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How to Discipline a Child with Reactive Attachment Disorder (RAD)

It’s the million-dollar question. How do we manage the behavior of children with RAD?

Therapeutic approaches can seem scarily permissive. Meanwhile, traditional parenting approaches backfire spectacularly.

At the root, most behaviors children with RAD engage in are intended for self-preservation – by sabotaging relationships and controlling their environments. It’s unlikely, however, that they’re introspective enough to be consciously doing this. These underlying motivations are etched like scars on their psyche.

Most likely, the in-your-face motivations of these kids are far more concrete. For example, our kids may be arguing incessantly because:

  • it’s a habit like biting their nails or spinning a pencil
  • they want to test our boundaries to see how flexible the rules are
  • they don’t really care about anyone else’s feelings or needs
  • they love to push our buttons and get a reaction

When we’re in the trenches trying to manage these behaviors it’s sometimes difficult to embrace therapeutic parenting approaches because they seem to discount these in-your-face motivations entirely. Instead, they focus completely on the underlying, unconscious motivations.

I’ve had therapists tell me that my son has no control over his behaviors – as if they’re as involuntary as a sneeze. I sure know that’s not the case. Click To Tweet

Yes, in the real-world of RAD parenting, we know the in-your-face motivations are every bit as real as the unconscious, underlying motivations. In fact, they’re what make the behaviors so painful to deal with emotionally. As a result, parents often focus on the in-your-face motivations and find themselves angry, frustrated, and easily triggered.

Let’s consider that in many children, both sets of motivations co-exist.

For example,

My child is arguing just because they enjoy pushing my buttons. It gives them a feeling of control which they unconsciously crave because they intrinsically believe the world is unsafe.

When we look at the motivations for the behavior more holistically like this we are able to have greater empathy, more patience, and find energy to invest in long-term approaches. Below are some resources I’ve found useful for specific strategies and approaches. Please be sure to comment and share what’s working for you.

Recommended Resources

The A-Z of Therapeutic Parenting

Sara Naish’s book “The A-Z of Therapeutic Parenting” it a balanced approach that’s both therapeutic and practical. She covers behaviors from Absconding to ZZZZ (sleep issues) and everything in between. For each behavior she helps us understand the broad range of reasons why a child might be doing it. She also provides strategies to prevent the behavior, to manage it in the moment, and to address it after the fact. These suggestions are refreshingly practical and obviously written by someone who has been in the trenches themselves. Read my full review or pick up a copy here: The A-Z of Therapeutic Parenting.

How to Discipline a Child with Reactive Attachment Disorder-2

How-to blog post

Check out this excellent post on how to discipline a child with RAD. This is one of the most complicated topics related to RAD. Most ‘discipline’ is ineffective and it can be quite risky.

How to Discipline a Child with Reactive Attachment Disorder – Every Star Is Different

The System

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

Book Reviews

RAD and Developmental Trauma in Fiction

These popular novels are twisty, psychological thrillers with surprise endings. They each feature a child with developmental trauma and/or RAD. Some details are true-to-life while others are just fiction…

Defending Jacob

Andy, a district attorney, believes his son Jacob, diagnosed with RAD, is innocent of the murder he’s been accused of. Andy puts all his efforts into Jacob’s defense despite mounting evidence against him. But is Andy really innocent?

The Foster Child

Psychologist, Imogen, refuses to believe her new patient 11-year-old foster child Ellie, is dangerous. She’s determined to protect Ellie from the distrustful and cruel adults and children around her. But is she the one who needs protecting?

Baby Teeth

Hanna is a difficult, non-verbal child whose mother is chronically ill. She’s adored by her dad, but mistrusted by her mother, Suzette. After Hanna breaks her silence with whispers threats, bad things begin to happen. Is Hanna really dangerous?

What’s just fiction…and what’s not.

*** WARNING! SPOILERS BELOW ***

When 14-year-old Jacob is accused of murdering a classmate it seems impossible – especially to his father, Andy, who is the local district attorney. Jacob is evaluated by a psychiatrist who diagnoses him with Reactive Attachment Disorder (RAD). The psychiatrist tells the family it is “unusual” for a kid to develop RAD without experiencing any abuse, neglect, or trauma. As the investigation gets underway, Jacob’s mother Laurie begins to question his innocence.
Jacob is ultimately exonerated of the murder. A few months later, however, his girlfriend mysteriously disappears. Andy again defends Jacob vigorously and will not consider the possibly he’s capable of these crimes. However, the truth dawns on Laurie as incriminating evidence mounts. Laurie is deeply conflicted by fear, guilt, shame, love, and desperation. To atone for herself, and to save Jacob from himself, Laurie purposely crashes her minivan into a concrete barrier, killing Jacob instantly.

What’s just fiction – It’s impossible to have with RAD without an underlying trauma per the DSM-IV diagnostic criteria. The author could have incorporated one of the causes of RAD in a “typical” biological families into his plot. Also, it’s unlikely for a child with RAD to be homicidal, as Jacob is, unless he has other serious co-morbid mental illnesses.

And what’s not – The story effectively portrays the common RAD symptoms of extreme manipulation and how father’s often do not “get it.” Also, the conflicted feelings of the mother are realistic and true-to-life. While her ultimate actions are unthinkable – real-life mothers of children with RAD may understand her desperation.

Read Defending Jacob

Ellie, an 11-year-old foster child, the only survivor of a house fire that took her entire family. She’s a child with a trauma background, but is now in a nice foster home. Unfortunately, she’s facing bullying from peers and dislike from teachers. Idealistic child therapist Imogen immediately lays blame on those around Ellie and is certain they are projecting their distain onto her. Wanting to shield Ellie from the unfair treatment of others, Imogen oversteps boundaries in the therapeutic relationship.

All too coincidental “accidents” happen around Ellie. For example, her foster brother teases her at dinner then wakes up and his mouth is super glued shut. Imogen is the only one who believes Ellie is the victim, not the perpetrator. In an unexpected twist, it turns out Ellie’s foster sister, resentful of foster children coming in and out of the home, is to blame for many of the problems. However, in the final scene we find Ellie flicking a lighter and contemplating her future. We realize she murdered her family and was complicit in what happened in the foster home.

What’s just fiction – While these situations can be difficult for siblings, the foster sister’s actions seem highly unusual and unlikely. Also, the book portrays many of Ellie’s responses as involuntary which is not always the case for children with developmental trauma. They can be angry and act out quite willfully.

And what’s not – While Ellie’s behaviors may seem over-the-top, unfortunately, they are all to familiar to parents of kids with RAD. The story also effectively captures how a therapist can be manipulated and mislead in these situations complex situations.

Read The Foster Child

Hanna is a difficult, non-verbal, 7-year-old. Her mother, Suzette, has a debilitating medical condition that has left her distant. While Hanna is not formally diagnosed with RAD, the hallmarks are there and likely a result of having an unavailable primary caregiver. Hanna is highly intelligent, but has angry outbursts and is kicked out of kindergarten. Suzette must homeschool Hanna who grows increasingly defiant, rebellious and resentful towards her. Meanwhile, Hanna is charming and loving with her father, Alex. He sees only an obedient, clever child. Hanna’s first words are whispered threats towards Suzette. And as Hanna begins to target her mother with physical violence, Suzette grows increasingly fearful.

It’s only after the situation has grown frighteningly dangerous that Alex happens to witness Hanna’s violent behavior for himself and understands there is a problem. Husband and wife work together to send Hanna to a residential treatment facility and they quickly accept the reality that she will live there indefinitely. In a sinister final twist, Hanna realizes what she must do. She must follow the rules at the facility so she can go home, get rid of her mom, and have her father all to herself.

What’s just fiction – The ease at which the family finds residential treatment for Hanna, and how quickly they accept her need for long-term care does not mirror the reality of most real-life families in this situation.

And what’s not – Most children with RAD target their mother, as Hanna does. They also hide their behavior well from their father and this can cause serious marital discord. While Hanna’s behaviors seem too extreme to be believable, parents of kids with RAD know they are in fact not that far fetched.

Read Baby Teeth

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For teachers of children experiencing the effects of early trauma

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

What is Reactive Attachment Disorder?

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

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

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

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

What you might see in the classroom

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

Other ways RAD may manifest in the classroom include:

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

Strategies that don’t work and why

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

Here are a few strategies that don’t work:

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

Strategies that do work and why

Work as a Team

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

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

Tips:

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

Rely heavily upon schedules and routines

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

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

Provide frequent choices and follow through every time

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

Tips:

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

Focus on teaching vs. attachment

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

Tips:

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

Recognize and act when kids go into survival mode

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

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

Side step power struggles

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

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

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

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

Download this free guide for teachers on how to work with kids who have developmental trauma. Click To Tweet
DTD and RAD Guide for TeachersDownload

Originally Published by IACD.

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

Navigating "the system", The System

What Social Workers Need to Know When Working with Adoptive Families

By brave adoptive parent and advocate Pernell Meier

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Please be sure to read the full article here.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

If your bucket is already filled to a quarter of an inch from the top, you simply don’t have room for a temper tantrum, a broken window, or a screaming child. Click To Tweet

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

So how can we begin to reduce our normal stress?

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

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

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

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

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

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

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

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

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

Originally published by Institute for Attachment & Child Development

Family and Friends, Home, Most Popular, Resources

Dear friends & family

Dear Friend,

I’ve told you before how I’m struggling with my child’s behavior but I’m not sure you understand how serious—how desperate—things are.

Here’s the unvarnished truth—my child relies on manipulation and melt-downs to control his surroundings. He refuses to follow the simplest of instructions and turns everything into a tug-of-war as if it’s a matter of life or death. Every day, all day, I deal with his extreme behavior. He screams, puts holes in walls, urinates on his toys, breaks things, physically assaults me and so much more. I’m doing the best I can but it’s frustrating and overwhelming.

Most people, maybe even you, blame me for my child’s behavior. This makes me feel even worse. I already blame myself most of the time, especially because I’ve struggled to bond with him.It’s heartbreaking to know he only feigns affection to get something from me. There’s not a parenting strategy I haven’t tried. Nothing has worked. Often, I feel like a complete failure as a mother and struggle to face each new day.

Fortunately, my child’s behavior makes a lot more sense to me now that he’s been diagnosed with reactive attachment disorder (RAD). Let me explain. When a child experiences trauma at an early age his brain gets “stuck” in survival mode. He tries to control the surroundings and people around him to feel safe. In his attempt to do so, he is superficially charming, exhibits extreme behaviors, and rejects affection from caregivers. Unfortunately, even with a diagnosis, there are no easy answers or quick treatments.

Even though I work so hard to help my child heal, friends and family often don’t believe or support me which is incredibly painful. I understand it’s hard for you to imagine the emotional, physical, and mental toll of caring for a child with RAD when you haven’t experienced it yourself. And, you can’t possibly be expected to know the nuances of the disorder and its impact on families like mine. That’s why I’m putting myself out there about the challenges I’m facing.

What I need most from you is a shoulder to cry on and an ear upon which to vent—without being judged, second-guessed, or not believed. Click To Tweet

When you undermine me, you inadvertently set back the progress I’ve made in my already tenuous relationship with my child. I wish you could understand how good my child is at manipulating people—how he turns on that sweet, charming side you usually see. In fact, you may never witness a meltdown or even realize he’s manipulating you. Yes, he’s that good. When you think he’s bonding with you, know there’s always an end in mind. He may seek candy or toys. The biggest win of all for him, however, is to get you to side with him against me.

Here’s how easily it happens—my child is sitting in timeout, looking remorseful as he watches the other kids play. You think I’m too hard on him and say, “He’s sorry and promises he’ll make better choices next time. How about you give him another chance?” You need to understand there’s a lot going on behind the scenes that you simply don’t see or know about.

When you undermine me, you inadvertently set back the progress I’ve made in my already tenuous relationship with my child. The structured consistency—what you feel is too strict—is exactly what my child needs to heal and grow into a healthy, happy and productive adult.

Please know I’m following the advice of therapists and professionals. Strategies for raising a child with RAD are often counterintuitive and, watching from the outside, you may not agree with them. That’s okay. But, instead of interfering, would you give me the benefit of the doubt?

Over the years, well-meaning people have said some pretty hurtful things to me, things like:

•All kids have behavioral issues. It’s a phase. They’ll grow out of it.
• He’s so sweet. It’s hard to believe he does those things.
•Let me tell you what works with my child…
•Have you tried _______?
• Oh, he’s just a kid. I’m sure he didn’t do that on purpose.
• A little love and attention is all he needs.

I know these sentiments are meant to be helpful, but here’s the thing—my child isn’t like yours.

He has a very serious disorder. Statements like these minimize our situation as if there are easy solutions that I just haven’t tried. Honestly, I’m not looking for advice. What I need most from you is a shoulder to cry on and an ear upon which to vent—without being judged, second-guessed, or not believed.

Reactive attachment disorder is a challenging disorder that’s difficult to treat so we have a long road ahead of us. Everyday is a struggle and I’d love to be able to count on you but not for advice or answers. I just need you to listen and offer encouragement. I know how deeply you care for me and my child and I’m thankful to have you in our lives. I’ve lost some relationships through this incredibly difficult journey. I don’t want to lose you too.

Sincerely,

A parent of a child with reactive attachment disorder

This is my latest blog post for the Institute for Child Development and Attachment. Please share this letter to raise awareness for parents of children with reactive attachment disorder.

Most Popular, Navigating "the system", Resources, The System

Open letter to a therapist from a mom of a child with RAD

Dear Therapist,

I am desperate for your help. I apologize ahead of time if I seem angry and defensive. I’m just burnt out and afraid you won’t understand. My son is completely out of control and nothing works.

I’ve tried to get help before from therapists and teachers, even police officers, but no one understands. They all think I’m exaggerating, or maybe even lying. My own mother says, “He’s just a kid,” and can’t understand what I’m dealing with is way beyond normal, way beyond safe, and way beyond what I can handle. My son went through trauma at a young age and has been diagnosed with reactive attachment disorder.

I’m not exaggerating when I say my son screams for hours. He’s torn his bedroom door off the hinges and put holes in his walls. His siblings are afraid of him. Sometimes I’m afraid he’ll burn down the house when I’m asleep.

When you meet my son, he’ll look like a very different child than he is with me. You’ll think I’m overreacting. I’m not. You see, my son is an expert at triangulating the adults around him. Due to his early trauma, he manages his surroundings and the people in them to feel safe. In doing so, he’s good at making everyone think I’m mean and crazy. Sometimes I start to believe it too.

I have a secret I should probably share with you—it’s true that I’m not perfect. I’m very aware of that fact. I’ve screamed at my son and lately I’m always angry and frustrated. I’m afraid to tell you this because you’ll think I’m a bad mom and blame me for everything. Most people blame me for my son’s problems. Yet, I’m the one person whose life has been turned inside out and upside down to try to help him.

Even though I’m not a perfect mom, I’m still a good mom trying my best. Click To Tweet

I’ve turned into an unhappy, negative, impatient person whom I don’t even recognize anymore. Sometimes I wonder if I have post-traumatic stress disorder, but feel stupid suggesting that dealing with a child could cause PTSD. It would be helpful for you to encourage me to get some therapy for myself.

Even though I’m not a perfect mom, I’m still a good mom trying my best. Before we get started, here’s what you need to know (because my son will tell you otherwise):

    • I feed my son three meals a day, plus snacks.
    • I don’t hurt my son.
    • I’m not the one who rips up his homework and throws it away.
    • He locks himself in the closet under the stairs. I don’t and wouldn’t ever do that to him.
  • Our house isn’t haunted, he’s not best friends with Justin Bieber, and he’s not going to live with his birth mom next week.

My son will tell you things in individual therapy that will take up all of our time to untangle.

In the meantime, we’ll be distracted from working on the really serious problems for which we need your help. This is why I’m going to insist on being present during all therapy sessions. Please understand it’s not because I have something to hide. I just want to keep things from getting worse than they already are.

Typical parenting strategies like sticker reward charts don’t work for my son. We’ve already tried all sorts of behavior modification strategies. I can’t ignore my son’s negative behavior either. I can’t just watch him hurt himself, his siblings, or destroy everything we own.

Please understand, our family is in crisis.

This is an emergency. We need help and we need it fast. That play therapy you do in the sand…I don’t know, maybe it works for some kids–but not for him. I’m not trying to be unreasonable; I just know what doesn’t work. If you don’t have experience working with trauma-exposed kids, please refer us to someone who does. I understand this is a very specific and serious issue that not all therapists have expertise in.

I’m willing to do whatever it takes to help my son heal and to fix our family. Please help us.

Sincerely,

Keri

Originally posted by the Institute for Attachment and Child Development.

Parenting a child with RAD, Parents and Caregivers

6 Steps to protect yourself from false allegations

Published by Institute for Attachment & Child Development

A sweet little kindergartener, with a Blues Clues backpack and big brown eyes, Devon went to school every morning with a hungry belly. At least that’s what he told the bus driver, his teacher, and the cafeteria ladies. When I got the call from his school, I was positively indignant. Not only did Devon eat breakfast every day, but he usually had seconds.

Within a few years, Devon’s lies had become dangerously calculated deceptions. “I’m gonna hurt myself and tell them you did it. They’ll arrest you,” he’d say cooly, before punching himself in the jaw. Other times he’d twist the tee-shirt he was wearing round-and-round, cinching it against his neck until it left a puffy, red ligature mark. He’d accuse me of strangling him.

Unfortunately, many children with reactive attachment disorder are capable of false allegations. “Due to early trauma, children with reactive attachment disorder feel safe when they can control their environments and push away people who try to get close to them,” said Institute for Attachment and Child Development Executive Director Forrest Lien. “False allegations are one way for them to achieve both.”

Even if we understand the diagnoses and social histories that prompt our children’s false allegations, however, being lied about can be infuriating and hurtful.

A child’s allegations, however outrageous or unlikely, will be investigated. This unwarranted disruption and family upheaval is collateral damage, necessary to make sure children who really are abused get the justice and safety they deserve. “By law, police officers or child protective service workers investigate all allegations of child abuse, as they should. Child abuse allegations need to be taken seriously,” says Institute for Attachment and Child Development Executive Director Forrest Lien. “On the other hand, it’s also harmful for children to falsely accuse adults of abuse charges.” The consequences of false allegations can be devastating if our children, master manipulators, manage to convince a guidance counselor, therapist, or police officer they’re telling the truth. Parents can unjustly face jail time and lose their children without reason.

Here are 6 steps you can take to protect yourself and your family if your child makes false allegations against you:

1. Keep a daily log. I use small notebooks that fit easily in my purse and document conversations with social workers and teachers, write notes after therapy appointments, and record details of any behavioral incidents. I also write down what my son eats for breakfast, what activities we do, and what time he goes to bed. The key is to be consistent and document even the mundane. Your log will be much less credible if you only log when an incident occurs.

2. Gather documentation. To establish a pattern of behavior, keep school disciplinary records, ask people to follow up on calls with an email, and, if your child is admitted to a treatment program, request their records when they are discharged. These documents may have mistakes or minimize your child’s behaviors so comb through them and request any corrections. Discuss false allegations with your child’s therapist. Your child may admit the truth to them and this can be documented.

3. Don’t lose your cool, or your credibility. When a therapist, teacher, or others bring an allegation to your attention, listen. Breathe. Keep the frustrated tone out of your voice,  don’t jump to defend yourself and never exaggerate. Sometimes you’re going to find yourself in a she said–he said and your credibility will be everything. A non-defensive response might sound like: “Gosh, I fed Devon eggs and toast this morning, but thanks for letting me know that he told you he hadn’t eaten. If he ever does miss breakfast, I’ll be sure to email you so we’ll be on the same page.”

4. Use video/audio recordings (sparingly). This is a tricky one that can backfire. First, remember that your words and actions on any recording will be judged, probably more harshly than your child’s. Second, you may be accused of provoking your child by recording them, especially if they scream at you to stop. In a few instances, I’ve been successful flipping my cell phone recorder on without my son seeing it. Give that a try.

5. Don’t go it alone. If things are spinning out of control, call a family member or friend to come over to act as a witness. Sometimes you may have to resort to desperate measures. For example, my son currently lives in a group home and I’ve refused to have visitations with him unless we are in a room with cameras and a staff member. We’ve had to cancel and reschedule visits because of this, but I cannot risk being alone with him.

6. Have a backup plan. Have a contingency plan so your other children do not end up in foster care if social workers remove them during an investigation of a false allegation. My sister and her husband have agreed to take my children if this should ever happen to me. It’s a worse case scenario, but you need to be prepared with a plan.

Though my son has hurled devastating false allegations against me, I’ve been able to avoid the worst potential outcomes by being proactive and meticulous about documentation. It’s extremely sad that I’ve had to do so. Yet, it’s a devastating reality that many parents of children with reactive attachment disorder must face to save their families.

Here’s a great resource with advice and information: Responding to Investigations Manual

In the News

Believing “children are resilient” may be a fantasy | Psychology Today

How did resilience become a standard? How did we come to view children almost as nuisances who just need minimal support? How did children’s needs become dismissable?

via Believing “children are resilient” may be a fantasy | Psychology Today

Navigating "the system", Parents and Caregivers

Why I use the word “rage” and not “tantrum” for my child with developmental trauma

What kind of parent calls the police when her kid has a tantrum? Or, even worse, tries to check him into a mental health hospital? Me.

Every time the cops arrived or we got to the hospital, my young son Devon transformed into an angel. I’d explain that he’d been throwing a terrible tantrum. Yet, his serene affect and puppy dog eyes would belie my words. It was hard enough to ask for help but to imagine the eye-rolls behind my back was humiliating. I probably reminded them of the woman who called 911 because McDonald’s had run out of chicken nuggets.

I probably reminded them of the woman who called 911 because McDonald’s had run out of chicken nuggets. Click To Tweet

Time and again, I was turned away without the help I so desperately needed because we all know what a “tantrum” looks like—a kid kicking his or her legs, crying and screaming, for maybe 10 or 15 minutes. By calling Devon’s episodes “tantrums” I was unwittingly minimizing what was actually going on and no one was taking me seriously.

These were no tantrums. Devon was:
  • Screaming, spitting in my face, and making himself throw up
  • Ripping his bedroom door off the hinges, and putting holes in walls
  • Punching, kicking, and attacking his brothers and sister
  • Pulling out his eyelashes and banking his head on the floor

These episodes of extreme behavior were happening several times a week and would often last for hours. I was in over my head and needed help, but because I was using the word, “tantrum,” people thought I was overreacting.

These weren’t “tantrums,” they were “rages.”

When I began to use the correct terminology to describe Devon’s behavior, health care and mental health professionals, even police officers, were more receptive. “Rage” was a magic word that made people pause, listen to my story, and try to help. Instead of brushing me off, they called in psychiatrists and social workers. They made referrals for local services. They stopped treating me like I was just a high-strung mother.

If your child’s behaviors are extreme, way beyond being a tantrum, your child may be having rages too. “Kids with developmental trauma can tantrum but they can also rage,” said Institute for Attachment and Child Development Executive Director Forrest Lien. “A child has a tantrum to attempt to get his way but it is contained. A rage is out of control and stems from the child’s fear and anger. It’s irrational and almost dissociative.” It can be difficult to tell the difference between a rage and a tantrum, especially when your child’s episodes have increased in severity and length gradually over time.

Here are some distinguishing hallmarks of a rage:

    • Rages are explosive

    • Rages feel scary and out of control

    • Rages last longer than a few minutes

    • Rages become physically violent and aggressive

    • Rages may include acts of self-harm

    • Rages often end in destruction of property or harm to others

These behaviors are not normal for a child of any age. If children acts out in these extreme ways, they need real help. Parents need help, too.

So, how does a parent get help? How do they get someone to understand the seriousness of the situation? They need to adequately describe and use the word “rage” when talking to therapists, pediatricians, and other professionals. The word “tantrum” paints a picture that is nothing like the extreme episodes the child experiences. When they start with, “My child has rages…” and then describe specifically what the episodes look like, how long they last, and how frequently they occur, people seem to listen more closely.

“Rage” is a word that works.

Has this worked for you? Are there other words that “work” you can share?