This blog is my place to vent and share resources with other parents of children of trauma. I try to be open and honest about my feelings in order to help others know they are not alone. Therapeutic parenting of adopted teenagers with RAD and other severe mental illnesses and issues (plus "neurotypical" teens) , is not easy, and there are time when I say what I feel... at the moment. We're all human!

Sunday, June 30, 2013

Five Stars! My Top 10(ish) things I couldn't do this without!


So many people ask what books and methods that I recommend for becoming a therapeutic parent and I realized that while I usually remember to label things this way on my reviews, I've never actually gathered them together.  

There are a lot of fantastic books and techniques not listed here (for example, TBRI which is awesome and a lot like the therapeutic parenting we do, but wasn't really around when we started this process).  Those here are the ones I felt helped me the most on my own personal journey.

Please view the posts on the right sidebar ---->;
These posts include everything I have read, learned, thought, on a ton of topics (like school, dealing with lying and stealing, traumaversaries, age appropriate parenting...). This post is about my favorite books and attachment gurus, but I hope you get a lot out of the other posts too! Some of my favorites, I've listed at the bottom of this post). 

Disclaimer:  Every child is different.  Their personalities, their histories, and where they are in their journey.  Parents and families are different too, and needs must change and adapt over time.  For this reason, no one technique or method will work for every child and family all the time.

How to Use This Blog
It is our job to try to find what works best for us and our family.  We will make mistakes and we will learn.   Most families end up taking bits and pieces of many different concepts and putting them together to form what works for them.  Please take what you need from what you find here, and respect that other’s journeys may be different from your own. 

I am by no means an expert, this information is from resources I've gathered from my own reading and seminar attendance, other Trauma Mamas and parents on the support groups I belong to, including and especially, the amazing people in the group I admin - Parenting Attachment Challenged Children

So here's my top 10 in no significant order!

I have done a whole series of posts on her books and seminars (see right sidebar of this blog) and HIGHLY recommend her books - especially Coming to Grips with Attachment which is full of practical advice and great with older child adoption.


2.  Can This Child Be Saved? Solutions For Adoptive and Foster Families by Cathy Helding and Foster W. Cline - 
Foster Cline is one of the authors of the Love and Logic books.  I really like the L&L books, but they don’t really work well with kids of trauma.  This book is different. The title is scary, but it is very empowering and validating to parents. 

The first part of the book is an overview of the disturbed child.  
The second part of the book gives more practical parenting tools.  

To me, the best part is that it lists both conventional and non-conventional techniques (like sticker charts) and and why they do and don’t work with our kids!


Two series of posts that combine most of what I've learned and/or used in a lifetime of working with special needs children, mentoring their parents, and caregiving (including my time as a director of a large preschool/daycare). Plus, of course parenting my own children - including my severely mentally ill adopted children with RAD. I've also got a Masters in Social Work with a focus on mental health and a Bachelors in Psychology with a focus on child abuse and neglect. (And I'm ancient! lol) 

These behavior management techniques are a combination of all the therapeutic parenting techniques, methods, books, advice... that worked for me.
Age-Appropriate Therapeutic Parenting - (Chapter 1: Parenting based on Developmental/Emotional Age) Trauma can cause significant delays in development (emotionally, socially, intellectually...).  Frequent moves and other traumatic life events can also cause delays or even get them stuck at the age the trauma occurred. We need to parent our children based on where the child IS versus where they “should be,” basing our expectations of our child on that child’s emotional age. To parent your child where they ARE, even if that means treating a teen like a 6 year old.  Or a 6 year old like a toddler.  These kids may find "normal" kid stuff overwhelming. We had to keep our children's rooms stripped to the essentials, avoid overwhelming places like grocery stores and birthday parties, and avoid letting them get tired or hungry...  (Explaining Age-Appropriate Parenting to Your Child )
Structure and Caring Support - Children NEED structure and caring support to feel safe and start to heal.   This feeling of safety is usually not based in reality – it is a perceived feeling of safety.
 If the child feels that they are in control instead of us then their world is not SAFE.
To outsiders, the high level of structure we provide seems controlling and overprotective, but Bear really did feel safer knowing we cared enough to pay attention to him. I believe Bear often acted out when he felt unsafe just to increase our level of supervision. 
Karyn Purvis and TBRI came along somewhat after my time, but it follows with most of what I've learned about therapeutic parenting. It's been highly recommended by other Trauma Mamas. I suggest you check it out!

The FAIR Club helped me be a better parent. It gave me a way to take the emotions out of consequences and adapt as my kids matured (Bob quickly figured out how to get around most methods - like 1-2-3 Magic - or they were level systems so complex that we just couldn't maintain them). W

The concepts behind The FAIR Club work better when you are dealing with older kids (I'm speaking of emotional maturity not chronological/ calendar age). 

I love that it adapts well when you have both bio kids (who can generally handle more complex consequences) and kids with attachment/ trauma issues (who need the added support when they are dysregulated). This allows all the kids to see that everyone has consequences for "misbehavior," so are less likely to mimic the behaviors that they feel a sibling "got away with."  

Our biokids learned from The FAIR Club and grew out of the need for it. We found that living 24/7 in a structured environment like The FAIR Club (without the writing assignments and extra chores) worked best for our adopted kids, and they will probably need it for much longer. Structure and Caring Support


4.  Caring for the Caregiver
I know it sounds stupid, but I needed "permission" and encouragement to take care of myself. 

Parenting a child with attachment issues is extra draining (especially when we're in the "fake it till you make it" stage) and we need extra support to deal with that. But it felt so wrong to prioritize myself over the needs of everyone else. Society tells us we should be nurturing and prioritize our family and people who work with our child tell us we have to prioritize that one child, you HAVE TO prioritize yourself over the needs of the family. 

One way I look at it is, like what they say on airplanes - you have to put the oxygen mask on yourself first and then take care of those around you. If you give and give and give without getting much, if anything, back, then there is nothing left!

Advocating for Yourself, Your Family, and Your Child - In That Order!
I also needed "permission to prioritize myself and the rest of the family over the needs of one child. Yes, my job as a parent is to help this child, but not at the expense of my marriage and the other children.

The Five Love Languages by Gary Chapman.  
This is not specifically a therapeutic parenting book, but I use the Love Languages daily.  Not just to help me understand my husband and family and express my love to them, but with every person I come in contact with.  With my employees, it helps to know how to best reward their achievements and motivate them.  With friends, I can figure out how best to express my appreciation or provide support.

Most importantly, it has helped me understand what I need, and making sure my "love tank" is full, which is key to helping me be a good therapeutic parent. My family struggles with their own needs and can't be counted on to fill my tank (although I have "trained" Hubby to speak to me in my Love Language!). 

Knowing my love language is Words of Affirmation means that I can focus my limited time on meeting this need for myself. In my case, through this blog and the FB group I moderate. I can't tell you how many times a thank you or a positive comment brightened my day and helped fill my tank. (Of course a negative comment, especially a troll, cuts deeply and leaves me feeling drained).

Self-Care - Caring For The Caregiver**
Getting Respite, Planning a Retreat**


5.  Finding the Joy aka Choosing Joy.  
This is one of the most important concepts that helped me.  Accepting life the way it is and choosing to be happy. Remembering that I haven't failed when my children or my life aren't what I wanted and expected them to be. 
You Haven't Failed!!**


6.  Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder by Paul Mason MS, Randi Kreger - I found this book to be helpful for anyone dealing with a child with an attachment disorder, not necessarily borderline personality disorder. It helped me better understand why they acted this way, which helped me be more empathetic. It also helped me with setting boundaries for my children.


7.  The Explosive Child and Raising Your Spirited Child - Neither of these books are specifically about children of trauma, but the latter is the only reason Bob survived to the age of 4!  I learned a lot about personality differences and what a difference tolerance levels can make.  I couldn't understand why Bob (and my other children) did a lot of the things she did, and this book really helped me have insight and empathy into our differences (and the things we had in common!).


8.  The Bipolar Child - This is another book that should be in the bookshelf of all parents who are dealing with a child with trauma and mood issues.  While trauma will not cause things like bipolar disorder, if a child has a genetic predisposition to mental illness, trauma can trigger early onset!  A substantial number of children end up in foster care, because they have mentally ill family members.  

This book discusses not only how Bipolar Disorder looks in children (which is significantly different than in adults), but also other disorders and issues with similar symptoms that can mimic bipolar disorder.  (ADHD, PTSD, trauma…).  It also discusses medications and their effects.  This is a great reference book!  

My children are also diagnosed with Bipolar Disorder.  I’m finding it interesting how much overlap there is between bipolar and RAD.  This book has some spots that are dry and tough to read, but has also got some extremely helpful info.  And not just for bipolar disorder in kids.


9.  Beyond Consequences Logic and Control: A Love-Based Approach to Helping Attachment-Challenged Children With Severe Behaviors by Heather T. Forbes and B. Bryan Post 

I use this book primarily to remind myself where my children are coming from (fear!), especially when they're Raging.  It helps me with empathy.  

When I read it though, I do have to keep in mind that it tends to be negative toward parents. The book's premise is that if we follow their recommendations then the child will get better, if the child doesn't get better, then it's our fault.  That's just not true! 
Therapeutic Parenting Chap. 2 Discipline Problems vs Behavior Problems


10.   Support 
Bloggers - I started on this journey feeling alone. No one around me had adopted teens. No one had adopted children with severe special needs. I found one forum that finally led me to people like me.
Blogger Christine Moers at Welcome to My Brain  is a weird, Christian chick with dreadlocks and tats, and the most amazingly warm, coach who really "gets it."  She co-created with Billy Kaplan, a DVD called "Chaos to Healing: Therapeutic Parenting 101" - which explains Dan Hughes' PACE technique extremely well and I recommend it.  She also does does therapeutic parent coaching and crazy, amazing YouTube videos.  I can no longer hear a certain song without substituting the word pee!
And Lisa at Life in the Grateful House, started this journey at about the same time I did, and I have the privilege to call her my friend. She has been incredibly transparent on her blog about her amazing work with her daughter J.

Plus many others who helped me with our unique, individual journey because something about them and the blogs they shared, resonated within me.  Check out the blogging world and see if there's someone out there that's like you and going through what you're going through or maybe is doing things totally differently than you would, but has something you can learn from. I admit I don't really have time to read blogs anymore, but they're in my reader because they've touched me in some way.  Like books on my shelves that I can go back and read sometimes when I need to hear from a friend.

The biggest reason I've made it this far:

Online support groups like Beyond Trauma and Attachment  and other Facebook Groups including the one I now admin, provide the most support I've ever found.  Parents from all over the world at all hours of the day and night, reaching out to people who "get it" to ask and answer questions, rant or rejoice, just let others know that they are not alone.  They sit in their living rooms or at Starbucks, or meet in real life.  Once a year, there is a large group of Trauma Mamas that meets in Orlando.  They've made more of a difference for me than any other therapist, medication, book or resource.  They "get it."  

Real life support - people like Hubby - who's always got my back, Grandma - who provided weekly respite for years - BLESS HER!, Leslie, Sherry, Lori, Kim... fellow trauma mamas who listen to me vent and give constructive advice, Terry and Mike and the COAC (local adoption support group) and the ACT crew, Kitty's attachment therapist... and my friends and family who don't really "get it," but who listen and support me anyway (Denise, Sharon, Caty, Cuz Susanna, Cuz John...)...




Saturday, June 29, 2013

Books and Methods Review - Love and Logic


Parenting with Love and Logic by Jim Fay and Foster Cline

Amazon review: Establish healthy control through easy-to-implement steps without anger, threats, nagging, or power struggles.

Library Journal:  Psychiatrist Cline and educator Fay's "Love and Logic" parenting method advocates raising responsible children through practice. "Helicopter" parents hover around their children while "drill sergeant" parents give orders to theirs, they claim. Neither of these styles permits children to learn how to make choices and learn from the consequences. The result is that as early as adolescence these children too often make bad decisions. In the context of a healthy, loving relationship, "Love and Logic" parents teach their children responsibility and the logic of life by solving their own problems, providing skills for coping in the real world. After laying out the principles of "Love and Logic," the authors provide "parenting pearls," which are strategies for applying the method to actual situations such as back-seat battles in the car, homework, and keeping bedrooms clean. This is an upbeat and sensible approach to child rearing that will be popular in public libraries.-Nann Blaine Hilyard, Fargo P.L., N.D.


Marythemom:  This book gives lots of practical advice that is great for helping me stay calm, and stop rescuing and controlling my kids.  It also gave me ideas of consequences and realistic expectations, and I use it to help me devise logical consequences for the FAIR Club (Parenting Teens with Love and Logic is good too!).  HOWEVER!  You have to keep in mind though that these books are written for kids who are attached and capable of feeling guilt (and therefore want to please their parents and care if Mom and Dad are upset with them) and are cognitively able to understand consequences.  

Our kids usually do not have DISCIPLINE problems they have BEHAVIOR problems.  In other words they are not misbehaving because they want to, but because they can't control themselves.  Most of the time their behavior is irrational.  


According to the L&L books, natural and logical consequences are the most efficient way to teach a child. Lectures, spankings, losing stickers, grounding and timeouts are usually so unrelated to the "crime" that often all they "teach" the child is to try not to get caught.

Natural and logical consequences work best because children learn best from them.  I prefer not to use the same consequences every time, because my children often decide that "doing the crime" is worth "doing the time" (especially those that don't believe they'll ever get caught).

A natural consequence is what happens if parents don't interfere (ex. a child runs away from you in the mall - and gets lost and scared). This is the MOST effective means of discipline. (Think about it - as a teen, how many times did your parents lecture you to drive the speed limit; you read it in the driver's handbook; you saw the signs posted on the side of the road. I'm guessing you ignored all that and got a speeding ticket, right?! I'm also guessing that made you more likely to drive slower. If you actually had an accident from driving too fast you're even more likely to drive even closer to the speed limit. People tune out lectures and nagging - consequences get their attention.)

A logical consequence is what happens when you don't want to allow the natural consequence to occur (especially if the child could get seriously injured or killed), but you want the child to still make the connection (ex. the next time you go to the mall the child must hold your hand). You might even give a real life lesson by allowing a child who habitually runs away to think they have gotten lost (while you keep an eye on the child from a hidden vantage point).


Helicopters, Drill Sergeants and Consultants:  Parenting Styles and the Messages they Send by Jim Fay
Marythemom:  I read a lot of Love and Logic books and other parenting techniques, what worked for others and finally developed the FAIR Club, thus switching to a more "Consultant" style, focusing on natural consequences and holding the kids accountable for their actions. This felt right and I was a better, calmer parent. I think I did fairly well but over the years I've found myself becoming more and more of a Drill Sergeant with Kitty and Bear.  It took a long time, and a lot of guilt, for me to finally realize that this was because Kitty and Bear NEED extreme structure and support.  

Can This Child Be Saved? Solutions For Adoptive and Foster Families by Cathy Helding and Foster W. Cline
Marythemom:  This is one of my 5 Star Books.  I really like the L&L books, but they don’t always work well with kids of trauma.  This book is different.  This is one of my favorite books to help with kids of trauma.  The title is scary, but it is very empowering and validating to parents. The first part of the book is an overview of the disturbed child.  The second part of the book gives more practical parenting tools.  To me, the best part is that it lists both conventional and non-conventional techniques and why they do and don’t work with our kids!

How to Discipline Kids without Losing Their Love and Respect by Jim Fay
Imagine...No More Arguing.Imagine...No More Manipulation.Imagine...Stess Free Parenting.For over fifty years, Jim Fay has worked with shcools, families, and children in the areas of teaching, parenting and discipline. In 1977, along with internationally renowned psychiatrist Dr. Foster W. Cline, he founded the Love and Logic Institute, Inc. which is dedicated to helping parents and educators create responsible kids. We know you will enjoy this book by beloved storyteller and parenting expert, Jim Fay, as he speaks to parents, educators, and community leaders about how to discipline kids without losing their love or respect.

Love and Logic Magic for Early Childhood: Practical Parenting from Birth to Six Years by Charles and Jim Fay
"This book offers nothing new, with much less content compared to its 'parent' book."

Thursday, June 20, 2013

Attachment Challenge

 I'm going to need someone to hold me accountable, because I've decided to do this Attachment Challenge  and I really don't want to.  Lately I've been feeling very frustrated with Kitty and I need to change it up.  She's staying with Grandma for the next week and a half, but I'll be seeing her daily.  I think I'll wait to start the actual challenge until she's home, but for the next 10 days I'll start adding things in gradually.  Anyone with me?

Oh my goodness.  I can't believe I'm considering this.  I wasn't willing to try it 3 years ago when Christine Moers from Welcome to my brain. net  first came up with this horrible Attachment Challenge For the last couple of weeks though I've been really struggling with Kitty.  I'm not sure if it's worse lately because she's not living at home right now (she's spending the next 2 weeks at Grandma's house so she can get to Vacation Bible School easily) so I'm out of practice at the daily routine of dealing with her, or the lack of buffer when she was home (when not at camp or on trips, Bob and Ponito are spending the majority of the summer at Grandma's so they can help her with babysitting my sister's kids - which Kitty is very jealous of, since she's not really invited, due to her being another child instead of a helper), or maybe because despite trying so hard to keep my expectations at the right level for her, I'm really frustrated with HER not being able to accept her reality.

So here's the challenge:



The Attachment Challenge

10 hugs a day
10 minutes of FUN attachment-inducing games (involving touch and/or eye contact)
20 minutes of doing something fun YOUR CHILD wants to do


IDEAS
  • Some of the posts we've come up with for doing when we're bored that might have some good things to do together - http://marythemom-mayhem.blogspot.com/2011/08/108-alternatives-to-boredom.html   
  • http://marythemom-mayhem.blogspot.com/2009/09/trapped-in-house.html
  • Prepare and shop together for a "letter party." 
  • Play catch with a big ball or balloon. The trick is you must maintain eye contact. Don't look at the ball. 
  • Hand Games like "Miss Mary Mack" etc...
  • Cuddle up on the couch and read a short book together. Take turns reading.
  • Tie one of each of your legs together and each of your wrists. Now together...go make a sandwich. Teamwork!
  • If you have a pre-teen or teen aged daughter...do her make-up (even if she doesn't normally wear any)
  • Hair - sitting in front of the mirror so you can catch each other's eyes - braid, curl, brush, gel, mousse...
  • Mani/ pedis!
  • Ask your child to take a photo portrait of you and you take one of him/her. Frame them on a wall next to each other. 
  • While sitting across from one another...ask your child to draw a portrait of you. You draw one of him/her.
  • Start two journals. In one...your child can ask you any question and you must answer. In the other...you may ask your child any question and they must answer. Leave the journals on each others beds every night for peeks into hearts and growing understanding.  (What makes you happy? What makes you sad? What are you afraid of? Do you have any regrets? What makes you laugh? Do you feel safe? What does family mean? Have you ever felt forgiven? etc....)
  • Write a poem using the letters of each other's names and read them to each other.
  • Scavenger hunt with loving clues from mom. end in favorite snuggle place.
  • Tubby that smell away. use deodorant/yummy lotions. anything to help the connection times (you can wear swimsuits). 
  • Color a coloring page or Mandala together. each person must color the spot and with the crayon of the other's choice. cross over/intertwine arms.
  • Slowly feed each other a bag of fruit snacks. one for one. give words of affirmation. (ie feel my love going down down to your tummy)
  • Cook a snack or make a fruit salad together.
  • Lotion each other's hands
  • Wii - Just Dance together - we're both bad at it
  • Sewing - this is an activity I've already planned for this summer with Kitty and 3 other girls.
  • Tossing goldfish in child's mouth from 5ft away - trying for 5 fish in a row
  • http://www.shabbybeachnest.com/101-idea-im-bored-jar/

Attachment Challenge Days 1&2 
Attachment Challenge Day 3
Attachment Challenge Days 4,5&6
Attachment Challenge Days 7, 8, 9 and a makeover
Attachment Challenge Day 10
Attachment Challenge Day 11&12 and a makeover
Ended Attachment Challenge to do chronotherapy for chronic insomnia

Thursday, June 13, 2013

Advice for someone adopting a 4yo with RAD

I recently got a request for advice from a woman in the process of adopting a 4yo relative diagnosed with the usual letters - RAD (Reactive Attachment Disorder), PTSD (Post Traumatic Stress Disorder), ODD (Oppositional Defiant Disorder) ...  I was quite concerned because the woman has a young family already, including an infant, and no experience with therapeutic parenting.  She was given a lot of conflicting advice from the therapists/ social workers and foster mother.  
**We had several emails back and forth. I don't feel comfortable sharing her emails, so please be aware that these are my responses to emails with information you're not seeing. In other words, sometimes this post will sound disjointed and random. **

Here's my advice:

*************************

Yes, there are different types of RAD and it's all on a continuum, BUT I don't know anyone that doesn't find that all RAD kids are pretty challenging, especially before any healing and attachment takes place.  This is a post I wrote about this subject:



Here's some general advice based on what you've told me:


  1.   Books and Methods - You mentioned Nancy Thomas. One of the most recommended books for parenting children with RAD is Nancy Thomas' stuff.  Nancy Thomas is good, but when you're starting out, she will SCARE you! 

    I'd recommend reading When a Stranger Calls You Mom, by Katharine Leslie instead, which gives you the why of why kids with RAD act this way, AND the how to deal with it.  This book and her other one Coming to Grips with Attachment are both excellent books that give practical advice (unlike a lot out there - which seem to say, love your kids more and if they're still messed up than it's your fault). 

    Nancy Thomas works well with younger children who are practically feral, BUT you have to be a strong person who can treat this one child VERY differently than your other kids.  In front of your other kids - which is even harder than it sounds.  If you're a laid-back parent, like I was, this is going to be one steep learning curve!

    I would read the posts I wrote about Katharine Leslie (they're in a box on the right sidebar of my blog) I find her advice to be very practical and a little easier to adapt to my parenting style.  As I got to know my kids better - discovering they felt safer with lots of structure and support - I found that it was easier to become the structured parent my kids needed.  Eventually the strict structure recommended by Nancy Thomas became easier to fit into my parenting style, but I definitely wasn't ready for it at the beginning.
  2.   Therapeutic parenting is different.

    Speaking of your other kids- PLEASE protect everyone and start off parenting this child differently than the other kids.
    I know how hard that is, but she NEEDS a different parenting style if she's going to heal.  Believe me, I was a laid back mom, and I learned the hard way that that was not what my kids needed.

     Kids with severe trauma issues do NOT learn by watching and having you as a role model like other kids.  They have to be taught things like reciprocity and empathy.  You are very lucky that she is so young, but a LOT of our values are established before age 5 (some say all!).

    RAD causes permanent brain damage and the brain has to be taught how to work around it (think of someone learning English for the first time - if they start learning before age 3, they will probably have no accent.  Before age 10, maybe a slight accents and will have a lot of the nuances and colloquialisms.  As an adult?  You will always be able to hear that English was not their first language.)

  3.   Constant Supervision. At first, do not trust her alone with the other kids (or pets).  It sounds awful, but I can't tell you how many parents have said they found out later that their RAD child was abusing their siblings when adults weren't around.  My girls were about the same age, so we let them play together, and found that our adopted daughter was doing a lot of trauma-processing with her doll play, and my bio daughter was being exposed to some stuff I didn't want her to have to handle!  Our son also required constant supervision because he was "parenting" the other kids - telling them what to do, intimidating and threatening them to give him what he wanted (and sometimes just for the heck of it).
  4.   Adopting out of birth order is hard and not recommended for good reason - especially as the kids get older and the neurotypical kids develop normally, and begin to pass their traumatized siblings.  Let everyone (including the kids) know from the beginning that you parent your children based on their individual needs.  It can still be difficult to explain to the children.  As mine got older, we used things like the trust jar to explain why.
     
  5.   SUPPORT! Find some online support - local is great if you live in a big enough city to have other RAD parents, but it is DIFFERENT parenting a RAD child than any other child.  There are some amazing groups on FaceBook if you want to friend me I can get you in.  I moderate a group with a lot of parents of younger children, for which you might be a good match. You've heard the saying, "It takes a village..." - You need one full of people who "get it."
  6.   RAD, ODD and PTSD all go hand in hand.  I don't think it's possible for a RAD kid to not have PTSD or Complex PTSD.  ODD is a VERY common diagnosis for RAD kids who are under the age of 5, because caregivers always get the RAD attitude. 

    SOME RAD kids are what I call "Charming RAD" (aka Disinhibited RAD) and can fool the general public into thinking they're fine (and that it's YOU with the issues).  These kids usually don't get diagnosed with ODD, because they're not defiant to everyone (just YOU!), including the person doing the testing, teachers, caseworkers... 

    The good news is, if your child really does have ODD then that can give you an advantage. I have a friend who’s daughter has both ODD and RAD, and she is definitely different from my daughter in that her refusal to comply with all adults is to such an extreme that they can almost use it to their advantage. For example, if the child doesn’t want to load the dishwasher and is doing it so slowly that she’s practically unloading it, they can prescribe her behaviors and tell her to do it slowly and poorly, and she speeds up just to “spite them.” I guess it could be a different cognitive level or being milder on the RAD spectrum, but we can’t “trick” our daughter like that. She is not oppositional to the point of losing track of what she wants from the situation. Or maybe she’s just not RAD enough to hate us so much that she’ll spite herself.  Difference between ODD and RAD.
  7.   Find a GOOD attachment therapistIt's not easy, but it's so important.  (Finding an attachment therapist - http://www.attachment.org/pages_find_therapist.php)  A good attachment therapist will have you in the room.  Will support you emotionally.  Will not attempt to establish a relationship with your child, but instead will help facilitate a relationship between you and your child. 

    If you get a bad therapist (who wants you out of the room, who makes you feel bad as a parent, who doesn't have a good understanding of attachment therapy, RAD and trauma... ), FIRE them!  A bad therapist is worse than no therapist at all. 

    At 4 years old, your child will probably be doing a lot of play therapy, but makes sure this is a specialist in attachment, trauma, adoption or you're wasting your precious time.
    Questions to Ask an Attachment Therapist
  8.   Primary Female Caregiver. When adopting a child with RAD, that primary mother/ child bond has been broken, and on an instinctual/ sub-conscious level, they get you mixed up with that birth mom. This sucks! Because it's not something they think about consciously, it's not easily accessed and healed.

    They find you threatening - you represent the caregiver who did not protect them, and you dare to try to love them - which is scary- because everyone who they love leaves them or hurts them -see The Frozen Lake story* by Nancy Thomas at the end of this message.

    Be aware that it's going to feel like your child hates you, and that most likely no one else will see it, even your spouse.  My husband is wonderful, but my kids acted totally different toward me, as their primary caregiver, then they ever did toward Hubby.  It took quite awhile to get him to see it. I think what helped most was reminding him that he knows me. I am not a liar. I don't exaggerate or make things up. I tried to get him to read books, go to seminars, talk to people who "get it," go to marriage therapy... it helped somewhat, as did finally seeing some of that the kids were so careful to hide from him and everyone else.

    Do "tag team" wherever possible.  Give yourself frequent breaks. This is a tough job, even with just one kid, let alone so many.  Above all, TAKE CARE OF YOURSELF!!  Remember if Mama ain't happy, ain't nobody happy!
  9.   Developmental Delays. Remember that trauma can cause significant delays in development (emotionally, socially, intellectually...).  Frequent moves and other traumatic life events can also cause delays or even get them stuck.  Most kids with PTSD (and brain damage from RAD) have a tough time with processing, memory, object permanence, emotional regulation... 

    Parent your child where they ARE, even if that means treating a teen like a 6 year old.  Or a 4 year old like a toddler. 
    They may find normal kid stuff overwhelming - we had to keep our children's rooms stripped to the essentials, avoid overwhelming places like grocery stores and birthday parties, avoided letting them get tired or hungry...
    Parenting Based on Developmental/ Emotional Age
  10.   PTSD. It might help if you picture PTSD like flashbacks into a warzone.  Kids of trauma are easily triggered, extremely sensitive to emotions, unable to regulate their emotions... causing them to react as if they are in a warzone.  You can't learn and attach if you don't feel safe and you're living in a war zone! 

    If you are in fight/flight/ freeze mode then you are thinking with the reptilian part of your brain.  The rational part of your brain just isn't online!  It doesn't help to hold your child responsible for what happens in the middle of rages - instead it works best to just move on after it's over and try to figure out what triggered it so you can avoid it in the future.  Hypervigilance (obsessively monitoring her environment) is super common among kids with PTSD.  It relaxes when they start to feel safe, but I don't think it ever really goes away.
    Why Doesn't My Child Feel Safe?
    Meltdowns and Dysregulation
    Rages

Most important, handle as much as you can now!  Cause puberty is hell and you want a secure attachment long before then.

Good luck!  Please feel free to ask questions and let me know if there is any way I can be of assistance.  

Mary

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Katharine Leslie. I hope you've started reading the Katharine Leslie stuff I have on my sidebar, it really helped me!!  It not only has practical advice, but it also explains the why.   Gives some idea of how to set up your household until your child is attached (Basic Package vs Luxury Package).

Abuse and Neglect. From what you say, I wouldn't be totally sure that she hasn't been abused.  Neglect can actually cause MORE damage though.  That many changes in caregiver is definitely a big factor in the RAD.

Holidays and other Traumaversaries. Sounds like she's going to have a LOT of traumaversaries; Christmas is a big one in our house too, and only because of what it represents, not even because they had anything in particular happen to them on that day.

Developmentally Appropriate - Play and Self-Entertaining. Not knowing how to play is pretty typical for kids of trauma.  Remember she's probably developmentally much younger than her chronological age.  Toddlers don't play with other children, but instead do what we call parallel play.  It's not until empathy develops at age 3 or 4 that they start to be aware of their playmates' needs and feelings.  It's a fact that toddlers, especially 2yr olds, are perfect examples of pretty much every major mental illness -

  • Megalomania - it's all about me.  MINE!
  • Bipolar Disorder - happy one minute, sobbing the next.
  • Schizophrenia - distorted reality
  • Obsessive Compulsive Disorder - Food can't touch!
  • Oppositional Defiant Disorder  - NO!!!!!
  • Attention deficit disorder with hyperactivity (ADHD) - I'm going to play with this... oooh shiny!  Squirrel!  
  • http://themetapicture.com/if-toddlers-could-post-on-facebook/


Early-Onset Diagnoses
Trauma can trigger early onset of bipolar and schizophrenia in those with a genetic predisposition, and of course RAD and PTSD mimic a lot of these symptoms.  Amazing chart that shows the difference between all the different typical childhood disorders.  This makes it difficult to impossible to tell what is actually causing the symptoms (and therefore making it harder to treat).

First Priority - ATTACHMENT -  I will say that attachment is your FIRST priority.

Medication. Once your child is attached, then you can start seeing which of these symptoms heal, and which might be symptoms of something that needs medication.  Sometimes the medication has to come first (again, trying to heal in a warzone!), and then it can be reduced when the child starts healing.  I know it sounds crazy to medicate a preschooler, and I'm not saying your child needs it, but remember that if a child is battling a chemical imbalance or suffering from extreme anxiety - then they can't focus on healing.

Puberty. Puberty can trigger a lot of issues as well, so it's best to get things as under control and healed as possible before then.
The Teen Years

"Tries to manipulate adults"
This is called triangulating, and RAD kids are EXPERTS at it!  We are ALWAYS aware of this and document it as much as possible to protect ourselves (you might also be careful about her being alone with males - she's a little young now, but I can tell you a LOT of kids will accuse males of sexually abusing them).  They can damage your relationships so fast it will make your head spin. Make sure your husband is as aware as possible about how RAD kids feel about caregivers. You need to be sure that he is aware of her manipulations.

I'm not sure why they do this.  I think sometimes they just

  • want to watch adults get all agitated, 
  • want adults to fight to distract them from the child and what's going on with him/her, 
  • are trying to recreate the chaos that their brains are used to -
    Just like alcohol, our kids can be "pickled" in adrenaline (or other stress hormones) in utero. It causes damage, and also causes adrenaline, anxiety, and chaos to feel "normal" and familiar. 

We don't always know why they act the way they do.  The main thing is for parents to be aware of it.

Avoiding Triangulation.  Constantly communicate with your spouse, it's probably easier with a 4 yr old, but my kids could ALMOST convince my husband that I said or did something.  Luckily he believed me over them, even when evidence said otherwise. We tried to always back each other up. If a child came to one of us asking for something, especially if they said the other parent said it was ok, when we were pretty sure our spouse wouldn't have said that, then we usually said something like, "I need to talk to Hubby (or Mom) about this first."

Be aware that they do the same with caseworkers, teachers, neighbors... any other adult they can.  I do believe that the child actually believes that "Mommy never feeds me," "Mommy said it was OK for me to cross the street by myself," "Mommy hit me."  Their version of reality is pretty distorted and between the ages of 4-6 they have what's called "magical thinking."
Lying and Stealing - Why Do They Do That?

I think preparing for the worst, and hoping for the best is a good idea.  Gotta run, more later!

Mary


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"The social worker and therapist say that the child is 'fine and plays sometimes,' but the foster mom says otherwise."

Sorry, but the play therapist and social workers are being played (or seeing what they want to see).  I'd believe the foster mother.  RAD kids act very differently around caregivers.  You need to go into this with your eyes wide open that this child is closer to the extreme end of RAD.  You will need to protect your family, especially the younger children.  DO NOT leave her alone with them, even during the honeymoon period you will hopefully get.

I'd start with life as structured as the foster mom has it set up.  Get into a routine quickly.  Do not have a lot of stuff in her room.  Do not try to make her life in any way like your other children's - go for the "basic package."

You are going to have to get this little girl to trust you, and the best way to do that is to be consistently caring and keep her safe (even from herself).  She will need lots of boundaries and structure to feel safe.

Child Proofing

Think of it as childproofing for a toddler.

Avoiding "No"s
You want to set up her environment so that she doesn't hear a lot of "No"s, there just shouldn't be an option of doing things that need a no.  If it were me, there would be no razors stored in the shower (that part of the FM's story scared me).

Logical Consequences.
Kitty also deliberately pooped herself while in foster care, and they found some ways around it (if she wanted to go swimming, which she loved, then she couldn't have had a poop incident the day before) - which I find to be a much more effective alternative to shaming and punishment.  We were lucky that Kitty didn't end up having this particular control issue with us, thank goodness, although we had lots of hygiene issues (The RAD Stink).

I think partly because we were very matter of fact about a lot of things, and since it didn't get a rise out of us, she eventually dropped it. Believe me, it's hard not to react!

Rewards and Punishments effect on attachment
I think you're lucky that she has a few things that she's allowed others to see are important to her (like wanting her hair looking nice), that shows trust.  I agree with using this as a reward, but be aware that if you take away things they find important, you risk them cutting off that attachment.

My daughter had gotten to the point that she'd completely shut down her emotions even her physical feelings (she literally couldn't feel tickling or even pinching!).

My son had no emotional attachment to anything - there was nothing you could offer or take away that made a bit of difference to him. We tried to think of it as being a prisoner of war. He'd lost everything multiple times, so tried to avoid attaching to anyone or anything (see the Frozen Lake story at the bottom of this post.

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When it come to discipline, the biggest thing to remember is that she's only 4, and I can almost guarantee that she's not really even that (trauma often damages/ delays development), so punishments that last longer than 4 minutes have little to no effect.

Time Ins vs Time Outs - Emotional Regulation
Most attachment gurus recommend "time ins" instead of "time outs."  My daughter needed a lot of help with emotional regulation - she never learned how to self-soothe.  She needed that from me.  I had to stay calm, use a soothing voice and have steady, even breathing.  Eventually she'd match my level (whatever that was, so if I was excited and angry...).
Calming Techniques

Lectures don't work
I've found that lectures that last longer than one word per year of the child's age is "heard" like the adults talk in Peanuts cartoons!  Additionally, for some reason kids can't hear "DON'T" at all.  Instead they take it as a suggestion!  So instead of "Don't climb on the table," they hear "There's a dance party on the table!"  A 3 year old should hear "Use walking feet" instead of "Don't run!!"

Here's some information I've posted about discipline/ punishment for kids under age 6:

Impulse Control
One day when my daughter, Bob, was about 15 months old, she was sitting on the floor in the kitchen, slamming a cabinet door.  Hubby came in and told her to stop.  She looked at him, seemed to understand, gave him a big, toothy grin, and slammed that cabinet door again.  Hubby was furious and wanted to give her a consequence.  I reminded him of his 30yo friend who had recently slammed his fist into a wall and broken his hand (and the wall). This adult friend knew better and impulsively did it anyway.  Can we really expect more impulse control from a child whose brain is not wired correctly yet?

If you can't do the time, don't do the crime.  
A lot of people think that if a child knows the consequences of lying, stealing or any other "crime," then they will be less likely to commit that crime or confess to a crime to keep from getting more severe consequences.

There are several flaws in this theory:

  • Lack of impulse control - means they might do it anyway without thinking
  • Distorted reality - they may not be able to see what they're doing as wrong and probably do not (cannot!) believe they will ever get caught. Lying and Stealing - Why Do They Do That?
  • Trauma history - in a lot of ways our kids are often like prisoners of war - no consequence is worse than what they've already lived through
  • Trust issues - they protect themselves by deliberately prevent themselves from caring about anyone or anything enough to allow themselves to feel upset if they lose it, even if it's more of a "sour grapes" kind of thing.
  • Life or death defense mechanism- these kids lie as if their life depends on it... because it does! It has in the past and it still feels like it does.  This is a core belief! A lecture, time out, losing their cellphone or even jail time doesn't matter more than death!


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*THE FROZEN LAKE  By Nancy L. Thomas

"In order to understand what an unattached child feels like, one must understand his perspective. Imagine that you are the young child who must cross a frozen lake in the autumn to reach your home. As you are walking across the lake alone, you fall suddenly and unexpectedly through the ice. Shocked and cold in the dark, you can't even cry for help. You struggle for your very life, you struggle to the surface. Locating the jagged opening, you drag yourself through the air and crawl back into the woods from where you started. You decide to live there and never, never to return onto the ice. As weeks go by you see others on the ice skating and crossing the ice. If you go onto it, you will die."

"Your family across the pond hears the sad news that the temperature will drop to sub-zero this night. So a brave and caring family member (that is you, the parent!) searches and finds you to bring you home to love and warmth. The family member attempts to help you cross the ice by supporting and encouraging, pulling and prodding. You, believing you will die, fight for your life by kicking, screaming, punching and yelling (even obscenities) to get the other person away from you. Every effort is spent in attempting to disengage from this family member. The family member fights for your life, knowing you must have the love and warmth of home for your very survival. They take the blows you dish out and continue to pull you across the ice to home, knowing it's your only chance."

"The ice represents the strength of the bond and your ability to trust. It was damaged by the break in your connection to someone you trusted. Some children have numerous bonding breaks throughout their young lives. This is like crashing them into the ice water each time they are moved, scarring and chilling their hearts against ever loving and bonding again."