The Secret Next Door (Child on Parent Violence)

Annie watched in horror as Charlie, red-faced with rage, snatched a picture frame off a wall and slammed it against the bedpost. The glass shattered. He picked up a long shard and brandished it like a dagger. Stalking towards Annie, he growled, “I’m gonna kill you.”

This type of abusive behavior in relationships is far too common. 29% of women and 10% of men in the US will experience domestic violence in their lifetimes. Child protective services investigates more than three million reports of abuse and neglect annually. However, Charlie and Annie’s altercation isn’t included in either of these statistics.

That’s because Charlie is a 13-year-old boy. And Annie is his mother.

What the parents living next door may be hiding

Like Annie, I’m the mother of a son who acts out. Both our boys are products of the foster care system, adopted as toddlers, and who are diagnosed with Reactive Attachment Disorder (RAD) and Conduct Disorder (CD), serious behavioral disorders. They have both received medication and thousands of hours of treatment, but nothing has helped.

When Annie and I tell friends, family, and mental health professionals about our sons’ behaviors, we are met with disdain and disbelief. In the same way many sex abuse victims are treated, parents like us are blamed and shamed into silence. We have been forced underground, into private Facebook groups where we find non-judgemental support from thousands of other parents in similar situations.

Four years ago, Lillyth Quillan founded the online parent support group, Parents of Children with Conduct Disorder. She says, “More than 1,000 families have come together to share their stories; to know they are not alone. They are emotionally raw and shredded to the marrow at how they’ve been treated and not believed by close friends and family.”

How many families this affects

The general public assumes these situations, where children are violent towards their parents, are isolated to a handful of sensationalized episodes of Dr. Phil.

This is simply not the case.

While the anecdotal evidence of children with serious disorders abusing their parents is abundant, quantitative data is desperately lacking. This is why I recently surveyed more than 200 parents of children diagnosed with, among other behavioral disorders, RAD and CD. This type of informal survey is an invaluable way to begin to understand the scope of the problem.

According to my survey, Are You In An Abusive Relationship? more than 90% of the respondents are in chronically abusive relationships – and the abuser is their child.

  • 93% say their child threatens them, other family members, or pets with physical violence.
  • 65% say their child grabs, hits, kicks, or otherwise physically assaults them.
  • 71% say their child hides their behavior from others and blames them for their outbursts.

These aren’t merely numbers; each one is a tragic story. Here are just a few of the examples shared anonymously by survey respondents:

“My son purposely hurts the cat to get my attention.”
“My daughter attacked me with a steak knife.”
“My son choked me and broke my wrist.”

Anonymous parents

These findings show that it is alarmingly common for children with serious behavioral disorders to abuse their parents.

When children abuse their parents

Intentional Child to Parent Violence (I-CPV) is deliberate, harmful behavior by a child to cause a parent physical or psychological distress. These are purposeful behaviors intended to gain control over, and instill fear in, parents. I-CPV takes many different forms and varies in severity. It is often chronic and usually directed at the child’s mother figure. [1]

One surveyed mom has a moon-shaped scar on her forehead from her 14-year-old daughter grabbing her by her hair and slamming her face onto the stove. Another mom says her son tried to push her down the stairs and makes homicidal threats towards her.

Parents like these sustain physical injuries and may develop mental health disorders including PTSD. They are isolated from friends and family. Their marriages can become irreparably damaged. They frequently lose jobs and friends. Other children in the home suffer secondary, if not primary trauma.

Without highly specialized treatment, the child perpetrating the abuse will not get better. Far too often, it becomes necessary to have them institutionalized, or end up incarcerated, for the safety of their siblings, parents, and themselves.

Hypervigilance – and fear – are common for parents in these situations. One mom describes how, “Before my son was taken to the hospital, then jail, and then a treatment center, I had to sleep with my door locked and a chair jammed under the knob because he knows how to pick locks.” She suffers with PTSD after years of chronic abuse.

Why children abuse their parents

While there is no one clear “cause” leading to antisocial behaviors like I-CPV, there are a number of underlying factors to consider. Perhaps the most significant is “developmental trauma,” a term coined by leading expert, Dr. Bessel van der Kolk, MD. When a child is chronically neglected or abused at a young age, their brain development may be impacted, causing long-term issues sometimes including physical aggression. This is called Developmental Trauma Disorder (DTD) and is commonly diagnosed as CD or RAD.

While developmental trauma can explain much of RAD, not all children who are violent towards their parents have a trauma background. Some children from nurturing families are diagnosed with CD. Psychologist Stanton E. Samenow, PhD specializes in working with juvenile offenders and says early identification of emerging antisocial behaviors is key. He points to a study that found “aggression at age 8 is the best predictor of aggression at age 19, irrespective of IQ, social class or parents’ aggressiveness.” [2] He believes, regardless of environment and parenting, children become antisocial by choosing the bad behaviors that eventually become an entrenched pattern.

As a parent, I don’t believe these are mutually exclusive views and find both to be informative. My son has a history of developmental trauma. As a result he struggles with impulsivity, attachment, and cause-and-effect thinking. At the same time, his behavior is not involuntary. He is making a choice when he acts aggressively and knows right from wrong.

Why families can’t get help

Even once parents understand the complexity and seriousness of the abuse taking place, there is nowhere to turn for help. Unfortunately, the systems designed to protect victims of other types of abuse don’t have a mandate to protect the victims of I-CPV.

Most domestic violence shelters are for intimate partners, and, for example, offer no help to a mother whose son or daughter beats her. Advice commonly given to victims of domestic violence simply doesn’t work. Take for example the following from the online article, “What to Do if You Are in an Abusive Relationship“:

1. Talk with someone you trust
Parents are rarely believed by friends, family, teachers, and mental health professionals. Instead, they’re blamed for their child’s misbehavior and labeled bad parents. One mom says, “My son can be incredibly sweet and charming when he wants to be. My friends, his teachers – my own mother – don’t believe my 9-year-old son is dangerous because he’s so good at hiding his behavior.”

2. Call the police if you are in immediate danger
Parents receive little assistance from police, especially if their child is under the age of 16. They also hesitate to press charges knowing incarceration is not the “treatment” their child needs. One mother called 911 after her son beat her. The officer said to her son, “It’s okay, Buddy, you’re not in trouble. Let’s talk.” The next time her son beat her, she ended up in urgent care.

3. Make a plan to go to a safe place such as a shelter
Despite their child’s abusive behaviors, parents are still legally and morally responsible for them. Even if parents want to seek safety, their hands are tied. “If I were treated this way by a man,” says one mother, “I would have left long ago. But because this is my daughter, my options are limited.”

Unfortunately there are no good solutions for these parents, and no quick and easy cures for their children. Few therapists and mental health professionals are equipped to offer the highly specialized treatment needed. While there are promising advances in neuroscience, emerging treatments are not accessible for most families. They’re expensive, rarely covered by health insurance, and unavailable in most areas.

Out of all the families she’s worked with, Quillian says only one family has ever received appropriate treatment. “One. One family experiencing what I believe to be the absolute bare minimum of care. One.”

What needs to change

I-CPV isn’t merely talk-show fodder. It’s happening behind closed doors in your neighborhood. It’s happening in Annie’s home. It’s happening in mine.

While the US lags behind, there appears to be growing awareness of I-CPV in the UK where a new domestic abuse bill includes I-CPV. US citizens can support these families by asking their legislators to draft similar legislation which would not only provide legal remedies, but more importantly, facilitate funding for research, prevention and treatment.

We need viable treatment options for our children, as well as resources to combat the violence and destruction we face in our daily lives,. We need help and the support of our communities. That begins with a national dialogue about I-CPV and viable treatment options for serious behavioral disorders.

Parents deserve the same support and understanding that all victims of abuse deserve. Until then, they will suffer physical and psychological harm while their child faces a lifetime of relational, educational, financial, and legal struggles.

Parents in crisis can’t parent therapeutically – so stop expecting us to.

My teenaged son called this evening to explain that he’d cursed his teacher out and thrown his desk across the classroom. He was upset because he’d lost his school issued Chrome book because he’d taken it home (not allowed, and not his first time) and had pornography on it. I listened patiently without judgement. He explained how his elopement from school ended in an entanglement in a pricker bush and contact with a concrete culvert which scratched up his arms and legs. He was covered with bloody scratches and scrapes. I expressed empathy as I sipped my coffee. I offered encouragement when he said he was going to try to earn back the Chromebook and even said I’d talk to the school to ask for a clear plan to work towards that goal. I told him I was proud of this choice to make tomorrow a new day.

Today I was a therapeutic parent superstar and here’s why:

Had this situation happened when my son was still living at home, I would have gone nuts. I would have been throwing out consequences and yelling. My anxiety would have been through the roof. I would have been angry, embarrassed, frustrated, and overwhelmed.

Back when my son was living at home, our family was in crisis. The situation had grown toxic. It took several years of his being in treatment programs, and my being in therapy and educating myself, to begin to find a positive way forward.

Unfortunately, this is not uncommon. Adoptive and foster parents aren’t prepared for the early childhood trauma most kids coming into our families have experienced. We usually reach a crisis point before we learn about therapeutic parenting. By that time, we’ve become desperate and demoralized. Our mental and physical health is so degraded that we are barely surviving. Our kids are out of control. Our life is out of control. We can’t even manage to brush our hair in the morning much less use a calm and kind voice after our child spits in our face.

No doubt, our children need us to be that calm and steady, therapeutic parent, but at that point, we simply don’t have the capacity to do it. And given the our current relationship with our kids, it’s likely we aren’t even the best person to do it. Though few dare tell the shameful truth – we likely have come to a point where we really don’t like our kid. It’s a struggle to be nice to them. It’s difficult to not feel adversarial towards them. If we’re really being honest, some days we’re as out of control as our kids.

Unfortunately, few therapists understand this. They usually underestimate our child’s extreme behaviors and the level of crisis our family is in. They assume we have the ability to parent therapeutically and shame us if we don’t. For our families to heal and thrive, this is something that must be recognized and addressed.

The only clinician I know who is talking about this and teaching other clinicians about this is Forrest Lien of Lifespan Trauma Consulting. (If you are a parent, please follow him on social media to support his efforts on our behalf.)

Families in crisis do not have the capacity to parent therapeutically. This is why we must:

1) Get help to families before they are in crisis (this means pre-adoption training and post-adoption support),

2) Support parents and families in a holistic way. Help us get to a place where we can parent therapeutically.

3) Surround families who are in crisis with supports. Stop shaming us for being broken and demoralized. Give us a hand up.

Parents must be healthy and educated to parent therapeutically.


A note about therapeutic parenting:

There are no perfect treatments for developmental trauma. My son hasn’t been able to access the highly specialized treatment he needs. My response to his phone call today doesn’t solve the problem – I realize that. However, consequences, though perhaps “deserved” won’t work, and will only further escalate my son. What I must do is choose the response that is most likely to move the ball forward. My goal is for him to remain in school and to not get kicked out of the group home. My goal is to de-escalate the situation. I highly recommend A to Z Therapeutic Parenting for practical information on therapeutic parenting.

Video: Early Childhood Trauma – we need treatments now!

Learn more

Aging out of RTF and into the real world: A dangerous proposition

Raising a child with Developmental Trauma

Immigration isn’t the only “system” that’s harmful to children

Why adoption stories aren’t fairy tales

It takes a village

Developmental trauma shouldn’t be a life sentence for any child or family

Scary Mommy

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.

An Introduction to Developmental Trauma

Also published by The Mighty (upcoming)

Nearly half of America’s children are exposed to one or more adverse childhood experiences (ACES). ACES include being neglected or abused, witnessing domestic violence, having a substance addicted or incarcerated family member, and being forcibly separated from a primary caregiver.

Children with a single ACE often have positive long-term outcomes. However, as ACES begin piling up, they can have very serious long-term impacts. This is most common among kids who have spent time in foster care and in high-risk families.

Chronic ACES that occur before a child reaches the age of five can cause “developmental trauma,” a term coined by leading expert and researcher Bessel van der Kolk.

Trauma and Brain Development

Developmental Psychopathy, the study of how trauma impacts the development of the mind and brain, is an emerging field. What we do know is the impact of trauma depends on what stage of brain development the child is in when they experience the trauma.

For example, if a child experiences chronic trauma at six months this is the peak of primitive brain development. Limbic brain development is underway and the cortical brain is in the beginning stages. Chronic abuse or neglect at this time has the potential to affect the primitive brain functions including coordination and arousal.

In addition, because the brain develops like sequential building blocks, any impairment of the primitive brain may cause the limbic and cortical brain to not develop normally. In this way, trauma can cause a devastating domino effect.

It’s important to understand developmental trauma is a brain injury. It’s caused by chronic trauma endured in the first five years of life when the developing brain is most vulnerable.

Diagnosing the effects of Developmental Trauma

Unfortunately, there’s no single diagnosis in the DSM-5 (the manual used by clinicians to diagnose mental illness) that covers all the symptoms of developmental trauma. For this reason, kids are often given several different, seemingly unrelated diagnoses.

A few of the most common are:

Attention Deficit Disorder (ADHD)
• Post-Traumatic Stress Disorder (PTSD)
• Reactive Attachment Disorder (RAD)
• Sensory Processing Disorder
• Anxiety disorders
• Learning Disabilities
• Developmental Delays
• Oppositional Defiant Disorder (ODD)

Visualize each of these diagnosis as their own umbrella with the associated symptoms beneath. Kids with developmental trauma are often balancing two, three, or more of these umbrellas. It’s not uncommon for a child to be diagnosed with ADHD, PTSD, RAD, and ODD – or any number of other combinations.

Unfortunately, this diagnostic method is a disservice to children who have developmental trauma.

Let’s take ADHD as an example. The ADHD diagnosis is for kids who have persistent symptoms of inattentiveness, hyperactivity, impulsivity that manifest in more than one domain, for example both school and home. ADHD is caused by a, often hereditary, chemical imbalance. Stimulant medications work because they increase certain chemicals in the brain.

Kids with developmental trauma may also be inattentive, hyperactive, and impulsive. However, the symptoms are not caused by a chemical imbalance as they are with ADHD. They are caused by underdeveloped and impaired brain functions or an over-sensitive fight-flight-freeze response. Stimulant medications can exacerbate other symptoms of developmental trauma.

Unfortunately, ADHD is not the only insufficient diagnosis commonly given to kids with developmental trauma. In many cases this can result in a child receiving ineffective treatment. Worse still, these diagnoses may mask the real issue and it will go untreated.

Developmental Trauma Disorder

To better serve children with developmental trauma, Kolk has proposed adding a new diagnosis to the DSM called Developmental Trauma Disorder (DTD). The new diagnostic criteria requires exposure to chronic trauma before the age of 5. This diagnosis would fully encompass the symptoms of developmental trauma bringing them under one umbrella.

The DTD diagnosis would enable clinicians to more accurately diagnose developmental trauma. In addition, comprehensive treatments for DTD could be developed. This an area of neuroscience Dr. Bruce Perry is pioneering with his Neuro Sequential Model of Therapeutics. His approach includes mapping of underdeveloped brain functionality and a process to stimulate healing in the order of natural brain development.

Largely due to political and financial forces, the DTD diagnosis was not included in the latest version of the DSM. Advocates are working to have it included in the next revision which is several years away. In the meantime, parents must know how to successfully navigate the current diagnoses to get their child proper treatment.

Getting your child the best care

Because DTD is not in the DSM, it is not an official diagnosis and not covered by health insurance. Until this changes your child will be given other diagnoses to fully describe his or her symptoms.

Here’s what you can do to ensure the best treatment:

  1. Early intervention is key so seek professional help as soon as you recognize there may be a problem or become aware of your child’s trauma history.
  2. Go ahead and accept the alphabet soup of diagnoses. These are essential to get health insurance coverage for the very expensive treatments and therapies your child may need.
  3. Get a psychological evaluation from a psychiatrist. If you know your child has a history of trauma, don’t settle for an ADHD diagnosis from your pediatrician. Ask for a referral to get a full evaluation.
  4. See a psychiatrist for medication management. For your convenience, most pediatricians will continue refilling prescriptions once the patient is stabilized. However, get started on the right foot with a psychiatrist.
  5. Seek out therapists and other practitioners who have experience working with traumatized children.

As your child’s primary advocate, it’s critical for you to keep the entire team focused on the trauma underlying his or her symptoms. Learn all you can about developmental trauma and keep it at the forefront when you discuss your child’s treatment plan with mental health professionals, educators, therapists, and pediatricians. These steps will ensure your child gets the best treatment available.

What is Reactive Attachment Disorder (RAD)?

Also published on The Mighty (upcoming)

I visualize my son’s mental disorder, Reactive Attachment Disorder (RAD), as a tug-of-war. If I tell him to wear blue socks, he’ll wear white. If I make his favorite sandwich, he’ll toss it in the trash and tell his teacher I didn’t send him with lunch. If I ask him to write his spelling words three times, he won’t even pick up his pencil. And there’s no negotiation. If I compromise and ask him to write them only once, he’ll still refuse.

No matter how inconsequential or mundane the issue is, my son treats everything as though it’s a tug of war, and the stakes couldn’t be higher. For him it’s a life-or-death battle. He must win at all costs – no matter how long it takes, and despite any consequences he’s given or any rewards he’s promised.

Kids with RAD have an indefatigable need to control the people and situations around them because they only feel safe when they prove to themselves they are in control. To understand this, we must go back to the underlying causes of the disorder.

What causes RAD?

RAD is caused by adverse childhood experiences (also called ACES) that occur during the first five years of a child’s life. This is when their rapidly developing brain is most vulnerable.

In my son’s case, he was neglected and abused before we adopted him out of foster care at the age four. Other ACES include witnessing domestic violence, having a substance addicted parent, and losing a primary caregiver.

These experiences can cause “developmental trauma,” a term coined by leading trauma expert and researcher Bessel van der Kolk. Depending on the timing, duration, and severity of the adversity, a child can be affected in two key ways.

  1. Stuck in chronic survival mode. The fight-flight-freeze is not meant to be our “normal.” Its purpose is to kick in to keep us safe from danger. When kids are chronically abused and neglected, their brains are chronically bathed in adrenaline. As a result, they may begin to default to fight-fight-freeze even in minimally threatening situations. These kids can be hypervigilant and seem to overreact.
  2. Interrupted brain development. Our brain develops sequentially beginning with the primitive brain which controls our basic functions including our breathing and heart rate. The limbic brain comes next and regulates behavior, emotions, and attachment. The cortical brain – where critical, abstract, and cause-and-effect thinking live – comes online last. When kids experience chronic trauma, their brain may not develop properly. These kids can be dysregulated and lack high-level thinking skills.

The impact of developmental trauma is on a spectrum with a variety of symptoms and severity. This is closely related to stage of the child’s brain development at the time the trauma occurred. Unfortunately, there is no single diagnosis that covers all the symptoms of developmental trauma. Children are often given multiple diagnoses including Attention Deficit Hyperactive Disorder (ADHD), Post Traumatic Stress Disorder (PTSD), and RAD.

What is RAD?

RAD is a diagnosis given to children who have experienced chronic developmental trauma before the age of five and did not form at healthy attachment to a primary caregiver, usually their mother. They grow up without an inherent sense of being safe and loved. Instead their psyche internalizes the message they must take care of themselves because no one else will.

The world feels alarmingly unsafe and unpredictable – and that’s why they lock into a tug-of-war with their primary caregiver. Remember too, these children may be “stuck” in survival mode. They may literally perceive an innocuous situation as threatening and kick into fight-flight-freeze mode. Their higher-level brain functions like cause-and-effect thinking may be underdeveloped. This is why they cannot be reasoned with or talked down.

How to end the tug of war

As a parent, the constant tug-of-war, is exhausting, frustrating, and discouraging. Our impulse is often to tug our side of the rope even harder – to teach our child who is boss. We dole out consequences and insist on compliance. They need to learn to respect authority and obey, right? It’s parenting 101.

But traditional parenting backfires spectacularly with kids diagnosed with RAD. They dig in their heels and tighten their grip on their side of the rope. It will inevitably exacerbate the situation and strain the relationship with our child.

It may seem counterintuitive, but to help our child drop his side of the rope, we must first drop ours. This is accomplished by employing therapeutic parenting strategies that prioritize relationship building and focus on the communication and the needs behind the behavior.

Let’s look at how therapeutic parenting can transform the tug-of-war with my son.

  1. When I tell him to wear blue socks, he’ll insist on wearing white. It doesn’t really matter what color socks he wears. I decide to let him make these types of choices whenever possible which enables him to enjoy some sense of control.
  2. He’ll toss his lunch in the trash and tell his teacher I didn’t send one. Perhaps he’s lining up a backup food source because he’s unconsciously afraid I’ll stop feeding him one day. By providing consistent nurturing over time, this need – thus this behavior – will diminish.
  3. Instead of writing his spelling words, he’ll stare at his pencil. I can make this a non-issue by leaving it to his teacher to follow up. If necessary, I can pursue a 504 plan or Individual Education Plan (IEP) to ensure the accommodations he needs to be successful.

And with that, I’ve dropped my side of the rope. We are no longer locked in a tug-of-war.

Of course, it’s easier said than done and takes great patience and perseverance. RAD is a very challenging disorder to manage and there are no quick and easy fixes. A good starting point is recognizing the underlying causes and educating yourself on the therapeutic parenting approach.

Understanding the long-term impact of early childhood trauma

Published by IACD here.

When Amias was born, I was totally and immediately infatuated with him. I breast-fed and co-slept. I almost never used a stroller or carrier – he was always in my arms. At his slightest whimper, I was there. When he was a toddler, Amias hated the bright Florida sunshine in his eyes. He would hold up a palm to shield his face as he rode in his car seat. When I hung a shade from the car window with suction cups, Amias knew for sure his mom would always take care of him, even if it meant “moving” the sun for him.

My adopted daughter Kayla didn’t grow up in this type of loving environment.

As a baby and toddler, Kayla would cry and scream to get someone’s attention when she was wet or hungry. Sometimes she was cared for. Sometimes she was ignored. Many times, she fell asleep still wet and hungry – having finally exhausted herself.

Kayla, age 3.

When we adopted Kayla out of foster care at three-years-old, she would scream for hours – literally hours – for seemingly no reason at all, no matter what we did in an attempt to comfort her. It was so severe a neighbor once pounded on our door and threatened to call the police and report us for child abuse. I really couldn’t blame him. I’d never known a child to scream for so long and for no reason.

Of course, though, there was a reason. We just didn’t know it back then.

Due to trauma during her early development, the lens Kayla viewed the world through was warped. It made even loving caregivers seem unsafe. Situations and people all appeared unpredictable. Kayla likely had no conscious awareness of this and she certainly could not verbalize it.

The Impact of Trauma

Leading trauma expert Bessel van der Kolk explains in his book The Body Keeps The Score that, “Trauma results in a fundamental reorganization of the way the mind and brain manage perceptions.” Because a young child’s brain is vulnerable, chronic abuse and neglect during the earliest years changes the way the brain normally develops–the root cause of developmental trauma disorder (DTD).

DTD can have a wide range of negative effects of varying severity. For Kayla it has caused a math learning disability, relational and attachment struggles, attention deficits, poor impulse control and more. These are daunting challenges in themselves but, remember, her view of reality is distorted which further compounds these issues.

To put this in context, consider for a moment how your worldview – optimistic, pessimistic, faith-based, etc. – impacts everything you do. For better or worse, we all filter our experiences though the lens of our worldview.

Amias and Kayla are only three-months apart in age, but their lenses are completely different because of their differing early childhood experiences. Kayla is far more prone than Amias to being anxious in new situations, to thwarting close relationships, and to misreading people and their intentions.

Due to the differences in their early childhood experiences and development, Kayla faces far more obstacles than her brother.

For many children like Kayla, developmental trauma can be a powerful determinative factor that dramatically impacts the quality of their relationships, their education and vocation, and mental and physical health. They have a higher risk for substance abuse, problems in school and incarceration.

Because Kayla was born into a different environment, she is at a disadvantage compared to her brother.

Healing the Impact of Early Trauma

Over time, a healthy attachment with a consistent caregiver like an adoptive parent can help alter the lens through which a child with DTD views the world. Unfortunately, it’s not as simple as changing out a pair of busted up, twisted, kid-sized sunglasses for a pair of top-of-the-line Ray Bans. If only it were as simple. You can think of the lens formed by developmental trauma as melted into a child’s cornea – that’s how deeply imbedded it is into the core of who they are.

“DTD falls on a spectrum. Some kids have more struggles than others. No matter the severity, however, the adults who raise them require extensive support of varying levels,” said the Institute for Attachment and Child Development Executive Director Forrest Lien. “Too often, however, caregivers are blamed and shamed rather than supported. This lack of support often leads to a variety of problems, including divorce and adoption disruption. Effective early intervention is vital for these families.”

For children on the moderate to severe end of the developmental trauma spectrum, highly specialized treatment is required to heal. For kids who are on the milder side of the spectrum, like my daughter Kayla, families can often find success through outpatient treatment, obtaining 504s/IEPs and implementing therapeutic parenting strategies.

Kayla has been with us for over a decade now and we’ve fought for support along the journey. Although her world will always be distorted to some extent by her trauma lens, she’s thriving despite her challenges. My hope is that someday Kayla will be secure enough in our relationship to know I’ll always move the sun and moon for her too.

Raising a Child with Developmental Trauma

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.”

Devon and Kayla

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 will 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:

  1. Behaviors that don’t respond to discipline (particularly therapeutic parenting methods)
  2. Tantrums that last far past the terrible twos and threes
  3. Persistent struggles severe enough to interfere with home life, school, or friendships
  4. 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

Devon with adoptive brother Amias

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.

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!)


2/3 of kids with RAD are first misdiagnosed with ADHD

It’s not ADHD!

Our recent Facebook poll showed that 67% of children first misdiagnosed with RAD (and other developmental trauma diagnoses) were first diagnosed with ADHD.

Survey by @RaisingDevon, March 2019

6 in 10 kids are being misdiagnosed with ADHD instead of RAD or other developmental trauma related disorders. Here’s what it matters:

  • Stimulant medications typically given for ADHD can exacerbate other symptoms the child is experiencing.
  • A misdiagnosis like this can cause significant delays in the child getting the treatment they need.

Keep in mind, kids with developmental trauma may have attention deficits and other symptoms of ADHD: inattentiveness, hyperactivity, impulsivity. However, the ADHD diagnosis doesn’t correctly point to the cause of those symptoms – the trauma. ADHD is a chemical imbalance often successfully addressed with stimulant medications. These same symptoms from developmental trauma are caused by a brain injury and stimulant medications can exacerbate other symptoms of developmental trauma. 

Here’s what parents are saying about how the misdiagnosis of ADHD impacted their child and family.

Our sons ADHD medicine amped him up causing extreme violent rages. He was arrested 3 times and faced felony assault charges from these rages. It wasnt until I was able to get a doctor to listen to me that he started to get better. His ADHD diagnosis and treatment made life hell at times. He is much better now and while we still have struggles, no one ends up arrested in the process.

S.H.

I parented my child so incorrectly..,we lost so many years. Letting go of the guilt was hard, so trust me I understand!

Katie

We went in completely unprepared for RAD [because of the initial ADHD misdiagnosis]. And it delayed getting a [correct] diagnosis and treatment by several years.

Jesi

We lost three precious years chasing the wrong problem.

Emily

Wrong medication for years, delayed us understanding how to cope with him. Still many professionals dont use the RAD diagnoses and always think ADHD when he can sit still and read for hours on end!

Katalina

Too many stimulants which caused aggression and chaos at home and in school. Terrible situation which makes me angry and bitter.

Karen

It’s how they minimized the problem, only mildly medicated him, and turned all the blame on us, because we apparently couldn’t manage basic behavior management. Mind you, this was social services AND a children’s hospital after an 11 day stay. Nor was it the last time. Still happening, only now he’s self-medicating with street drugs…

Sarah

Why kids with developmental trauma get diagnosed with ADHD

  • RAD and ADHD have many overlapping symptoms. With developmental trauma, kids can be hyperactive, have attention deficits, and other ADHD-type symptoms.
  • Most kids are getting this early misdiagnosis from pediatricians who are very familiar the ADHD diagnosis, but not as well versed in RAD or developmental trauma.
  • ADHD is a go-to diagnosis for kids who are struggling with hyperactivity and inattention school. It only requires diagnosis from a pediatrician and there are a number of medications that can be easily prescribed.

The difference between ADHD and RAD

While RAD and ADHD have overlapping symptoms, skilled clinicians can differentiate between the two. In a 2010 study by the University of Glasgow, researchers found these core items that point to a RAD diagnoses vs. ADHD.

Disinhibited items

  • Does s/he preferentially seek comfort from strangers over those s/he is close to?
  • Is s/he overly friendly with strangers?
  • If you are in a new place, does X tend to wander away from you?
  • How cuddly is s/he with people s/he does not know well?
  • Does s/he ask very personal questions of strangers?

Inhibited Items

  • Does s/he often stand or sit as if frozen?
  • Is s/he a jumpy child?
  • Is s/he wary or watchful even in the absence of literal threat?
  • When you have been separated for a while (e.g. after an overnight apart), is it difficult to tell whether s/he will be friendly or unfriendly?)

While not all children with RAD will exhibit all these symptoms, they are not symptoms of ADHD. Asking these diagnostic questions can enable clinicians to differentiate between the two disorders.

Full information on this research study can be found here:

How to get the right diagnosis

It’s critical that a child gets the correct diagnosis so they can receive the treatment and medications they need without delay. Here are some steps you can take to ensure this happens for your child.

  1. Inform your pediatrician (and any other clinicians) about developmental trauma your child may have suffered. Be sure to use the term “developmental trauma” and that you are concerned your child’s brain development may have been impaired.
  2. Ask your pediatrician for a referral to a psychologist for a full psychological evaluation. A referral may be necessary for your health insurance and also enable you to get into see a psychologist sooner. If the pediatrician suggests trying ADHD medications first, remind him/her of your child’s background and respectfully insist on the referral.
  3. Be cautious about accepting prescriptions for stimulants for ADHD. See a psychiatrist for medication recommendations. Once your chid is stable on mediations usually a pediatrician will take over dispersing them for your convenience.

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 disorderadults living outside of the child’s homemay 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.

The making of a murderer?

Our Failed Solutions for Seriously Ill Foster Youths (published by The Chronicle of Social Change)

Justin Taylor Bean, removed from his abusive birth parents as a toddler, spent the next two decades in psychiatric hospitals and more than 40 residential facilities.

Over the years, his physical and verbal aggression increased despite treatment and medication. Then, at the age of 22, Justin strangled to death a fellow group home resident.

During his sentencing last month, District Attorney Laura Thomas argued almost sympathetically that Justin “did not have a chance — it was all over for him at age 2.” She then asked that he be sentenced to a life behind bars, which he was.

“There’s not a miraculous cure,” Thomas said. “The public needs to be protected from him forever.”

Many will be outraged by this story, but few will understand how something like this happens. After all, all the warning signs were there. Doesn’t that mean this could have been prevented?

Sadly, it’s not that simple.

More than a million children each year experience early childhood trauma, most often due to abuse and neglect. “Developmental trauma,” a term coined by leading expert Dr. Bessel van der Kolk, affects a child’s brain development. The impact can be devastating, including severe attachment and behavioral issues. These traumatized children need comprehensive, specialized professional intervention and treatment – treatment that’s expensive and not available in most areas.

Unfortunately, I know all too well just how true this is. My adopted son, Devon, has also attempted to seriously harm fellow residents in group homes – more than once. Like Justin, Devon has a diagnosis of reactive attachment disorder and has a similar treatment history. My son could easily have killed someone, he’s just been small enough that staff can control him.

He’s received medication and thousands of hours of therapy. He’s only become more violent and dangerous. Unable to safely live at home, he’s been in and out of psychiatric residential treatment facilities for years. All I can do is helplessly watch as he careens toward adulthood, an angry and violent young man.

What’s clear from Devon and Justin’s stories is that our mental health system does not yet know how to effectively treat children with the most severe developmental trauma. Residential treatment facilities, often the only available choice, are virtual incubators for violence, and many children leave more dangerous than they went in. And far too many end up institutionalized or incarcerated.

As a society, we take these already broken and vulnerable children, and like a gruesome medieval torture press, crush their hope for a good future. We perpetuate their trauma by piling on with broken systems that exacerbate the very problems they try to address: foster care, family court, health care, mental health services and juvenile justice, to name a few.

Further, our communities don’t understand developmental trauma and underestimate its impact. And so, schools, unwitting parents, therapists and social groups pile on too. Under this pressing weight, what hope is there for these children?

The vast majority of people with mental health disorders do not go on to commit murder. But given our apathetic and broken mental health system, developmental trauma can be its own life sentence for youth in the child welfare system. It negatively affects all areas of life – relational, legal, educational and financial. A few victims, like Justin, go on to commit violent crimes.

How many lives have to be destroyed? Isn’t it time to recognize developmental trauma as the unsolved challenge it is, and prioritize funding research, prevention and treatment? Until we do, too many broken children will continue to grow into broken adults and we will continue to see tragedies like the murder committed by Justin.