Maybe you're a foster or adoptive parent. Or perhaps you're a mother who was ill when your child was born and the two of you were separated for a time.
For any of a number of reasons, children can develop reactive attachment disorder (RAD). Nancy Thompson, M.S., a licensed mental health professional from Omaha, Neb., in a recent seminar at Western Iowa Tech Community College in Sioux City discussed how to recognize RAD, the causes, and how to deal with the debilitating psychological and learning impairment that can affect any child in any home.
Thompson said when she began counseling that she saw many children "falling through the cracks". She said it wasn't until brain research became widely accepted that RAD became accepted as a clinical diagnosis.
Unfortunately, the ability to make and stay in relationships is not the only side effect of children with RAD which can even affect brain development, said Thompson. "You get a feel for language by being talked to, being spoken to," Thompson said. Current research shows that can even take place in the womb. And the first three years are the most critical.
"That's when a lot of your view of the world is formed," Thompson said. "How many wires get hooked up in the brain depends on the type of experiences you've had."
When children come under stress, they may regress or overreact.
"They always know what wasn't right," Thompson said. "And that's the stuff that they see first. It's very hard for parents to keep their spirits up when this kid will always tell you what wasn't right."
Parents should not take anything the hypercritical child says or does, though.
Reactive attachment disorder is not always a parent's fault. It can actually happen in the womb as a biological reaction that happens during intrauterine life.
Symptoms can vary from mild to moderate to severe. They can include poor eye contact, lying, stealing, food and touch issues, control battles, problems with trust, and infantile rages.
Unfortunately, some RAD symptoms may indicate to many adults that the child has no attachment problems at all.
If a child loves everybody, "that's the problem," Thompson said. By easily forming attachments with everyone, the child actually is unable to form real, significant, and long-lasting attachments with a single individual. That "affection" could actually be a facade or coping mechanism in which the child is overcompensating for having no attachment feelings at all.
According to Thompson, the "attachment cycle" begins with need. The child will fuss or cry and, if the child's needs are satisfied, the child will begin to develop self esteem and trust.
However, if the infant's needs are not met over a substantial period of time, RAD can begin to develop. Self esteem comes out of basic trust, said Thompson. She said we often call people insecure who have trouble trusting others. In all actuality, that insecurity could come from an abusive childhood or medical problems.
"You may have effects from experiences you know nothing about," Thompson said. Those experiences could include illness, operations, or illness for a parent.
"Attachment is something that grows," Thompson said. "It can be damaged. Anything that is not a direct no is a yes. Learn carefully to watch your language when a kid asks you for something."
There are ways of dealing with RAD in children, though. For starters, never expect to get total results at once in improving behaviors. Even getting "token" compliance by getting a child to take out the garbage before allowing that child to see a movie is a start.
Parents need to break the negative attention-seeking cycle. Positive reinforcement works much better.
If a RAD child is extremely angry, try to get the child to drink cold water. That makes blood pressure drop immediately, Thompson said.
Thompson said it also helps to not talk to children in a place where the child got out of control. By walking to another place, blood gets away from the brain and the child is better able to relax enough to cope with feelings.
Another thing that might help with a RAD child is "pattern disruption" in which the caregiver says something totally unrelated. That breaks the anger escalation cycle.
Placing a light weight on a child's shoulder can help. Even older children like hugging smaller kids' toys such as beany bag toys, said Thompson.
And above all, like Rome, don't expect everything to be solved in a day.
"Progress does not go straight forward," Thompson said. "It zig zags. These kids have a lot of baggage inside that you may never know about."
Thompson said that early intervention with both therapy for the child as well as training the parent with effective parenting techniques as soon as possible can made a tremendous impact in helping the child.
While a caregiver who is not a mental health professional should never try to diagnose and treat a RAD child, caregivers can be trained to recognize RAD symptoms and convey that information to counselor or social worker.