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We need to do better

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.

We need to do better

Here’s what “trauma informed” looks like…

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

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

Leaving class to call home

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

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

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

Protecting siblings from viewing an arrest

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

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

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

A private place to eat

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

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

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

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

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

Parenting advice

Attachment repair strategies for children with RAD
Kayla “then”

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

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

Kayla “now”

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

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

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

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

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

Resources, Tips to navigate "the System"

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

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

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

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

Behind the scenes

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

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

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

Start off on the right foot

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

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

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

Work within the system

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

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

Resources

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

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

Developmental Trauma and Reactive Attachment Disorder (RAD) handout for teachersDownload

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

We need to do better

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

Parenting advice

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

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

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

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

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

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

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

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

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

The warning signs

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

Here’s what you need to look for:

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

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

Getting help

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

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

Here’s what you need to know:

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

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

Parenting advice

You’re angry…I totally get it

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

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

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

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

Your child feeds off your anger

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

It’s counterproductive with teachers, therapists, and others

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

It’s unhealthy for you

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

How to stop being angry

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

Here are some ways to begin: 

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

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

Resources

NEW video teaches kids about trauma and the brain

I am so excited to share this exciting new resource with you! The Brain Game is a new psycho-educational, 20-minute video, It’s designed to teach children about how trauma may have impacted their brain and what they can do about it. It was created by Family Futures, an adoption support agency based in London.

The Brain Game is designed around video game imagery and vernacular children are familiar and comfortable with. This is effective because each “level” is first played on easy mode. This sets the stage for what healthy and normal is. Then the level is replayed on hard mode and kids learn how trauma can make things more difficult for them.

Here’s the introduction to The Brain Game which will give you a good idea of the look, feel, and accessibility for children.

01: Intro

Here’s a sneak peek at the other 4 levels of The Brain Game.

02: THE WOMB
Kids learn how substance abuse, nutrition, and their parents’ stress can impact the ability of their brain to develop properly even before they are born.
03: BIRTH
Kids learn the potential impact of being sent to ICU, being born dependent on alcohol or having an inhospitable environment as an infant.
04: BRAIN BUILDER
Kids learn about the primitive, feeling, and thinking brains and how early traumas can cause “big” feelings. The also learn about fight-flight-freeze responses.
05: HOW WE CAN HELP
Kids learn that their brain is like “plastic.” It can change and grow and overcome many of their early traumas.

Why do I like The Brain Game?

  1. It reinforces the idea that children cannot control the trauma they’ve gone through.
  2. It acknowledges the unfortunate reality that kids may be stuck playing life on hard mode.
  3. It offers hope by showing how kids can help themselves change and live happier lives.
If you've been through a painful childhood there's a lot you can do to take control, to change how you think, and to enjoy the rest of your life. – The Brain Game via @FamilyFuturesUK Click To Tweet

How you can use this resource

Parents – The Brain Game is a wonderful way to help children who have experienced trauma understand what’s going on with their mind and body. It’s also a valuable tool for siblings to foster an empathetic and supportive family environment.

Groups – The Brain Game can be watched with small groups of children and used for discussion. And don’t overlook it’s value for adults either. Trauma is a complicated and emotionally charged topic and many adults will learn from this video.

Therapists – The Brain Game is an excellent tool for therapists to use with children who have experienced trauma. It will be an effective discussion starter and a good way to get parents and children on the same page.

This resource is not useful for kids only!
The paradigm shift to trauma informed is a tricky one and this video can be eye opening for adults as well.

Details

Where to buy: Online via Family Futures (be sure to tell them I sent you!)
Length: 19 minutes
Format: MP4 download

RAD and related diagnoses

Developmental Trauma and Psychosis

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

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

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

Is there a correlation between DTD and psychosis?

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

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

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

Psychosis, however, is not a symptom of DTD.

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

(March 2019)

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

Potential causes of “psychotic” symptoms

1. The psychotic symptoms may be made up.

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

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

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

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

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

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

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

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

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

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

Disorders including schizophrenia, schizoaffective disorder, and bipolar with psychotic features. According to Dr. John F. Alston, MD. who has decades of experience working with RAD kids, bipolar is the most likely inherited disorder these children have. These can be particularly difficult to diagnose in children because adoptive parents don’t have knowledge of hereditary mental illnesses that may run in the family. 

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

Children truly experiencing psychosis may believe they can time travel, read minds, or that they have other superpowers. They may believe the TV is “talking to them” or hear other voices. They may see visual hallucinations. Often, they cannot distinguish between delusions and reality. In one case I am personally aware of, a teenager became convinced their sibling was a clone and made multiple attempts to kill them. They believed their mother was non-verbally communitcating with them and instructing them to do this. Fortunately, this dangerous situation was discovered in time and the child was admitted to a psychiatric facility. Within days of being put on antipsychotic medication, their psychotic symptoms went away.

The good news is that antipsychotics can be very effective. However, many people who struggle with these types of mental illness do not stay on their medications. Often, they embrace the psychosis as a “superpower” or what makes them special, and do not like how the medication quiets or eliminates the voices and other symptoms. If your child is prescribed an antipsychotic, it is essential that you remain vigilant in ensuring they stay on their medication.

For correct diagnoses, a professional evaluation is essential. 

Don’t panic – but do get professional help.

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

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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.

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Understanding the long-term impact of early childhood trauma

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

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

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

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

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

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

The Impact of Trauma

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

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

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

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

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

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

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

Healing the Impact of Early Trauma

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

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

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

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

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Raising a Child with Developmental Trauma

Published by Fostering Families Magazine (May/June 2019)

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

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

Unfortunately, it wasn’t so simple.

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

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

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

What is Developmental Trauma?

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

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

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

Devon and Kayla

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

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

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

Early Intervention is Key

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

To determine if your child needs professional intervention watch for:

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

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

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

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

How to get help

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

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

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

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

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

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

Love is critical, but it’s not enough

Devon with adoptive brother Amias

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

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

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

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