Category: Parents and Caregivers

A Dad’s Struggle Accepting Reactive Attachment Disorder Diagnosis

Learn about a Dad’s struggle with awareness and acceptance of a Reactive Attachment Disorder (RAD) diagnosis and helpful tips to overcome the challenge of accepting related Developmental Trauma Disorders.

click here to learn more about Christine Hartmann…

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.

5 creative ways to foster attachment

Kayla “then”

When Kayla was a newly adopted toddler I’d rub my face against her pudgy cheek as I tucked her in for the night. “Look at that,” I’d exclaim. “A freckle just jumped off my face onto yours!” She’d giggle and ask me to count her freckles.

Like most kids that come from hard places, Kayla struggles with attachment. Kids who have experienced early childhood trauma often don’t form a strong bond with a primary caregiver as an infant. As a result, they may unconsciously fear the closeness of relationships and thwart attachment. They also don’t have the context of a healthy mother-child bond from which to understand other relationships. As a result they don’t naturally form healthy relationships with family, friends, romantic partners, teachers, co-workers, and others. 

Kayla “now”

Kayla is now a persnickety 16-year-old, but I sometimes still “rub freckles” onto her face, much to her fake chagrin. While attachment isn’t easy for her, our relationship is very close and a source of safety and comfort for her. One way our bond solidified was through our silly – and simple – nightly freckle ritual. Our kids needs are challenging and complex and we need to find creative ways to reach them and help them learn healthy attachment.


Every child and parent are different, but here are five creative attachment ideas that have worked for other families. 

  1. Taking mommy-and-me swimming lessons with younger children can be a great, natural way to facilitate physical contact. Over time a child will learn to feel secure in the safety of his or her parent’s arms. (Of course, take into consideration if your child is fearful of water or swimming before trying this.)
  2. Braiding hair, painting toe nails, and foot massages are another way to encourage gentle, loving physical touch. These activities can facilitate hours of easy conversation and connection. Gentle face massages can also be a calming bedtime ritual.
  3. Sharing a secret with your child is a way to connect in a special way. It doesn’t have to be anything big – a childhood memory, a favorite snack, or secret wish. Once you’ve shared your secret, your child might just want to share one of their own. Be sure to respect and cherish it.
  4. Sharing a sleeping space, a staple of attachment parenting, can be accomplished with older children by allowing them to sleep in your room or laying with them until they fall asleep. This can provide a tremendous amount of comfort to a young, traumatized child.
  5. Cooking and baking together is a tactile and practical way to spend quality bonding time with your children. For kids with food issues, this can also be a way to give them a sense of control over an area of their life that may seem erratic and unpredictable. (See below for our family’s chocolate chip cookie recipe.)

Don’t forget to reciprocate. Let your child brush your hair and paint your nails too. Accept their special gifts and secrets, no matter how trivial they may seem. Attachment is a two-way process and you must be as fully engaged as you want them to be.


As promised, here’s my family’s cakey chocolate chip cookie recipe passed down from my kids’ great-great-grandmother. Enjoy!

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.

Adoption: How not to be like a frog boiling in a pot

Adoption can be a lot like the Frog Boiling in a Pot metaphor. We jump in heart-first and are deliriously happy to have finally made it through the long, emotional, and expensive adoption process. We relax back to enjoy our new family without realizing there’s a fire beneath the pot we’ve leapt into. As the water gradually warms around us and we adjust and acclimate.

Tantrums evolve into rages.
Late potty training graduates to poop smearing.
And squabbles escalate into fist fights.

Meanwhile we’re unaware of how serious the situation is becoming. By the time we realize the danger, the water is already boiling.

Due to our child’s early trauma,
we’re often jumping into a heating pot.

Unfortunately, many children who are adopted have gone through early childhood traumas which can result in a myriad of issues: severe behaviors, sensory processing issues, attention deficits, learning disabilities, attachment challenges, and more. Early intervention is key, but often the gradual worsening of the symptoms makes it difficult to recognize when to get help. As a result, our kids don’t get the early interventions they need which is a delay that has significant impacts on their prognosis as well as the family’s health.

When I adopted my son at the age of 3, there were plenty of warning signs that we needed professional help – at least in hindsight. As things grew gradually worse over the years, I didn’t realize how serious the situation was. When had he gone from toddler tantrums to chasing siblings with a baseball bat? When had he begun to weaponize urination when he was mad? Sometimes, when we are living in these types of situations we are much like the frog in the pot – we don’t realize what’s happening because we are acclimating to it bit by bit. In my case, it took a scary incident for me to recognize the danger and act.

We have dreams and high hopes wrapped up in adoption that make it hard to admit we need help. That’s why it’s so important to understand that, for kids with severe trauma, love alone is not enough. To heal and thrive these children need highly specialized services and, even so, may continue to struggle at some level throughout their whole life.

For the best prognosis, early intervention for childhood trauma is key. This is why every adoptive (and pre-adoptive) parent must know the warning signs and where to find help.

The warning signs

In our pre-adoption classes we learn some behaviors are “normal” for kids who have been in the system. This includes issues related to food, potty training, aggression, hygiene, attachment, and learning. What we often don’t understand is that adverse childhood experiences (ACES) affect each child differently and some children have such severe symptoms they cannot be managed by parents – especially when there are other children in the home. You must know the warning signs.

Here’s what you need to look for:

  • Behaviors are creating a safety issue for the child, their siblings, or parents.
  • Over time you do not see any improvements; only a worsening of symptoms.
  • The child is unable to successfully function in school, daycare, or other settings.
  • They are perpetually “in punishment” at home.
  • You are being triggered and feeling depression, anxiety, anger, or other PTSD symptoms.
  • Your child’s tantrums are lasting hours and/or are violent.
  • You dislike your child and begin to dread spending time with them.
  • There is not a growing attachment between you and your child.

If you’re unsure, remember, it’s always better to reach out for help early than to wait too long. Waiting is not simply wasted time. It exacerbates your child’s condition and can damage their relationship with you and other family members.

Getting help

Even more challenging than recognizing you need professional help, is finding it. Children who have been traumatized in foster care or orphanages need more than “trauma informed” resources. They need help from individuals who are experienced working with this specific population of children and their families. If you begin to work with a pediatrician, therapist, or other professional who “doesn’t get it,” don’t stick around. Though well-meaning, those without this specialized background can make things worse.

Children who have been traumatized in foster care or orphanages need more than #traumainformed resources. They need help from professionals who are experienced working with this specific population of children and their families. via… Click To Tweet

Here’s what you need to know:

  • Your child needs a comprehensive psychological evaluation for the most accurate diagnosis (ask your pediatrician for a referral).
  • As soon as your child begins to experience learning or behavioral problems at school ask for a 504 or IEP evaluation.
  • Look for therapy services that are for the whole family:
    • Outpatient FAMILY therapy (not individual)
    • In-home FAMILY treatment
  • Know where your local mental health hospital is (google “Mental Health Emergency Care” for your city).
  • Contact the police department ahead of time and ask how to reach the CIT (Crisis Intervention Team) should you require law enforcement help.
  • If you adopted from foster care, contact your agency about respite, medicaid coverage, and other services.
  • Join online support groups to network with other parents and find the best local resources. These are my favorite groups and the ones I’m most actively involved with:

Remember, even in the most severe cases, with early interventions and specialized treatment, there IS hope for kids who have experienced early childhood trauma. Here’s one story where early interventions saved a family.

You’re angry…I totally get it

Our homes are in utter disarray: broken toys and torn books, holes in the walls, heirlooms at the bottom of the trash can. We’re spit on, yelled at, hit, kicked, and sometimes worse. We endure hours of screaming and mayhem Every. Single. Day. We beg for help, but get criticized instead. We deal with crazy lying, poop smearing, and food hoarding. At night we sob into our pillow feeling as though we can’t bear another day. We are demoralized, frustrated, beaten down – and yes, we are angry.

People looking in from the outside have unrealistic expectations of parents who are struggling to raise kids who have developmental trauma. They seem to believe we should have an infinite well of patience, kindness, and energy. But that’s simply not reasonable or realistic. When our children flip out, they’re not the only ones who go into fight-flight-freeze mode. We do too. It’s a natural response to being physically and psychologically attacked. 

Of course, this may not happen to most parents, but that’s because their children have tantrums not rages. Picture the most calm, serene mother you know from church, the playground, or your child’s school. Know this – she too is only human. If she was struggling with what you are, she also would be on the very edge of sanity. Eventually she also would become angry too. It’s only normal.

As a fellow parent of a child diagnosed with Reactive Attachment Disorder (RAD), I completely understand your anger. However, after years of healing, I also have the benefit of hindsight. And here’s what I’ve learned: While anger is a natural response, it doesn’t serve you or your child well. And here’s why…

Your child feeds off your anger

Your child is likely unconsciously acting out of early hurts. They may have spent their formative years perpetual fight-flight-freeze mode and, as a result, thrive on the adrenaline rush of chaos. They crave control over a world they unconsciously perceive as unsafe and unpredictable. Knowing they can push your buttons gives them reassurance of their power. When anger rolls off you in waves, it bolsters the waves their anger has been building. Feeding off one another you can end up with a tsunami. 

It’s counterproductive with teachers, therapists, and others

It can be easy to let our anger fly at teachers, therapist, other parents – all the people who don’t understand and, as a result, make things worse. While this can be momentarily cathartic and feel well deserved, it ultimately does not serve us well. This is just the excuse these people need to label us as unreasonable and out of control. It also reinforces the perception that our child is merely the victim of bad parenting. Ultimately, angry outbursts undermine our credibility and it can be almost impossible to turn back that tide. 

It’s unhealthy for you

Prolonged anger can be deeply harmful to your psychological, spiritual, and physical health. Your blood pressure spikes, you over eat and can’t sleep properly. You may develop chronic health conditions or mental health problems. Anger can cause you to accidentally rear-end another car. You lose your ability to be rational. When you are already carrying such a heavy load, these health issues can be catastrophic and have long-term and lasting effects.

How to stop being angry

It’s not easy and there are no quick fixes. After all, you are living in a highly stressful environment with extreme challenges and relentless demands on you. This is why you must look for realistic ways to begin to reign in your emotions and feel good about small wins.

Here are some ways to begin: 

  • Recognize your triggers and avoid them. Just like our children, we have our triggers and we can cope by avoiding or minimizing them. For example, maybe you’re triggered more easily when you’re hot, tired, and running late. Keep a snack in your purse and simplify your calendar as much as you can. If it sets you on edge when your child slams their bedroom door, install a slow-close hinge or strategically pad the door frame.
  • Build your resilience. If you’ve been at this a while, you know it’s unlikely you’ll be able to change your child’s behavior – especially in the short term. What you can do is build your own resilience so you can tolerate more. For example, if your air conditioner is constantly breaking that extra heat may be stoking the fire within you. Repairing your air conditioner can be a pragmatic way to make it easier to cope. 
  • Understand why your child acts the way they do. You can build greater empathy and patience by learning about developmental trauma and reactive attachment disorder. By understanding why your child behaves the way they do, you can often blunt your anger with compassion and you’re better equipped to grab for your therapeutic parenting tool box
  • Seek treatment for your own mental health. It’s common for parents of children with extreme behaviors to develop PTSD. Find a therapist who can help you through this difficult time, even using tele-conferencing if that’s a way to squeeze it in. Also, consider asking your primary care doctor about options for anxiety and depression medications to help take the edge off. 
  • Take care of yourself. Easier said than done right? Girls night out, date nights, and Zumba classes may be completely out of reach.However, you can use aroma therapy, DVR your favorite shows, and fill your social media feeds with encouragement. My favorite self-care is a chair massage at the mall (20 min, no appt necessary) and a non-fat Starbucks latte pre-ordered on my app and picked up through the drive through.
  • Consider residential treatment for your child. It’s an unfortunate reality, but for some families a residential treatment facility (RTF) may be the best option. Consider RTF if your child is unsafe towards themselves or other children in the home. Remember, if you are at your breaking point, you are no longer able to effectively parent and RTF may give you some breathing space to recharge and heal. 

None of these suggestions are quick fixes or silver bullets. What they are is a way forward. This isn’t something you are going to resolve overnight. When trying to get your emotions, and especially anger, back under control it’s important to realize even small incremental improvements are a huge win. Do it for your family. Do it for yourself. 


Developmental Trauma and Psychosis


When my son was 12 he’d “snap” into one of two personalities – a ballerina or a thug – by shaking like a wet dog. As a ballerina he’d loop his arms over his head and plie across the lawn, deftly ignoring calls to come in for shower time. His thug personality was less benign. He’d curse and swagger, punching walls and sometimes people. 

Like many moms, I fancy myself a bit of a human-lie-detector, and was pretty sure my son was faking these “personalities.” This was confirmed by the results of a neurological exam, brain scan, and full psychological evaluation. No indications of psychosis. What he had been diagnosed with, however, was Reactive Attachment Disorder (RAD), also called Developmental Trauma Disorder (DTD). 

This left me wondering if there is a link between DTD and psychosis, and what parents can do to get their child the best possible treatment.

Is there a correlation between DTD and psychosis?

Up to 3.5% of the general population experiences psychosis. Psychotic symptoms most commonly include: 

  • Visual hallucinations – seeing things that aren’t there.
  • Auditory hallucinations – hearing things that aren’t there.
  • Sensory hallucinations – feeling things that aren’t there.
  • Delusions – beliefs that are not true and are irrational.

DTD is a brain injury caused by early childhood trauma (and RAD is just one related diagnosis). DTD can have wide ranging symptoms with varying severity depending on the stage of brain development the child was in when the trauma occurred. Symptoms can include attention deficits, poor impulse control, developmental delays, underdeveloped cause-and-effect thinking, aggression, and more. 

Psychosis, however, is not a symptom of DTD.

Though psychosis is not a symptom of their developmental trauma, some children with DTD do report hearing voices, seeing “beings,” or seem delusional. To delve deeper, I conducted a survey on this topic. Out of 184 parents, over 1/3 said their child reports symptoms of psychosis. 

(March 2019)

This is a significant number and a concern for many families. Since psychosis is not a symptom of DTD, if your child has reported any of these concerning symptoms the first step is understanding the possible causes. 

Potential causes of “psychotic” symptoms

1. The psychotic symptoms may be made up.

When a person fakes psychotic symptoms it is called malingering psychosis. Manipulation and lying are common behaviors of children diagnosed with DTD. These strategies are often used to gain a sense of control in what feels like an unsafe and unpredictable world. This was the case with my son. 

Tracy, another mom, says her son faked multiple personalities and was even diagnosed at one point with dissociative identity disorder (DID). After professional psychological evaluations, the clinician identified it as malingering psychosis. “He knew exactly what he was doing,” she says. 

Qualified psychologists are equipped to discern between malingering and true psychotic symptoms. Don’t rely on your own gut feelings. It’s always best to get a professional evaluation. In addition, if your child is faking symptoms they need treatment for the underlying reasons for this behavior.

For help with malingering psychosis, find a therapist who has extensive experience working with adopted or foster kids who have developmental trauma.

2. The psychotic symptoms may be a drug side effect. 

Children with DTD are commonly diagnosed with RAD, PTSD, ADHD, ODD, and more. They are frequently on a cocktail of serious medications, some of which may have psychosis as a potential side effect. 

Jessica’s son saw “little goblin creatures” when he was taking medications. “The last time, he said a naked man woke him up and told him to go outside,” she says. “Praise God he didn’t listen! That was a scary time.”

Psychotic symptoms may be a side effect of a drug, the result of drug interactions, or due to abruptly stopping or inconsistently taking the medication. Remember too, illicit drug use like LSD can cause psychotic symptoms. While appropriate medications have been helpful for many children it can takes some time to find the right combination.

For the best treatment insist on seeing a psychiatrist for medication management.

3. The psychotic symptoms may indicate a co-morbid disorder.

Disorders including schizophrenia, schizoaffective disorder, and bipolar can cause psychotic symptoms. These can be particularly difficult to diagnose in children because adoptive parents don’t have knowledge of hereditary mental illnesses that may run in the family. 

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

Angela, says her daughter “creates her own ‘truths’ or ‘realities.’ “At 11 and 12 I would hear her having long talks with herself but I never knew if she was putting on an act or if it is real…” This is a dilemma for parents because what seems like delusions may be immature thinking caused by the DTD.

For correct diagnoses, a professional evaluation is essential. 

Don’t panic – but do get professional help.

If your child is reporting psychotic symptoms, don’t panic – but do get professional help. Whether your child has malingering psychosis, is suffering a drug side effect, or has a co-morbid disorder they are signaling for help. With proper treatment and early intervention these children can grow and thrive.

How to Start a Local Support Group

Parenting a child with developmental trauma and Reactive Attachment Disorder (RAD) is extremely isolating and difficult. As parents, we simply don’t fit into the typical parenting support groups. We need our own “extreme parenting” support groups which are hard to find. Finding community and support are key to our own mental wellness and providing the best care we can to our children.

If you’re considering starting your own local group, here are some tips to help you get started.

Keep it simple

  • Create a “come as you are” atmosphere with no strings or commitments. Some parents may only come once or may not be able to attend regularly. Make sure people know it’s okay to show up in their sweats, for just an hour, or only once every few months. This is the flexibility acceptance parents desperately need.
  • Don’t overcommit yourself as the leader. Start with scheduling single events or a monthly meetings rather than weekly meetings. Most parents of kids with trauma simply won’t have time to attend more frequently and as a leader it’s important to not overcommit.

Make it comfortable

  • Select a meeting place where people will feel comfortable to share. While meeting in a coffee shop can be convenient, remember how sensitive your discussions will be. Try to meet in a home, a church conference room, or private room at a local coffee shop.
  • Limit attendees to parents only. Having social workers, therapists and other professionals changes the tone and will make parents hesitant to share transparently.
  • Set ground rules ahead of time and repeat them at every meeting. Two important ones to include are:
    • Confidentiality – What’s shared in the meeting, stays in the meeting
    • Judgement-free – Parents need to be able to share their anger, frustration, sadness, and guilt without being judged.
    • Limited advice – It’s great to provide each other with ideas and resources, but the focus of your group should be to provide encouragement and a place to be heard.

Pick a format that works

Owl timer from Amazon
  • Organic Sharing. Parents are desperate to be heard and know they aren’t alone. A wonderful way to do this is to allow people to share their stories and updates on their lives. If you choose this format here are a few things to consider.
    • Make sure everyone has a chance to share. You can do this without seeming insensitive by using a fun timer – perhaps a 5 minutes – for each person.
    • Consider a talking stick for discussions to prevent interruptions and rabbit trails.
  • Book studies. Picking a practical book to read and discuss can be an excellent way to facilitate a support group meeting. Here are a few to consider:
  • Expert presentations, videos, local events, etc…. There are all sorts of possibilities, so be creative and engage your attendees for ideas.

Find parents to invite

If you’re just getting started you may not know other parents to invite. Rest assured, there are many parents in the same position as you are – and most also feel completely alone. Here’s some ways to connect:

  • Join online support groups and write a post asking who else is in your city. The two groups I like to recommend and am most active in are Attach Families Support Group and The Underground World of RAD
  • Provide information about your group to providers you work with: therapists, exceptional children teachers, pediatricians, the agency you foster/adopted through, and others.
  • Attach Families is working to create an international directory of support groups. Here’s a flyer you can reproduce to handout and please be sure to let them know about your group.

Remember, small is good – a turn out of 3-4 parents is a wonderful start. If your group becomes large – regularly more than 10 people – consider breaking into two groups by geography or date/time.

A few thoughts on logistics

  • Use an RSVP system like the free version of SignUp Genius. This can be helpful because it’s easily shared on social media.
  • Start a Facebook Group to communicate with local parents about your group and share information on other local events and resources.
  • Use name tags and provide light snacks and drinks. Be sure to have a couple boxes of tissues on hand.
  • If you are a leader and need advice on handling specific situations please reach out to Attach Families.

I’d love to support you too! If you’d like copies of my book Reactive Attachment Disorder: The Essential Guide for Parents to provide free of charge to members of your support group please contact me.

10 Survival Strategies for Summer

As school winds down, many families look forward to beach vacations, summer camps and lazy days. They break out the backyard sprinkler, sunblock and barbecue grill. But parents of children with developmental trauma disorder (DTD), like myself, often dread the long summer days which are anything but relaxing and enjoyable. 

Our kids will sabotage fun activities and have behavioral and emotional meltdowns on a regular basis. They’re likely to disrupt anticipated family vacations with rages and extreme behaviors. And it’s a waste of money to enroll our children in summer camps they’ll only get kicked out of. 

There’s no use sugar coating it—summer is going to be challenging for our families. But there is hope. 

Here are 10 strategies to help you survive summer (and maybe sneak in some relaxation time too):

1. Have realistic expectations.

We often view summer as an opportunity to focus on getting our child’s negative behavior under control. It’s important (for both you and your children) to be realistic, however. Maybe simply getting through the summer is a huge accomplishment. Plan activities your child enjoys and that you feel good about—playing basketball, riding bikes, maybe watching cartoons at times if you need a break. Remember, a daily tug-of-war is not a way forward.

2. Pick your battles.

For summer success, go back to the basics with family rules and chores. Don’t wait for your children to wear you down. Instead, make conscious, up-front decisions you can own. Explain to the kids that chores and rules still need to occur during the summer. Yet, plan them in a way that doesn’t cause extra stress for you or the family. For example, neatly-made beds may make a bedroom look tidy, but is it worth 30 minutes of your day? Is it worth feeling stressed? Is it worth kick-starting adrenaline pumping through your child’s body? Decide what is and is not negotiable for you, within reason. 

3. Keep the kids busy.

Help your kids sleep better at night and get into less trouble by keeping them busy. Remember, many kids with DTD are developmentally delayed. Get creative and offer tactile activities like play dough which can be fun for kids of all ages. If your child can handle it, recreational sports, camps and trips to the playground are all great ideas. Look for opportunities in your area. For example, you could sign your older teens up for the free teen summer challenge program through the gym Planet Fitness to help build their self-esteem and get those feel-good endorphins flowing.

4. Plan ahead.

Help your kids transition from the routine of school to home by maintaining regular bedtime and mealtimes. Also, plan regular activities the whole family can look forward to and enjoy together. You don’t have to break the bank either. You could look into free summer bowling programs or outdoor concerts, for example. Go in knowing that using these outings as a reward or consequence isn’t going to work (see Why Sticker Charts (and other traditional parenting techniques) Don’t Work). Instead, view these as opportunities for your kids to get their energy out and have fun as a family.

5. Utilize local services.

If your child is on the severe end of the spectrum for DTD, you may need to access community services over the summer. If they can’t function safely at home, talk to their therapist about options like partial hospitalization or day treatment. Some communities offer local camps and programs for at-risk kids where your child will receive additional supports. If your child has an IEP, they may qualify for summer school through the district as well.

6. Have a crisis plan.

While it’s important to be optimistic, we also must be realistic. Summer is likely to be long and hard with many meltdowns along the way. Take some time to really consider what your child’s triggers are and ways to avoid them before they even begin. Also, plan practical ways to de-escalate situations. Instead of implementing consequences, focus on reintegrating them back into family activities as quickly as possible. Be sure to have a crisis plan for when your child is unsafe, including a way for siblings to remain psychologically and physically safe.

7. Keep up with therapy and medications.

Your child will have different stressors during the summer than during the school year. This is why medications and therapy cannot take a summer break. Many psychological medications cannot be stopped without adverse effects and, if they can, your child likely needs the added support of the medications as they navigate the summer. Also, keep up with your child’s therapy and treatment appointments even if the schedule is irregular.

8. Carve out time for yourself.

It’s important to balance the needs of everyone in the family— including your own. Letting your kids sleep in a bit later than normal during the summer can be one practical way to make time for yourself. If you’re a stay-at-home parent, consider having your spouse take some vacation time so you can get a break from being the primary caregiver. Spend that time out of the house relaxing and enjoying a bit of summer. Perhaps your spouse can work 4-day weeks to provide some support. In some cases, it may be worth considering a spouse taking Family Medical Leave (FMLA) to help care for the child.

9. Plan respite for siblings.

Siblings only have one childhood and deserve to enjoy their summer too. Be intentional in planning ways for them to escape toxic stress and have fun. Enroll them in overnight camps and day programs. Always try to arrange transportation with other families so your troubled child cannot sabotage their sibling’s activities with misbehavior. Consider letting siblings spend extended time away with grandparents or cousins.

10. Simplify, simplify, simplify.

You have limited ability to control your child’s behavior but you can reduce other stressors in your life. Don’t overcommit yourself to activities and find ways to simplify the mundane tasks of life. Hire a teenager to mow your lawn and bring in a maid service to clean the kitchen and bathrooms whenever possible. Have a pizza place on speed dial and buy quick-fix meals. By eliminating stressors from your life, you increase your capacity to handle stress. This is good for everyone in the family.

Your family dynamics are unique. Some of these strategies will work for you and some will not. You’ll probably be more successful with children on the mild-to-moderate end of the spectrum. Be creative and pragmatic. Hopefully these 10 summer survival strategies will spark some optimism for a more manageable and enjoyable break.

Understanding the long-term impact of early childhood trauma

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

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

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

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

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

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

The Impact of Trauma

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

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

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

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

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

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

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

Healing the Impact of Early Trauma

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

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

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

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

Raising a Child with Developmental Trauma

Published by Fostering Families Magazine (May/June 2019)

Three-year-old Devon, whose name has been changed to protect his privacy, had big, chocolate brown eyes and was eager to please. His sister Kayla, 2, was feisty, with gobs of curly hair and dimples. During our pre-adoption waiting period, Kayla screamed for hours on end, seemingly for no reason at all, and couldn’t be consoled. I found Devon elbow deep in the toilet playing with his feces. At mealtime, he’d eat fast and furious then throw up all over the table. Once, I found Kayla hiding in the pantry and clutching a jar of peanut butter.

Despite all this, my husband and I jumped heart-first into the adoption. We understood these behaviors weren’t uncommon for foster kids. We believed all Devon and Kayla needed to heal was the love of a forever family.

Unfortunately, it wasn’t so simple.

By referring to these concerning behaviors as “normal for foster kids,” it’s easy to lose sight of the why behind them. For example, Kayla was frequently left alone in her crib for hours as a baby. When she cried because she was hungry or wet, no one came. These experiences etched an innate sense of insecurity on her psyche. 

Devon lost his birth mother at 6 months when he was removed from her care and her parental rights were eventually terminated. His mind couldn’t understand, but his body absorbed the loss. 

Leading trauma expert Bessel A. van der Kolk uses the expression, “The body keeps the score,” to illustrate how the body remembers trauma with tragic, long-term impacts for kids like Kayla and Devon – even if they find a loving forever family.

What is Developmental Trauma?

Developmental trauma occurs when a child experiences chronic abuse or neglect before the age of 5. These are the years when the brain is developing rapidly and is particularly vulnerable. 

Trauma may disrupt a child’s sequential brain development, according to psychiatrist Dr. Bruce Perry. This can cause, for example, impaired cause-and-effect thinking and poor self-regulation. Their behaviors, emotions, and thinking are developmentally immature because they’re literally “stuck” at earlier developmental levels. 

Also, when a child experiences frequent activation of their fight-or-flight response due to abuse, their brains can be overexposed to the stress hormone cortisol. As a result, their fight-or-flight pathway may activate in even minimally threatening situations. Forrest Lien, executive director for the Institute for Attachment and Child Development, explains: “These children live in constant ‘survival mode’. They are hyper vigilant, do not trust others, and feel the need to control their environment at all times to feel safe. Therefore, they do not allow adults to parent them and cannot have healthy relationships.”

Devon and Kayla

Developmental trauma affects each child uniquely and its impact varies in symptoms and severity. The symptoms can include attachment difficulty, self-esteem problems, anxiety, sleeplessness and a lack of impulse control.

Kayla has overcome a math learning disability, has close friends, and is a creative and independent 15-year-old. However, the trauma symptoms haven’t disappeared entirely. She still sleeps on the floor instead of in her bed, and won’t eat in front of non-family members.

Devon, unlike his sister, falls on the moderate to severe end of the spectrum for developmental trauma. Now 17, he lives in a psychiatric treatment facility. He’s physically aggressive and has no close friendships. He has pending criminal charges for assault and is on track to turn 18 with an 8th grade education. 

Early Intervention is Key

Like many foster and adoptive parents, I was unfamiliar with developmental trauma and didn’t know the warning signs. I only realized we needed professional help when Devon, at 9, karate chopped his adoptive little brother in the throat and pushed him down the stairs. Regretfully, those early missteps and missed opportunities exacerbated his condition. 

To determine if your child needs professional intervention watch for:

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

Trust your instincts and err on the side of caution. There’s no harm in getting a professional evaluation, while the cost of not getting help early can be devastating. If you delay, your child may turn to unhealthy coping mechanisms including drugs, promiscuity, and self-harming.

Untreated developmental trauma can result in behaviors that cause kids to be expelled from school, institutionalized, or face criminal charges. Other siblings in the home are at high risk for primary and secondary trauma. Parents, especially mothers, may develop PTSD

This doesn’t have to happen. Your child’s future isn’t yet written. Early intervention can change their trajectory academically, vocationally, legally and relationally.

How to get help

The best place to start is with your child’s pediatrician – but be wary of the ADHD diagnosis they might dole out at first. While developmental trauma may cause attention deficits and poor impulse control, an ADHD diagnosis doesn’t tell the full story. Also, the stimulant medications prescribed for ADHD can exacerbate symptoms. Instead, ask for a referral to a psychiatrist for a comprehensive psychological evaluation and diagnosis.

Developmental trauma doesn’t currently map to any single diagnoses. As a result, your child will likely be given multiple diagnoses to fully cover their symptoms. These may include:

  • Post Traumatic Stress Disorder (PTSD)
  • Anxiety Disorder
  • Reactive Attachment Disorder (RAD)
  • Oppositional Defiant Disorder (OD)
  • Sensory Processing Disorder
  • Developmental Delays
  • Learning Disabilities 

For a child with developmental trauma, these diagnoses are interconnected and need to be addressed in the context of the underlying trauma. For example, PTSD-like symptoms caused by developmental trauma requires different treatment than PTSD caused by combat according to Dr. van der Kolk. 

This is why it’s critical to engage clinicians who have experience working with traumatized children, foster kids, and adopted kids. Work with a psychiatrist to explore medication choices. Get an Individualized Education Plan (IEP) in place at school to ensure your child receives the services and supports to be successful.

Unfortunately, there are no quick or easy fixes to developmental trauma, but there is hope with early intervention. 

Love is critical, but it’s not enough

Devon with adoptive brother Amias

Raising a child with developmental trauma can be incredibly difficult and isolating. The more you understand your child’s trauma history, and learn about the science of trauma and therapeutic parenting, the better equipped you will be to help your child heal. Join a local or online parents support group (I recommend, The Underground World of RAD or Attach Families Support Group), prioritize your self-care, and consider seeing a therapist if you begin to feel overwhelmed.

“Love and time will not erase the effects of early trauma,” says Lien. “The best first step is to secure the child in a healthy family but that is only the beginning.”

Children who have experienced developmental trauma desperately need the love of a forever family, but love alone isn’t enough. Get professional help early, before the behaviors and emotions grow too big and overwhelming.

"Love and time will not erase the effects of early trauma. The best first step is to secure the child in a healthy family but that is only the beginning.” – Forrest Lien, executive director @InstituteAttach Click To Tweet

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.