Reactive Attachment Disorder

[sl_underwood]

Does anyone have any resources for parenting a child with RAD? I need advice, especially on how to deal with the lying and stealing. I am thinking I am in WAY over my head and I am starting to understand how parents can just give up. It is just so hard, constantly fighting to help a child who quite literally makes life a living hell for all those around them. Any advice?

 

[bookwormde]

Look for the cause.

bookwormde

 

[KirstenB]

I don't have any experience. But I swear I've seen questions about this over on the Community Board. Maybe post it there too?

 

[Ka' eo]

Does anyone have any resources for parenting a child with RAD? I need advice, especially on how to deal with the lying and stealing. I am thinking I am in WAY over my head and I am starting to understand how parents can just give up. It is just so hard, constantly fighting to help a child who quite literally makes life a living hell for all those around them. Any advice?

Hi, I adopted a 2 year old with RAD, who had other issues too. It was extremely challenging. 9 years later, he is doing very well, but he still can be a bit difficult sometimes. We were extremely consistent, very firm, never left him with any daycare providers other than 3 hours of preschool (which he should have been expelled from, but they wanted our money). We never used physical punishment and used time ins (which meant keeping him right by our side when he was out of control). You cannot engage in the defiance and naughty behavior and really have to develop a neutral response.

Do you have a professionals you are working with? Have you joined some forums for RAD? You need a lot of support from friends, family, professionals and others who have had children with RAD.

How old is your child?

 

[sl_underwood]

He is 6, was adopted at 5, suffered horrific abuse and neglect - which the psych who tested him said was the cause of the RAD. We pulled him out of school and have been homeschooling him at the psych's reccomendation. She thought it would build the bonds and help with attachment. We do alot of eye contact, and cuddling, as well (another thing she suggested) Currently, he is without a psych. We have 3 psychs in our city and two have already seen him and dropped him, I have an appt with the 3rd one in the area next monday, and it doesnt sound like she is entirely sure she can do anything for him either. I am pretty much getting nowhere with him at this point. Our honeymoon stage lasted longer than most as the truly horrible behaviors have only emerged in recent months. I am sure there were signs I missed but I really wanted to believe what the social workers were telling me. I wanted to believe if I just loved him enough and gave him enough it would all be fixed. I am starting to think nothing I do will ever be enough.

 

[Ka' eo]

Oh boy. So he is severely traumatized as well. Why did the two psychs drop him? Look, I have treated RAD kids who burned down houses and worse that came around. I don't want to give you false hope since I know nothing about him or you, but it takes years for him to build up trust and believe he is safe and some kids come around. Some do not. Do you have a team in a major hospital that you could work with? And do you have any supports?

Love alone won't cut it and it is going to take longer than a year. I understand completely what you are going through.

 

[D&DDisney]

First, I want to say you have all my sympathies. I know what you are going through
My DS11 has RAD. We adopted him at 2.5 yrs from a European ophanage. We didn't realize it at first because our horrible adoption agency NEVER warned us about this. Finally got to talking with someone with experience and they helped us with referals.

It's been 9 years for us and all I can say is it does get better. Slowly - VERY SLOWLY. We've seen countless psychologists, psychiatrists, behavior specialists, social workers, doctors, etc. and NO ONE has any clue. They try to tell you that they can help you, but in reality, they are just shooting at a target in the dark.

All the psych people wanted to do was medicate my son to the hilt. Diagnosed him w/ just about every issues there is. The only thing we hit on was his ADHD of which he is still on meds to treat that. They were the only meds we saw a real difference with. The rest we stopped cold. Such a waste of money and time.

We did the holding, eye contact, and all the other techniques they give you to do. But we saw very little results with that. Bought every book there is to help, but that didn't work either. The only thing that truly has worked is CONSISTANCY. We have kept his schedule/days very much the same to give him a sense of security.

The lying and stealing and other bad behaviors never go away. Just get less frequent. We make it very clear to him every time he does something that it is NOT accecptable and then move on.

My son has lots of issues at school but I would NEVER home school him because I (we) need the break. He does have an IEP so we've written very specifically how he needs to watched constantly and what they are to do with him when he does misbehave.

Please take care of yourself and if you ever want to talk more PM me. I'd love to help you vent. The biggest thing with RAD is to have a good support system and don't worry about what others think about the way you are parenting your child. Go with your gut!! You'll find that most RAD parents know more than the professionals.

 

[Ka' eo]

The lying and stealing and other bad behaviors never go away. Just get less frequent. We make it very clear to him every time he does something that it is NOT accecptable and then move on.

For our son it has improved tremendously. He is a different child even from 2 years ago. I had a better experience with you regarding professionals. I needed therapists for the support. I also got some good advice. Did they hit it head on? No. But how could they? And truly, diagnosing children is VERY challenging. ADHD, PTSD, ODD, RAD, Depression can all manifest in the same ways. I agree medicating RAD is useless. But just getting his adhd addressed is something very positive.

My son has lots of issues at school but I would NEVER home school him because I (we) need the break. He does have an IEP so we've written very specifically how he needs to watched constantly and what they are to do with him when he does misbehave.

I could homeschool my son now. I really felt like you when he was a toddler up through say 2nd grade. Our son had RAD, as well as adhd and aperger's. It was a nightmare. Now he is a pleasure to be with. My husband made the breakthrough with him. He was so much more patient than I was. And our pets. I truly believe all our animals helped him.

So I just have a more optimistic view because we overcame it. But I understand where you are coming from.

 

[D&DDisney]

That's terrific that you made such progress Ka'eo! So happy for you.

I think kids with severe RAD are a tougher nut to crack. When we had our son evaluated by a neuro-psych doc, she said he was "a perfect textbook case of full blown RAD." Great!!! How lucky are we??

 

[Ka' eo]

That's terrific that you made such progress Ka'eo! So happy for you.

I think kids with severe RAD are a tougher nut to crack. When we had our son evaluated by a neuro-psych doc, she said he was "a perfect textbook case of full blown RAD." Great!!! How lucky are we??

The profound neglect of those orphanages is just so horrible. Our son would get out of his room and out of the blue go into his sister's bed and bite her. She was 11 months and was doing nothing but sleeping. He bit, kicked, spit, hit, threw, climbed up bookcases and knocked them over. NO ONE in my family would watch him for more than an hour. He also did not sleep. His tantrums would go on for hours. I thought I was going to lose my mind. So I really understand. He was severely neglected and abused, but he got something during those 2 years from somewhere. Enough that eventually we broke through.

I have never been so isolated in all my life. I lost all my friends, and still rarely do alot socially because all three of our kids (they are full bio sibs) have adhd, and it is just too chaotic. It is miles better than the old days. I NEVER sang "If they could only stay little til their carter's wear out."

I am so sorry for you and all the parents that go through this. No one who has not gone through this has any clue. And some professionals do understand, but if you don't live it, how can one really know. So I don't blame them.

 

[bookwormde]

OK I understand better, RAD is one of the "paths" that PTSD children "take". I know it is often impossible but whatever information you can get about his life before he came to you is invaluable in trying to work through the underlying issues and avoiding imprinted triggers. A full evaluation including sensory, social, EF, developmental is very important to "fill in the pieces". RAD is primarily a defensive reaction, so the less reactive you can be (easier said than done) the more opportunity there is to create appropriate healthily bonds. We see lesser versions of this in many autistic kids who are not diagnosed properly or not appropriately supported after a diagnosis. RAD from direct intentional abuse is certainly much more intense and challenging but has lots of parallels.
PTSD in children is a rapidly evolving area of clinical practice so I would recommend reading up on the most current papers on the subject.
It is also important to understand that children who have neurological variances are abused and suffer from PTSD at much higher rates than the average populations so checking and eliminating these possibilities if they do not exist or confirming the existence is essential.
bookwormde

 

[sl_underwood]

Luke also has an ODD, PTSD, ADHD and PDD-NOS dx on top of the RAD. He has very painful arthritis due to the abuse (multiple broken bones- some healed incorrectly, etc) I have one friend who has a child with RAD but she is so overwhelmed that I feel awful calling her. I am finding it hard to maintain a consistent schedule- though I am working on it. It would be much easier to do if he were in school each day, of course the schools in our area are a disaster. The school wants to put him in special ed and forget about him even though he is only a year behind his peers, except for his speech which is more delayed due to hearing loss from abuse. He just recently had surgery to repair the damage done to his ear drum and the speech is improving at lightening speed. As for why the other therapists gave up, it was because he wouldnt let them in, even a little. One had been with him since his 3rd birthday and gave up at 5. The other started with me at that point and really didnt see him much but attempted to give me the tools to work with him but both thought medications were the best course of treatment. He has been on so many antipsychotics, antidepressents, meds to sleep, meds to make him less hyper, meds to turn him into a mindless zombie, nothing has really helped. She also believed he needed to be kept away from other adults and I needed to be the only person working with him. She also talked me out of asking for respite care in our adoption agreement as she thought that sending him away even so I could get a break would be detrimental to him. And then she gave up on us when he wasnt progressing the way she hoped he would, ie- none of the meds worked. We have been without anyone for about 4 months. There are no support groups here, no therapists who specialise in RAD. I found some dvds online to purchase and I am considering these as they are supposed to teach me what to do to help him. I just dont know what to do. It feels so hopeless. I am glad to hear that some of you have managed to help your child heal. I think I do need some support but I never have a moment to myself to actually talk to someone without him around. Thanks to all of you for trying to offer some support.

 

[bookwormde]

OK first off thank you for trying to help this child.
Second is that it is very clear that you do not have the level of clinical support in your local area to help this child so you need to broaden your approach. You are going to have to go to a major nation or international center for PTSD.
One of the first things that you need to know (if you had competent clinicians they would have already told you this) is that the "alphabet soup" diagnosis your child has received are for the most part maladaptive manifestations of underlying issues or layers of issues. RAD, OCD, ODD, hyperactivity and so forth all fall into this category. Unfortunately clinicians (particularly psychiatrists) focus on these item due to lack of competency in the underlying issues. Certainly if these issue are immediately dangerous or seriously damaging they need to be dealt with so they fall below this level, but it is very likely that the course of treatment that your child has been prescribed is doing much more damage than long term benefit.
PTSD is the layer above this and is where you need help from the best clinicians in the country (or world). This is not an easy task but it is doable. This will be your full time vocation for at least a year or 2.
One very important item is that other children need to be seeing a councilor regularly through this process (at least every 2 weeks) as do you and your spouse (at least monthly). since the impact on them is significant. You also need to be very open and honest with them about the level of challenges that the family faces with their new sibling. While you can to expect or even ask this of them, often they are the key to long term progress.
There is 2 primarily types of abusers who do this to children (a little simplistic but a useful set of division at this point). First is the sociopath who do it for pleasure and/or control. Most of these children do not survive so I am going to assume that this would not the case. The second is the reactive abuser, who through their own inadequacies, insecurities and anxiety, react inappropriately when faced with situations (with children typically behavior) that they do not understand, do not have the skills to "parent" and do not fit within the environment that they require for the abusers "needs".
As I said you need to understand the dynamics of the abusive environment if you are going to help this child effectively. The adoptive agency, or past councilors should be able to supply all this information (since confidentiality does not apply in situations of criminal abuse). With RAD there is typically a pattern of abuse and some level of apology/ forgiveness either from the abuser or a combination of the abuser and another caregiver. This is why RAD is so hard to work with, since the child has learned this pattern and being "supported" is just in their experience preparation for more abuse.
Also from the abusing "family" history you find out if there are similar manifestation or characteristics of other neurological issues. Just remember that if there are common manifestations (or even just other different manifestations) in the abusing family that these are not directly "inherited" but come form an underlying situation in an unsupportive environment (many less than competent clinicians make this inaccurate cause effect assumption).
Now up one move level. While this child may have been a perfectly healthy, neurologically typical child at birth, you have to do your best to determining this ,as I said a large proportion of children who are abused to this level have "differences" which is part triggered the abuse. MR, Downs, Physiological disabilities and Autism are the most common. The first 3 are typically superficially evident so they are "figured into the equation" up front. Very often children who are higher up on the Autism spectrum do not get identified since many of the manifestations of PTSD are the same as for Autism children who are unsupported. Only major medical center who have a clinical group that specializes in higher functioning Autism and has a consultative PTSD group that they work with ware competent to make this determination and be able to make effective clinical recommendations.
Quite honestly if this is the case you are probably looking at least some (2 weeks to a month) time in an inpatient treatment environment as the "meds" are removed or reduced to appropriate level and the needed supports are initiated and you receive training in how to support your child and his needs.
I know this sounds very overwhelming and probably not where you thought you would be with this adoption, but it is manageable if done from an informed perspective.
Remember stop chasing the maladaptive manifestation behavior unless they are overtly damaging (otherwise you will be doing it for the rest of your lives) and focus Items above them (PTSD and the potential for neurological variations) so your child can make as much progress as possible to a healthy and fulfilled future.
IF you can disclose an area of the country you are in if you want I can do some research on appropriate major clinical center to meet your child's needs.
bookwormde

 

[Kat77]

I truely believe that unless you have lived with a RAD child you will never fully understand the extent of damage that can be done to a little soul. RAD intervention is often not sucessful and quite far from helpful in a great number of cases. You get some true nut jobs in the field... We're eight years in so I might be even more jaded than most. Rebirthing and holding therapy used to be a popular treatment for RADishes . I cringe and run from many of the suggestions we've encountered.

So I just reread this thread and I truely love my fellow DISer's! Just like they all said, we are nothing if not consistant! Unfortunately, that has meant constant supervision on my part... when she is outside of our watch for extended periods, bad things will eventually happen... I have lead scouts and coached cheer because sadly she will not behave otherwise (wastes time on fake injuries or telling odd lies). Where as, it is not an issue with me around since there is no pay off.

I've instructed adults to reply to DD's (usually quite obvious) lies with the following statement: "That sounds like a lie, I would like to hear the truth but really do not expect it from you at this point." Then become indifferent. It does help her to cut down on lying to those people willing to step up and do this.

 

[Ka' eo]

I truely believe that unless you have lived with a RAD child you will never fully understand the extent of damage that can be done to a little soul. RAD intervention is often not sucessful and quite far from helpful in a great number of cases. You get some true nut jobs in the field... We're eight years in so I might be even more jaded than most. Rebirthing and holding therapy used to be a popular treatment for RADishes . I cringe and run from many of the suggestions we've encountered.

So I just reread this thread and I truely love my fellow DISer's! Just like they all said, we are nothing if not consistant! Unfortunately, that has meant constant supervision on my part... when she is outside of our watch for extended periods, bad things will eventually happen... I have lead scouts and coached cheer because sadly she will not behave otherwise (wastes time on fake injuries or telling odd lies). Where as, it is not an issue with me around since there is no pay off.

I've instructed adults to reply to DD's (usually quite obvious) lies with the following statement: "That sounds like a lie, I would like to hear the truth but really do not expect it from you at this point." Then become indifferent. It does help her to cut down on lying to those people willing to step up and do this.

You sound very wise and have a great attitude. Constant supervision is right. We really need a smaller house because we are in the same room together ALL the time. It has to be that way, even still.

Bookwormde, you scripted out a great clinical response. May I ask what your profession is?

 

[Kat77]

Right there with you on needing a smaller house.
DD is not allowed upstairs with guests (making gameroom useless), backpacks stay downstairs in dining room, no phones upstairs, our home office looks like a computer lab (no internet in bedrooms!).... at times it seems super controlling but there are reasons for these rules...and NONE are are about control, it always comes back to safety here!
I will share our most recent incident involving DD10... she is not allowed to play unsupervised outside, I was cleaning the van so I urged her to come out while she could, at one point I notice a large group kids heading to the side of our house to be out of MY view (but I let them go b/c I assumed (oh so rightly) someone had been dared to kiss... LOL!). They returned quickly enough. TWO WEEKS LATER, I learn DD and another boy are on Youtube kissing! The girl who took the video is DD's bestie & not for one second do I believe my DD was unaware of the plan to post it. In fact, I do assume DD hatched the plan and this other girl got caught in the scheme since it's a known mission of DD's to be on YouTube (blocked at home). Ugh- 5 minutes w/ME nearby and she STILL makes it onto Youtube! Gotta respect that dedication to deviant behaviors. Kissing dares, I can deal with, but tween sex videos, not so much! Reeling her back into my sight at all times again...

 

[D&DDisney]

Right there with you on needing a smaller house.
DD is not allowed upstairs with guests (making gameroom useless), backpacks stay downstairs in dining room, no phones upstairs, our home office looks like a computer lab (no internet in bedrooms!).... at times it seems super controlling but there are reasons for these rules...and NONE are about control, it always comes back to safety here!

Same here. Its just the constant supervision that will drive you nuts. My son is the opposite. He acts better if I am not around. When I used to volunteer at school he would purposely do things that would make me angry or test me. I finally had to step back and stop doing that.
Now he can be left in his room (very stripped down room I must add) for small periods of time.

I hope this thread goes on for a while and will be the support group we all need.

 

[KirstenB]

I truely believe that unless you have lived with a RAD child you will never fully understand the extent of damage that can be done to a little soul. RAD intervention is often not sucessful and quite far from helpful in a great number of cases. You get some true nut jobs in the field... We're eight years in so I might be even more jaded than most. Rebirthing and holding therapy used to be a popular treatment for RADishes . I cringe and run from many of the suggestions we've encountered.

So I just reread this thread and I truely love my fellow DISer's! Just like they all said, we are nothing if not consistant! Unfortunately, that has meant constant supervision on my part... when she is outside of our watch for extended periods, bad things will eventually happen... I have lead scouts and coached cheer because sadly she will not behave otherwise (wastes time on fake injuries or telling odd lies). Where as, it is not an issue with me around since there is no pay off.

I've instructed adults to reply to DD's (usually quite obvious) lies with the following statement: "That sounds like a lie, I would like to hear the truth but really do not expect it from you at this point." Then become indifferent. It does help her to cut down on lying to those people willing to step up and do this.

Can I ask, respectfully, when responding to your dd's lying, why you put in the part about, "But really do not expect it from you at this point". Are you trying to challenge her to tell the truth, like reverse psychology? Or are you literally telling her you don't expect her to tell the truth? It's so hard to read intonation, in written words.

I'm not trying to be obtuse, or anything. Our younger dd has autism, and we discipline her very differently from our other dd. So I do understand trying different approaches.

 

[Kat77]

Do not misunderstand me. DD honeymoons with her teachers, she's a charmer. She just takes up unnecessary time and attention with superficial things like jammed fingers and scratches. She hangs on the teachers like a baby monkey needing affection. Last year, she learned she could get all sorts of special attention by saying mom and dad were in the middle of a horrible divorce . I probably need to ban televison but really you can invent good lies from anywhere.... and several kids in her class were going to the counscelor b/c this was true for them.

Then, the teachers are freaked when sweet, loving DD is caught with a stolen cell phone for the first, second & third time at school. She cried croc tears the first time and by the third time she was indifferent towards school police officer I insisted they call in...

By the end of a school year, most teachers tend to feel "used" by DD. While I can totally sympathize, they often ignored my advice and set themselves up for the position.

 

[Kat77]

Can I ask, respectfully, when responding to your dd's lying, why you put in the part about, "But really do not expect it from you at this point". Are you trying to challenge her to tell the truth, like reverse psychology? Or are you literally telling her you don't expect her to tell the truth? It's so hard to read intonation, in written words.

I'm not trying to be obtuse, or anything. Our younger dd has autism, and we discipline her very differently from our other dd. So I do understand trying different approaches.

We really do not expect the truth. There is no hidden meaning or challenge, just acknowledging we are aware we are being lied to.
Something about this approach makes her less likely to randomly lie for attention. Not at that moment but in general. It seems to help and punishing her does not.