Reactive Attachment Disorder

Shawna (10 years old) & I had an interesting conversation a couple of weeks ago.

It started with Billy & I talking with her about how she tries to manipulate & control people. We were basically talking with her about how people want to be treated and that manipulating & controlling people, and situations is not a way to gain trust. So we asked her why she thinks she does it. She thought for a moment and said "I think it's because I was adopted". I asked her what she meant (thinking she couldn't find the right words to use) and she said "Well, kids who were removed from their home and got adopted are supposed to have problems with it, right?"

Although we openly discuss the reason she (and her two siblings) were removed from their birth home, placed in foster care and later adopted by us, I saw that she was confused about her past and she thought all her problems stemmed from being adopted, not from the abuse and neglect that led up to her being adopted.

That night while she slept, I went through all the papework that I have from when we finalized their adoption and I also got some information together on Reactive Attachment Disorder

The next day, her & I sat down and talked. I told her about the attachment cycle. This was something we discussed in great detail in our training classes (classes you must take before you can adopt an abused child). The cycle goes like this...the baby has a need (hunger, needs to be changed, illness, etc) they signal that need by crying, their primary caregiver (usually the mother) meets their needs. If this cycle is repeated over and over again by the same caregiver, the baby will learn to trust and be able to continue on in their development.
On the other hand, if that need is not met, or is met inconsistantly or by different caregivers, that baby learns to not trust and that the world is unsafe. They learn that they cannot depend on adults. They learn that they must be in control of their life for their survival.
As I was talking to her, she said "That's what happened to us".

And she was right.

Children with RAD learn to see the world very differently than the rest of us. They learned in those first couple of years that they could not rely on adults to keep them safe.

Attachment Disorders range in severity. In fact, the attachment continuum runs from securely attached through degrees of attachment issues all the way to those who suffer from severe attachment disorder. Some children suffer from mild, moderate or severe attachment issues and some from mild, moderate, or severe attachment disorders. For that reason, when you seek out an attachment therapist you're asked to rate each symptom on a scale of 1-10. This checklist is what we filled out on Cimion & Shawna (Jacqueline shows no signs of RAD. When they were removed from their abusive home, she was placed with loving people that she attached to). They were both formally diagnosed with moderate attachment disorder while still in foster care and that was confirmed again when we sought out the help of an attachment therapist two years ago. Cimion was also diagnosed as passive agressive. The year they spent in attachment therapy was worth every penny and every hour we put into it and my parenting of them is a direct result of their disorder.


Regarding the above checklist...
1) All children with RAD have control issues. The key question is, “How extreme or intense is their need to be in control?” These control issues are captured in a number of the 28 symptoms listed in the checklist. The child with RAD is oppositional, argumentative, disobedient or often defiant. They are exceedingly strong-willed and will go to great extremes to be in charge. Their need to control comes from their intense fear that further harm will occur if they are once again as helpless as they were as babies.

2) Most children with RAD have problems with anger. Many will express their anger overtly, having frequent temper tantrums and a short frustration tolerance. A smaller percentage of children will be passive-aggressive and engage in annoying, frustrating, and aggravating behavior. Often this is disguised by a facade of innocence or hidden in socially acceptable behavior. For example, a child with RAD can hug a parent so hard it physically hurts. To a casual observer, it would seem the child’s hug was a loving act. In reality, the child inflicted pain, a hurtful act, within a hug, which is a loving act. This is the hallmark of passive-aggressive behavior or indirect anger.

3) Children with RAD have problems developing a conscience. In the most severe children, their conscience is entirely absent. They have no remorse, regret, or guilt when they violate their parents’ or other people’s rights. In the milder condition of RAD, the conscience is underdeveloped. A number of the items on the checklist are related to the child having little or no conscience.

4) All unattached children have trust issues. They do not trust their parents and the parents cannot trust their children. The severity of trust issues is directly related to the severity of the RAD condition. A number of the 28 symptoms assess the child’s desire and willingness to live outside their parent’s circle of control by being deceptive and disobedient. This failure to develop a bond of love, trust, and cooperation must be present in order for a child to be accurately diagnosed with RAD.

Shawna has come a long way but when I notice even the smallest sign of old behaviors, I increase my interactions with her. Time outs, grounding, punishments, etc, does not work with RAD kids. What I do is limit the number of adults she has contact with and the number of outside activites she has and spend more time with her. When I draw her closer to me and to home, I see that she feels safe and that she can feel better about trusting me. Removing her from school was one of the best things I did for her in dealing with her attachment issues.

When she & I had our talk that day, I showed her court papers she had not seen before. We also looked at the list of multiple placements she had before coming home to us. We talked about how this can effect a young child and how it changed her view of the world. In Gregory Kecks article, he talks about not minimizing the trauma these children went through and that affirming their reality is part of their healing.

Shawna has overcome large obstacles in her life and I have no doubt that she'll heal from this trauma.
She's already on her way.