Weekly Roundup, Sunday Sep 15, 2019

Popular posts

Netflix’s ‘Unbelievable’ Is Based On A Devastatingly True Story
Have you seen this new series on Netflix? It is an important story about a young woman who aged out of foster care, was raped, and then not believed.

Why Adults Who Have the Savior Complex Aren’t Healthy for Kids From Trauma
It’s not necessarily bad to want to make children’s lives healthier and happier. It’s not even bad to make plans for how we’d be kind to children we work with or will work with in the future. The problem comes when we assume that our plans truly encompass all the pieces of the puzzle and that other plans are less worthy. When we train ourselves to look at children who are in trouble and assume that the adults are at fault, we train ourselves to believe that all children are innocent and all adults are guilty. 

How to Create a Classroom That Supports Adopted Children
Adoption is a wonderful solution for children whose parents are unable or unwilling to care for them for whatever reason. However, many children who are adopted face challenges that their peers in school do not. They may have suffered trauma, are struggling to transition into a new home, or have trust issues due to their early experiences. Educators need to be aware of these challenges and should make an effort to create a classroom environment that supports adopted children and makes it easier for them to succeed.

You can get PTSD from dealing with a young child?
I was diagnosed with PTSD, but I brushed it off. How could dealing with a young child cause PTSD? Looking back I now believe I had in fact developed PTSD and it took years for me to heal.

Mindfully Talking To Kids About 9/11
Most of our children will have faint memories of the event, many were too young to remember it, and some weren’t even born yet. It becomes a challenge for us to know what to say about it and how to say it in a developmentally age appropriate way.

Dear ER Staff: My Son Never Asked to Be a Regular
I know there are some of you who roll your eyes and wish it wasn’t us again when you see his name show up on your patient board. Believe me, I wish it wasn’t us again too.

1 in 5 kids who’ve spent time in foster care are LGBTQ: Valuable resources for parents
According to a recent study more than 1 in 5 kids in the foster care system is LGBTQ. Their foster/adoptive families may or may not be accepting of their sexual identity. This can be particularly challenging for young people who are already grappling with the impacts of early childhood trauma.

Here’s what “trauma informed” looks like…
Far too often, however, trauma informed care is little more than a buzzword. 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.

Help! My Child’s Only Interests Are YouTube and Video Games
YouTube and video games can bring a ton of stress into a mom’s life. I want to encourage you that your child’s interests may be healthier and much more intelligent than we tend to assume when YouTube and video games are in play (see what I did there). I am learning that that there is nothing to fear or fight when your child’s only interests are YouTube and Video Games.

Recommended books of the week

Videos

Best shareables

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.

Weekly Roundup, Sunday Sep 8, 2019

Popular posts

To the Teacher of My Child With Sensory Processing Disorder from @lynnsollitto
Dear Teacher, My child has sensory processing disorder (SPD). This means her brain interprets sensory information differently than most people’s. When she has to process multiple sensory stimuli, she feels overwhelmed and may shut down, which can distract her from her learning.

5 creative ways to foster attachment from @RaisingDevon
Every child and parent are different, but here are five creative attachment ideas that have worked for other families. 

Manifestation Determination from @parentcenterhub
At specific times, and for certain violations of the student code of conduct, IDEA’s discipline procedures require school systems to conduct what is known as a “manifestation determination review.” The purpose of this review is to determine whether or not the child’s behavior that led to the disciplinary infraction is linked to his or her disability.

How to survive an active shooter situation from @RaisingDevon
I recently attended Active Survivor Training (also called Active Shooter training) with my children. What we learned was invaluable and, as our personal story shows, the lessons can be used in real-life situations.

Reactive Attachment Disorder in Adults Ruins Relationships
Relationships are an integral part of our lives, and when we don’t form a healthy attachment with our parents and guardians, we can develop severe disorders as adults. Reactive attachment disorder happens when a child doesn’t form healthy bonds with their parents, and as a result, if left untreated, reactive attachment disorder follow a person into adulthood. 

Nurses and teachers are changing the world: It’s time their paychecks reflected that.
Imagine a world without nurses and teachers. Where would we be without the amazing people that work daily to educate us, help make us feel better, and so much more?

Recommended books of the week

Video of the week

News & Headlines

Editorial: Grandparents need help raising kids from TRIBLive

Parents Should Sleep With Babies At Least 3 Years for Optimal Brain Development, Pediatrician Says

Family lives in fear after adopting troubled girl from The Daily Item

Best shareables

Weekly Roundup, Sunday Sep 1, 2019

Popular posts

RAD Symptoms – which are most common?
Parents of kids diagnosed with Reactive Attachment Disorder (RAD) are all too familiar with the symptoms. Anecdotally we often list food hoarding, violent outbursts, crazy lying, to name a few. But which symptoms are most common? To explore this further we collected data on 277 children and analyzed the results of the 236 who have been formally diagnosed with RAD.

Online support groups for parents of kids with trauma
Unfortunately, you may not fit into typical parenting support groups. Your child’s behaviors and emotions may be so extreme that other parents can’t relate. As their parenting-101 and common sense advice falls flat and over time, their lack of understanding can feel an awful lot like blame. So where can you find the support and community you so desperately need? One fantastic option is a private online support group.

10 Tips to Prevent your Child’s Recess from being Taken Away.
From @ADayInOurShoesIEP
Let’s put an end to this “taking away recess as punishment” trend once and for all!

The ugly truth about trauma
Each Childhood neglect and abuse is invisible to the untrained eye, we tend to imagine our children having only bruised and bleeding hearts.In reality, some of our children have huge gaping trauma wounds. The gash is infected and oozing puss. Warning- Graphic Image.

6 signs of PTSD in RAD caregivers
From @Gina Heumann
Many people (including at one time, me) associate PTSD only with combat veterans, police officers who’ve been involved in tragic events, and rape or sexual assault victims, but there are actually quite a few other causes for this debilitating condition. As a caregiver for a child with reactive attachment disorder, I would never have recognized or suspected PTSD in myself until someone pointed it out, and even then, I just tried to suck it up and think myself better. While some people can heal themselves over time, the vast majority of PTSD sufferers require professional treatment in order to fully recover.

10 Disturbing Signs It’s Not Your Body But Your Soul That’s Tired
If we ignore the signs that our energy is depleting, it can lead to very serious consequences such as chronic anxiety, mental health issues, and depression.

Languishing in Residential Care Made Me Worse. Unconditional Love Helped Get Me Better
From @ChronicleofSocialChange
People talk a lot about how important it is that every foster kid grows up in a loving home. While well intentioned, most of them are approaching that idea from an abstract understanding. They have never known a loving foster home, and they certainly have not experienced the alternative. I learned the hard way how important this concept really is. 

Being the primary parent is exhausting
From @closetoclassy
Being a parent is seriously the most mentally taxing thing I’ve ever done. Single parents are the known bad asses of the parenting world, and I’m not here to dispute that, because we all know how hard that role is. What I have to say may be an unpopular opinion but I’m going to say it, because I know I’m not the only one who feels this way—I’m so freaking exhausted being the primary parent.

“I Don’t Think We Can Do This Much Longer.”
From @authornealierose
That’s something so many people say when they are struggling with a traumatized child. Here’s advice from another trauma mama.

Why You Should Never Bad Mouth Your Child’s First Family
From @confessionsofanadoptiveparent
It can be a difficult thing to not do, at times, because your child’s storyline may not be very positive. But it’s critical that we never bad mouth our child’s first family. Here’s why…

Here’s a great video with information on early childhood trauma

Recommended books of the week

In the news

More than eight in 10 men in prison suffered childhood adversity – new report
Male prisoners are much more likely than men in the wider population to have suffered childhood adversities such as child maltreatment or living in a home with domestic violence, according to a new report by Public Health Wales and Bangor University.

A new high school will have sleek classrooms — and places to hide from a mass shooter
A $48 million major construction project at Fruitport High School will add curved hallways to reduce a gunman’s range, jutting barriers to provide cover and egress, and meticulously spaced classrooms that can lock on demand and hide students in the corner, out of a killer’s sight.

How Adoption Medicine Clinics Aid Forever Families
Adoption medicine clinics – which aim to address the complex medical, developmental, psychological and social needs of adopted children – have emerged around the country in response to shifting societal trends. Typically housed in major medical centers and children’s hospitals, they got their start in the 1990s, when international adoptions were on the rise.

Extensive Data Shows Punishing Reach of Racism for Black Boys
White boys who grow up rich are likely to remain that way. Black boys raised at the top, however, are more likely to become poor than to stay wealthy in their own adult households.

Best shareables

Weekly Roundup, Sunday Aug 25, 2019

Helpful for back to school…

Trauma handout for teachers

2/3 of kids with RAD are first misdiagnosed with ADHD
Kids with developmental trauma may have attention deficits and other symptoms of ADHD: inattentiveness, hyperactivity, impulsivity. However, the ADHD diagnosis doesn’t correctly point to the cause of those symptoms – the trauma. 

Popular posts…

What it’s like to be the sibling of a child with RAD
In their own words, how siblings are affected by children with attachment disorders and what parents can do to help.

…Why you should be aware of your family history from @guardianng
These are just some of the reasons therapists inquire about family history. Mental and physical health is affected by many things and the situation that one is exposed to have a significant impact on adulthood.

Staying Calm During a Tantrum from @Foster2Forever
I don’t know about you, but sometimes my child can certainly push my buttons, and can trigger me into my own “mommy meltdown.”

How to Explain Adoption Dissolution to Adopted Kids from @creatingafamily
How do we explain an adoption dissolution to adopted kids without making them feel like they do could be given away? If you ever face this challenge here’s some helpful advice.

The Special Needs of Adopted Children
Whether you are religious or not, this list from Sherrie Eldridge is a powerful tool. She’s included Bible verses for those who would like them.

The Dismantling of a Non-Profit – A Bird’s Eye View of Traumatized Adoptive Family Systems from @followmarykalbach
Therapeutic parents are walking wounded with wounds that nobody sees except those also walking the same path. Many of us can’t do this anymore. We have no resiliency…

4 Questions to Ask When Early Childhood Trauma Causes Behavior Issues via @Foster2Forever
Recently, my child wanted me to buy him sunflower seeds after baseball practice. I knew he needed to eat a good meal so I just wanted to get him home for dinner. As the situation escalated, I tried to reason with my child, but he was becoming more irritated…

Recommended books of the week…

In the news…

What Happens When The Adopted Kids Of Anti-Gay Parents Come Out? via @BuzzFeed
Evangelical Christians are the religious group most likely to adopt but are also most likely to oppose homosexuality, which can make life complicated for gay adopted kids.

Adopted son, 22, of ex-NFL lineman Barry Bennett is charged with shooting dead his parents via @dailymail
Authorities say the Bennetts were found shot and alleged that the couple’s adopted son had expressed thoughts of killing them in December, while lodged at a mental health facility.  

Best shareables…

Weekly Roundup, Sunday Aug 18, 2019

Popular posts…

Tips to work with your child’s school (includes free teacher handout) from @RaisingDevon
Here’s tips to work with your child’s school and a pdf handout for teachers.

When They Judge Us, They Show Their Weakness — Not Ours from @additudemag
“When someone judges your parenting or your child, don’t engage — don’t respond to it and, most importantly, remember that it’s not about you or your child. It’s about somebody who has a need to make themselves feel morally superior to you, even for a brief second.”

How the “System” Nearly Turned My Son into a Sociopath from adoptingfaithafathersunconditionallove.org
Young adults who commit heinous crimes weren’t always evil. Once upon a time, they were innocent children – like my oldest son.

We have to get serious about child-on-adoptive-parent violence from @CommunityCarePage
Too many adoptive parents experience aggression from the traumatised children they raise. Peter McParlin, who has experienced it first-hand, argues that it is time for change.

College $$$ for foster care alumni from @RaisingDevon
Sadly, only 3% of foster care alumni will earn a bachelor’s degree compared to 60% of the general population.Many states now offer full tuition exemption to state and community college for kids who spent anytime in foster care including adopted foster children. Here’s a state-by-state list.

Team Sports May Help Children Deal With Trauma from @NewYorkTimes
Training, working hard and learning to win and lose help children develop resilience, experts say.

10 Reasons for Adoptive Parents to Be in Child’s Therapy Session from @creatingafamily
Commonly, most therapists meet with the parents alone, and then work with the child alone with a short time for both parties together. While this practice is commonplace, it is not optimal for adoptive or foster families.

In the news…

The connection between trauma and addiction from @carrierclinic
Researchers have been studying the connection between trauma and addiction in order to understand why so many drug and alcohol abusers have histories of traumatic experiences. Data indicates that a child who experiences four or more traumatic events is five times more likely to become an alcoholic, 60% more likely to become obese, and up to 46 times more likely to become an injection-drug user than the general population. 

Study finds psychiatric diagnosis to be ‘scientifically meaningless’ from @neurosciencenews
A new study, published in Psychiatry Research, has concluded that psychiatric diagnoses are scientifically worthless as tools to identify discrete mental health disorders.

Labor Dept rules IEP meetings a valid reason for family and medical leave from @EducationDive
The U.S. Department of Labor (DOL) has issued an opinion letter stating parents and guardians are allowed to use the Family and Medical Leave Act (FMLA) intermittently to attend Individual Education Program (IEP) meetings with teachers, school administrators and others involved in planning education services for children with special needs.

In a split-second, a CMPD officer shot my husband and saved my life my oped from @WBTVNews3
By vilifying officers who act in good faith we are promoting a defensive police culture that could easily cost someone their lives. It very well could have cost me mine.

Parents sue Centennial adoption agency claiming they weren’t informed of Chinese son’s sexual-abuse issues from @denverpost
Adopted child raped younger adoptive kids, lawsuit claims

Best shareables…

Journey to the Son: One mother’s heart wrenching journey

Guest post by Carla A. Carlisle

On March 22, 2010, my life was forever changed when I became a first-time foster parent to a beautiful 10 day old, two-month premature baby boy. I knew that becoming a foster parent would mean major lifestyle changes, I didn’t know that my connection to this child would change me at the essence of my being. I was told that 99% of children taken at birth don’t go back to their birth parents, but this one fell in the 1%. At six-months-old, this dear sweet baby boy was returned to his birth mother. In the six months I interacted with his birth parents, I learned about what I can now call “generational trauma”.

Learn more here.

Years of work experience, degrees on the wall, and a tremendous support system meant nothing in the face of the next eight years. I almost immediately gave up my foster license since I couldn’t stay connected to the birth family that this precious son of my heart and be licensed by the county.  I tossed that license out like trash on Sunday because it paled in comparison to the life I knew was in the balance.

For the next six years, the birth parents and I had a tumultuous relationship. I felt, and continue to feel, such compassion for them both – as they grew up in survival mode without the foundation of love, life skills, and the village many of us take for granted.  I learned of horrific experiences the birth mother experienced. and at some point, I wondered how she could be expected to care for this child – or the other 10 she lost to the system long ago. 

At age 5, the child of my heart spoke of dying by suicide. I shouldn’t have been surprised because he heard it from his birth mom daily, but it broke my heart in a million tiny pieces. After an overnight observation, it was brushed off as bullying at school. This told me that the observation psychiatrist did not read a word of his file, did not look at birth parents’ mental health records, or even read what I shared despite my life being in danger at the hands of the parents.  At age 6, this big brown eyed angel attempted to die by suicide twice. The system told me he didn’t mean it.  They said his mom’s voice recorded death threat wasn’t made against him, it was made against me, so it didn’t matter. The son of my heart was now in patient at a behavioral health facility.  

Although I had talked to attorneys and child advocacy groups over the years, I was told there was no path to custody because there was no blood shared between us (and that meant there was no way to get him help).  But wait, I remembered my estate planning attorney shared the names of three family law attorneys and the next three days changed everything: 

Day 1 : I called all three family law attorneys and the last one was the charm. Talking to the paralegal let me know I was with the right person.  The same day, birth father terminated the service provider who was trying to provide therapeutic services. 

Day 2: I met with the attorney, he collected my evidence and made me aware of “in locos parentis” – in place of the birth parents – or simply I had been acting like his birth mother most of his life. The same day I received a call that the birth father withdrew him from school.

Day 3: We went to court and got domestic violence restraining orders on behalf of my son and me as well as emergency custody.  I took the protection orders to behavioral health immediately. Shortly thereafter, the birth father went to behavioral health to check this sweet, yet confused child out of behavioral health.  Due to the restraining order, he was not allowed on the floor.

My sweet, innocent child had experienced more trauma than anyone had imagined.  He had seen his birth mom try to kill his birth dad multiple times.  I was ashamed for a while, but he also saw his mom strike me in the face. This became a major traumatic event for him (and me). He saw drugs, domestic violence, porn and so much more.  He lived in two worlds: with me and then in a chaotic world with no boundaries – there was a mother, a father,  and a boyfriend in the house.  The husband was in prison.  My son was threatened, he was put in the position of an adult with adults who were emotionally frozen in their childhood, lacked maturity, understanding, and empathy.  But I can’t blame them; this was all they knew.  

Watch Carla read a chapter from her story below and check out her book here.

Since October 2016, we’ve been on the path to healing.  What worked best? Trauma Focused – Cognitive Behavioral Therapy (TF-CBT).  He learned at a 6/7-year-old level, he trusted, and he able to share his trauma stories with me.  We had sessions together, we processed together, and we grew together. On the other hand, I had service providers who charged for services they didn’t do (yes I reported it), and underpaid/overworked Qualified Professionals who were there for a check.  Yet, I did meet people along the way who cared, who went above and beyond like that very special teacher we all run across at least once in our lifetime.  Intensive In-Home therapy was helpful once we got to the third service provider.  We had a plan that worked for my son.  

After two years in court, tons of money, and oh so much stress and fear, the adoption is final and my son is doing well.  Despite the diagnoses of PTSD, ADHD, DMDD, major depression and anxiety, I have a resilient child who is playing tackle football, thriving from music therapy, increasing his gross motor skills through day to day activities and occupational therapy.

I’ve been diagnosed with situational depression and anxiety.  I have to force myself to focus on self-care, but I do.  I have to focus on hope; although I have moments in which I’m discouraged. I pray.  I believe in prayer with works.  I have to work to make things better. I do vent, but I keep working.  Helping one child, one parent, one situation matters. 

We’ve added two older sons to our family, which has given him the big brothers he really wanted.  I can’t say I’m going to give him the dad, he may just be stuck with a family of four and two dogs for now. 

I share my journey to motherhood; the love, isolation, failure, disappointment, drama and trauma as well as the triumphs, small steps forward and love of my son in my memoir, Journey to the Son. If nothing else, I hope our story says you are not alone. Our struggles may be different, but it is exhausting, nonetheless. Take good care of yourself. 


Carla A. Carlisle is the author of Journey to the Son, an emotionally riveting memoir about a woman’s eight-year battle with the system for the child of her heart, who suffers from prolonged trauma caused by his birth mother, a victim herself of perpetual physical, emotional, and mental abuse. Carla is a child and mental health advocate who is leading a movement to educate community and faith-based leaders, public officials, and child and family services providers about trauma and its impact on abused children to provide safe and healthy environments to keep them alive, safe, stable, and resilient. For more information, visit https://carlaacarlisle.com or find Carla on social media at @CarlaACarlisle.

How Racism, Trauma And Mental Health Are Linked

Research shows African-Americans are less likely to access treatment for mental illness.

Cultural norms and the stigma associated with having a mental illness are partly to blame, according to Shardé Smith, assistant professor of human development and family studies at the University of Illinois at Urbana-Champaign.

Smith studies the role that race-related stress and trauma has on entire families, and what strategies people use to cope.

She spoke recently with Side Effects Public Media about the barriers to mental health treatment for African-Americans and the relationship between racism, trauma and mental illness.

This interview has been edited for length and clarity.

What are some of the barriers that prevent African-Americans from seeking help for a mental illness?

Mistrust of the therapeutic system stems from events like the Tuskegee experiment and other systemic injustices where African-Americans were treated unfairly. There’s also shame and negative beliefs about mental health care, and the assumption that an individual or community failed in some way, which led to these issues. And for those who are part of a religious community, sometimes mental illness is seen as not having enough faith in God.

What is the role of systemic racism in all this?

Systemic racism is the institutionalization of racism through policies and practices that show up in all of our systems. And it’s through systemic racism that mental health issues arise and are maintained.

For example, living in an impoverished community with less access to proper food and nutrition can be very stressful and can create mental health problems among individual family members. Another example could be the funneling of black youth through the justice system, where they’re more likely to either go to jail or be a part of the system than to receive proper mental health care.

There are also inequalities in our education system that can create gaps in wealth. This can lead to mental health problems, and systemic racism also means there’s a lack of access to proper mental health care, cultural biases from health providers, misdiagnoses such as attributing certain behaviors to delinquency as opposed to survival coping strategies for the trauma people have faced.

What role does trauma play?

Trauma plays a huge role. The disparities that we see cause trauma, and a lot of times that trauma goes unaddressed, and it’s not named as such. So it’s difficult finding treatment for the trauma because we don’t have a name for it.

What are some examples of trauma?

Race-related trauma could include the traumatic experiences, emotionally, psychologically, physically that manifest as the result of experiencing one or multiple events. Sometimes we think of traumas, such as natural disasters, sexual trauma, or car accidents, which are traumatic events. But sometimes we don’t think about race-related trauma as a part of that, and it’s important to include that in our understanding of trauma and how it can effect marginalized communities and African-Americans.

To loosely quote Kimberlé Crenshaw, if there’s no name for a problem, you can’t see a problem. And if you can’t see a problem you can’t solve it. And sometimes we don’t name these traumas as racial traumas that black and African-Americans are experiencing.

This story was produced by Side Effects Public Media, a news collaborative covering public health.

Follow Christine on Twitter: @CTHerman

Developmental Trauma and Psychosis


When my son Devon 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 Devon 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 Devon had been diagnosed with, however, was Reactive Attachment Disorder (RAD), also called Developmental Trauma Disorder (DTD). 

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

Is there a correlation between DTD and psychosis?

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

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

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

Psychosis, however, is not a symptom of DTD.

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

(March 2019)

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

Potential causes of “psychotic” symptoms

1. The psychotic symptoms may be made up.

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

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

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

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

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

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

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

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

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

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

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

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

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

For correct diagnoses, a professional evaluation is essential. 

Don’t panic – but do get professional help.

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

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

Why adoption stories aren’t fairy tales

Adoption finalization is a reason to celebrate. Parents have filled out mountains of paperwork, waited months or years and shed many tears to get to that moment. They wear matching tee-shirts, eat way too much cake and splash photos all over social media. Adoption day is so momentous that it feels like a “happily ever after” in itself. After friends and family return home and the frosting is wiped clean, some adoptive families are left with a much different “ever after” than anticipated. They can struggle immensely feel completely alone. 

While a friend, family member or professional can support an adoptive family in multiple ways, one simple task is most important—to understand that adoption stories aren’t fairy tales. And the path to happily ever after can be extremely difficult to find for kids with developmental trauma. Once a person understands this reality, they can offer more effective support to an adoptive family over time.

Unfortunately, the judge’s pen isn’t a magic wand for kids who come from hard places. “While many people think that love or ‘good parenting’ will make up for the early trauma a child experienced, it’s just not that simple,” said Executive Director Forrest Lien. “Families of kids with developmental trauma need extensive support and specialized services.” 

Without early and effective intervention, many adopted children from hard places continue to struggle academically and socially[i]—even in stable, loving families. They’re at increased risk for substance abuse and criminal conduct and at higher risk for mental health issues.[ii]

When adopted kids struggle, it’s easy for those around them—family, friends, community—to point the finger at adoptive parents. They’re quick to blame the adoptive parents for not getting help for their child. Or they criticize the child for willfully squandering the opportunities given to them.  

“While many people think that love or ‘good parenting’ will make up for the early trauma a child experienced, it’s just not that simple,” said Executive Director Forrest Lien. “Families of kids with developmental trauma need extensive support and specialized services.”

But an adoptive parent cannot serve as a hero or the villain in combating the effects of a child’s early trauma. And the child cannot simply “get over” developmental trauma. 

Adoption is better likened to the nostalgic “make your own adventure books” where readers make choices that lead to different endings. But depending on their geographical location, proximity to specialized therapists, level of trauma their child experienced early on, financial situation, insurance provider, etc., adoptive parents don’t have many viable good options from which to choose. 

Make Your Own Adoption Adventure: Story of Bobbi

To begin to understand the reality for many adoptive families, take a walk through their unfortunate “adventures”—

Chapter 1

Bobbi, age 7, squirrels food away under her pillow and gets into fights at school. Her parents notice these behaviors aren’t getting better. Bobbi needs to see a therapist who has experience working with adopted kids with developmental trauma. This would put her on the path to happily ever after. However, this is unlikely to be a choice available to Bobbi and her family. Here’s why:

 No matter the path chosen, most parents unwittingly go it alone.  They often hope traditional parenting methods will eventually work. Or they find a therapist who lacks specialized training in developmental trauma. Either way, matters get worse with time.

Chapter 2

By the time Bobbi is a teenager, her behavior is increasingly risky. She’s experimenting with drugs, partying and sexting. At this point, Bobbi needs to go to a specialized in-patient treatment program for her safety and the safety of others. This would put her on the path to happily ever after. However, this is unlikely to be a choice available to her and her family. Here’s why: 

  • Most residential programs mix together kids with a variety of conditions instead of offering specialized treatment for developmental trauma.
  • Many families cannot afford the out-of-pocket costs left over after the limited insurance coverage provided. 

Chapter 3

Unfortunately, many children like Bobbi grow up in institutions where they do not get better. Others get tangled up with the juvenile justice system. By then, choices are even more limited as early intervention is key for optimal healing.  

Why the good options are limited

Developmental trauma can have far reaching and severe impacts. Kids may suffer from attention deficits, developmental delays, behavioral problems and more. Because developmental trauma is a disorder stemming from brain impact during critical developmental stages, there are no shortcuts to happily-ever-after—no quick fixes or easy solutions. Even well-informed adoptive parents and early intervention by qualified clinicians is not always enough. However, proper and early interventions definitely offers hope.

Here’s how that can happen:

  1.  Adoptive parents must be given comprehensive training on developmental trauma and therapeutic parenting. They need support to parent their child and to recognize when they need professional help. 
  2. Adopted children must have access to effective, specialized mental health services. This treatment needs to be accessible and affordable.

It’s both shockingly simple and profoundly tragic. Parent training and specialized mental health services are just common sense. Yet, far too many adoptive families are headed down a rocky and difficult path due to lack of these two basics. 

Although the path toward “happilly-ever-after” isn’t as simple as one would hope, friends, family and professionals can at least try to understand the journey. And they can advocate and educate on behalf of these families. 

The Institute for Attachment and Child Development and I invite you to choose your own adventure in creative ways to support and advocate on behalf of the adoptive families. It’s time for communities to join together to make sure our vulnerable children have every possible resource to reach their happily ever after. Because when you support adoptive families, you support children from hard places and the generations that follow.

Originally published by the Institute for Attachment and Child Development here.

[i]https://ifstudies.org/blog/the-paradox-of-adoption/
[ii]https://www.childwelfare.gov/topics/can/impact/long-term-consequences-of-child-abuse-and-neglect/crime/

California Looks To Lead Nation In Unraveling Childhood Trauma

Imagine identifying a toxin so potent it could rewire a child’s brain and erode his immune system. A substance that, in high doses, tripled the risk of heart disease and lung cancer and reduced life expectancy by 20 years.

And then realizing that tens of millions of American children had been exposed.

Dr. Nadine Burke Harris, California’s newly appointed surgeon general, will tell you this is not a hypothetical scenario. She is a leading voice in a movement trying to transform our understanding of how the traumatic experiences that affect so many American children can trigger serious physical and mental illness.

The movement draws on decades of research that has found that children who endure sustained stresses in their day-to-day lives — think sexual abuse, emotional neglect, a mother’s mental illness, a father’s alcoholism — undergo biochemical changes to their brains and bodies that can dramatically increase their risk of developing serious health problems, including heart disease, lung cancer, asthma and depression.

“[Nadine] has probably single-handedly done more to elevate this issue than anyone else,” said Dr. Mona Hanna-Attisha, the pediatrician known for documenting the rise in children’s blood lead levels in Flint, Mich., after the city switched its water supply.

With Burke Harris’ selection as the state’s first surgeon general, California is poised to become a vanguard for the nation in embracing the research that traces adverse childhood experiences, or ACEs, to the later onset of physical and mental illness. In pockets across the country, it’s increasingly common for schools and correctional systems to train staff on how academic and behavioral problems can be rooted in childhood trauma. Burke Harris envisions a statewide approach whereby screening for traumatic stress is as routine for pediatricians as screening for hearing or vision, and children with high ACEs scores have access to services that can build resilience and help their young bodies reset and thrive.

As California’s surgeon general, she will have a powerful bully pulpit — and the firm backing of a new administration with deep pockets. In his first weeks in office, newly elected Gov. Gavin Newsom has made clear he intends to devote significant resources to early childhood development. He has named several recognized experts in child welfare, along with Burke Harris, to top posts, and is promoting child-centric policies that include extended family leave for new parents, home nursing visits for new families and universal preschool. In his first state budget proposal, released last month, Newsom called out ACEs by name and committed $105 million to boost trauma and developmental screenings for children.

“It should be no surprise to anyone that I’m going to be focusing on ACEs and toxic stress,” Burke Harris said in a phone interview just days into the new job. “I think my selection is a reflection of where that issue fits in the administration’s priorities.”

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A Game-Changing Study

Adversity is the sort of thing we intuitively understand, at least to some extent. Having a parent who struggles with addiction or mental illness is hard on kids, as is growing up in a neighborhood marked by poverty, gun violence or drug abuse.

A 1990s study laid the groundwork, however, for an understanding of adversity that suggests it poses a pervasive threat to public health.

During interviews with patients at a Kaiser Permanente obesity clinic in Southern California, Dr. Vince Felitti was shocked at how many said they had been sexually abused as children. He wondered if the experiences could be connected. (Kaiser Health News, which produces California Healthline, is not affiliated with Kaiser Permanente.)

As head of the Department of Preventive Medicine at Kaiser Permanente in San Diego, he had access to a huge pool of patients to try to find out. Together with the Centers for Disease Control and Prevention, he surveyed more than 17,000 adult patients about 10 areas of childhood adversity. Among them: Did a parent or other adult in your household physically abuse you? Emotionally abuse you? Sexually abuse you? Go to prison? Was your mother regularly hit? Did you often go hungry? Were your parents divorced? The researchers scored each patient, assigning a point for each yes, and matched up the responses with patients’ medical records.

What they found was striking. Almost two-thirds of participants reported experiencing at least one kind of adversity, and 13 percent — about 1 in 8 — said they had experienced four or more. Those who reported experiencing high doses of trauma as children were far more likely to have serious health problems as adults, including heart disease, stroke, cancer and diabetes. And the higher their ACEs score, the worse their health was likely to be.

This extended to mental health, as well: Adults who reported experiencing four or more ACEs were 4.6 times as likely to have clinical depression and 12 times as likely to have attempted suicide.

In the 20 years since, scientists have built on the research, replicating the findings and digging into the “why.” In the simplest terms, traumatic events trigger surges in cortisol, the “stress” hormone. When those surges go unchecked for sustained periods, they can disrupt a child’s brain development, damage the cardiovascular system and cause chronic inflammation that messes with the body’s immune system.

And where children really get into trouble is when they also are missing the best-known antidote to adversity: a nurturing and trustworthy caregiver. Without that positive stimulation, children can end up with an overdeveloped threat response and a diminished ability to control impulses or make good decisions. Children with high ACEs scores are more likely to develop attention deficit hyperactivity disorder, known as ADHD, and cognitive impairments that can make school a struggle. They are more likely to grow into adults who drink to excess, are violent or are victims of violence.

The research is compelling, because it has the potential to explain so many intractable health problems. What if some portion of Generation ADHD really has PTSD? What if obesity and hypertension are disorders with roots in childhood experiences, and not just what we eat for dinner?

‘What Happens To You Matters’

Until now, Burke Harris’ professional epicenter has been Bayview-Hunters Point in San Francisco. It’s a vibrant community with a history of activism, but also deeply impoverished, and blighted by pollution and violence. It was there that Burke Harris, at her pediatric clinic, noticed that many of her young patients with serious medical conditions also had experienced profound trauma. And patients who had experienced serious adversity were 32 times more likely to be diagnosed with learning and behavioral problems than kids who had not.

When a colleague introduced her to the ACEs study, she saw her patients written between its lines. Though these problems might be concentrated in Bayview, they certainly weren’t confined there. This was a health crisis transcending race, class and ZIP code.

In the years since, Burke Harris has worked to advance ACEs science though her work at the clinic and her nonprofit research institute, the Center for Youth Wellness. She regularly travels the country to train fellow pediatricians in trauma screening and treatment. She has written an acclaimed book on the issue, “The Deepest Well,” and her TED talk on the topic has been viewed nearly 5 million times online.

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Now, she’ll be directing her singular focus back on California.

She plans to start with a statewide tour to hear from doctors and other health leaders about barriers to increasing pediatric screening and care. She’ll also be talking about the science of ACEs. “It’s Public Health 101 that raising awareness is a critical form of primary prevention,” she said.

But even with the funding included in Newsom’s budget, there are challenges to standardizing trauma screening. For one: In medicine, it’s common practice that you screen only for what you can treat. Many doctors — even those persuaded by research on adversity — have raised concerns about the lack of established protocols for treating childhood trauma. What can a pediatrician, with her 15-minute time slots and extensive to-do list, do about the ills of an absent parent, or a neighborhood riddled with gun violence?

In general, experts working on the issue say a critical ingredient in helping kids heal is ensuring they find and develop healthy relationships.

“All of us want to feel seen, heard, understood and supported,” said Alicia Lieberman, a researcher at the University of California-San Francisco who specializes in early childhood trauma. Involving parents is an essential aspect of treatment, particularly because so many have experienced trauma themselves. “It has to start with an acknowledgment that what happens to you matters.”

Researchers have found early success in seemingly simple interventions: Therapists coaching parents by filming and playing back positive interactions with their child. Therapists working with teachers on how to support their students. Key to success, said Pat Levitt, chief scientific officer at Children’s Hospital Los Angeles, are quality programs that start early and recognize the role of relationships.

At her clinic, Burke Harris coordinates with a team that wraps a child in care, treating mind and body. When a patient scores high on the adversity scale, she can send them down the hall to a therapist; connect them with classes on meditation, nutrition and exercise; involve the family in counseling; and aggressively monitor for and treat any physical manifestations.

Most clinics aren’t set up for this staff-intensive approach.

Dr. Andria Ruth, a pediatrician with the Santa Barbara Neighborhood Clinics in California, is among those researching how to “treat” adversity within a more traditional doctor’s office. Her research team is randomly assigning patients who screen positive for trauma into one of three groups. One group is assigned a navigator who connects the family to services for basic needs, such as food and housing. A second group also sees a behavioral health therapist at their child wellness visits. The third group receives both those services, and gets home family visits from therapists.

Ruth has a healthy skepticism about what’s possible, but she and her colleagues are convinced childhood trauma does pose a potent health threat: None of them felt comfortable including a control group that wouldn’t receive any services.

In the big picture, these experts say, addressing the fallout of traumatic stress will require a broader paradigm shift, to a system that recognizes that bad behavior can be a physical symptom rather than a moral failing. Gov. Newsom has signaled a move in that direction: In January, he said he would transfer the Division of Juvenile Justice out of the Department of Corrections, which runs the state’s prison system, and into the Health and Human Services Agency.

Garnering that kind of official backing is a powerful boost, said Jason Gortney, director of innovation at the Children’s Home Society of Washington, that state’s oldest and largest nonprofit dedicated to child welfare. His organization has lots of programs with promising results, he said, but connecting them to state agencies that aren’t used to working together is a challenge.

With Burke Harris crusading from the surgeon general post, Gortney said, he and fellow advocates across the country are hoping California can provide a beacon.

“Maybe California can show some of the other states how to do this,” he said.

This story first published on California Healthline, a service of the California Health Care Foundation.