how incredibly serious (and dangerous) these behaviors can be. However, it focuses on ADHD, Dyslexia, and Autism as the underlying causes. It’s important to note that the most significant underlying cause of these school behaviors is complex trauma – with nearly half of Americas children suffering at least one adverse experience hurting kids are in every classroom.

One of the highlights of the film is Dylan, an adult man now reflecting on his behaviors as a school aged child. His problems began in 6th grade when didn’t want to do what he was told to do. “I wanted to do things my way,” he says. When discussing his interactions with law enforcement in high school, Dylan says he was rebelling and acting out because he was unhappy. However, the experts on the film don’t address this type of willful behavior. In fact, they specifically say the kids have the motivation, but not the skills to succeed.

While it’s frowned up on in our society to say – some of our kids do have serious, willful behaviors. These children likely also have emotional issues, are disregulated, and may be hyperactive. They may lack the skills they need to succeed. They may also lack motivation and be willful in their behaviors. To find real solutions that work we have to start looking at children’s needs more holistically and realistically. When we deny a child’s control over their behaviors we steal their agency and cripple their chances of sucess in the future.

Photo Credit: The Kids We Lose, PBS

My thoughts…

Teachers need to teach

The film does a great job of showing just how serious and dangerous kids’ behaviors can be. However, it seems to unfairly put the onus on teachers with a focus on the need for teacher training so they can mitigate and manage the behaviors. In my opinion, behavior management (at this level) is not a teacher responsibility. We need support staff that will allow teachers to teach.

Restrains aren’t therapeutic, but we need an alternative

The film effectively shows how shocking and disturbing physical restraints can be. It goes on to explain that restraints are not therapeutic or educational – and therefore have no place in schools. However, the film doesn’t offer an alternative solution. There are cases where a child is completely out of control and unsafe to themselves and others. If we are do do away with physical restrains we must have a realistic acute solution – while continuing to provide long term treatment.

Teachers and peers matter too

It’s often forgotten that these types of extreme behavioral problems create a toxic environment for teachers and peers who are entitled to a healthy environment. The producer argues, “Instead of kids being taught to behave in school they are removed from school.” While this is a valid point, we must consider the needs of everyone – the struggling child, other students, teachers, and support staff.

It’s complicated

Photo Credit: The Kids We Lose, PBS

When my son Devon was in 5th grade he didn’t want to come inside after recess. All the other students were lined up at the door waiting as teachers called for Devon to come. He finally walked over with a large rock in his hand. He slammed the rock into a window and it shattered. Then Devon walked down the line of his peers punching them. When his teacher rushed over to stop him, he punched her in the stomach.

Here’s what I know:

  • Devon’s behavior clearly signaled mental health issues that needed treatment.
  • Physically restraining Devon wasn’t therapeutic or educational, but absolutely necessary.
  • Devon’s teacher had a right to work in a safe and healthy environment.
  • Devon’s behavior was traumatic and disruptive to other students.

These are complicated situations and we will not solve them by painting with a broad brush or focusing on only one prong. To find real solutions for behaviorally challenging students we must be willing to honestly define the problem(s), view the child holistically, and balance their needs along with the needs of others.

The Kids We Lose is a thought provoking film worth your time to watch. After you view it please leave me a comment to let me know what you think.

Why adoption stories aren’t fairy tales

Adoption finalization is a reason to celebrate. Parents have filled out mountains of paperwork, waited months or years and shed many tears to get to that moment. They wear matching tee-shirts, eat way too much cake and splash photos all over social media. Adoption day is so momentous that it feels like a “happily ever after” in itself. After friends and family return home and the frosting is wiped clean, some adoptive families are left with a much different “ever after” than anticipated. They can struggle immensely feel completely alone. 

While a friend, family member or professional can support an adoptive family in multiple ways, one simple task is most important—to understand that adoption stories aren’t fairy tales. And the path to happily ever after can be extremely difficult to find for kids with developmental trauma. Once a person understands this reality, they can offer more effective support to an adoptive family over time.

Unfortunately, the judge’s pen isn’t a magic wand for kids who come from hard places. “While many people think that love or ‘good parenting’ will make up for the early trauma a child experienced, it’s just not that simple,” said Executive Director Forrest Lien. “Families of kids with developmental trauma need extensive support and specialized services.” 

Without early and effective intervention, many adopted children from hard places continue to struggle academically and socially[i]—even in stable, loving families. They’re at increased risk for substance abuse and criminal conduct and at higher risk for mental health issues.[ii]

When adopted kids struggle, it’s easy for those around them—family, friends, community—to point the finger at adoptive parents. They’re quick to blame the adoptive parents for not getting help for their child. Or they criticize the child for willfully squandering the opportunities given to them.  

“While many people think that love or ‘good parenting’ will make up for the early trauma a child experienced, it’s just not that simple,” said Executive Director Forrest Lien. “Families of kids with developmental trauma need extensive support and specialized services.”

But an adoptive parent cannot serve as a hero or the villain in combating the effects of a child’s early trauma. And the child cannot simply “get over” developmental trauma. 

Adoption is better likened to the nostalgic “make your own adventure books” where readers make choices that lead to different endings. But depending on their geographical location, proximity to specialized therapists, level of trauma their child experienced early on, financial situation, insurance provider, etc., adoptive parents don’t have many viable good options from which to choose. 

Make Your Own Adoption Adventure: Story of Bobbi

To begin to understand the reality for many adoptive families, take a walk through their unfortunate “adventures”—

Chapter 1

Bobbi, age 7, squirrels food away under her pillow and gets into fights at school. Her parents notice these behaviors aren’t getting better. Bobbi needs to see a therapist who has experience working with adopted kids with developmental trauma. This would put her on the path to happily ever after. However, this is unlikely to be a choice available to Bobbi and her family. Here’s why:

 No matter the path chosen, most parents unwittingly go it alone.  They often hope traditional parenting methods will eventually work. Or they find a therapist who lacks specialized training in developmental trauma. Either way, matters get worse with time.

Chapter 2

By the time Bobbi is a teenager, her behavior is increasingly risky. She’s experimenting with drugs, partying and sexting. At this point, Bobbi needs to go to a specialized in-patient treatment program for her safety and the safety of others. This would put her on the path to happily ever after. However, this is unlikely to be a choice available to her and her family. Here’s why: 

  • Most residential programs mix together kids with a variety of conditions instead of offering specialized treatment for developmental trauma.
  • Many families cannot afford the out-of-pocket costs left over after the limited insurance coverage provided. 

Chapter 3

Unfortunately, many children like Bobbi grow up in institutions where they do not get better. Others get tangled up with the juvenile justice system. By then, choices are even more limited as early intervention is key for optimal healing.  

Why the good options are limited

Developmental trauma can have far reaching and severe impacts. Kids may suffer from attention deficits, developmental delays, behavioral problems and more. Because developmental trauma is a disorder stemming from brain impact during critical developmental stages, there are no shortcuts to happily-ever-after—no quick fixes or easy solutions. Even well-informed adoptive parents and early intervention by qualified clinicians is not always enough. However, proper and early interventions definitely offers hope.

Here’s how that can happen:

  1.  Adoptive parents must be given comprehensive training on developmental trauma and therapeutic parenting. They need support to parent their child and to recognize when they need professional help. 
  2. Adopted children must have access to effective, specialized mental health services. This treatment needs to be accessible and affordable.

It’s both shockingly simple and profoundly tragic. Parent training and specialized mental health services are just common sense. Yet, far too many adoptive families are headed down a rocky and difficult path due to lack of these two basics. 

Although the path toward “happilly-ever-after” isn’t as simple as one would hope, friends, family and professionals can at least try to understand the journey. And they can advocate and educate on behalf of these families. 

The Institute for Attachment and Child Development and I invite you to choose your own adventure in creative ways to support and advocate on behalf of the adoptive families. It’s time for communities to join together to make sure our vulnerable children have every possible resource to reach their happily ever after. Because when you support adoptive families, you support children from hard places and the generations that follow.

Originally published by the Institute for Attachment and Child Development here.

[i]https://ifstudies.org/blog/the-paradox-of-adoption/
[ii]https://www.childwelfare.gov/topics/can/impact/long-term-consequences-of-child-abuse-and-neglect/crime/

95% of adoptive parents jump in heart-first, but unprepared

Our recent Facebook poll showed up to 95% of adoptive parents are not sufficiently trained on developmental trauma and the related diagnoses including Reactive Attachment Disorder (RAD).

Survey by @RaisingDevon March 2019

While adoptive parents don’t understand the scope and magnitude of developmental trauma, they do do expect children coming out of foster care to have some issues. Among the adoptive and fostering communities, these are considered “normal for foster kids”:

These issues are indeed common among foster kids, but normalizing them is a problem.

Because parents are told these behaviors are normal, and will diminish once the kids are safe in their “forever home,” they don’t raise the alarm bells they should. We often lose sight of the fact these behaviors are usually symptoms of neglect or abuse.

All children adopted out of foster care or international orphanges have, by definition, experienced one or more adverse childhood experience (ACES). ACES are traumas including being separated from a caregiver, physical abuse, neglect, and more. Unfortunately, most adopted children have more than one ACE which can cause developmental trauma when experienced by a child before the age of 5. During those formative years, their brains are rapidly developing and so particularly vulnerable.

According to one study documented in The British Journal of Psychiatry, nearly 50% of children from deprived backgrounds (and from foster care) may meet the diagnostic criteria for Reactive Attachment Disorder (RAD).

YET only 5% of adoptive parents are trained to recognize the signs of developmental trauma and get help for their child.

This is a staggering lack of pre-adoptive training considering the high likelihood (as high as 50%) their child will have developmental trauma.

Here’s what parents are saying about the lack of pre-adoption training

In foster parenting training we were told about RAD but that it was so rate that it was not worth much discussions as we would likely never see it in our home.”

Micci

We knew RAD was a likely thing when we started fostering, not because our agency bothered to tell us, but based on our own research.

Adrienne

We knew and were trained and immediately sought help through a therapist we were already using. It didn’t change a thing though. She still tried to have me killed this past November. All the resources, professionals, etc didn’t make it any better.

Christina

I recognized something was wrong on day 2. It took me 10 months of researching to find what it was.

Julia

Yes I knew, but NO I was completely unprepared for the extent to which the challenges would be.

Laura

We adopted 15 years ago and were told nothing and knew nothing about RAD. I should add that I am a medical professional and was never taught anything about this.

Nancy

We were not taught about it. In fact we were not even told he had been diagnosed with it. Of course we were told that he had had Leukemia and would need follow ups.

Beth

Love alone is not enough

While few pre-adoptive parents are trained on developmental trauma and RAD, they are consistently told “these kids only need the “love of a forever family” to heal and thrive.” While it’s true they need love in a forever family, love alone is not enough.

Just as love cannot heal a broken arm, strep throat, or leukemia – love alone cannot heal developmental trauma. Developmental trauma is a brain injury that requires highly specialized treatment.

Without adequate training, parents are unprepared to recognize the symptoms and get the early intervention these children so desperately need. Sadly, far too many families are already in crisis before they get professional help. In some cases the children end up institutionalized or incarcerated. Other families are forced to trade custody for mental health care. Some adoptions fall apart.

These are preventable tragedies, in many cases, if only pre-adoptive parents were trained and prepared.

What parents need in pre-adoptive training

For adoptive children to thrive, our pre-adoptive training (often called MAPP classes) must be reformed. The information needn’t be told in a way that scares away prospective adoptive families. But it does need to be comprehensive and allow each family to honestly evaluate their ability to care for a child from hard places. It also needs to equip parents to recognize when they need professional help and to know how to get it.

Prospective adoptive parents ned to walk away from training with:

  • A comprehensive understanding of developmental trauma – the science of trauma, the risk factors, and potential impacts to the child.
  • A familiarity with the hallmark symptoms of Reactive Attachment Disorder (RAD).
  • Practical training on the how-to of therapeutic parenting.
  • A full understanding of the warning signs that a child needs professional help.
  • Guidance for how and where to find help.

Parents must understand that they are not able to heal developmental trauma on their own. Let’s give them the information, community supports, and mental health resources they need to successfully help their child heal and thrive.

Resources

If you’re an adoptive parent who wasn’t provided with training on this important topic, here are some resources to check out. More resources are listed on our Resources for Parents page.

Support Groups

(Let them know @RaisingDevon sent you!)


Childhood Trauma Leads to Brains Wired for Fear

This story was produced by Side Effects Public Media, a news collaborative covering public health.

Negative childhood experiences can set our brains to constantly feel danger and fear says psychiatrist and traumatic stress expert Bessel van der Kolk. He’s the author of the recently published book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. 

A  report by the University of San Diego School of Law found that about 686,000 children were victims of abuse and neglect in 2013. Traumatic childhood events can lead to mental health and behavioral problems later in life, explains psychiatrist Bessel van der Kolk, author of the recently published book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. 

Related: How two professors are helping children cope with violence

Children’s brains are literally shaped by traumatic experiences, which can lead to problems with anger, addiction, and even criminal activity in adulthood, says van der Kolk. Side Effects contributing producer Barbara Lewis spoke with him about his book. 

Barbara Lewis: Can psychologically traumatic events change the physical structure of the brain?

Dr. Bessel van der Kolk: Yes, they can change the connections and activations in the brain. They shape the brain.

The human brain is a social organ that is shaped by experience, and that is shaped in order to respond to the experience that you’re having. So particularly earlier in life, if you’re in a constant state of terror; your brain is shaped to be on alert for danger, and to try to make those terrible feelings go away. 

The brain gets very confused. And that leads to problems with excessive anger, excessive shutting down, and doing things like taking drugs to make yourself feel better. These things are almost always the result of having a brain that is set to feel in danger and fear. 

As you grow up an get a more stable brain, these early traumatic events can still cause changes that make you hyper-alert to danger, and hypo-alert to the pleasures of everyday life. 

BL: So are you saying that a child’s brain is much more malleable than an adult brain?

BK: A child’s brain is virtually nonexistent. It’s being shaped by experience. So yes, it’s extremely malleable.

BL: What is the mechanism by which traumatic events change the brain?

BK: The brain is formed by feedback from the environment. It’s a profoundly relational part of our body.

In a healthy developmental environment, your brain gets to feel a sense of pleasure, engagement, and exploration. Your brain opens up to learn, to see things, to accumulate information, to form friendships. When you’re traumatized you’re afraid of what you’re feeling, because your feeling is always terror, or fear or helplessness. I think these body-based techniques help you to feel what’s happening in your body, and to breathe into it and not run away from it. So you learn to befriend your experience. 

But if you’re in an orphanage for example, and you’re not touched or seen, whole parts of your brain barely develop; and so you become an adult who is out of it, who cannot connect with other people, who cannot feel a sense of self, a sense of pleasure. If you run into nothing but danger and fear, your brain gets stuck on just protecting itself from danger and fear. 

Related: Some Early Childhood Experiences Shape Adult Life, But Which Ones? 

BL: Does trauma have a very different effect on children compared to adults?

BK: Yes, because of developmental issues. If you’re an adult and life’s been good to you, and then something bad happens, that sort of injures a little piece of the whole structure. But toxic stress in childhood from abandonment or chronic violence has pervasive effects on the capacity to pay attention, to learn, to see where other people are coming from, and it really creates havoc with the whole social environment.

And it leads to criminality, and drug addiction, and chronic illness, and people going to prison, and repetition of the trauma on the next generation. 

BL: Are there effective solutions to childhood trauma?

BK: It is difficult to deal with but not impossible. 

One thing we can do – which is not all that well explored because there hasn’t been that much funding for it – is neurofeedback, where you can actually help people to rewire the wiring of their brain structures.

Another method is putting people into safe environments and helping them to create a sense of safety inside themselves. And for that you can go to simple things like holding and rocking.

We just did a study on yoga for people with PTSD. We found that yoga was more effective than any medicine that people have studied up to now. That doesn’t mean that yoga cures it, but yoga makes a substantial difference in the right direction.

Trauma-Informed Care: School Counselors Take On At-Home Trauma In The Classroom.

BL: What is it about yoga that helps?

BK: It’s about becoming safe to feel what you feel. When you’re traumatized you’re afraid of what you’re feeling, because your feeling is always terror, or fear or helplessness.  I think these body-based techniques help you to feel what’s happening in your body, and to breathe into it and not run away from it. So you learn to befriend your experience. 

It takes a village

My son Devon has a long track-record of making false allegations against staff at treatment facilities where he’s a patient. “I’m afraid Devon might make up a story about me too,” I recently told his therapist Cathy. “If CPS got involved, I could lose my other kids during the investigation…” In my mind I imagined my youngest son being dragged off to foster care even for one night. It’s a mom’s worst nightmare.

Cathy stammered a response, apparently incredulous I believed my son capable of such a thing. 

When Cathy and I spoke the following week, she’d already discussed the issue with Devon. “I explained to him exactly why you’re so concerned about false allegations.You could be arrested. You could lose your other kids. False allegations could ruin your life,” Cathy said, recalling her words to Devon. She continued, “When I explained this to Devon, he was so upset. Now that he knows how serious this is, you have nothing to worry about.” 

I was dumbfounded. I felt as though Cathy had handed my son the user’s manual for a weapon of mass destruction. And our family was the potential target. Telling Devon just how powerful false allegations are was extremely risky. It gave Devon all the more reason to do so. 

Unfortunately, Cathy was unfamiliar with the nuances of developmental trauma disorder—a result of Devon’s early childhood neglect and abuse. Because Devon lacks an innate sense of security, he can be very manipulative in an attempt to control his environment. “When children’s brains are impacted by trauma during early development, they live in a fight/flight ‘survival mode’, do not trust others and rely entirely upon themselves,” said Institute for Attachment and Child Development Executive Director Forrest Lien. “They will go to great lengths to push others away—especially primary caregivers—to feel safe. Sometimes, that includes false allegations.”

When “help” isn’t helpful

Those on the “other side” of developmental trauma disorder—adults living outside of the child’s home—may want to help the child and family but lack the insight to do so. With DTD, there is often more happening than meets the eye. If therapists, educators, police officers, and other professionals aren’t familiar with the nuances of developmental trauma, their interventions sometimes make already volatile situations worse. This is why parents like myself can seem defensive, inflexible and frustrated. We desperately need support from community resources. Yet, we’re also desperately afraid they’ll exacerbate our child’s condition, damage our hard-won and tenuous attachment with our child or put our family in danger. 

Here are some real-life examples of misunderstandings about developmental trauma that have had a harmful impact on families:

Tom’s Story

Ms. Linda, the school cafeteria worker, was charmed by 6-year-old Tom. He told her stories about how his mom mistreated and didn’t feed him. Ms. Linda always had a cookie or treat for Tom. She even told him that some kids get ‘re-adopted’ if their family isn’t a good fit. In fact, she said, she’d love to adopt a little boy just like him. That afternoon, Billy went home and demanded his mother let him be “re-adopted.”

Things to consider from the “other side”—

Kids with developmental trauma can be superficially charming. Again, it is often a learned survival strategy because they unconsciously feel unsafe in the world. By having this “secret” with Ms. Linda, Tom was bonding with her instead of his mom. Instead of encouraging Tom to build healthy relationships within his new family, she gave him an easy out. Mom needed Ms. Linda to contact her about the situation so they could get on the same page and partner together in Tom’s best interest. 

Janey’s Story

Janey had a bad month. She’d been in a fight and had run away. She’d broken her bedroom window. She’d been suspended from school. During therapy Janey, her mom, and the therapist set some goals for Janey to work on. Then, just as the session was ending, the therapist smiled maternally at Janey. “Look at her, mom,” she prompted. “She just needs love. That’s all this is about. A little girl who needs her mom to love her.” Janey’s behavior did not improve during the following month.

Things to consider from “the other side”—

Kids with developmental trauma need clear and consistent parenting in order to thrive. While Janey certainly needed her mom’s love, that should not be used to excuse her from accountability for her actions. This is not a mindset that will be helpful to Janey in the long run. Unfortunately, Mom walked away from this session feeling blamed and beaten down. And Janey had no motivation to work toward more effective strategies. Mom needed the therapist to do attachment work but also to hold Janey accountable for her actions. 

Nate’s Story

Nate, 13, was enraged and lunged at his mom with a shard of glass. She called the police. By the time the officer arrived, Nate was calm and sitting in a recliner as though nothing had happened. The officer looked between hysterical mother and serene son and made a snap judgement. “This seems like a ‘parenting problem’,” he said. He then reassured Nate not to worry and that he couldn’t be arrested for anything at his age. The next time Nate acted up, he told his mother there was nothing she could do to stop him—the policeman said so.

Things to consider from “the other side”—

Kids with developmental trauma may escalate until they reach a hard limit. Without limits, they may continue to behave violently and endanger themselves or others in their family. Mom needed the officer to speak with her privately to understand the full story and to express any concerns he may have out of earshot of Nate. Even if the officer was not going to make an arrest, Mom needed him to speak sternly to Nate so he’d understand how serious his actions were. 

Unfortunately, in these examples, well-meaning professionals made the situation worse. They inadvertently derailed treatment, disrupted attachment work, caused confusion and stoked deep resentments and hurts. In some cases, they put the children and families they were trying to help in greater danger. 

Ways professionals can best support children with DTD and their families

The best ways to help children who have developmental trauma can feel counterintuitive and, therefore, requires more than common sense. If you’re a mental health professional, educator, police officer or other community resource, please educate yourself on developmental trauma and therapeutic interventions so you can help families like mine. One place to start is the Institute for Attachment and Child Development new online resource library. 

Here are some good things to know as a professional working with children and families—

  1. Realize things may not be as they appear. Pause to consider that there may be complex, nuanced mental health issues involved.
  2. Consider that parents’ concerns and fears may be justified – that we may not be overreacting. Our children may be dangerous even at startlingly young ages, particularly if they have a co-morbid mental disorder.
  3. Realize children with developmental trauma may act very differently in front of you than how they behave behind closed doors with their parents. The situations you encounter are likely far more complicated than an innocent misunderstanding.
  4. Discuss your concerns frankly with parents, but always privately. Partner with us—out of earshot of our children—to resolve and manage the situation and present a unified front.
  5. Refer us to local crisis services and community resources. We often don’t know where to turn for help but are eager to follow-through on any recommendations for services that can be helpful for our child and family.
  6. As a clinician, feel comfortable referring clients with developmental trauma elsewhere if appropriate. If you do not specialize in developmental trauma, it is vital to know your limitations. Do your best to connect families with therapists who specialize in the disorder.

We desperately need the community to rally around our families and provide support. To successfully help our children heal, we need to partner with trauma-informed therapists, educators, and law enforcement officers. If our children, who come from hard places, are to thrive and live happy, well-adjusted lives, it’s going to take a village. 

Some names and identifying details have been changed to protect the privacy of those involved and all stories are being told with permission.

What we might learn from another tragic story of mental health help given too late, too little

Caleb, 11, was thin with blond hair, glasses, and a big smile where crooked teeth jockeyed for space. He and his brother, Elijah, were adopted by Martin and Dena Lishing when Elijah was a toddler and Caleb was a baby. Their young birth mother struggled from addiction.

Born a preemie at 24-weeks-old and weighing only 1 pound, Caleb beat the odds. His 5th grade teachers remember him as shy, inquisitive and loving. He wore cowboy boots to school every day. He was fascinated by all things Titanic. A classmate says, “He was really funny. He always had jokes and puns to tell.”

It was a warm, overcast evening on April 23, 2018–Caleb was asleep in his bed. An adult babysitter was in a nearby room. Meanwhile, 13-year-old Elijah dismantled their grandfather’s locked gun cabinet to access a .357 Magnum. Caleb was sleeping on his stomach when Elijah shot him in the back, killing him.

This tragedy was the first murder in the small, sleepy town of Streetsboro, Ohio in 20 years. But it wasn’t the first time police were called to the Lishing home on Alden Drive.

Mental health interventions, too late

Over the years, the family had attempted – unsuccessfully – to get mental health treatment for Elijah although details are not public. Reports indicated Elijah tried to commit suicide twice. In 2017, Elijah was charged with indecent exposure on the school bus. In 2018, his stepmother called police because he became “unruly.” When he told officers he was thinking of harming himself, they transported him to a local behavioral health center for evaluation.

Only four days later, Elijah shot and killed his little brother Caleb. Police have not disclosed Elijah’s motive but say it was premeditated.

Psychologist Dr. Amy Thomas testified at the sentencing hearing that Elijah suffered early childhood abuse. Elijah claims, in addition to neglect from his birth mother, he was subsequently abused in the Lishing home. He details harsh punishments from a young age and says his adopted mother was more devoted to premature Caleb than to him. The Lishing couple also divorced several years after the adoption.

Thomas diagnosed him with reactive attachment disorder (RAD), also called developmental trauma disorder (DTD). This often occurs when a child experiences chronic abuse or neglect before the age of 5. A child with DTD has disrupted brain development and, if not provided early and highly-specialized intervention, can suffer long-term and devastating impacts. They have difficulty forming healthy attachments with caregivers and others which can lead to familial, social, educational and legal issues. Dr. Thomas also diagnosed Elijah with post-traumatic stress disorder and conduct disorder, both common diagnoses for children with DTD.

Elijah’s situation is even more complex than DTD alone, however. Dr. Thomas testified that Elijah also suffers from paranoia and stated that a previous clinician had diagnosed him with schizophrenia. Reflecting on the time of the murder, Elijah told the court, “I was living inside my head, unable to determine the difference between imagination and reality.” This points to serious mental illness in addition to complex DTD.

The worrisome correlation of complex developmental trauma and mental illness

Dr. John Alston, psychiatrist for the Institute for Attachment and Child Development, finds a strong correlation between complex DTD and co-morbid mental illness. In his studies, Dr. Alston recognized that adults who abuse or neglect their children often do so as a result of a mental illness. Thus, their children may suffer the unfortunate combination of both the nature (genetics) and nurture (attachment) consequences.

And when children with complex DTD inherit a mental illness, it is often in a profound way according to Dr. Alston. He gives the analogy of more commonly-known childhood health issues. “You never hear of symptoms of childhood diabetes in a mild form, you never hear of childhood asthma in a mild form. They are always inherited in a severe or profound form and therefore the earlier the onset, the more severe the disorder, the more intensive the treatment needs to be,” said Dr. Alston. “It is exactly the same when we are talking about mental health disorders.”

Elijah told the court, “I was living inside my head, unable to determine the difference between imagination and reality.” This points to serious mental illness in addition to complex DTD.

Forrest Lien, Director of the Institute for Attachment and Child Development, is adamant that not all children with developmental trauma are dangerous. Rather, it is often the unfortunate combination of specific and severe disorders. “Developmental trauma disorder alone does not deem a child dangerous. Furthermore, not all children with DTD have a mental illness. Yet, some do,” Lien says. “Children with complex developmental trauma often feel angry and can lack empathy. When you combine a child who feels slighted and vengeful with a misdiagnosed or poorly-treated severe bipolar disorder with psychotic features, it can be dangerous.”

Neuroscience is an emerging science and this link between early trauma and mental illness is not well known. However, given the potential for sometimes dangerous antisocial behavior, it is critical that clinicians still give careful consideration to these correlations. It is vital, Dr. Alston says, to differentiate the impact of severe trauma from potential mental illness symptoms in order to properly diagnose and treat the whole child. 

The case for better mental health support

Unfortunately, Elijah’s developmental trauma and co-morbid disorders were not accurately diagnosed until after he was incarcerated—not in time to prevent this horrific incident. He did not receive appropriate treatment and the costs to his family and himself have been enormous.

Martin and Dena are heartbroken having suffered the loss of their children. Innocent 11-year-old Caleb’s life has been cut short. And they must now grapple with the incarceration of their other son.

“When you combine a child who feels vengeful and slighted with a misdiagnosed or poorly-treated severe bipolar disorder or schizophrenia with psychotic audio and visual hallucinations, it can be dangerous,” said Institute for Attachment and Child Developmental Executive Director Forrest Lien.

Elijah, now 13, is a convicted murderer facing a lifetime of struggles. He has been sentenced to juvenile detention until he turns 21 and at that time his case will be reevaluated with the potential for adult detention time. According to the Record Courier, “Judge Robert Berger said that despite abuse the boy suffered as a child, it did not excuse shooting and killing his brother.”

Perhaps with earlier diagnosis and interventions, Elijah wouldn’t be sitting in a prison cell today. Caleb might be running around the playground instead of being memorialized by the Titanic-shaped play fort the community is erecting in his memory.

Published originally by IACD here. Updated 1/28/2019 after sentencing.

How kids in “typical” biological families grow up with attachment issues

Adults who grew up in so-called “typical” families—the families we pay no or little attention to because it looks “normal”, okay, or good-enough—can struggle too. In this post from IACD Robert W. McBride, LCSW, MSW offers insight into the experiences that may cause attachment issues in children who are not foster kids and not adopted.

Phil the Farmboy
Phil was raised in a small mid-western town where his father operated several grain silos and mom was a teacher. Phil described his family as stereotypical—a happy, church-going, farmland family—dad, mom, daughter, and son. He described himself as mostly shy, afraid, unhappy, and somewhat angry as a child. When Phil was eight-years-old, his father began to take him to work at the silos after he got out of school. He picked up the dead rats, swept out the train cars, and cleaned the elevators. By the time he got home, his mouth and nostrils were red and raw, his throat was constricted and scratchy, and his eyes were swollen nearly shut from the dust…read the full story here.

Beth the Big Sister/Mother
Beth grew up in a large western city. She did not know who her father was and her mother had been addicted to drugs until Beth was fifteen-years-old. She had four siblings by four different men. Beth raised her siblings—bathed, fed, dressed them, did the laundry, and many other caregiver roles from a very early age. As a child, she was afraid someone in authority would find out her mother was an addict and party girl and break up the family…read the full story here.

What it’s like being the sibling of a child with RAD

“It’s like living in a prison. We can’t go anywhere. All doors are locked. Alarms everywhere. We can’t have friends over. Stuff goes missing. We’ve all had black eyes, split lips and bite marks…we’re the ones who suffer.” – Grace, 14, on living with a sibling with reactive attachment disorder.

Grace’s experience is not uncommon for siblings of children who fall on the moderate to severe range of reactive attachment disorder (RAD). The dysregulation and other challenges of RAD restrict family activities, cause stress and chaos, and require a disproportionate amount of parental attention and energy.

Siblings are too often the overlooked victims of the disorder.

I initially thought that adopting another child would enrich the lives of my other kids. I certainly never imagined that it’d be a traumatizing situation. For years, my children were routinely exposed to scary outbursts and stressful conflicts. They were humiliated and embarrassed at school – especially after their brother who has RAD punched a teacher in the stomach. They missed out on sleepovers, birthday parties, and were late to basketball and soccer practices. Doing my best in the moment – surviving – I didn’t realize how difficult things were for them until much too late. They had internalized fear, anxiety, and anger.

Doing my best in the moment – surviving – I didn’t realize how difficult things were for them until much too late. It was only later that I realized how traumatized siblings internalize fear, anxiety, and anger.

The struggles and emotions of brothers and sisters of children with RAD—siblings like Grace—can best be understood through their own words. I put up a post on two online Facebook support groups to gather those sentiments. In those posts, I requested parents to ask their children what it’s like having a sibling with RAD. I’ve included their responses throughout this article and only edited their comments for grammar.

Living in Fear

Many siblings are trapped in a perpetual state of anxiety and vigilance, fearful for their own safety and the safety of their parents. They’re often targeted with physical aggression and witness terrifying situations.

Here’s what siblings are saying:

“I can feel her getting all angry and I get worried and feel a little sick in my stomach. When she gets really bad and is yelling and screaming and hitting you [mom] I feel upset that I can’t stop her, that I can’t protect you from her.” – Chad, 10

“Mommy, I am scared. She hurts me.” – Susie, 6

“Is the door locked?” – Jake, 15, sleeping on his parent’s bedroom floor with his 10 and 12-year-old brothers.

“I’m scared she’s going to do something to me. But I won’t let her know I’m scared.” – Mia, 11

“I wish she could live somewhere else. I don’t like her anymore. She’s never nice.” – Ava, 4, whispered to her mother afraid her sister with RAD would overhear and retaliate.

“No, Sis!” – Emma, 2, screamed in a nightmare after watching her 12-year-old sibling with RAD physically attack her mother.

“Why is she always so mean to me? She’s always hateful and yelling at me.” – Ashley, 10. A middle child, Ashley also has a brother with RAD. Of him she says, “He lies to get me in trouble. He hits me and threatens to kill me and swears at me.”

What you can do

Put alarms on sibling’s doors to help them feel safe. Give them the option of sleeping on a daybed in your bedroom. Make a concerted effort to minimize their exposure to violence and danger with an escape plan out of escalating situations. This may mean calling grandma to be picked up, going outside to play or another option that works best for your family.

Internalizing dysfunction

For many siblings, family life can be highly dysfunctional and confusing. This can lead to a warped view of normal family relationships with devastating, lifelong impacts. Siblings often struggle to differentiate the person from the disorder and come to hate their brother or sister who has RAD.

Here’s what siblings are saying:

“She always says she’s sorry and goes right back to being so happy when I’m still hurt. I can’t trust her anymore because she always says she won’t do it again and then usually does in the very same day.” – Beth, 10

“I never want children of my own. What if something goes wrong and they end up like her? I just couldn’t handle raising a child like that!” – Marie, 29

“Mom, does he have to come home? You are so much nicer when he is gone.” – Brandon, 12

“Sometimes I feel like no one can see me because my mom and dad give [my sister with RAD] constant attention.” – Honor, 6, who after having to help out with her RAD sister says she never wants to have children.

“It breaks my heart to hear my baby sister say she hates me and is going to kill me tonight! It’s not fair.” – Samantha, 15, said weeping.

“They’re always mad, sad, and don’t like their mom or dad, and lie all the time.” – Addison, 10, on why all siblings are bad.

“Don’t you get it? She is a horrible person.” – Kayla, 12, when she found her mom sobbing over something her sister with RAD said.

What you can do

Let siblings be honest about their feelings and don’t minimize their experiences. Find a good therapist who can help them process and gain some perspective. An outside person, like a therapist, can help them develop empathy and compassion while maintaining healthy boundaries.

Many people think that time apart is counterintuitive in helping a child with RAD and their family heal and attach. Yet, it’s quite the opposite with the right model.

Losing their childhood

Siblings don’t live the carefree lives of others. They miss basketball practice and piano lessons when their sibling flips into a rage. They aren’t able to go on family vacations and outings are often cut short. Their treasures and toys are broken. Their allowance is stolen. For them, growing up can be less than ideal and full of heartache and challenges.

Here’s what siblings are saying:

“I’m only 10-years-old! I’m too little to have to deal with this stuff!” – Ethan, 10, once a happy-go-lucky boy who is in therapy. ‪

“It was depressing and exhausting. I was never allowed to have fun.”  – Michael, 10, who has been in therapy for the last two years.

“It feels like living in a minefield. Looks peaceful and nice one minute, war zone the next.” Jeffrey, 8

“I never get to have friends over and I missed my best friend’s birthday party. I already had a present and had to give it to her at school on Monday.” – Abby, 11

“They have no idea what it’s been like!” Skylar, 8, cried after neighborhood kids blamed her when her sister with RAD, 11, was removed from the home. Her sister was removed because she was planning to murder Skylar and her family.

“I can’t wait to move out.” – Hunter, 17. When Hunter’s sister Ava, 10, also traumatized by their sibling with RAD heard this she said, “You can’t leave me here with her!”

“Sometimes it feels like it will never end.” – Emma, 15, who has started cutting to “release” the pain, is severely depressed, and has lost 40 pounds in the last year after witnessing the tantrums, explosions, anger, aggression, violence, and threats of a sibling with RAD.

Siblings don’t live the carefree lives of others. They miss basketball practice and piano lessons when their sibling flips into a rage. They aren’t able to go on family vacations and outings are often cut short…For them, growing up can be less than ideal and full of heartache and challenges.

What you can do

Enlist family and friends to help siblings with rides to practice, science fair projects, and other important activities. When accomodations cannot be made, acknowledge your child’s feelings and validate them. Enroll them in camps. Let them stay with grandma or auntie for long vacations to get a break and enjoy their childhood.

Collateral damage

Many parents, myself included, are so consumed with the minute-by-minute challenges of raising a child with RAD that they underestimate, or don’t fully recognize, the impact on siblings. It was only after my son was admitted to a residential treatment facility that I began to fully understand how his disorder had impacted my other children. To this day my youngest son who lived in fear of his brother for the first five years of his life is highly anxious and at age 11 is afraid to sleep alone. I often wish for a do-over.

When assessing treatment options for your child with RAD, be mindful of the needs of siblings. Many people think that time apart is counterintuitive in helping a child with RAD and their family heal and attach. Yet, it’s quite the opposite. “Time apart allows the parents and other children to heal from their own trauma while, at the same time, kids with RAD learn how to attach and to live in a family,” said Executive Director Forrest Lien. “When the children return to their own families after the Institute, everyone is stronger. They can live together safely. We’re strengthening families so they don’t fall apart forever.”

Don’t make the mistake of imagining siblings are coping and doing okay. Don’t, like me, realize only once the damage has been done. There are no perfect answers, but understanding how RAD impacts siblings is a good starting place. Don’t let them be collateral damage.

Don’t miss these posts:

What to consider before you adopt

How moms of kids with RAD get PTSD

Some names have been changed to protect the privacy of these children.

Disclaimer: As an Amazon Affiliate I earn referral fees when you use my links.

Why Residential Treatment is good (and not good) for kids with RAD

What’s your success been with Residential Treatment Facilities (RTF)? My son, Devon, has been in 2 group homes and 5 psychiatric residential facilities (PRTF).  They feel like ‘holding tanks’ that have actually made him worse. Unfortunately, they’ve been necessary to keep Devon and my other children safe.

Here’s a great pro and con analysis from IACD. Let me know your thoughts…

Most parents who are considering residential treatment for their children with reactive attachment disorder (RAD) feel depleted. After years of therapy and countless other measures, they often feel as though their children are worse off than before. These families are close to running out of money, time, and support. The people in their lives don’t recognize what truly goes on in their homes. They just don’t get it. The parents themselves know, however, that their entire household suffers as a result. They need help.

The decision to send a child to a residential treatment center (RTC) is difficult (although sometimes that decision is made for parents which is an entirely different topic). To add to the difficulty, most parents are struggling with secondary PTSD as a result of raising children with PTSD. They are in “survival mode” themselves. If you or someone you support is in the midst of making such a decision, consider the following.

Read the Pro’s and Con’s and the complete article here.

Be sure to checkout these op-eds I’ve published on this topic:

I’ve tried the system. It doesn’t work. (My take on the Parkland shooting published by the Sun Sentinel)

Don’t blame workers for psych center woes. (My take on some local RTF abuse published by the Charlotte Observer)

Dear friends & family

Dear Friend,

I’ve told you before how I’m struggling with my child’s behavior but I’m not sure you understand how serious—how desperate—things are.

Here’s the unvarnished truth—my child relies on manipulation and melt-downs to control his surroundings. He refuses to follow the simplest of instructions and turns everything into a tug-of-war as if it’s a matter of life or death. Every day, all day, I deal with his extreme behavior. He screams, puts holes in walls, urinates on his toys, breaks things, physically assaults me and so much more. I’m doing the best I can but it’s frustrating and overwhelming.

Most people, maybe even you, blame me for my child’s behavior. This makes me feel even worse. I already blame myself most of the time, especially because I’ve struggled to bond with him.It’s heartbreaking to know he only feigns affection to get something from me. There’s not a parenting strategy I haven’t tried. Nothing has worked. Often, I feel like a complete failure as a mother and struggle to face each new day.

Fortunately, my child’s behavior makes a lot more sense to me now that he’s been diagnosed with reactive attachment disorder (RAD). Let me explain. When a child experiences trauma at an early age his brain gets “stuck” in survival mode. He tries to control the surroundings and people around him to feel safe. In his attempt to do so, he is superficially charming, exhibits extreme behaviors, and rejects affection from caregivers. Unfortunately, even with a diagnosis, there are no easy answers or quick treatments.

Even though I work so hard to help my child heal, friends and family often don’t believe or support me which is incredibly painful. I understand it’s hard for you to imagine the emotional, physical, and mental toll of caring for a child with RAD when you haven’t experienced it yourself. And, you can’t possibly be expected to know the nuances of the disorder and its impact on families like mine. That’s why I’m putting myself out there about the challenges I’m facing.

[bctt tweet=”What I need most from you is a shoulder to cry on and an ear upon which to vent—without being judged, second-guessed, or not believed.” username=”RaisingDevon”]

When you undermine me, you inadvertently set back the progress I’ve made in my already tenuous relationship with my child. I wish you could understand how good my child is at manipulating people—how he turns on that sweet, charming side you usually see. In fact, you may never witness a meltdown or even realize he’s manipulating you. Yes, he’s that good. When you think he’s bonding with you, know there’s always an end in mind. He may seek candy or toys. The biggest win of all for him, however, is to get you to side with him against me.

Here’s how easily it happens—my child is sitting in timeout, looking remorseful as he watches the other kids play. You think I’m too hard on him and say, “He’s sorry and promises he’ll make better choices next time. How about you give him another chance?” You need to understand there’s a lot going on behind the scenes that you simply don’t see or know about.

When you undermine me, you inadvertently set back the progress I’ve made in my already tenuous relationship with my child. The structured consistency—what you feel is too strict—is exactly what my child needs to heal and grow into a healthy, happy and productive adult.

Please know I’m following the advice of therapists and professionals. Strategies for raising a child with RAD are often counterintuitive and, watching from the outside, you may not agree with them. That’s okay. But, instead of interfering, would you give me the benefit of the doubt?

Over the years, well-meaning people have said some pretty hurtful things to me, things like:

•All kids have behavioral issues. It’s a phase. They’ll grow out of it.
• He’s so sweet. It’s hard to believe he does those things.
•Let me tell you what works with my child…
•Have you tried _______?
• Oh, he’s just a kid. I’m sure he didn’t do that on purpose.
• A little love and attention is all he needs.

I know these sentiments are meant to be helpful, but here’s the thing—my child isn’t like yours.

He has a very serious disorder. Statements like these minimize our situation as if there are easy solutions that I just haven’t tried. Honestly, I’m not looking for advice. What I need most from you is a shoulder to cry on and an ear upon which to vent—without being judged, second-guessed, or not believed.

Reactive attachment disorder is a challenging disorder that’s difficult to treat so we have a long road ahead of us. Everyday is a struggle and I’d love to be able to count on you but not for advice or answers. I just need you to listen and offer encouragement. I know how deeply you care for me and my child and I’m thankful to have you in our lives. I’ve lost some relationships through this incredibly difficult journey. I don’t want to lose you too.

Sincerely,

A parent of a child with reactive attachment disorder

This is my latest blog post for the Institute for Child Development and Attachment. Please share this letter to raise awareness for parents of children with reactive attachment disorder.

via An open letter to friends/family of those raising kids with reactive attachment disorder – Institute For Attachment and Child Development

Movie Review: The Boarder

When Annika and Zeb adopt Carl, an 11-year-old boy from the foster care system, they’re confident he’ll heal and thrive in their loving home. Carl seems sweet and charming – at first.

The vestiges of Carl’s childhood neglect and abuse soon spill out. The “ripped from our lives” plot of movie The Boarder (2012) will be all too familiar to families of children with reactive attachment disorder (RAD). [bctt tweet=”The “ripped from our lives” plot of movie The Boarder (2012) will be all too familiar to families of children with reactive attachment disorder (RAD).” username=”RaisingDevon”]They’re sure to see themselves in its authentic cast of characters—the adopted child suffering the effects of trauma, the “nurturing enemy” mom, the duped dad, and the suffering siblings. For others, the movie is an eye-opening introduction to a disorder many do not know or truly understand.

As the plot unfolds, mom Annika is confused and hurt when Carl spurns her love and affection. But as Carl’s behaviors become more concerning – violent outbursts, lying, stealing, and smearing feces – she sees that he is severely emotionally disturbed. She realizes it is not a problem that can be loved away.Meanwhile, Carl’s adoptive siblings Jarren and Lexi resent Carl’s surly attitude and how he takes all of their mother’s energy and time.

Carl cleverly hides his worst behaviors from and ingratiates himself with his new adoptive father Zeb. When Annika looks to Zeb for support, he takes Carl’s side. Zeb believes his wife has become paranoid, impatient, and oversensitive. As Carl’s behaviors grow more extreme, Annika is consumed by guilt, fear — and anger. She wonders if she’s going crazy as she spirals into despair and hopelessness.

Carl is eventually diagnosed with reactive attachment disorder (RAD), a result of his early childhood trauma. True to life, even with a diagnosis, there are no easy answers for this family.

By the end of the movie, viewers join in Annika’s horror that Carl may have killed the family dog. It is indeed a jarring movie, particularly for those who have never even heard of the term RAD. Some viewers likely gravitate towards the movie’s tagline that “sometimes evil is born”. This myth, however, is skillfully dispelled through flashbacks to Carl’s abuse and neglect at the hands of his birth mother and her boyfriend. Carl is cast as both a victim and a perpetrator – eliciting both sympathy and anger from the viewer.

Despite being an independent film with a modest budget, The Boarderoffers a surprisingly nuanced peek into the lives of families struggling with RAD including:

    • the painful struggle to attach to a child who actively thwarts love and affection

    • the damage caused when a child is adept at triangulating the adults around them

  • the overwhelming sense of guilt that compounds into hopelessness and despair

This authentic depiction is no doubt the result of extensive research by the screenwriter, Jane Ryan, as well as her own personal experience adopting two children who suffered early childhood trauma.

It is important to note that most children are unlikely to have all the RAD symptoms Carl has – he represents a true worst-case scenario. Also, the family has the financial means for Zeb to move into an apartment with Carl and later to pay for his residential treatment. Many families are not as fortunate. The film is likely to leave parents longing for a supportive parenting group like the one Annika and Zeb join.

To find support is one of the most difficult challenges in raising kids with RAD. “Who hasn’t judged a parent harshly when they see a child spiral out of control?” asks producer Jolene Adams. “We simply do not understand the level of difficulty that these parents are dealing with. These are not spoiled children, they are victims acting out in a never-ending loop of abuse.”

There’s a staggering lack of awareness about RAD in our communities, schools, churches, and families. With this film, Ryan and Adams bring awareness so children with RAD and their caregivers can get the treatment and support they so desperately need.

The Boarder offers new insight and understanding into the inner working of a family coping with a child diagnosed with RAD. The Boarder, also released by Lifetime as Troubled Child, is available for rent on Amazon and can be streamed free by Amazon Prime members. The DVD can be purchased at theboardermovie.com. The film is rated PG-13 and viewers should be aware that it includes profanity and depictions of violence and sexual aggression.

Have you watched The Boarder or shared it with family and friends? Love to hear your thoughts.

Originally published by IACD here

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How parents of kids with RAD get PTSD

“It’s unreasonable to force a parent to bond with a child whose behaviors have led to his or her PTSD,” said Institute for Attachment and Child Development Executive Director Forrest Lien. “The whole family needs healing in order to foster parent-child attachments.”

Published by the Institute for Attachment and Child Development here.