Category: Navigating “the system”

Parents of kids with RAD: 10 Unfortunate truths you must know

Parents of kids who have severe Reactive Attachment Disorder (RAD) often feel as if they are on the verge of a nervous breakdown. They are afraid – perhaps even terrified – of their children. They literally wonder how they’ll make it through the next day. Some are suicidal. Many are depressed, fearful, and unable to cope. Too many parents, years after their child is grown and gone, deeply regret sacrificing their other children, their marriages, and their mental health and wellbeing. 

I’ve been there.

This is straightforward advice, one parent to another that you’re not going to find anywhere else. It’s specifically for parents of children who are dangerous and violent and does not necessarily apply to children with mild or moderate RAD symptoms.

Let’s strip away the platitudes and talk about surviving. Here’s my unfiltered, pragmatic RAD-parent-to-RAD-parent advice: 

1. If your child has been diagnosed with RAD and is exhibiting extreme behaviors that you can’t safely deal with on your own, get your child into treatment as soon as possible.

Do whatever it takes. Go to the mental health ER every single time your child’s behavior is dangerous to himself and others – even if it’s every week or every other day. Your insurance company will be most likely to fund the treatment your child needs if they understand the gravity of the situation. When they are made aware of your child’s needs by regular ER visits made when your child needs intervention, they will be more likely to approve the needed treatment. 

2. If your child is violent towards you (Child on Parent Violence – CPV), you may need to press criminal charges.

Child-on-Parent Violence is quite common in homes where a child suffers from RAD. Yes, the justice system is unlikely to do them any good. But it may be the only option to keep you safe. Don’t put your safety in jeopardy by waiting too long.

3. Don’t beat yourself up for not having natural affection towards your child.

You have been the victim of trauma akin to domestic violence and no one believes a victim should naturally feel affection toward her abuser. It’s hard for us to think of children – even young grade school aged children – in these harsh terms, but it’s the reality. 

4. Be prepared for false allegations.

CPS will take seriously even the most absurd claims – despite witnesses and video footage – and you absolutely can lose ALL your children during these investigations. If the allegations are substantiated you can lose your children forever.  If your child has started making false allegations against you, consider this a huge warning – act fast to get help. 

5. Enjoy your summer break and let siblings enjoy it too.

If that means setting your child with RAD up with a TV and game system, do it. What good are parenting ideals if you sacrifice siblings to reach them? Someday you’ll look back on these years and be amazed at how you managed day to day. Be pragmatic and don’t lose yourself in a losing battle.

6. Your children are being exposed to domestic violence.

Exposure to hours of screaming, explosive rages, and physical attacks is harmful to siblings. They are being forced to live in a state of hyper-vigilance that can cause anxiety, depression, PTSD, and so much more. It would be considered child abuse or neglect for a mother to allow their children to be exposed to similar behavior spousal domestic abuse. Find a way to protect and provide time to talk with a therapist for siblings – they have rights too, and you have an obligation to them too. 

7. Some children with RAD abuse their siblings. 

They may bully younger siblings or abuse them physically, emotionally, or sexually. This is something you must keep a very close eye on. Remember children with RAD are often extremely manipulative and this can enable them to abuse their siblings right under your nose.

8. Realize that someday you may have to choose between protecting your non-RAD children and keeping your child who is exhibiting extreme, dangerous RAD behaviors at home. 

This may mean putting your child in residential programs that seem to be little more than “holding cells.” It may mean filing criminal charges against them. These are heartbreaking choices no parent should have to make, but they may be coming your way. Start mentally preparing yourself now.

9. If it is necessary for your child to receive help in a residential treatment facility, understand that the experience may aggravate your child’s behavior, possibly making it worse. 

Yes, in residential treatment facilities your child will be exposed to children with worse behaviors, and many of the “treatments” will empower your child to continue with his behaviors. Despite this, these facilities are sometimes the best, the necessary choice when you need to protect the child from himself and to keep siblings safe.

10. Your child’s therapist and treatment team are very likely to turn on you. 

As the parent, you are an easy target for therapists, and much easier to focus on than RAD. Also, providers need to show positive outcomes to continue receiving funding and some will skew the truth to do it. Always remember that this is your child’s team, not yours.

Adapted from: Reactive Attachment Disorder (RAD): The Essential Guide for Parents

Christmas Gift List for kids in Residential Treatment Facilities (RTFs)

It can be challenging to Christmas shop for kids who are living in residential treatment facilities (PRTFs, RTFs, or group homes). There are almost always restrictive rules about personal items along with special rules for Christmas gifts. For example, in most facilities electronics, candy, and hardback books are not allowed.

So what can you give your child for Christmas? Below is a list curated from parents who have successfully navigated the holiday season while their child is living in an RTF.

But first, here are some tips.

  • Gifts deemed inappropriate or against policy will likely be thrown away and not returned to you.
  • Most facilities do not allow wrapped gifts because they need to approve the items.
  • Often gifts must be dropped off on a specific day.
  • You may not be allowed to open Christmas gifts with your child. If this is important to you, ask their therapist about doing so during a family therapy session or home visit.
  • Kids in higher level facilities aren’t allowed to have “dangerous” item which may include shoe laces, belts, hard back books, calendars with staples, etc.
  • Ask the facility if your child will be getting additional gifts from local charities or the facility. As you shop, it can be helpful to know if you are supplementing gifts or supplying all your child’s gifts.
  • Plan for the gifts you buy to be lost or destroyed. Shop at Walmart and don’t give expensive gifts. Label what you can with your child’s name.
  • To successfully navigate Christmas gift giving with the least amount of frustration and waste, email your child’s therapist your planned gift list ahead of time for approval.

Christmas Gift List
(For kids in RTF)

  • Clothes
  • Pillow
  • Stuffed animal
  • Pajamas
  • Markers and coloring books
  • Dot to Dot books
  • Playing cards
  • Family Pictures
  • Art Supplies
  • Basket ball
  • Soccer ball
  • Foot ball
  • Journal
  • Hygiene supplies
  • Hair bands
  • Stickers
  • Pillow case
  • Picture book of “happy” memories
  • Paperback books
  • Crayons
  • Teddy bear
  • Gloves
  • Hat
  • Shoes
  • Puzzles
  • Funky Socks
  • Magic 8 Ball
  • Comic books
  • MP3 Player/iPod Shuffle with no internet access
  • Stationary
  • Legos
  • Crazy Aaron’s thinking Putty
  • Blanket – burrito etc
  • Posters
  • Calendar (no staples)

Please let me know your additional ideas so I can add to this list!

A few thoughts about realistic expectations…

Kids with developmental trauma, especially those diagnosed with Reactive Attachment Disorder (RAD) are likely to turn any situation into a power struggle, including their Christmas gifts.

Even if you give them a gift they’ve been asking for – that you know they’ll love – you can expect them to:

  • Tell the therapist they know you aren’t planning to give them any gifts because you don’t love them.
  • Complain to staff about the gifts they do get, and say they don’t like them.
  • Destroy the gifts even if they love them and desperately wanted them.

It may feel personal, but it’s simply how your child relates to the world because of the lasting effects of early childhood neglect and abuse. Unfortunately, you may end up feeling manipulated, lied about, coerced, and judged. It can be tempting to withhold gifts because of these behaviors or because your child is not cooperating with treatment, but that’s not a good strategy.

First, keep in mind that it will be very difficult to execute. Staff will likely compensate by giving your child extra gifts creating an opportunity for triangulation.

Additionally, your child’s therapist will almost certainly see your lack of gifts as a sign you are a cold, and unloving parent – and the focus of your child’s treatment will be side tracked.

Most importantly, your child will internalize feelings of rejection and this will not be a learning lesson no matter how well-intentioned you are. Jessie Hogsett, who was diagnosed with RAD as a child, reminds us that our child’s actions aren’t necessarily reflective of what’s going on inside. He says “I remember being in an RTF during Christmas. So lonely. And I felt totally unwanted. Horrible times. A gift would have made me feel wanted, special, and thought about.”

So, plop on your Christmas hat, sip a peppermint latte, and go shopping.

Here’s what “trauma informed” looks like…

Due to startling research on the impacts of Adverse Childhood Experiences (ACEs) on children, there is emphasis on “trauma informed care” in many sectors – education, childcare, health care, justice, and more. Far too often, however, trauma informed care is little more than a buzzword. In fact, many community resources exacerbate problems for families in crisis.

Over the last few months, my family has benefited greatly from several examples of truly trauma informed care. Let’s take a look at what “trauma informed” really looks like.

Leaving class to call home

My 12-year-old son Brandon recently lost his father under traumatic circumstances. As a result, he constantly worries about my safety. I receive these types of text from him multiple times a day:

Sometimes he’s texting from a friends house, sometimes just upstairs in his bedroom. If I don’t immediately see the text and respond, he becomes panicked. This posed a serious problem with the start of school where he has to leave his cell phone in his backpack.

When I explained the situation to the school counselor she immediately put in place a practical, trauma-informed solution: Brandon’s teachers have been instructed to give him a pass to Student Services whenever he asks for one. He’s then allowed to go into the office and make a short call home to check on me. While this could be viewed as disruptive, it is no where near as disruptive as his anxiety mounting for hours until it becomes debilitating. This way he checks in – 5 minutes – and is able to go back to learning. Shout out to @nwsarts

Protecting siblings from viewing an arrest

As my kids sat eating snacks at the kitchen table, I had no idea the police were on their way to my house to arrest my 17-year-old son Devon on outstanding assault charges.

When the police arrived they pulled me aside and explained they were about to arrest Devon. Then the officer added, “Do you have a place you can take your other kids so they don’t have to see their brother arrested? We’ll wait for you to take them.” Dazed, I took Devon’s siblings next door.

Once I recovered from the shock of the arrest, I was deeply grateful to the officers. They realized the potential for secondary trauma and were proactive in preventing that. They could have just swept in and handcuffed Devon. Instead, they were trauma informed and acted in the best interest of the whole famiy. Shout out to @CMPDnews

A private place to eat

Food issues are extremely common for kids who have been abused or neglected. My adopted daughter Kayla, now a teenager, has always struggled eating in front of other people. This poses a significant problem in school as she cannot concentrate when she’s hungry. In addition, during basketball season this can become a serious health concern.

Instead of diminishing this very serious concern, my daughter’s teachers have gone out of their way to create an accommodation that is both practical and helpful – one that is truly trauma informed. Kayla is allowed to eat her lunch in one of the teacher’s classrooms. As a result, she gets the daily calories she needs to thrive in school. This has been a simple and effective way of removing a barrier to Kayla’s academic success. Shout out to @LNCharter and @corviancourier

Each of these solutions is straight-forward. Simple even. So what makes them truly trauma informed?

  1. They recognize the underlying trauma
  2. They don’t minimize the issue
  3. They are practical and effective

Families like mine need more community resources who are educated about developmental trauma and willing to implement practical, sensible, trauma informed solutions that will enable our kids grow and thrive.

Tips to work with your child’s school (includes free teacher handout)

I can’t tell you how many days I’ve navigated through carline with a drink holder full of steaming hot cups of coffee. Every school year I’d learn how my kid’s teachers took their coffee. On my way to drop the kids off at school in the mornings, I’d pick up a coffee for myself and one more to go. Especially when they were in elementary school, the kids loved their teacher’s reaction to the nice, fresh cup of coffee – and I loved the good will it built. In fact, when I found a teacher to be particularly challenging to work with, I’d throw in a muffin or cookie. That’s right – kill them with kindness and generosity and 9 times out of 10 it paid off in spades.

Working with teachers and school staff can be challenging for any parent, but more so for parents of children with special needs. Parent’s of kids with Developmental Trauma and/or RAD struggle even more because of the nature of these diagnoses. Few schools are truly trauma informed and our children are often adept at triangulating adults.

I have five children and we’ve got 504s and IEPs. We’ve navigated suspensions and expulsions. We’ve been to alternative schools and been in co-taught classrooms. Below is my hard-earned advice for how to navigate the system successfully.

Behind the scenes

Like any “system” we work with as parents, it’s important to pull back the curtain and understand how that system works and recognize its dysfunctions. Many of us have become so frustrated with a teacher, school administrator, or principal that we blow our top. We feel justified because they are being so unreasonable, causing our child undue hardship, or simply aren’t acting fairly. Unfortunately, our strongly worded emails and outbursts can have long-reaching negative impacts on our child’s school experience.

  • Teachers and school staff talk. Teachers and administrators talk about students, and even more often about their “cranky,” “unreasonable,” “mean” parents. The 6th grade English teacher vents her frustration to the 6th grade history and science teachers. The 8th grade teachers give the high school teachers and administration a heads up. If you are perceived as a difficult parent to deal with – everyone knows.
  • Parents are labeled and handled. Administrators and teachers will make a determination about what kind of parent you are based on even one interaction. While this may not be fair, it’s simply the reality. They’ll often meet ahead of time to strategize how to “handle” you in meetings and conferences which can lead to the incredibly frustration realization it’s the one of you against all of them. And once you’ve been labeled – it sticks
  • You won’t win (at least in the long-term). Sometimes a “strongly worded email” or conference can seem to be effective. But it’s important to realize your child will be in school for 13 years. Winning one battle at all costs can have serious long-term impacts. Once the school labels you as a “problem parent’ they’ll strategize how to best handle you in the future. A nasty email may win the battle – it won’t win the war.

While we all wish this wasn’t true, it’s human nature. For the sake of our children, we must understand the reality and become pragmatic. At least that’s been my strategy and more often than not it’s been successful.

Start off on the right foot

It’s so important to start the new school year in good faith and without a chip on your shoulder. Instead of assuming your child’s teacher is “going to be a problem,” start out by believing they’re going to be a partner. This means seeing the classroom through their eyes and empathizing with their needs. I have several teachers in my family and know it is a hard, often thankless job. Many teachers spend weekends and evenings grading papers and pay for supplies out of their own pockets. Most go into the job because it’s their passion, but can become discouraged and burnt out .

  • Be polite and act in good faith. A little genuine kindness and please and thank you can go a long way – especially with teachers who are overworked. Look for opportunities to compliment your child’s teacher. If called for, apologize and seek to make amends.
  • Be reasonable and solution oriented. It’s so important to recognize and respect the limitations of schools and teachers. Don’t lock yourself into one solution. Be an active listener and go into every meeting with a spirit of collaboration and mutual support.
  • Be ‘that’ parent. Reach out to your teacher in practical ways. Be the parent who they can count on as volunteer. Send in extra supplies when they’re requested – and when they aren’t. For example, all teachers always need extra pencils, tissues, and hand sanitizer.

Let’s not forget that as parents we find it incredibly challenging to care for our child, especially when their behaviors are extreme. Imagine a teacher trying to do that while teaching a full classroom of children. A bit of empathy and consideration can go far.

Work within the system

Fighting the system for reforms is a noble cause and one we all must support. However, the strategy for personal success is almost always learning how to work within the system. Thankfully, there are standard, legal processes to insure your child receives the educational supports they need and are entitled to. It can be a long process to obtain a 504 or IEP (Individual Education Plan), but well worth it because they are comprehensive plans with legal requirements. There are also many free or low-cost parenting advocates who are trained to assist parents in negotiations with their schools and setting up of 504s and IEPs.

  • 504s A 504 is a detailed plan for how the school will remove learning barriers for students with disabilities. Most commonly these include accommodations (how a student learns) like extended time for testing or priority seating. A 504 is easier to get than an IEP and usually the best stepping stone to an IEP.
  • IEPs An IEP is a legal agreement for a student to receive special education services. The IEP agreement can include both accommodations (how a student learns) and modifications (what a student learns). For example, it may include pull out educational services or classes co-taught by a traditional teacher and a special education teacher. An IEP requires an evaluation. Typically diagnoses like ADHD or RAD can qualify a student.

Resources

Be sure to check out this excellent resources on the ins and outs of navigating special education services for your child. From Emotions to Advocacy

Here’s a handout you are welcome to reproduce or email to your child’s teacher: Remember, approach is everything. You don’t want to come across like a patient being wheeled into surgery while handing the surgeon a diagram of the heart. Just offer this handout to teachers and school staff as “helpful information about my child’s diagnoses,” I find it’s always best delivered with a cup of coffee!

As parents of children with special needs, we’ve all had that sick feeling when we realize teachers and school staff have circled the wagons – and it’s “us” against “them.” Use the strategies in this article to make sure you are part of the team and that everyone – teachers, school counselors, principals, and you as the parent – are linking arms and circling your child with the supports they need.

Aging out of RTF into the real world – a dangerous proposition

J.D. spent his teenage years growing up in a residential treatment facilities. He celebrated his 18th birthday by walking out through those doors – free to make his own decisions and live life his way. Within days, J.D. was causing a public disturbance. Police were called. They told him to put his hands in the air. He laughed. He mimed a gun with his fingers. The officers open fire.

J.D. fell to the ground – dead.


For those of us who’s kids have spent years in residential treatment facilities (RTFs) – growing only more dangerous and violent – this story strikes like a death bell in our chest.

My son Devon has been bounced trampoline-style from facility to facility since he was 10. He’s been in these facilities because he cannot live safely at home. He poses a threat to himself and to his younger siblings. However, instead of getting better in these therapeutic settings, his behavior has become worse. 

Because of the polices of these facilities, Devon has committed assaults and serious vandalism with no consequences. 

  • He’s created thousands of dollars of property damage –  no consequence.
  • He’s made false allegations of abuse – no consequence
  • He broke a woman’s thumb – no consequence.
  • He stabbed a kid in the back with a pencil – no consequence.
  • He punched a girl in the back of the head – no consequence.

Unfortunately, this is how treatment facilities work. The underlying idea is if you consequence kids, that’s all you’ll ever do and they won’t be able to receive therapy. This is true, but on the flip side, what if the “therapy” the kid is receiving in leu of consequences does not help? What have they learned?

My son will turn 18 in a handful of months. He’s itching to leave and at one-minute past midnight he’ll bolt. He won’t have a high school diploma or have any job skills. Worse, he won’t understand that there are consequences in the real world. He’s come to believe that, with a bit of fast talking, he can turn any situation into a ‘therapeutic incident’ and deflect consequences. 

I’m sure that’s what J.D. thought too – before he was shot and killed by police. He expected them to beg him to calm down, offer him coping skills, and at worse drop him to the ground in a physical restraint. I have no doubt that J.D. did not understand the danger of his behavior.

For the safety of our kids, who will someday age-out of residential treatment and into the real world we must find a balance. I don’t pretend to know the answer and there are no quick and easy solutions to this problem. But here’s what I do know: Our kids must have effective treatment AND understand that their choices have consequences. 

My kids’ pediatrician told me this story. He personally knew this young man and the incident happened several years ago. 

RTF: A bad option, that’s sometimes the best option

My son Devon was 10-years-old when I dropped him off at a residential treatment facility (RTF) for the first time. I knew almost instantly it wasn’t going to work. They didn’t believe in consequences. School work was optional. With unlimited dessert and no rules, it was more like a summer camp than a program for kids with severe behavioral problems.

I called my sister for advice and my words came out with a sob, “He’s going to get worse here.”

“Without hesitation, my sister said, “You have to get him out of your house. Nothing else matters right now.”

“But he’ll see this as a reward.”

“I don’t care if it’s Disney World. We’ll deal with that later. Leave him,” she said. 

And I did.

Devon’s behavior had been growing increasingly unmanageable and dangerous over the previous 18 months. He was having violent outburst every day and the stress level in our house was toxic for everyone. My youngest son, who was 4, was especially frightened and would tremble with fear when he sensed Devon’s anger mounting. I was suffering from PTSD—even though I didn’t realize it at the time.

I’d been trying to get help for Devon for years. We’d tried outpatient therapy, intensive in-home therapy and partial hospitalization. He wasn’t getting better and I had no idea how to help him. I only knew what I was doing wasn’t working. 

As I’d predicted, Devon’s behaviors did become dramatically worse from the RTF. However, my sister had recognized what I could not – it was still the best option available to us. Unfortunately, if you’ve exhausted outpatient options and your child is becoming unsafe, it may be your only option too. 

Why RTFs don’t work

While an RTF may be the best – or only – option available, it’s important to have realistic expectations. These facilities are rarely effective for kids with developmental trauma disorder. In fact, they can exacerbate the symptoms, and here’s why:

1. The treatment is not specialized for developmental trauma. Your child will be placed with kids who have a variety of issues including anxiety disorders, eating disorders and PTSD. The coping skills they will learn – like taking deep breaths, playing with a stress ball and counting to ten – are not enough to heal the brain injury caused by developmental trauma.

2. The workers are under-trained, overworked and underpaid. Your child will work with a licensed clinician for therapy. Yet, the general supervision is typically provided by workers who have a high school diploma and on-the-job training. Our kids are very challenging to deal and the chronic understaffing and inadequate training results in inconsistent quality of care.

3. The staffing structure lends itself to triangulation. Because workers are rotated (and have high turnover) they are easily triangulated – especially against the therapist and parents. Unfortunately, your child is likely to gain a sense of control by behaving this way – a feeling they unconsciously crave – and will continue even when it sabotages their treatment.

4. The kids become institutionalized. In these facilities, your child will be exposed to and influenced by kids with sexualized behaviors, horrific language and physical violence. They’ll quickly learn the ropes and how to work the system to their advantage, for example, by making false allegations to retaliate against staff or peers. This is knowledge they’ll ultimately use to manipulate the staff and you as well.

RTFs are intended to teach your child how to cope and let them “practice” good behavior for when they return home. Yet, the artificial environment and behavior-based modification techniques do not help them to truly heal. 

“Kids with DTD learn to work within the external structure of residential treatment facilities. It doesn’t get internalized for them though,” said Institute for Attachment and Child Development Executive Director Forrest Lien. “Ultimately, most kids go back into their families and fall apart. Sadly, it’s oftentimes the only option for parents.” 

Sadly, unless you are able to send your child to a program that is highly specialized for developmental trauma, your child is unlikely to get better. 

When to consider an RTF anyway

Parents who are considering sending their children to an RTF often ask for my advice. It is a very personal decision and every child and family is different. However, the following are a few words of hard-earned wisdom I often share. 

1. Consider an RTF if your child is unsafe to himself or others. Remember to consider not only the physical, but also psychological well-being, of other children in the home.

2. Consider an RTF if you are at your breaking point. You cannot help your child when you are unstable yourself. An RTF may be the breather you need to regain perspective.

3. Consider an RTF if your child  engages in unlawful behavior. An RTF is likely a better option that juvenile detention where your child will get a criminal record and receive little treatment.

The decision to send your child to an RTF should be a last resort but you may be at that point now. You alone are not able to heal developmental trauma any more than you can set your child’s arm or cure his leukemia. The best you can do is access the best possible treatments available and support and love your child through the process. 

For us, an RTF was the best choice because Devon had become unsafe to himself and his siblings. And after years of giving it my all, I had nothing left to give. He’s now 17 and in his ninth RTF. It’s not the forever family I’d hoped for and not what any parents wants. Yet, it is often the best of the limited choices families like mine have. It is the best choice for us. And while my son doesn’t live at home, he’ll always be a part of our family.

First published by Institute for Attachment and Child Development.

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 Reactive Attachment Disorder (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.

When pigs fly: the day my son’s therapist apologized…

Today my son’s therapist apologized to me. (Go ahead, take a moment to pick yourself up off the floor, then keep reading…) If you’re the parent of a child diagnosed with reactive attachment disorder (RAD) you know just how significant this is. 

As parents of children with developmental trauma, one of our biggest pain points is dealing with therapists who don’t “get it.” They blame us, are manipulated by our kids, and offer our families little practical help. At best they’re ineffective, at worst they cause enormous damage.

My son’s current therapist, we’ll call her Amy, has made the classic blunders we’re all so familiar with.

      • She tells my son all he really needs is my love, excusing him from responsibility.
      • She praises his cunning circumvention of rules as “trying really, really hard.”
      • She disagrees with me openly and emphatically in front of my son.
      • She makes me the “bad guy” in therapy sessions.
      • She prioritizes her relationship with my son over mine.

Can I get a show of hands? I sure know most of us are struggling with these very same issues.

But today something unexpected happened. I confronted Amy and she acknowledged she could have handled things better and apologized. We then worked together to come up with a reasonable path forward. I very nearly fell off my chair.

In retrospect, here are a few things that may have contributed to this success:

  1. I was confident, not defensive. When we act defensively, therapists are quick to write us off as unreasonable, close minded and pissed off. It’s important to be in a place where we know our rights and can speak as confidently and unemotionally as we might in a business presentation.
  2. I didn’t get personal. We’ve all been offended and hurt by therapists and it’s easy to become wrapped up in those feelings. But when we do, our confrontation goes off the rails. In the end, the conversation shouldn’t be about our feelings at all. It should be about the needs of our child.
  3. I focused on my child. Don’t talk about what the therapist has done to you, or how they have made you feel. Keep the focus on what’s best for your child. My child needs to be safe. My child needs to build a strong secure relationship with me. These are specific things you and the therapist can agree on.
  4. I was specific and kept it simple. If you walk into these conversation with a laundry list of problems, it’s far too easy to get lost in the weeds. Pick one specific issue that highlights the underlying problems to focus on. Make it specific, actionable, and simple. Pick something as objective as possible.
  5. I was reasonable. What can you expect out of a confrontation? You’re not going to change the therapist’s style or philosophy. You’re unlikely to educate them on RAD and DTD, although you might crack open the door for that. What you should be able to do, is come to an understanding and agree to some ground rules.

It sure felt good when Amy apologized to me, but that mattered far less than the action plan we put into place. With a common goal established we agreed to:

  • Meet prior to family therapy sessions to agree on how news will be delivered to my son and how to approach what will be discussed in the session.
  • If  a topic comes up that we need a sidebar on, before discussing in front of my son, I’ll use a code word and she’ll put off that topic until after we’ve had a time to talk privately.

Every therapist, family, and child is different. Some therapists are easier to work with than others and this isn’t a one-size-fits all formula for every situation. Still, I hope reflecting on my experience may provide a useful starting point as you work hard to advocate for your kids and help them get the therapy they need.

Today my son’s therapist apologized to me. If you’re the parent of a child diagnosed with reactive attachment disorder (RAD) you know just how significant that is. In fact, you might have to pick yourself up off the floor after reading that. Click To Tweet

How have you been successfully able to work with therapists?

5 things I learned at ATTACh 2018

Recently, I had the privilege of attending the ATTACh 2018 conference. I learned from keynote speakers including leading researcher and author of The Body Keeps The Score, Dr Bessel van der Kolk, M.D. and attended a variety of workshops and parent sessions.

Here are 5 things I learned and want to pass along to you:

  1. Keep a beach ball on hand. To have effective conversations with our kids we need to first connect. A great way to do this is to throw a beach ball back and forth while having a discussion. Getting into rhythm with your child will help them focus and make your conversation more productive. I love the idea of doing this with these emoji “feelings” balls.
  2. Talk with your child about their history. Not talking about your child’s history doesn’t keep them from thinking about it. All it means is they’ll be trying to figure it out on their own without your help. Have sensitive, age-appropriate conversations about your child’s birth story and trauma history. Help them process the information in bite-sized chunks with love as the special-sauce that makes it palatable.
  3. IEPs can focus on core content. Coloring maps, making index cards, and completing projects – all that busy work may be to much for a child with a history of complex trauma to manage. Work with your school to get your child a 504 or IEP. With an IEP you can request that your child’s work load be limited to only tasks and knowledge required for course mastery.
  4. Our LGBQT kids have too little to lose. In our society coming out can mean losing some of our family, friends, social groups, dreams, and more. An adopted foster child may have limited connections already. They may have only one friend or a single family connection.  For them, coming out means risking it all. It’s important to be sensitive to how scary this can be for our kids with a history of abandonment or difficulties with attachment.
  5. Adoptive parents are the key. The single determinative factor in positive outcomes for traumatized children is having a positive, healthy attachment to a caregiver. This is why the adoptive parent is a crucial role in healing. While these children need professional treatment, a healthy relationship with an adoptive parent is powerful healing salve.

Also be sure to also check out my post on what I learned about Developmental Trauma Disorder at the conference.

ATTACh has made their conference affordable for parents and has a track of sessions designed specifically for us. In 2019 they’ll be in Scottsdale, Arizona. I strongly encourage you to consider attending upcoming ATTACh conferences. ATTACh 2019.

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.

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.

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

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

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

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

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

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

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

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

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