What is Reactive Attachment Disorder?
Reactive attachment disorder is a disorder very common among foster and adopted children. RAD is a diagnosis where children have difficulty attaching to their primary caregiver. This is usually due to past trauma such as abuse, neglect, or abandonment. It is very similar to PTSD because it is a result of a specific event or series of events. Children with RAD have extreme mood swings, fake charm, difficulties with attachment, difficulties with trust, and a lack of “stranger danger.”
Foster or adoptive parents of children with RAD are often frustrated with feelings of inadequacy, of helplessness, of isolation, and generally, of being a bad parent. This is understandable because dealing with children with RAD can sometimes be infuriating! It can seem that the more we discipline, the worse it gets. Many foster parents are ready to throw in the towel!
Let’s face the facts: children with RAD exhibit extreme behavior! Foster or adoptive parents sometimes feel the need to match the intensity of the discipline with the form of behavior of the child. The unspoken hope is that the fear of being disciplined will prevent them from acting out the next time. When, in fact, severe discipline causes the child to relive the abuse he suffered under his primary caregiver. Because every human being’s default setting is set toward survival, the child simply wants to protect himself. He doesn’t feel that the discipline is for his good; he feels like his very life is at stake. So, he doesn’t take to discipline very kindly.
What is Discipline?
So, let’s take a step back to define our terms. What is “discipline”? It literally means “to teach.” It is different from the word “punishment” which is not so didactic. When we punish a child, we simply want to stop a behavior. But when we discipline a child, the goal should not only be to stop a behavior but to teach a new behavior. This may be difficult for a child who has had to be “the parent” to their siblings because the real parents were absent. Or it may be difficult for a child because the domestic violence they witnessed is nearly impossible to forget. Or because the language their parents used is embedded in their brains. So, removing one bad behavior from their repertoire is not enough; it must be replaced with something rewarding.
Causes of RAD
Let’s look at RAD from the child’s perspective. Children with RAD have experienced trauma. Adults have a framework for dealing with stressful situations; children do not. Therefore, a few minutes of a frightening event can scar them for life! That event, or events, will be forever implanted on their minds! Yes, placing them in a new environment can help, but the stronger the trauma, the longer it will take that child to recover. Knowing this can give us a different perspective when it’s time to discipline.
– Abuse. Many children with RAD have undergone severe abuse. From being hit, kicked, and/or spit at, the pain they have suffered creates emotional pain that doesn’t soon fade away. Sexual abuse is also very common amongst children who need to be placed in foster care or children who are adopted overseas. So, the “react” in RAD is the reaction to the past abuse they have suffered. To use corporal punishment on a child who has been severely abused may actually reinforce the trauma.
– Neglect. The current opioid crisis has had a dramatic effect on our society; it has over-burdened an already burdened foster care system. The opioid epidemic claims about 60,000 lives a year in overdoses. Many of these people are parents with little ones. Illicit drug use is not a victimless crime. Children are the biggest victims when it comes to drug addiction, whether their parents overdose or not. When this happens, a child is left to fend for themselves; must learn to grow up quickly; must learn who to trust and who not to trust; and basically, learn how to survive. RAD is not uncommon for children who have drug-addicted parents.
– Abandonment. The worst feeling in the world for a young child is to get separated and lost in a public place. Whether in a park, a mall, a sporting arena, a theme park, or a department store, the feeling can be terrifying! It is easy to get separated when there are dozens or hundreds of people and not one of them is a familiar face. It’s equally terrifying for a parent who is frantically searching for the lost child. But what happens when the child abandons the child purposefully? That child will forever grow with a sense of feeling unwanted, feelings of worthlessness, and quite frankly, feelings of abandonment. How do you think that child will react to future events in large group settings? Do you think that a child who has feelings of claustrophobia and has a meltdown in the middle of a grocery store will respond positively to being spanked in public?
What May Not Work for a Child with RAD
When we look at the causes of RAD, we realize that disciplining them like our biological children may not work. But something does have to be done. But note, there is no pill for RAD. There is no magic concoction. RAD is a lifelong condition. It cannot be cured, but it can be managed. However, each child is a unique individual who has experienced extreme trauma. Keep that in mind.
– Corporal Punishment. In most, if not all states, using corporal punishment on a foster child is illegal. Most adoptive parents think they have free reign to do so. However, corporal punishment may actually reinforce the negative behavior because it triggers their memory of abuse and neglect. So, think twice.
– Time-Out. This may have worked on your own biological child who has not experienced trauma. But for a child who has a history of neglect, it is disconnecting them from their new parents, who they desperately need to connect to.
– Threatening. First of all, never threaten something you cannot follow through on. Secondly, many of these children have already been threatened in the past. Thirdly, they will test you to see if you are serious.
– Yelling. After a while, yelling just becomes “white noise.” Or they have been yelled at in the past, which will trigger a behavior to protect themselves.
– Individual psychotherapy. RAD children tend to be very manipulative. With all due respect, therapists can be manipulated too. Trying to determine fact from fiction while in session can be a challenge.
What May Work for Your Little One with RAD
While traditional discipline methods may not work with your kiddo with RAD, some other methods might. What we are trying to build in our foster or adoptive children with RAD is flexibility and resilience. A lot of these interventions are principles you need to develop within yourself. But they are worth it.
– Connection. Dr. Bruce Perry, a renowned psychiatrist, has a saying about kids from hard places: “Connect before you correct.” Kids with RAD are disconnected from attachments. Therefore, it is the foster/adoptive parents’ job to reconnect that child. It will be tough because it is difficult for that child to trust adults. And can you blame that child? If his flesh and blood couldn’t be trusted to provide safety and protection, why should he trust you? Connection will take time, but it will be worth it.
– Communication. Not lectures, but real communication where you actively listen, watch body language, and sometimes fill in the blanks for children too young to accurately communicate what they are feeling. Remember, behavior is communication! So, crying, screaming, and other behaviors are a symptom of a much deeper issue. Be quick to listen.
– Time-in. Rather than isolate a child away from you, bring them in closer. I totally understand the need to redirect a child from a potentially volatile situation. And sure, time-out works for kids who have not been traumatized. But some of these kids have been left alone for hours, if not days. Rather than putting them in their room for 5-10 minutes, put them next to you. Their relationship with you, as the caregiver, is the most important relationship they will have.
– Calmness. In the middle of a storm, boats in the water need a fixed object to steer by in order to get to safety. A lighthouse. Parents who have kids with RAD need a lighthouse. When their emotions are out of control, they need to know that there is someone who is rock solid, calm, and confident; someone they can trust. Someone they can run to in times of trouble. That would be you! Be their lighthouse!
– Patience. Helping a kid with RAD recover from their trauma is not going to happen overnight. As a matter of fact, the longer the trauma occurred, the longer it will take to recover. Be patient! Try different techniques, get educated. And if one thing doesn’t work try something else. Celebrate small victories. Instead of five meltdowns a day, your little one has only two! Yay!
Lastly, remember that while a child may be chronologically one age, they may be developmentally another age. So, while your child may be 10 years old, developmentally, they may be 5. So, yelling, “Act your age!” does little to help that child to develop. Many children with RAD are behind their peers, physically, emotionally, socially, and intellectually. Relate to them according to their developmental age rather than their actual age.
What to Do for Yourself?
Foster and adoptive parents who care for kids with RAD can experience a great deal of frustration. They feel they are victims of triangulation and manipulation. And they feel no one can understand what they are going through. It is very easy to feel guilty because it seems like you’re not a good parent. You may be on the verge of giving up. But take hope, there are things you can do to hang in there. Self-care is very important. Consider the following options when you are at your wit’s end.
– Respite. Take a break, for Pete’s sake! You are not Wonder Woman! You are not Superman! And even they needed a break from time to time. Respite is a brief time away from the foster or adopted child. There may be many reasons for respite such as a parent’s illness or hospitalization, a funeral, or an out-of-state trip that was planned before the child was placed. Or it may simply be a quick date to go to the movies or to a nice restaurant with a good friend or a significant other. Don’t feel guilty! If you have nothing to give your child with RAD, how can you be effective? Children who lack attachment demand so much time and attention that time away from him/her to refocus and regroup is essential!
Foster parents should be provided respite hours to pay the respite provider. In some states, if your child is enrolled at the local behavioral health clinic then that clinic may be able to provide additional hours of paid respite. If you’re an adoptive parent, seek out other adoptive parents with whom you may be able to “swap” kids. It is important to use the same respite provider and to have regularly scheduled respite times. Consistency will significantly reduce the number of negative behaviors during respite. Most RAD kids behave during respite. It is also important to get background checks on all of your respite providers.
– Support. Get a team of people around you who can give you physical, emotional, and creative support! People who will provide meals, provide car seats, and just be a listening ear. This team of people can be family, friends, neighbors, and church family who understand and can sympathize with you.
Hopefully, the above article has given you a different perspective on discipline from the child’s point of view. Remember what they need, rather than what you need at that time. Look forward into time and visualize what you want your child to be. Sometimes, we, as parents, are stuck in the moment and can’t see a way forward. That’s exactly what is happening to your little one. They are stuck in their trauma. It is up to you to be a model and an example of resiliency that you want them to be.
Derek Williams is an adoption social worker and has been in the field of child welfare and behavioral health since 2006, where he has assisted families in their adoption journey. He and his wife started their adoption journey in 1993 and have eight children, six of whom are adopted. His adopted children are all different ethnicities including East Indian, Jamaican and Native American. He loves traveling with his family, especially to the East Coast and to the West Coast and is an avid NY Mets fan! Foster care and adoption are his passions and callings for Derek, and he is pleased to share his experiences with others who are like-minded.