Category: The System

The Secret Next Door (Child on Parent Violence)

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

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

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

What the parents living next door may be hiding

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

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

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

How many families this affects

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

This is simply not the case.

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

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

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

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

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

Anonymous parents

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

When children abuse their parents

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

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

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

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

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

Why children abuse their parents

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

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

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

Why families can’t get help

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

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

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

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

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

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

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

What needs to change

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

Intentional Child on Parent Violence (I-CPV) isn't merely talk-show fodder. It's happening behind closed doors in your neighborhood. These parents need support and viable treatment options for their kids. Click To Tweet

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

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

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

Joker: A warning we should heed

At my teenaged kids’ insistence, I took them to watch Joker in the theater, expecting a typical action-packed, comic book movie – not a genre I typically enjoy. Instead, I sat in the darkness, stunned to near-tears by it’s devastating portrayal of how early childhood trauma and untreated mental illness can spiral into tragedy. 

The poignant film explores the backstory of comic book villain Joker: a man named Arthur Fleck who has a disturbing past and a troubling present. It is a compelling and nuanced portrayal of untreated trauma and mental illness. 

Joker is incredibly violent and disturbing, certainly earning its R-rating, but at the same time reflects a reality we are already seeing in our society today. Early childhood trauma is at epidemic levels. Our mental health system is in disarray. We aren’t meeting the needs of the vulnerable around us and sometimes violence and tragedy are the price we pay as a society. 

There’s a huge amount of controversy swirling around the film and it’s portrayal of mental illness. After watching the movie, I believe the real controversy we should be focused on is why we don’t have affordable, accessible, effective treatment for mental illness and early childhood trauma!

"You think Joker is controversial? What's really controversial is that we don't have affordable, accessible, effective treatment for mental illness and early childhood trauma." – Keri Williams Click To Tweet

*** Spoilers Below ***

In the film, Joker, we meet Arthur Fleck shortly after he’s been discharged from a mental health institution. He’s receiving mediocre city mental health services, living in poverty, and attempting to build a semblance of a life for himself.

While the film does not specify all of Arthur’s diagnoses, his symptoms include hallucinations, paranoia, delusions, and feelings of despair, loneliness, and worthlessness. Arthur’s one obvious diagnosis, Pseudobulbar Affect (PBA), fits of uncontrollable laughter, results in severe bullying. We also learn Arthur was abused and neglected by his mother during early childhood. This included severe head trauma as well as psychological and emotional abuse. Arthur has never been able to access the treatment he needs to manage his condition, much less heal, or thrive. He’s completely lacking social skills, unable to hold down a job despite his best efforts, and even with medication, unable to feel happy or optimistic.

Unfortunately, Arthur is not simply a far-fetched character. We have “Arthurs” living and breathing all around us – in our daycare centers, classrooms, workplaces, and neighborhoods. Early childhood trauma is a hidden epidemic affecting millions of people. While victims of early childhood trauma and/or people who have mental illnesses aren’t necessarily violent, the combination of untreated trauma and mental illness with psychosis can be dangerous. Furthermore, high-risk children are not receiving effective treatments in residential treatment facilities. They are aging out ill-equipped to function in the adult world and at high risk of criminal behavior and incarceration. Like Arthur, most of these individuals want to be happy. They want to have good lives. However, we, as a society, fail them by not providing effective, affordable, accessible treatments for trauma and mental illness. Like Arthur, these people struggle to navigate even the basics of life.

Arthur, though teetering like a wobbling house of cards, is trying to build a life for himself. He’s trying to find some happiness. But it’s obvious to the viewer that he simple doesn’t have the resources or skills to do so. And so begins Arthur’s devastating spiral that should be a warning for us all. 

  1. Arthur loses his services (therapy, medications, etc) due to city financial cuts.
  2. He’s fired from the job he loves – sure he made a mistake, but he’s given no mercy or compassion.
  3. He follows his dream to be a comedian, and falls flat. He’s mocked mercilessly.
  4. He’s physically assaulted for laughing (his Pseudobulbar Affect) and in self-defense shoots and kills two men on a train. In a panic, he kills another.
  5. He’s cruelly rejected by the man he believes to be his birth father.
  6. He learns his mother abused him as a child and anger that has been festering in his unconscious for decades surfaces.

The spiral tightens. Arthur is drawn to the rioters who praise him as a vigilante for the killing on the train (which was in fact, self-defense). He becomes more violent and murders several people. In his mind, his path has become inevitable as all other doors – all other options – have slammed closed in his face. 

Does this not reflect the crumbling path of so many young people in our society today? People who struggle on the edge of society: to hold down a jobs, to form relationships, to find their next meal, or place to sleep. This instability is the fate of so many people who have experienced early childhood trauma and/or are mentally ill because they are unable to access effective treatment and services. Is it any wonder that they are hopeless, desperate, and caught in a downward spiral? Is it any surprise that some end up engaging in criminal behavior? That some act out violently?

Towards the end of the movie, Arthur has fully transformed into the Joker. Wearing chalky make-up and a sardonic smile, he sits on a talk show stage and casually confesses to the train murders, Before shooting the talk show host point-blank in the face, Joker says, “I’ve got nothing to lose. Society has abandoned me.” And we can’t disagree: He has got nothing to lose. Society has abandoned him.

It only takes thumbing through the headlines to know that far too many of our most vulnerable have been abandoned by society and with nothing to lose have picked up guns and lashed out violently too. Read more about one recent incident here. This will continue until we prioritize affordable, accessible, effective treatment for early childhood trauma and mental illness.

NOTE: In case it wasn’t clear in this post, I am not saying that mental illness or childhood trauma lead to violent behaviors. What I am saying is that untreated mental illness and untreated childhood trauma can put people on a dangerous spiral.

Yoga at school may help your child, but what about mine?

Recently I’ve seen several headlines about schools who are introducing yoga as a way to address student behaviors. The West Fargo Pioneer (link no longer available online) explains this way:

Behavior issues stem from a multitude of reasons. However, studies show that students today are more likely to experience trauma and have mental health needs, increasing the likelihood of classroom disruptions and behavioral issues. 

In a classroom of 20, one or two students on average will be dealing with serious psycho-social stressors relating to poverty, domestic violence, abuse and neglect, or a psychiatric disorder, according to the Child Mind Institute.

This type of stress can shorten periods of brain development and limit brain growth in early years, making it harder for students to regulate emotions and concentrate on learning. 

And while schools can’t control students’ experiences outside the classroom, they can help students learn how to cope with stress and regulate emotional outbursts. Social-emotional curriculum aims to help students recognize and deal with emotions and tackle the increased presence of stress and trauma.

It’s absolutely true that every classroom has children who have experienced trauma. Early childhood trauma is an epidemic. It’s absolutely true that these experiences affect a student’s ability to learn and cope in school. It’s also absolutely true that some students will benefit from yoga. It will help by,

  • Reducing stress
  • Improving concentration
  • Increasing self-esteem
  • And more…

This is why PBS suggests Managing School Stress by Bringing Yoga Into the Classroom. And Education Week applauds Ditching Detention for Yoga: Schools Embrace Mindfulness to Curb Discipline Problems.

Great ideas, however news articles like these give the impression that yoga is an inexpensive, quick fix for childhood trauma. For kids on the moderate to severe end of the spectrum, this simply isn’t the case.

Here’s the problem

Many kids with developmental trauma are so dysregulated they cannot follow instructions or calm themselves enough to even choose to participate in yoga. A 10-year-old who flips desks, curses at the teacher, and fights with other kids is likely not able to safely or effectively participate in yoga.

Furthermore, kids who have extreme behaviors and emotions may be extremely disruptive during yoga activities. This can cause other students to be unable to focus and benefit from the exercises. A 6-year-old who refuses to follow instructions, pesters other kids, and runs around in circles, will disrupt the entire atmosphere.

If a child has a cold, a spoonful of honey does wonders. However, that same spoonful of honey is not able to cure a child who has strep throat. Here’s the ugly truth about trauma: Some kids who have experienced trauma have needs far beyond what a spoonful of honey can heal. Without comprehensive and specialized treatments, these children are unlikely to benefit from yoga at school. They probably won’t even be able to successfully participate.

A spoonful of honey soothes a sore throat, but it can't cure strep throat. Yoga in schools is wonderful, but kids with developmental trauma need comprehensive, specialized treatments. There are no quick fixes or easy solutions. Click To Tweet

I cringe at the “yoga in school” headlines because they minimize the devastating, often debilitating, effects of trauma on our kids. Most people who read the articles, or just skim the headlines, will assume childhood trauma is easily treated.

Don’t get me wrong – I applaud schools incorporating yoga into their curriculum and behavior programs because it can be helpful to so many children. However, yoga cannot curb extreme behaviors caused developmental trauma. It is a far more complicated and challenging issue.

Let’s get our kids to a healthy place where they can benefit from yoga. You can help by learning how trauma effects kids and sharing our video to help raise awareness for the need for accessible, affordable, and effective treatments.

Video: Early Childhood Trauma – we need treatments now!

Learn more

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

Raising a child with Developmental Trauma

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

Why adoption stories aren’t fairy tales

It takes a village

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

Scary Mommy

Originally published by Scary Mommy as Developmental Trauma Absolutely Destroyed My Family

My husband and I jumped in heart first when we adopted out of foster care. Devon was three with big brown eyes and a shy smile. His two-year-old half-sister, Kayla, was spunky with freckles and gobs of curls. We already had two young sons and I eagerly imagined a lifetime of annual family photos, beach vacations, holidays, and birthday parties.

Early on we learned that Devon and Kayla had been neglected and abused, and they’d been in multiple foster homes. Because of this, they both were anxious and inconsolable at bedtime. Devon squirreled food away under his bed and sometimes gorged until he threw up. He was aggressive, played with his feces, and urinated in odd places around the house.

These behaviors concerned us, but in our pre-adoption training we were told they were completely “typical” for foster kids and there was nothing the love of a “forever family” couldn’t heal.

Over the next few years we went on the beach vacations I’d dreamed of and the kids had birthday parties at Chuck E Cheese. They played soccer and learned to swim and ride bikes. Kayla settled in, but Devon continued to struggle. I tried many different parenting strategies, but he wasn’t motivated by rewards or deterred by consequences. Two years after the adoption, our family grew once again with the birth of our youngest son Brandon.

Devon started kindergarten and enjoyed the first few weeks with his Blue’s Clues backpack and matching lunch box, but then the calls home began. One day he pulled the fire alarm. Another time he ran out of the school and an assistant principal had to chase him away from the busy road. He often refused to do his homework, especially if I told him to. Once he became so angry he pulled his bedroom door off the hinges. He was six.

It was clear something was seriously wrong, but I had no idea what it was or what to do about it.

By the age of eight, Devon’s tantrums lasted two or three hours at a time. He’d smile at me and say, “I feel like having a fit.” And then he would. He knocked holes in walls, broke toys, and chased his siblings with a baseball bat. I tried to be patient, but it seemed impossible. Sometimes he’d kick my head or try to climb out the van window while I was driving.

Adding to my frustration, Devon was adept at hiding his behavior from my husband. When he heard the garage door open, and realized Dad was home from work, he’d snap off his tantrums like a light switch. As a result, my husband thought I was overly sensitive or overreacting. When I reached out for help – to teachers, family, friends, therapists – they too assumed this was a parenting problem.

Sometimes I wondered if they were right. There were times I lost my temper, said things I shouldn’t have, and overreacted. I grappled with guilt, shame, disappointment, and anger.

Tired of being blamed, I plastered on a smile in public and hid behind closed doors. I grew more isolated and lonely. I developed a sleep disorder, was hyper-vigilant, and constantly on edge. In retrospect, I realize Devon’s tantrums had, by this time, morphed into rages. This created an environment of toxic stress for his siblings, and though I didn’t yet know it, I’d developed PTSD. I was so busy just surviving, I had little insight into how dire the situation had become.

Then, one afternoon, Devon angrily karate chopped little Brandon in the throat. Moments later he pushed him down the stairs. One giant shove from behind. Brandon wasn’t seriously hurt but it was the wake-up call I needed.

I began to take Devon to the mental health emergency room whenever he became unsafe. I had no idea what else to do. The first time I signed him into the psych ward, my heart pinched. This wasn’t the adoption happily ever after I’d imagined for us. Still, I was optimistic we were on our way to getting help.

The ER psychiatrist started Devon on medications. They didn’t seem to help. After several visits and one admission, the hospital referred us for intensive outpatient services.

Devon began to receive 15 hours of treatment and therapy a week. The treatment team helped me create a safety plan for Devon’s brothers and sister. They would run upstairs and lock themselves in my bedroom whenever he became physically aggressive. For everyone’s safety, they coached me to restrain him in what I called a “bear hug.” I was terrified, exhausted, and heartbroken all at once.

A few days into fifth grade, Devon punched his teacher in the stomach. He plucked out his eyelashes and wrapped a belt around his neck. That’s when his therapist sat me down to explain that Devon needed to be in a residential treatment program.

I balked. We just needed more therapy or different medications, didn’t we? There must be something else we could try…

She shook her head and insisted. His behavior was dangerous and the months of outpatient services he’d been receiving weren’t helping.

Devon was admitted to his first residential psychiatric facility when he was only 10 years old and we expected him to return home, much better, after a few months of intensive treatment. But while there he broke a staff person’s thumb. He caused thousands of dollars of property damage. He vomited and urinated on staff, and stabbed other residents – kids like himself – with pencils. He tried to strangle himself with his shirt.

As this continued for months, and then years, I was confused. Devon was receiving countless hours of therapy. Why wasn’t he getting better? Why weren’t his medications helping? It didn’t make sense.

I began to do my own research and learned about developmental trauma – the effect chronic abuse and neglect can have on young children. These kids perceive the world as unsafe and unpredictable and can go into fight-or-flight mode in even minimally threatening situations. Trauma can also disrupt their brain development. They may feel the loss of their birth mother so acutely they begin to unconsciously view any new mother figure as the enemy.

Suddenly Devon’s behaviors made more sense – his impulsivity, emotional and behavioral dysregulation, desperate need for control, and targeting of me. It was such a relief. Now that I knew what was wrong, I was hopeful Devon could finally get help.

Though the therapists agreed Devon had developmental trauma, their treatment approach didn’t change. They simply slapped on more diagnoses and tweaked his cocktail of drugs. They continued with the same ineffective therapies.

I was at a loss for a way forward. I thought back to the three-year-old little boy who we believed only needed was the love of a forever family. By then I’d realized love couldn’t heal developmental trauma any more than it could cure leukemia or set a broken bone. And the mental health system clearly had no solutions. Devon’s condition was getting worse in the treatment facilities. But what else could we do? With the safety of his younger siblings to think of, Devon was too dangerous to live at home.

Today Devon is 17 and has been in a parade of group homes, psych wards, and treatment centers. We visit him regularly, but he’s not stable or safe enough to move home. He’s been on numerous antipsychotic drugs and has received an alphabet soup of diagnoses: ODD, ADHD, CD, RAD, PTSD, DMDD, and more. He’s proven to be extremely resistant to traditional therapy, a hallmark of developmental trauma. With each new placement he’s grown more dangerous and violent. He’ll soon turn 18 and age out of the treatment centers as an angry young man.

I am angry too.

Ineffective treatment has snuffed out Devon’s once bright future and our family has been broken. Hundreds of thousands of children suffer developmental trauma, yet the mental health system has no answers. I recently heard leading trauma researcher Bessel van der Kolk speak at a conference and he confirmed what I learned the hard way: We have a long way to go in the work to develop effective treatments for developmental trauma.

How is this possible? Why isn’t the public outraged? I’m convinced it’s because our stories aren’t being told. We talk freely about the challenges families face when their child has leukemia or other physical illness. But there’s a taboo around mental health struggles.

Yet, there are thousands of families with stories virtually identical to Devon’s, and to mine. Like me, these families receive little support. Gaslighted, blamed, and shamed into silence, they’ve gone underground into private and secret online support groups. Their suffering is treated like a dirty little secret instead of the national crisis – the tragedy – it is.

Realizing this has only cemented my commitment and determination to raise my voice louder and to use my blog to call for increased funding and new research for treatments for developmental trauma. I am speaking out not only for Devon and my family, but for the thousands of families and children who have no voice.

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

Documentary exploring the school-to-prison pipeline

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

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

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

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

Photo Credit: The Kids We Lose, PBS

My thoughts…

Teachers need to teach

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

Restrains aren’t therapeutic, but we need an alternative

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

Teachers and peers matter too

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

It’s complicated

Photo Credit: The Kids We Lose, PBS

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

Here’s what I know:

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

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

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

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. 

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

In recent months, the stories of migrant children separated from their parents at the border have tugged at our hearts. The news media is rightly exposing how early childhood trauma – such as separation from a mother – can cause lifelong, negative impact.

The issue of childhood trauma may only recently have become front page news with the crisis at the border, but it’s all too familiar for adoptive and foster families. Reactive attachment disorder (RAD), rare among the general population, is most prevalent among adopted and foster children. Due to early childhood trauma, they are often unable to form meaningful attachments to caregivers and may exhibit extremely challenging behaviors.

Instead of enjoying playful childhoods, these children struggle to cope with everyday life. As a result, some are unable to earn a high school diploma and too often get tangled up in the criminal justice system. Disorders like RAD, that are caused by early childhood trauma, are literally stealing away our children’s future.

In advocating for children we must cast a wide net

Regardless of our politics, we can advocate together on behalf of innocent children. Let’s consider that immigration isn’t the only “system” that’s harmful to children. The foster care, adoption, and criminal justice systems are also dysfunctional with misguided policies that traumatize and retraumatize our children. The impact of this trauma is staggering, life-altering, and devastating.

Here are just a few of the ways it happens:

  • Some vulnerable kids are overlooked by “the system” and left in abusive and neglectful situations.
  • Some kids are unable to be placed in a permanent family because “the system” makes repeated, misguided attempts at reunification.
  • Some kids are unnecessarily removed from their caregivers and processed into “the system.”

Sadly, “the system,” intended to protect our vulnerable children is broken.  

These children, with trauma scars indelibly etched on their psyche, need specialized treatment to heal and thrive. Few get it. The mental health community is woefully unprepared to recognize and treat RAD. Where treatments are available, most families cannot afford them. As a result these damaged children grow into unstable and unhappy adults.

We can do better

Let’s join together for all children – migrant children, foster kids, and adopted children – who are so often collateral damage of policies not focused on their best interest and well-being. There is power in our collective outcry. It’s time to leverage our collective outrage and advocate for reform of “the system” and for meaningful treatments and resources to treat trauma-caused disorders like RAD.

Image: A boy and father from Honduras are taken into custody by U.S. Border Patrol agents near the U.S.-Mexico Border on June 12, 2018, near Mission, Texas. via @Huffington Post

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.

What I Wish People Knew About These Popular Social Media Quotes…

Everyday I see quotes like these on social media:

Behavior is not a kid being bad, it’s a form of communication.

My behavior is a symptom of my trauma, not willful non-compliance.

These types of sentiments garner thousands of likes, shares, and re-tweets. But for families like mine, they simply don’t ring true.

My son, Devon, has been diagnosed with Reactive Attachment Disorder (RAD), a result of early childhood trauma. My husband and I adopted him out of foster care when he was 4 and prior to that he was neglected and did not form a close attachment with a caregiver. This is called “developmental trauma,” a term coined by leading expert Bessel van der Kolk.

Kids who experience chronic neglect and abuse may begin to default to fight-or-flight mode in even minimally threatening situations. Developmental trauma can also disrupt the brain’s development causing impaired or under developed cortical brain functions including cause-and-effect thinking and abstract thinking. RAD is a common diagnoses for these kids.

I liken RAD to a tug-of-war. For example, Devon will become belligerent over anything from what color socks he’ll wear to if he’ll use a seat belt. His screaming fits last for hours – literally hours – and often include property damage and dangerous physical aggression. Devon treats every situation as though it’s life-or-death, in a desperate attempt to control the people and situations around him.

Are Devon’s extreme behaviors related to his developmental trauma? Of course. He’s driven by the unconscious trauma scars etched on his psyche.

His behavior IS communication.

His behavior IS a symptom of his trauma.

That doesn’t mean his behavior isn’t also willful.

Devon makes a choice when he refuses to buckle his seatbelt. He chooses to tip desks over in his classroom. He chooses to break windows and chase his siblings with a baseball bat.

Certainly, there are some disorders where symptoms are involuntary such as schizophrenia and alzheimer’s. However, RAD is a behavioral disorder. Control and anger issues are symptoms of this disorder.

Kids with RAD can be both unconsciously motivated by underlying trauma scars and willful. These two things can and do coexist. In fact, this is what makes parenting a child diagnosed with RAD so challenging.

Our child enjoys pushing our buttons because it gives them a feeling of control, which they unconsciously crave. That’s the underlying motivation and the pay off, but that doesn’t negate the child’s role in making a choice to engage in certain behaviors.

The idea that a person has no control over their behaviors is not healthy for anyone. I refuse to take away my son’s agency. If he has no control over his behaviors. then he has no hope for a better life and no hope for the future.

As a parent in the trenches, here’s my take on the social media quotes I listed above:

  • I recognize my son’s behavior is a symptom of his trauma, but also as willful non-compliance.
  • I listen to the communication behind my son’s behavior, but I also tell him his behavior is bad.

As I like to tell my son, a sneeze is involuntary – stabbing someone with a pencil is not.

Let’s acknowledge that our children’s mental health is complex and nuanced. Let’s stop painting with such a broad brush. Causes behind our children’s behaviors aren’t always simple enough to be encapsulated in a snappy social media quote.

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

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

Survey by @RaisingDevon March 2019

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

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

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

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

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

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

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

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

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

Micci

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

Adrienne

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

Christina

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

Julia

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

Laura

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

Nancy

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

Beth

Love alone is not enough

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

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

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

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

What parents need in pre-adoptive training

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

Prospective adoptive parents ned to walk away from training with:

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

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

Resources

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

Support Groups

(Let them know @RaisingDevon sent you!)


For a determined would-be school shooter, there’s always a way – until we address the underlying causes

 Only a few days ago, I had the opportunity to plant a gun in a school.

The doors were unlocked. There was no security guard. No office staff was signing visitors in. No one was monitoring the surveillance cameras.

It was Saturday morning, and I was attending my son’s recreational basketball game at a local public middle school. The school was wide open. I could have easily walked in with a duffle bag slung over my shoulder, an AR-15 and ammo hidden inside. If I was a student, I could have stashed the weapon in my locker, but the heap of lost and found items would make a good hiding place too. And just that easily, I would have secreted away a weapon for easy access.

There’s always a way to get a weapon into a school. More than once I thought about this as I watched students at my daughter’s charter school pass through metal detectors. They pulled three-ring binders, laptops, cell phones – anything with metal – from their bookbags and passed them around the detector. But couldn’t a pistol be hidden in a binder and pass into the school undetected?

As controversy swirls around efforts to keep guns out of schools –school officers, armed teachers, wanding, metal detectors – we must remember these steps alone cannot protect against every determined and resourceful would-be school shooter. It’s not enough to try to stop violent plans already in the execution stage. Instead, we must understand what leads young people to act violently and implement comprehensive, proactive measures to address the underlying causes.

It's not enough to try to stop violent plans already in the execution stage. Instead, we must understand what leads young people to act violently and implement comprehensive, proactive measures to address the underlying causes. Click To Tweet

Dr. Terry Levy of Evergreen Psychotherapy Center co-authored “Kids Who Kill: Attachment Disorder, Antisocial Personality, and Violence” in the aftermath of the Columbine school shooting. In it, he pointed to evidence of the relationship between early childhood trauma and violence.

Research has shown elevated cortisol levels caused by early childhood trauma,  typically chronic abuse and neglect, can impact a young child’s brain development. As a result, they may struggle with emotional regulation, linking cause-and-effect, abstract thinking, and other high-level brain functions. Not all, but some of these children may become aggressive and violent.

The correlation between early childhood trauma and violence is frightening given the number of students at risk. According to the Child and Adolescent Mental Health Initiative at Johns Hopkins, almost half of all children have experienced at least one type of childhood trauma. As a result, a staggering number of students walk into our schools every day with a festering wound borne of childhood trauma. Most often, the wound is unrecognized and untreated. At best, we might slap on a band aid, but rarely do we treat the underlying trauma.

We’ve known about the link between childhood trauma and violence for 20 years, yet little has changed. Our society does not recognize the devastating impact of childhood trauma on it’s victims or the collateral damage on our community as a whole. We do not prioritize funding for research needed for prevention and meaningful treatments. And as a result, our communities continue to face acts of violence from young people.

Just last month we learned about four North Carolina (my home state) middle school students who were planning a Columbine style attack on their school. This was thwarted, but you can be sure many other future attacks will not be stopped in time. For a determined would-be school shooter, there’s always a way.

Childhood trauma is an epidemic in our society and without treatment, children will not heal and will have little hope for a happy and productive future. For some, their trauma wound will grow so unbearably painful they’ll lash out violently. No metal detector, locked door, gun sniffing dog, or wand will stop them.