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What to do when CPS comes knocking…

An interview with Diane L. Redleaf, a family defense pioneer

Nationally-known leaders have called Diane L. Redleaf the “conscience of the child welfare system,” the driving force behind creating a “better, fairer child welfare system” and “the people’s lawyer.” Diane has played a leading role in hundreds of important cases on behalf of families, with over 60 published court opinions. She has also led legislative efforts that have benefited millions of children and families.  Her litigation and legislative advocacy has created due process remedies for wrongly accused family members and created social service and housing support models for families throughout the United States.

Child protective services (CPS) plays a vital role in keeping kids safe. For this reason, CPS investigators often err on the side of caution to ensure children aren’t exposed to harmful situations. Even when allegations are false, caregivers can face lengthy investigations. This unwarranted disruption and family upheaval is collateral damage, necessary to make sure children who really are abused get the justice and safety they deserve. 

For many parents of children with complex developmental trauma disorder (typically diagnosed as reactive attachment disorder or RAD) these interactions with child protective services are an unfortunate and challenging reality.

To legally advance the false allegations of a child with DTD is an unrecognized, innocent and unintended form of further harm to that child.

Children with RAD may make false allegations in their desperate attempt to control the people and situations around them. The resulting investigations disrupt the family, are tremendously stressful and in rare cases the outcome can be devastating.

Innocent parents and caregivers are often frightened and lack the resources and knowledge to defend themselves and protect the interest of their children. I recently had the opportunity to speak with Diane Redleaf, a leading civil rights lawyer for families in the child welfare system. She has extensive experience defending and advocating for parents who face false allegations of child abuse and neglect. She’s the founder of the Ascend Justice (formerly, Family Defense Center) where she served for many years as the Executive Director/Legal Director. With over 60 published court opinions, she’s played a leading role in hundreds of important cases and policy change efforts on behalf of families. Today she’s an advocate for families through her private legal practice Family Defense Consulting.

In our interview, I asked Diane how falsely accused parents and caregivers can successfully navigate the child protection system. While this cannot substitute for legal advice or address individual circumstances, I’m excited to share her invaluable guidance and tips.       

Keri: Kids like mine, who have RAD, sometimes make false allegations of abuse. As parents we’re afraid CPS investigations will be unfair and that we’ll lose our kids. Does that really happen? Are our fears justified?

Diane: It is a justified fear. You may assume the system will protect your rights and that justice will be done. That’s not always the case. There is a tendency to reinterpret everything as the parent’s fault. It may not happen the first time, but if the child makes allegations over and over, it’s possible they will finally get to an investigator who believes them.

Keri: CPS once knocked on my door at 1 a.m. because my son made a false allegation of abuse. What do you recommend a parent do in this situation?

Diane: Certainly be polite. In general, I never recommend you invite them in if you’re the only person around. You need a third party present. This will help ensure the investigator does not misrepresent what you say to them. You might suggest going into the office to discuss the situation at another time.

Keri: How can we protect ourselves during an investigative interview as parents? Is it a good idea to ask to record the interview?

Diane: In some states it’s perfectly permissible to record the interview, but that can get the investigators’ back up. Definitely have a third party present and keep your own notes. Put everything in writing.

You also need to be prepared for commonly asked questions. You can find a list in the Responding to Investigations manual found on the Family Defense Center website. For example, investigators will ask if you use drugs, have a domestic violence problem or have a history of mental health treatment yourself. If your answers to these questions could be problematic, you need to have thought through your responses because the information you give likely will be used against you. You don’t want to be provocative but you have the right to say, “Thank you very much, but I’m declining to answer any further questions.”

Keri: What if CPS wants to talk to our kids? Can they interview them without permission at school or similar locations?

Diane: It’s such a basic question but there isn’t a clear answer as a matter of law. They shouldn’t be able to speak to a child at school without the parent’s permission, especially if it’s not an emergency. They cannot speak to a child in the home without parental consent unless they have a court order or a dire (life-threatening) emergency. Children also have the right to not talk to investigators but of course they get intimidated easily. This is why it’s important to try to set up the interview in a therapeutic setting, especially if the child has a mental health issue. This will help make sure false statements aren’t repeated unchecked, that the situation doesn’t escalate unnecessarily and that the child doesn’t feel uncomfortable.

Keri: Many parents like myself keep daily documentation of our children’s behaviors. Some parents also use security cameras. Are those good strategies?

Diane: In general, keeping as much documentation as possible in terms of a diary is a very good idea. It’s really important for people to educate and work with their service providers. A lot of times they are your best allies. If there’s a history of false allegations, you need the service providers to document it. Having that documentation readily available will disarm the investigators because they’ll realize they may not have a strong case to go forward with.

Using security cameras depends on personal judgement and may sometimes be helpful. But I worry that cameras can be a double-edged sword—they may not show the full incident for example, or they may be used to show the parent was unreasonable even if all the parent is doing is defending herself. Video footage is more open to interpretation than parents may realize. And at the same time, video can capture the real out-of-control behavior of the child in a way that is otherwise hard to describe in words.

Keri: These investigations can be extremely frustrating and sometimes we get angry about how we’re being treated. Is it safe to vent on social media?

Diane: It’s a bad idea. I understand why parents do it but Facebook creates a written record. You worry that those communications will go straight to the state’s attorney or the judge who is going to interpret the child’s behavior as the result of the parent having a temper. It may not happen very often, but if a prosecutor wanted to access those communications, they absolutely could. And if they wanted to use them against the parent in court they almost certainly could. Remember only communications with your lawyer, and in some cases a therapist, are truly confidential.

Keri: So, what can we do if we feel the investigator or agency is targeting us or treating us unprofessionally?

Diane: You begin by going up the chain of command to register your concerns about how the matter is being treated. Start with the supervisor and go all the way up the line to the director. Unfortunately in some states you won’t get anywhere with that. At some point going to a legislator might be a good idea. If your concerns are legitimate, legislators can intervene and get a bad situation addressed. If there is an ombudsperson or inspector general in the agency then a call to them can be a good idea too.

Keri: When do we need a lawyer?

Diane: If you get the sense there is the possibility of legal action or you need advice on how to answer potentially problematic questions then getting legal counsel is a good idea. There are cases that get closed as unfounded right away. In those cases, getting a lawyer isn’t necessarily a good use of your funds and may make things worse. Unfortunately, you may be viewed as having something to hide if you get a lawyer. The investigators are often not sophisticated enough to understand that you can be innocent and still need or want a lawyer.

Keri: What type of lawyer handles these types of cases?

Diane: One of the reasons I founded the Family Defense Center in 2005 is that so many families truly didn’t know where to go or how to find help. The situation is better now than in 2005 — there is a much more organized family defense bar nationally and there are even well-coordinated networks of family defense attorneys in some states (Colorado, Illinois, Michigan, North Carolina and Washington state are the ones I know the most about). However, in many places, it is still extremely hard to find a knowledgeable and affordable lawyer. Lawyers who aren’t well versed in this area will oftentimes advise families to go along with what child protective services is asking. I don’t necessarily give that advice because I’m trying to protect people. Even unaffordable lawyers may not be knowledgeable so it is especially important to ask questions about the lawyer’s child protection defense experience. Lawyers who have represented families with mental health issues often have the experience needed for these cases so that can be a good place to start.  

 Keri: One of our big fears is that we’ll lose our children during an investigation. In my case, I’ve pre-arranged for my sister to take them. What can parents do proactively to ensure their children won’t go into foster care?

Diane: Exactly what you are suggesting is a good idea. Also, short term guardianships are a legal protection that can be developed as a plan. If it happens that the kids get taken, it’s really important for support people and family to go to court. Judges often see families who show up to court alone with no support or people willing to be a resource for the family. A big group of supporters showing up to court creates a whole different dynamic.

Keri: I understand you have a very limited practice these days and are focusing your efforts on advocacy. Are there other resources you can recommend to families?

Diane: When I was with the Family Defense Center I wrote the manual, “Responding to Investigations” which is posted on their website. It is used by both parents and lawyers who want to understand the questions and concerns that arise during a child protection investigation.

Keri: I’m really excited about your recent book, They Took the Kids Last Night: How the Child Protection System Puts Families at Risk. Tell me more.

Diane: The book is about how the system is not adequately protecting parents in wrongful allegation cases. I cover several cases where there is a medical misdiagnosis of abuse, usually with very young children who cannot say what happened. I focused on these types of cases in particular because they make it easy for the average person to understand how things could go wrong and the dynamics of these situations. I use these cases as a vehicle to talk about the challenges families face in proceedings where the presumption of innocence is not honored in practice. I discuss in detail what family defense is all about and make recommendations for some fundamental changes in the system to protect children by protecting their families. (Find more information about Diane’s book and request a discount code on her website here.)

The information in this article is intended to provide general guidance for “wrongly accused” parents who are involved in child protective investigations. It does not constitute specific legal advice.

Interview first published by IACD here.

What to do when CPS knocks on the doorDownload

Before you adopt…

Two-year-old Kayla was shy with dimples that winked when she laughed. Her brother, three-year-old Devon, had curly brown hair, freckles and a quick smile. We’d long dreamed of adopting foster kids and my husband and I jumped in heart-first.

During the mandatory three-month pre-adoption waiting period, Devon and Kayla had some concerning behaviors – issues with food, problems potty training and impulse control – but foster parenting training had prepared me. I knew these were completely normal issues, nothing that couldn’t be healed with the love of a forever family.

What I didn’t know was that Devon and Kayla had experienced early childhood trauma. I discovered that they had learning disabilities, cognitive issues, attachment struggles and behavioral problems over the years. I was woefully unprepared to parent these two beautiful, hurting children.

I did the best I could raising Devon and Kayla but I have regrets in retrospect. Knowing what I do today, I would still have jumped into the adoption heart-first, but I wish I’d also had more information, been better prepared and gone in with the right mindset.

The impacts of early childhood trauma

In the United States there are over 100,000 children waiting to be adopted out of foster care (1). There are thousands more living in orphanages around the globe. Unfortunately, many of these children have histories of neglect, physical abuse, sexual abuse, emotional abuse, abandonment and more. When these experiences occur during critical time periods of development, the child’s brain development can be disrupted.

The impact of early trauma is broad and varies in severity. Renowned psychiatrist Dr. Bessel van der Kolk coined the term development trauma disorder (DTD) to describe its effects on some children. Children with DTD typically struggle to form meaningful and authentic relationships, regulate their emotions and control their impulses and aggression. Many of them have sleep issues, poor executive functioning, learning disabilities and low self-esteem. While certainly not all adopted and foster children suffer from DTD, many do.

There are no quick and easy fixes for the effects of early trauma, unfortunately. A healthy, positive attachment to a stable and consistent caregiver, however, is key to positive outcomes for these kids. Adoption is an important piece of the puzzle for many children to heal from early childhood trauma.

Here are some important ways families can prepare for adoption:

1. Learn everything you can about the impacts of early childhood trauma. Despite what people sometimes assume or want to believe, children do not simply outgrow serious impacts of trauma. “Good parenting” also does not heal the disorder. You need to educate yourself beforehand to know what to look for and who to call upon if you need assistance. A few recommended resources to get started include The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk, M.D. and the Institute for Attachment and Child Development blog.

2. Be realistic in your expectations. Traumatized children need stable love to heal but love alone cannot repair the damage of early childhood trauma and mental disorders. Many children with DTD will need life-long care and intensive mental health and educational services.

3. Consider your ability to manage difficult behaviors and challenging special needs. Every family has differing levels of resilience and abilities to take on challenges. Be realistic when considering your bandwidth. Children with DTD can actively thwart your affection and have serious behavioral problems. It’s possible your adopted child may need a stay-at-home parent. Is this something you are financially able to manage? Also consider the time requirements for tutoring, counseling, occupational therapy, and medical and psychiatric appointments.

4. Think carefully about other children in your home. Having a sibling with special needs can be both a positive and negative experience. It will undoubtedly result in your resources being stretched and shared. If your child has a history of aggression or violence, it’s best if they are the youngest child in the family. It’s almost always beneficial for children to have their own bedrooms. Siblings will need access to respite activities – camps, time away with grandparents and friends and one-on-one time with you.

5. Work closely with your adoption agency. Request a copy of all available records for the child and read them thoroughly. Insist on a full psychiatric evaluation by a mental health clinician so you can understand the challenges your child faces. If you’re adopting out of foster care, ask that your child remain qualified for Medicaid regardless of your income. Negotiate a subsidy and understand the appeal process should your financial obligations change.

6. Build a strong support system now. Lack of support is one of the greatest issues adoptive families face. Don’t assume family and friends understand the challenges of adoption and early childhood trauma. Even adoptive parents typically don’t understand the realities of raising a child with DTD until they have the experience. Provide friends, family, neighbors and educators with resources and ask them to partner with you before the child enters your home, if possible. Consider who you will be able to call on to pick up a child from school, help with dinner in a pinch and to listen without judgement when you just need a supportive ear. Reach out and join local and online support groups.

Children who have experienced early childhood trauma desperately need to be welcomed into families as part of their healing process. Unfortunately, too many adoptive families go in with unrealistic expectations and are unprepared for the challenges they will face. If you decide to adopt, be sure to consider the trauma history of the child and prepare yourself and your family for the challenges ahead.

Before you adoptDownload

1 – https://www.adoptuskids.org/meet-the-children/children-in-foster-care/about-the-children

Originally published by IACD

For teachers of children experiencing the effects of early trauma

If you are a classroom teacher you almost certainly have students who have experienced childhood trauma. A recent national survey on children’s health found that 47% of all children in the United States have had at least one adverse childhood experience (footnote below). For some, the unfortunate result is reactive attachment disorder (RAD), a serious disorder caused by trauma during a child’s early development.

What is Reactive Attachment Disorder?

Though reactive attachment disorder (RAD) is rare in the general population, it is more common in adopted and foster children. When a young child is neglected or abused they may fail to form a meaningful attachment to a primary caregiver. Their brain development is stymied and the flight or fight neural pathways are strengthened. As a result, even minor stressors can send them into flight-or-fight mode.

“Adults must work as a team for kids who’ve experienced early trauma. These kiddos desperately manage their surroundings to feel safe,” said Institute for Attachment and Child Development Executive Director Forrest Lien. “Though when they divide adults working to help them, as they often do, they actually feel less safe. It confirms their belief that they cannot depend on adults to care for them.”

Children with RAD often lack cause-and-effect thinking, have control and anger issues, are unable to attach to caregivers, are emotionally and physically immature and sometimes have an underdeveloped conscience. Due to their innate survival needs, they are desperate to control the people and situations around them, are resistant to treatment and tend to self-sabotage, making the disorder particularly difficult to treat.

In the school setting, children with RAD struggle to maintain friendships, are often bullied, and may become bullies themselves. Due to their disruptive and dysregulated behavior they are commonly labeled “problem kids” and struggle academically. Unfortunately, these children can find it difficult to succeed in school and too often end up involved in the juvenile justice system.

What you might see in the classroom

Students with RAD, often in survival mode, are focused on controlling their classrooms and teachers rather than learning. They may have “meltdowns” or angry outbursts, but are equally adept gaining control in more subtle ways. For example, the student may constantly interrupt their teacher. They may complete their work but choose not to turn it in, wander around the classroom when they should be seated or ask for excessive bathroom breaks.

Other ways RAD may manifest in the classroom include:

  • Developmental delays and learning disabilities – Depending on when the child experienced early childhood trauma, various areas of the brain are likely underdeveloped. Often these are lower level brain functions, and like a domino effect, higher brain functions do not develop normally either.
  • Superficial charm – Many children with RAD are polite, helpful, considerate and loving in the classroom – while wreaking havoc in their homes. This dichotomy can be so pronounced that teachers doubt parents’ reports of the student’s behavior or wonder why teachers from earlier grades thought the student was so difficult. Generally this good behavior lasts only for a short time and it often termed the “honeymoon period” by specialists of early trauma.
  • Lack of forethought and insight – In response to innate insecurity, these students use maladaptive coping strategies to gain an immediate sense of comfort without regard for the consequences. These behaviors can include stealing, violent outbursts, physical aggression and an overall lack of boundaries.
  • Manipulation and lying – These students may lie to get out of trouble, to get their own way or for no reason at all. Outwitting an adult is a way for them to gain control and feel safe. In addition, they may use manipulation and lying to triangulate adults.

Strategies that don’t work and why

Traditional classroom management techniques and strategies are ineffective and often counterproductive when working with students with RAD. This can be frustrating but understandable given that these children are stuck in survival mode and frequently default to fight-or-flight behaviors.

Here are a few strategies that don’t work:

  • Behavior modification isn’t effective because these students often lack cause and effect thinking and are not sufficiently motivated by rewards. Furthermore, these tactics convey to the student what is important to the teacher. The student can use that information to thwart the teacher and gain control of the classroom.
  • Punishments act to reinforce the student’s innate sense of worthlessness. The teacher and student will find themselves locked in an ineffective cycle of misbehavior and punishment when the teacher is punitive.
  • Multiple warnings are perceived by the student as weakness and an opportunity to continue misbehavior. These nearly always backfire.
  • Reprimanding often provokes an extreme reaction, especially when done publicly because it plays into the student’s already low self-esteem and can trigger their internalized self-loathing and anger.
  • Zero tolerance policies leave teachers with little latitude when the student refuses to comply. Teachers may find themselves shocked by the obstinacy of the student who continues to up the ante.
  • Focusing on “why” is counterproductive because these students typically lack analytical and abstract thinking skills. Asking why or explaining why is likely to be frustrating for both teacher and student.
  • Responding emotionally to a student’s behavior is unhealthy for the teacher and places the student squarely in the driver’s seat. When a teacher takes a student’s behavior personally and becomes provoked to anger, the student is in control.

Strategies that do work and why

Work as a Team

Children with RAD are adept at triangulating the adults around them in order to maintain control and thus feel safe. The student often works diligently to ensure a team approach does not ensue. They often lead teachers into believing they are being mistreated at home, while manipulating parents into believing the teacher is being unfair to them. Some children may deem the teacher his or her “preferred adult”, also leading to triangulation.

If you remember only one strategy as a teacher, remember to work alongside other adults in the best interest of the child. “Adults must work as a team for kids who’ve experienced early trauma. These kiddos desperately manage their surroundings to feel safe,” said Institute for Attachment and Child Development Executive Director Forrest Lien. “Though when they divide adults working to help them, as they often do, they actually feel less safe. It confirms their belief that they cannot depend on adults to care for them.”

Tips:

  • Engage with the parents who have a deep understanding of the child’s behavior and strategies that work. Do not rely on take home folders or sending communication notes home with the student. They likely will not make it. Instead, use direct communication like emails and phone calls.
  • Transparency is critical. Always confirm any concerning stories the child may tell you. For example, children with RAD may tell their teachers they weren’t given breakfast or that they are otherwise mistreated at home. This is meant to elicit sympathy and to have the instant gratification of having “tricked” an adult. Always let the student know that you’ll be confirming their report with their parents before proceeding.
  • Work with your school administration to develop a crisis plan. If a child’s behavior becomes unsafe, you must have a way to quickly remove other students from the situation and to keep the student who is in crisis safe. The best approach is to have a carefully detailed plan ahead of time.
  • Use 504 and IEP meetings to advocate for accommodations and modifications that will assist the student. Parents often know their child needs additional services, but do not know specifically what is needed. As an educator you have insight that can be immeasurably helpful to both students and parents.

Rely heavily upon schedules and routines

Children benefit from schedules and routines. For a child with RAD, this will begin to build a foundation of safety so they can focus on learning. Clearly identify the schedule, routines and rules with the student. During the first few days of school, do not get sidetracked by the student’s initial superficially charming behaviors as this is almost certainly the honeymoon phase. Just as you do with all students, implement a routine from day one. Know that the students with RAD often aim to bend the rules and get exceptions. However, making an exception will not build goodwill. Instead, the student will perceive it as weakness and you will spend the rest of the year trying to regain control of the classroom.

“Well-meaning adults often attempt to ‘save’ kids with RAD without realizing that they’re doing more harm,” said Executive Director of Institute for Attachment and Child Development Forrest Lien. “The best thing adults outside the home can do is to focus on their specific roles in the child’s life. Educators should focus solely on educating the child. It is the most caring thing a teacher can do for students with RAD.”

Provide frequent choices and follow through every time

As behavior modification is not effective for students with RAD, provide choices instead. Do so consistently and follow-through. For children who feel the world is innately unsafe and unpredictable, stability is key.

Tips:

  • Give choices that allow you to maintain control as the teacher, while empowering the student. For example, ask if they’d like to do their silent reading at their desk or on a pillow in the reading corner. By approaching the student this way, you can often distract them from willful disruption and obstinacy.
  • Be discrete when discussing matters with the student. Feeling backed into a corner, publicly shamed or teased is likely to trigger a negative, possibly violent reaction.
  • Rely upon natural consequences which are best for all students including those with RAD. Always use a neutral or empathetic tone and keep it as simple as possible.
  • Don’t take away recess or lunch time as consequences because these students need the physical outlet and the break away from the classroom.

Focus on teaching vs. attachment

Children with RAD struggle to form meaningful attachments with their caregivers. While it can be difficult to understand, attempting to build an attachment with the student thwarts the attachment they are working to form with their parents. Attachment work is best left to parents working alongside therapists. “Well-meaning adults often attempt to ‘save’ kids with RAD without realizing that they’re doing more harm,” said Executive Director of Institute for Attachment and Child Development Forrest Lien. “The best thing adults outside the home can do is to focus on their specific roles in the child’s life. Educators should focus solely on educating the child. It is the most caring thing a teacher can do for students with RAD.”

Tips:

  • Your relationship with the child must be consistent and neutral. Encourage students to focus on learning while at school. It may be best to think of it as a “business-like” relationship.
  • Do not allow the student to be inappropriately affectionate with you by engaging in behavior like hugs, hand-holding and secret sharing. You can affirm their parent’s role, and promote attachment healing, by consistently directing students back to their parents for advice, decisions and affection.

Recognize and act when kids go into survival mode

Unfortunately, some children with RAD have violent outbursts and engage in self-harming behaviors. It is essential that you focus on the safety of the student and the other students at these times. Acting early, before the situation escalates, is key.

  • Identify triggers such as being hungry, frustrated during math, bored during silent reading or teased by other kids to mitigate those triggers. At the very least you can be on high alert to watch for escalation signs and react quickly.
  • Recognize non-verbal clues including grimaces, stamping feet, fisting hands, or making growling noises. Recognizing these precursors is key to reacting early before a situation escalates out of control or becomes dangerous.
  • Call in help as soon as you notice the non-verbal clues that a student is escalating. Enact the student’s crisis plan, calling on administration and other appropriate support staff for help.
  • Focus on safety by moving other students out of the area per the crisis plan. Do this as quickly and efficiently as possible. When other students are away and safe, you will be able to focus on keeping the student who is in crisis safe as well.

Side step power struggles

Children with RAD tend to try to make everything into a life-or-death tug of war. This is because even minor stressors or conflicts can seem catastrophic to them. You need to drop your side of the rope.

  • Show empathy by focusing on the underlying causes of the student’s disruptive behavior and dysregulation. The behaviors can be extremely frustrating, overwhelming and hurtful. It’s normal to feel emotional, but when you lose your cool, the student is in control. Be prepared to remove yourself from the situation if you cannot cope.
  • Don’t engage in endless arguments as this is usually counterproductive. The student is likely to capitalize on any discussion as a way to thwart the rules. They also may use it as an excuse to disrupt the class and escalate the situation.

RAD is a lifelong condition that takes years of intensive therapy to successfully address. These strategies aren’t going to resolve all your student’s challenges in the classroom. However, you can set small, reasonable goals that will enable them to make progress and experience successes.

These strategies can make their behavior more manageable and create the best possible learning environment for all your students.

DTD and RAD Guide for TeachersDownload

Originally Published by IACD.

Footnote:  Sacks, Vanessa, et al. “Adverse Childhood Experiences: National and State-Level Prevalence.” Child Trends, Research Briefs, July 2014, www.childtrends.org/wp-content/uploads/2014/07/Brief-adverse-childhood-experiences_FINAL.pdf

Out Of Options, Parents Of Children With Mental Illness Trade Custody For Treatment

Illinois Newsroom–Jul 31, 2018

When Toni and Jim Hoy adopted their son Daniel as a toddler, they did not plan to give him back to the state of Illinois 10 years later.

“Danny was this cute, lovable little blonde-haired, blue-eyed baby,” Jim said. There were times Daniel would reach over, put his hands on Toni’s face and squish her cheeks.

“And he would go, ‘You pretty mom,’” Toni said. “Oh my gosh, he just melted my heart when he would say these very loving, endearing things to me.”

But as Daniel grew older, he began to show signs of serious mental illness that manifested in violent outbursts. When his parents exhausted all other options, they decided to relinquish custody to the state to get Daniel the treatment he needed.

Listen here as the Hoys tell about how they gave up custody of their son to get him needed mental healthcare.

“To this day it’s the most gut-wrenching thing I’ve ever had to do in my life,” Jim said. “But it was the only way we figured we could keep the family safe.”

[bctt tweet=”To this day it’s the most gut-wrenching thing I’ve ever had to do in my life. But it was the only way we figured we could keep the family safe.” username=”RaisingDevon”]

Across the U.S., children encounter many barriers to mental health treatment, including a shortage of psychiatric beds and coverage denials from insurance companies. In a desperate attempt to get their child treatment, some parents have discovered a last resort workaround: they trade custody for treatment.

Known as a psychiatric lockout, a parent brings a child to a hospital and refuses to pick them up. The child then enters foster care, and the state is obligated to pay for their care.

This happened to Daniel in 2008, and has happened to thousands of other children before him, according to a report from the Government Accountability Office.

Today, despite a 2015 Illinois law that states families should never have to trade custody for mental health treatment, at least four children a month enter state custody this way, according to data obtained by Side Effects.

Out of options

Daniel grew up as the youngest of four children in Ingleside, just north of Chicago. As a baby, he’d been severely neglected — starving and left for dead — and the early trauma Daniel experienced affected his brain development.

At around age 10, his post-traumatic stress disorder manifested in violent outbursts.

“You could almost tell the stories that would describe him like a monster,” Toni said.

“He held knives to people’s throats. He tried putting his fingers and his tongue in the light sockets. He broke almost every door in the house.”

In the car, there were times when he’d reach over and grab the wheel while Toni was driving to try and force the car into oncoming traffic. Other times, he would lash out at his siblings.

“At the same time, he’s a little boy,” she said. “He didn’t want to be that way. He didn’t like being that way.”

Despite Toni and Jim’s efforts to help their son with therapy, the violence escalated. Daniel was hospitalized almost a dozen times over a period of two years.

His doctors said he needed more intensive mental health services than he could get while living at home. He needed 24/7 residential treatment, but both Daniel’s private health insurance, and the secondary Medicaid coverage he received as an adoptee, denied coverage.

So the Hoys applied for a state grant meant for children with severe emotional disorders. They also asked for help from Daniel’s school district, which is supposed to cover a portion of the costs when students need residential care. They were denied both.

“We were told we had to pay out of pocket for it,” Toni said. The treatment could cost up to $150,000 a year, and that was money they didn’t have.

Then, during Daniel’s 11th hospitalization, the Illinois Department of Children and Family Services, or DCFS, gave the Hoys an ultimatum.

“[They] basically said, ‘If you bring him home, we’re going to charge you with child endangerment for failure to protect your other kids,’” Toni said. “‘And if you leave him at the hospital, we’ll charge you with neglect.’”

Out of options, the Hoys chose the latter option as a last-ditch workaround to get treatment.

Once the DCFS steps in to take custody, the agency will place the child in residential treatment and pay for it, said attorney Robert Farley, Jr., who is based in Naperville.

“So you get residential services, but then you’ve given up custody of your child,” he said. “Which is, you know, barbaric. You have to give up your child to get something necessary.”

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Get Toni’s book here.

Taking it to the courts

The Hoys were investigated by DCFS and charged with neglect. They appealed in court and the charge was later amended to a “no-fault dependency,” meaning the child entered state custody at no fault of the parents.

Losing custody meant Toni and Jim could visit Daniel and maintain contact with him, but they could not make decisions regarding his care.

Toni spent months reading up on federal Medicaid law and she learned the state-federal health insurance program is supposed to cover all medically necessary treatments for eligible children.

The Hoys hired a lawyer, and two years after giving Daniel up, they sued the state.

Less than a year later, in 2011, they settled out of court, regained custody of Daniel, who was 15, and got the funding for his care.

Around the same time, Farley decided to take on the lack of access to mental health care on behalf of all Medicaid-eligible children in the state. He filed a class-action lawsuit, claiming Illinois illegally withheld services from children with severe mental health disorders.

“There [are] great federal laws,” Farley said. “But someone’s not out there enforcing them.”

In the lawsuit, Farley cited the state’s own data that shows 18,000 children in Illinois have a severe emotional or behavioral disorder, yet only about 200 of them receive intensive mental health treatment.

In a settlement in January, a judge ruled the state must make reforms to comply with Medicaid law. The state has until October to come up with a plan to ensure all Medicaid-eligible children in the state have access to in-home and community-based mental health services.

A law that didn’t fix the problem

While these legal battles were taking place, lawmakers began their own work to ensure parents no longer have to give up custody to get their children access to mental health services.

In Illinois, six state agencies interact with at-risk children in some form. But Democratic state Rep. Sara Feigenholtz said they operate in silos, which causes many children to slip through the cracks and end up in state custody.

“It’s almost like these there’s a vacuum, and the kids are just being sucked into DCFS,” she said.

Feigenholtz worked to get a bill passed in 2014. The Custody Relinquishment Prevention Act, which became law in 2015, orders those six agencies to work together to help families that are considering a lockout to find care for their child and keep them out of state custody.

So the agencies developed a program together that launched in 2017 — years after the deadline set by the law. It aims to connect children to services.

But Feigenholtz said the fact lockouts still happen shows a lack of commitment on behalf of the agencies.

“I think the question is: Shouldn’t government be stepping in and doing their job? And they’re not,” she said. “We just want them to do their job.”

B.J. Walker, head of DCFS, said the reasons lockouts happen are complex. “If law could fix problems, we’d have a different world,” she said.

Walker said many children in need of residential treatment for mental illness have such severe or unique conditions that it can be a struggle to find a facility that’s willing and able to take them.

Even for families that get state funding to pay for the care, families Side Effects Public Media spoke to said the waiting lists can run six months or longer. When parents are unable to arrange a placement, the child may enter state custody, and as ProPublica Illinois reports, they could languish for months in emergency rooms that are ill-equipped to provide long-term care. Some out-of-state facilities are not willing to accept Illinois children, citing concerns over severe delays in payments that stem from a recent two-year budget crisis in Illinois.

The program to prevent lockouts requires families take children home from the hospital after medical providers have done everything they can. But many parents say it’s not an option for them because their child remains too violent for home.

For these reasons, children continue to enter state custody as a final effort by their families to help them.

A spokesman for DCFS said in an email that, when the agency gets blamed for this problem, it’s like when a pitcher comes in at the end of a losing game to save the day and gets tagged with the loss.

What it will take to prevent lockouts

Lockouts can happen anywhere, but Heather O’Donnell, a lawyer with a Chicago-based mental health treatment provider, Thresholds, said the situation is particularly bad in Illinois.

She said a big part of the problem is that society sweeps mental health conditions under the rug until there’s a crisis.

“We don’t have a very good system in Illinois for children or adolescent or young adults with significant mental health conditions,” O’Donnell said. “What Illinois needs to put into place is a system that helps these families early on so that these kids never get hospitalized.”

That’s what the state is trying to fix now.

The consent decree issued as part of the class-action lawsuit settlement requires the state to propose a plan by October to ensure all Medicaid-eligible children in the state have access to mental health services in their communities, with changes slated to begin in 2019. Farley estimates the changes will cost the state several hundred thousand dollars, based on what it cost other states like Massachusetts to implement similar reforms.

The difference treatment and family can make

Daniel Hoy is now 23 and has been out of residential treatment — and stable — for five years. He has a 2-year-old daughter, works nights for a shipping company in Rantoul, in central Illinois, where he recently moved to be closer to his parents.

Daniel said treatment was tough, and he would not have gotten better without his parents’ love and support.

“Sometimes it’s so hard to do it for yourself,” he said. “It almost helps to know that I’m doing it for myself, but I’m also doing it for my family and for our relationship.”

Toni’s thankful that despite losing Daniel while trying to help him, they ultimately made it through intact. She’s in touch with other families that have gone through lockouts too and most, she said, are not as lucky.

That’s why Toni said she will continue to speak out about this issue. “Kids do need services,” she said. “But they also need the support of their families. And when they have both, a lot of kids can be a lot more successful.”

Get Toni’s book Second Time Foster Child: How One Family Adopted a Fight Against the State for their Son’s Mental Healthcare while Preserving their Family

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

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What Social Workers Need to Know When Working with Adoptive Families

By brave adoptive parent and advocate Pernell Meier

Social workers have been an ever-present part of my family. Over the course of 13 years, we have parented 7 children from foster care, 5 of whom we adopted. In that time, we have had countless social workers in and out of our lives. Some have been rock-stars and stepped-up for our family and kids, advocated and pulled strings. Others have been toxic and blatantly destructive to our well-being. And the vast majority have fallen somewhere in the middle – neither appreciably helpful, nor actively working against us. Though these workers were generally decent people with their hearts in the right place, I’ve been struck by how much even caring and well-meaning social workers can be unintentionally damaging…

This amazing post goes on to provide concrete ways social workers can support adoptive families:

#1 – We desperately need your help.  
Life with an emotionally disordered child, particularly one with attachment disorder, is profoundly hard…

#2 – We need to be believed.
Most of us present one way to the world and another way to those closest to us. They can turn on the charm and show their absolutely impressive best sides to you, while five minutes later becoming unimaginably cruel to us. I know that this is hard to believe…

#3 – You might be one of the only persons who we can talk to.
Most adoptive parents of high-needs kids have the same experience – friends and family fall away. The challenges are just too hard for people to process, so avoiding it is much easier. And venting to people can bring forth the inevitable, “You did this to yourself!” comments

#4 – We expect that you will be educated on these issues.
Over the years, we have found such an unimaginable lack of basic education on matters related to trauma, prenatal exposure and attachment that the process of trying to educate and explain becomes draining. We are turning to you as an expert…

#5 –  When we tell the truth about our lives and our children, this does not mean that we do not love them or lack commitment.
Telling social workers about what is really going on at home backfires and gets used as ammunition against us to further cement the workers’ original views of the family. This atmosphere creates self-censorship as the adoptive parents come to view most social workers as either not helpful or detrimental.

#6 – We don’t speak social work.
You have your own specific acronyms, and ways of speaking and understanding things, just as all professions do. But when you are talking to us, please consider that we are not always going to know what you mean…

#7 – No, we are not triggering them.  
Ok, let’s be real. Sometimes we do, just as any parent will occasionally handle a situation poorly.  But, these children do not turn into raging, mean, or out-of-control persons because we are in general doing something to them that makes them that way…

#8 – Yes, we have skills.  
We have read more than you could possibly know, called and talked with anyone we could, watched videos, taken trainings, and turned our values and our way of thinking inside out to try to make things better…

#9 – Your meetings can be painful and often feel like a waste of time.
Please know that we are likely dealing with quite a few different social workers, support persons, doctors, therapists, school officials, etc. and we have a lot of meetings that we need to attend…

#10 – You are not our child’s friend.
When you approach interactions with our children from the perspective that the most important thing is having a positive relationship between the two of you, you inadvertently damage our parental relationship because you put on those empathy blinders that do not allow you to even see, let alone confront deceit, poor behavior, manipulation and destructive dynamics…

#11 – You continually undermine us.
You set meetings with them without even bothering to tell us, thus keeping us out of the loop and making us play catch-up. You buy them things that we have said “no” to. When they have been behaving terribly and break the rules, you take them out for ice cream or fancy coffee…

#12 – You have enormous power over our lives and that is frustrating and scary.  
As the gatekeeper, you are the one who gets to decide if we “need” something or we do not. When you deny us what we’re asking, please understand that this is “just business” to you and to us it feels like a hot knife slicing through us…

#13 – You get to go home.
We don’t. This is our home. This is our life. At the end of your long, stressful work days trying to make the world a better place, you get to go home to a quiet house or to your attached children, where your pets and other vulnerable children are not being abused, put your purse or wallet and car keys down without thinking to lock them away, and shrug off the day’s worries. For us, our homes often feel like prisons…

#14 – You cannot imagine our grief and our guilt.
Often co-mingled with our grief is our intense guilt. Raising a child with special needs seems to inevitably bring this on as we often second-guess and agonize over so many of the decisions related to our children’s care. Often our lives are so impossible that absolutely nothing feels like the right thing…

#15 – We need you to be honest and acknowledge your mistakes.
We need to trust you because the repercussions of you either baldly lying, withholding essential information, or manipulating us to obfuscate the truth can be devastating. In this power imbalance, you hold the cards. We have little recourse when you do things that create harm…

#16 – You hurt the kids.
Social workers will come and go, but we will always be there. You are not their parent, we are, and the best thing you can do to help them is to help us with the excruciatingly hard task of standing by them…

Please be sure to read the full article here.

Parenting a challenging child? Here’s how to increase your resilience

Do you ever roll out of bed already over it? At your limit before the day starts? Knowing you can’t take even one more surly look, one more rude comment, one more call from school, one more violent outburst? I’ve been there too.

As parents of children with reactive attachment disorder (RAD), life can be so stressful it feels impossible to face another day. When we near our tipping point, our instinct is to imagine that finding a way to “fix” our child will immediately relieve the stress we are experiencing. In reality, as necessary as it is, getting help for our child often adds more stress to our lives because it comes with therapy appointments, challenging therapeutic parenting approaches, and disputes with insurance companies. Effective treatment for kids with RAD is a daunting, long-term proposition.

Raising, finding help for, and advocating for a child with RAD is difficult. It’s stressful. Parents get PTSD, become depressed, and struggle with other mental health issues. They lose friends and family, and turn into someone they feel they don’t even know. This is why we need to find ways to increase our resilience by effectively addressing the stress in our lives.

Al Coates MBE, adoptive parent and advocate, is flipping the paradigm by focusing on practical ways we as parents can increase our resilience – our ability to take whatever’s thrown our way, figuratively or literally. With his background in social work, Al has tweaked the Stress – Vulnerability Model (1) specifically for parents who are raising challenging kids.

To understand the Stress – Vulnerability Model let’s start by imagining a bucket. Inside the bucket are your stressors – each one like a cup of water that’s filling your bucket up. For now we’ll set aside the stress specifically related to parenting a child of RAD. Instead, let’s focus on the stressors that are with you before you even start your day.

    • Money – are you scraping by and just making ends meet, worried about retirement, or struggling to pay the mortgage?

    • Career – are you in a job that’s unfulfilling, or perhaps under a great deal of stress with deadlines and frustrated customers?

    • Relationships – is your relationship with your spouse strained or do you have a toxic friend or family member in your life?

    • Other children – do you have a special needs child who requires extra help, or a high school football player that needs to get to practice on time five days a week?

    • Everyday nuisances – how about that neighbor’s dog that barks like crazy, or an air-conditioner that’s on the fritz too often leaving you hot and sweaty?

    • Social history – do you have a personal history of neglect or abuse, something that can be easily triggered?

    • Medical – are you the kind of person he needs eight hours sleep or someone who has debilitating migraines?

If we think of each of these stressors as a cup of water, it’s easy to see how we can wake up with our bucket almost full. If your bucket is already filled to a quarter of an inch from the top, you simply don’t have room for a temper tantrum, a broken window, or a screaming child. That’s how we reach our tipping point. What sloshes out – over the side of our bucket – is anger, frustration, tears, and more.

[bctt tweet=”If your bucket is already filled to a quarter of an inch from the top, you simply don’t have room for a temper tantrum, a broken window, or a screaming child.” username=”RaisingDevon”]

Now imagine waking up with your bucket only half full. You’d have a whole lot more to give your kids in terms of time, energy, and patience. You’d be a more resilient parent, able to weather the storms that come your way.

So how can we begin to reduce our normal stress?

    1. Create a personal list of stressors and solutions. Using the list above as a starting point, write down the stressors in your life and possible solutions. For example, one of my stressors is a propensity for migraines. A solution would be to set a cell phone alarm so I remember to take my preventative medications.

    2. Go for the low hanging fruit first. Start by picking off the stressors that are easy to address. For me, that might mean asking a teammate to give my son a ride home from football practice. Look for quick and easy ways to take a scoop of stress out of your bucket.

    3. Set some longer-term goals. Other changes may be more difficult to make such as  changing jobs or affording a new air conditioner (although a rotating fan or two might be a short-term solution). Don’t stress yourself out trying to de-stress by taking on too much at one time. Pick one goal at a time to focus on.

As you work through this, remember change takes time. But, every drop of stress relief is one less drop in your bucket. Even small changes can begin to make a difference.

It’s also important to recognize that not all our buckets are the same size. Some of us have short buckets – stress is very difficult for us to handle. Others have tall buckets – they can tolerate higher levels of stress. Another way to build your resilience is to increase your stress tolerance. Here are just a few strategies to get you started.

    • Get your endorphins pumping even if the only exercise you can fit in is power walking around the field during your kids’ soccer practice.

    • Take care of yourself. It’s not as impossible as you might think. Check out our self-care list for exhausted, frazzled, frustrated parents without a minute or ounce of energy to spare.

Raising children with challenging behaviors can feel overwhelming. To be successful, we as parents, must be resilient enough to handle the inevitable stress that comes our way. Take the time to consider what stressors are in your life and ways you can lower the water in your bucket.

(1) Stress Vulnerability Model –  from Zubin & Spring (1977) Brabban & Turkington (2002).

Originally published here by Institute for Attachment & Child Development

The Boy Who Cried Abuse

Devon was a boy who cried wolf. On several occasions, he claimed workers had purposely hurt him. When he mumbled about Mr. Myron beating him up. My stomach churned not knowing what was true, what was exaggeration, and what was an outright lie. It was hard to imagine a worker beating Devon, but not hard at all to imagine Devon accidentally hitting his head during a restraint. I was pretty sure this was somehow Devon’s own fault, and that the investigation would bear that out, but were those fingermarks on his neck? How could that be an accident?

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.

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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

Opening our foster care adoption

Published by Adoptive Families May 2018 Issue

Jennifer laughed a little too loudly, running her fingers through her long, fluorescent blue and pink hair. The only flaw on her heart-shaped face was a pale scar to one side of her mouth, like a hairline crack in porcelain. There we were, sitting across from each other in a booth at Chili’s Bar & Grill with our children—hers by birth, mine by adoption.

Jennifer was seeing them for the first time in more than a decade. Devon was 12 with light brown skin. And, now that he was sitting next to her, I could see he had her easy smile. Kayla, 11, fidgeted in the seat next to me, pulling at the strings of her ripped jeans. She cast shy looks my way.

***

My husband and I adopted Devon and Kayla from foster care when they were toddlers. Because it was a closed adoption, they received new birth certificates and social security numbers to permanently sever the relationship with their birth mother, Jennifer.

When Kayla was five, her curiosity was piqued about her birth mother. I’d patted my growing baby bump and told her and her brother that they were once in Jennifer’s belly, like the baby in mine. “What does Jennifer look like? Where does she live?” Kayla had asked.

I wasn’t sure, so I’d pulled out and read through the adoption case files. When Devon was born, Jennifer was 17 and a foster child herself. He was an infant when she left him sleeping in a motel room to meet a friend in the parking lot. Another guest heard his cries and called 911. Devon was unharmed and his diaper was still dry, but Jennifer was arrested for child abandonment. With no one to bail her out, she was in jail for a month before the charges were dropped. By that time, Devon was in foster care. Kayla was born a few months later, and, since Devon was already in foster care, social services took her too. Eventually Jennifer’s parental rights were terminated.

I told Kayla and Devon their mom was poor and had no family to help her. She loved them and wanted them to be taken care of and that’s why we became their parents. I framed a small photo—a carefully cropped mugshot—of Jennifer for each of them. Kayla, especially, treasured hers.

I kept tabs on Jennifer throughout the years in case Devon and Kayla wanted to contact her when they became adults. Several years ago, while she was serving time for check fraud, I sent her a Christmas card with pictures of the kids. Separated by hundreds of miles and thick prison walls, I didn’t want her to know where we lived, so I sent the letter through a relative.

A couple weeks later I received her forwarded reply. Jennifer’s curly script was embellished with doodled hearts and flowers. “I was so surprised to get this! I will always treasure these pictures. Thank you for taking such good care of my babies when I could not take care of them myself. ”

I read and reread the three-page letter braced for bitterness to slice me like a paper cut. Finding none, I was haunted by the suspicion that the real crime that cost Jennifer her children was being poor. After all, it’s not unheard of for parents to leave kids unattended in a hotel room—running to the lobby, grabbing something out of their car, switching a load of laundry—and they don’t get charged with child abandonment. They don’t lose their children forever.

***

After being released on parole, Jennifer joined Facebook. She had a penchant for duck-face selfies and over-the-shoulder poses that showed off her Kardashian-esque bottom. She called her boyfriend—a tall, handsome black man with an ankle monitor—her king. She was his queen. Many pictures showed “Coogie” tattooed across her chest, a term I could only find in the online Urban Dictionary: “A cool ass mutha f–er. A cool gangsta.”

Jennifer couldn’t have been more different from me, a conservative, suburban mom. Still, unable to resist dipping my toes in to test the water, I set up a new Facebook account and sent Jennifer a friend request. Seconds later she accepted. Over several months I uploaded hundreds of photos of Devon and Kayla. Jennifer giddily shared them with her Facebook friends, many of whom commented that the kids looked just like her. I noticed it too.

Jennifer and I messaged regularly. She told me about her job assembling furniture and living with her boyfriend in his mother’s house. She was especially proud to have earned her GED and cosmetology license in prison.

When I trusted her to Devon and Kayla, she sent a picture of their initials tattooed on her ankles. “You see? I’ve never forgotten you! I went through a lot when I was younger. I was living on the streets. I’m so sorry. I know you might be angry with me, and that’s OK, but can we be friends? I love you and always will.”

Devon was ambivalent about the relationship, but Jennifer and Kayla swapped emoji stories and pictures of their hairstyles and outfits nearly every morning. Some afternoons they would bike, dance to the radio, or play with the puppy together—courtesy of FaceTime.

Jennifer was seeing a court-ordered therapist, taking medication for her bipolar disorder, and submitting to regular drug testing. I was rooting for Jennifer but worried whether she could keep her life on track once off parole. This felt like a once in a lifetime opportunity for Devon and Kayla, so I booked her a flight to visit.

***

At the airport, Kayla cradled a Grande Caramel Frappuccino with whipped cream and a drizzle of caramel sauce—Jennifer’s favorite. With her fluorescent hair and bright pink jeans, we had no problem picking her out of the crowd at baggage claim. Kayla snuck up behind her, so close that when Jennifer spun around squealing, she nearly dropped the Frappuccino. Teetering on black, stiletto boots Jennifer kissed Kayla and Devon’s cheeks and pulled them into an awkward hug. Devon eagerly took the handle of her suitcase, leading the way to the exit, and Jennifer cooed at his chivalry.

Kayla climbed up on a large concrete block to give her a better vantage point, and therefore a better likelihood of seeing the shuttle before her brother. She hugged herself to keep warm. “Why didn’t you wear a coat, you silly goose?” Jennifer peeled off her thick coat and put it on Kayla, then wrapped her arms around herself against the cold.

Once in the parking garage the kids trotted ahead of us. Jennifer whispered that she hadn’t smoked for hours—since she left Colorado. “Would it be all right to have a cigarette real quick?” she asked.

“Of course. It’s fine.” I hoped my smile conveyed my sincerity. This weekend promised to be stressful enough without Jennifer having nicotine withdrawal. While she hid out of view behind other cars, I loaded the kids into my minivan.

“Doesn’t she know that’s bad for her?” Kayla blurted. “Doesn’t she know she’ll get lung cancer?”

I hushed her. Jennifer was our guest and we would let her be comfortable.

***

At Chili’s Kayla squirmed in her seat next to me, shrugging shyly whenever Jennifer asked her a question. Devon was chirpy, eager to capture and hold Jennifer’s full attention. He told her he liked bowling, video games, soccer, LEGOs, and dogs. His favorite color was green and his best friend was named Bobby.

“So, let me tell you what my boyfriend and I do—we pick each other’s noses.” Jennifer mimed the motion. “Then we make the other person eat it. Isn’t that funny?” She hooted with laughter and the kids thought she, if not the story, was hilarious. Me, not so much.

Devon nibbled on a chip and Jennifer exclaimed, “You need more cheese than that! You’re not worried about double dipping are you? Don’t be silly!” Dunking her half eaten chip into the queso Jennifer levered the whole thing into her mouth. She looked around the table, chomping enthusiastically. Then, pausing, she slowly lifted a hand to cover her mouth. “Oh,” she mumbled. “You don’t double dip, do you.”

“Don’t worry about it.” I waved my hand, permission for Devon and Kayla to double dip as well.

Jennifer’s face flushed. “I’m so embarrassed. I’m just so different than ya’ll.”

It was true. I held down a professional job and owned a house and two cars. I had student loans and no criminal record. While Jennifer spent her evenings partying, I spent mine packing school lunches and helping with homework. She double dipped. I did not.

As we left the restaurant I touched Jennifer’s arm. “You and I are different, but I’m glad we are. The kids have a special relationship with you that they can’t have with me. I’m so happy you’re here.” Beaming she gave me a quick hug.

Later that night, I supervised showers and teeth brushing, then Jennifer tucked Devon and Kayla into bed. She kissed them each good night, told them she loved them, and blew more kisses from the door.

***

The next day we went bowling and out for lunch. She gave Devon and Kayla piggy back rides and pushed them on the swings at the playground. That evening we had hot chocolate and popcorn. Devon and Kayla pulled out our scrapbooks and showed Jennifer pictures of themselves and scanned copies for her of their artwork and school work from over the years.

I asked Jennifer to tell us Devon and Kayla’s birth stories. Pulling Devon onto her lap, and with Kayla curled up next to her on the couch, Jennifer told us that Devon was her Valentine, born on February 14. Her foster mother, Teresa, had been there for the birth. Devon had soft brown eyes and all she wanted to do was hold him.

When Jennifer was pregnant with Kayla she’d had no friends to take her to the hospital. Kayla came out with a pouf of curly hair. All the nurses said she was the prettiest baby girl they’d ever seen. “You were so cute!” Jennifer tickled Kayla’s side until they both giggled and rolled off onto the floor.

Before we went to bed, Jennifer drew a thick tree trunk and the outline of a wide leaf canopy on a piece of paper. She wrote in the names of Devon and Kayla’s grandparents, aunts, uncles, and cousins. She noted that her mother, Debbie, had died from colon cancer. Aunt Darlene had breast cancer and Jennifer’s half sister, Katie, had cerebral palsy. I was touched by this simple family tree and the kids’ birth stories, gifts most adopted children never have.

***

On Sunday evening Kayla lay on the kitchen counter and Jennifer cradled her head in the sink. She massaged in shampoo and conditioner, stopping several times to gently kiss Kayla’s forehead. Jennifer blow dried and flat ironed Kayla’s hair in the playroom while they watched cartoons together. Devon had gone to bed long before and Kayla fell asleep with her head on Jennifer’s lap.

“I never abandoned Devon,” Jennifer told me. “I went to the parking lot for just a few minutes to meet a guy friend who was going to give me some money. This girl who stayed in the motel too was upset because he was her ex-boyfriend, so she called the cops on me.”

Jennifer had no family; she was 16 when her mother signed her over to social services. “I wasn’t a good kid. I know that. I stole from my mom and ran away a lot. She and her husband didn’t want me back. See this scar?” She leaned toward me and pointed to the tiny scar I’d noticed beside her mouth. “One time I got into a fight with another girl at a group home and she stabbed me in the arm and face.”

After a long silence I asked, “What happened with Kayla?”

“The social worker took her right after she was born. I’m not gonna lie to you,” she said. “I left the hospital and I sat on the curb outside. I had nowhere to go, no one to call for a ride. I just gave up. I knew I would never be able to get them back living on the street.” The despair and regret on her face made my stomach churn with nausea. I was deeply disturbed. That wasn’t how things were supposed to work.

The next morning we dropped the kids off at school before I took Jennifer to the airport. After hugs, kisses, cheek pinching, and giggling we waved goodbye. Before Jennifer entered the security line we hugged. I knew I’d always see Jennifer’s beautiful face reflected in Devon’s smile and Kayla’s dimples. We promised to do another visit soon, but that never happened.

***

As I’d feared, with the weight of a felony tethering her, Jennifer struggled to keep her head above the water when she got off parole a few months later. She struggled to find jobs and housing. Without health insurance, she stopped seeing her therapist and taking her bipolar medications.

On Christmas Eve I called Jennifer so Devon and Kayla could say Merry Christmas. No answer. No call back. She hadn’t posted on Facebook since December 21. By January, I was very concerned and scoured the Internet. I knew to start with arrest records. Sure enough, Jennifer had gotten tangled up with a gang and was arrested trying to use stolen checks. Charged with three felonies, she faced a decade or more of prison time.

Several days later, I penned the address of the jail onto an envelope and added Jennifer’s inmate number. Before sealing the envelope, I slid in pictures from her weekend visit. Later I would make a small deposit to her commissary account. When I put the envelope in the mailbox and raised the flag, I knew this would be only the first of many letters.

As I walked back inside the house, Kayla was already putting her shoes on, excited to go. She had a salon appointment to get a purple streak in her hair.

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