Tag: Special needs

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.

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