Monday, February 24, 2014

Watching Trust Grow: An Example of a RAD Child Attaching

Hi Friends, We are re-running this "classic" from 2012... We think you'll find it helpful and "evergreen." 

by John and Diane.


RAD stands for Reactive Attachment Disorder and is otherwise referred to as trust disorder, attachment disorder and a number of other names, but basically refers to kids (in this example) who have had a trauma in early childhood and are therefore unable to form attachments or trust others.  They have a lot of very predictable behaviors, including manipulating others, lying, anger issues and social issues (not making friends.)

I have worked with many, many children who have had attachment disorders of various degrees. If I have gotten them very young (before 5 or 6,) I have been able to make good progress with building trust.  After that age, trust building and attachment is still possible, but it is a lot more work.

I wanted to share with you a case as an example of how some of the things I have talked about in other blog posts about building safety zones and layers of trust work. (See: The RAD Child: Situational Trust and Safety Zones:Part 1. The Bedroom    and Working with Foster Kids and RAD Kids: Part 2: Building on Situational Trust: Bartering for Goods

This example revolves around a boy we will call Steve.  I got him from a hospital setting. My home was his last hope, as he was deemed very hard to deal with due to highly manipulative behavior, demanding, refusing to participate in therapies and school lessons. He was unable to go to school. He was 12. He had been abandoned as an infant and adopted as a younger child.  He had ADD, RAD and Obsessive Compulsive Disorders. Because of violent outbursts his “parents” had put in a treatment center.

When Steve moved in he had his own room (each child must) and had his own separate bathroom. Normally children might have to share a bathroom, but my other kids shared a bathroom on another floor, so Steve had a bathroom on the main floor, which he could use, as well as any guests and visitors.  Steve was an obsessive cleaner and enjoyed decorating. This is how he comforted himself, and made himself feel safe. It lessened his anxiety.  He decorated his bedroom, and then I allowed him to decorate the bathroom as well.  He put fountains and other things in there that really wouldn’t be my tastes, but I allowed him to do it, to advance his feeling of being part of the family and make him feel safe. He was enlarging his safety zone from his room now to include the bathroom as well, which would eliminate any potential peeing issues in his room, as many kids will do that out of anxiety. (See the blog post:  Why is My Foster or Adopted Kid Urinating in The Closet (in a Jar, Towel, Hamper, Soda Can): The Red (or Yellow in this Case) Flag and How to Deal with It.
…..)

Next I wanted to expand his “safe zones” to include the living, kitchen and dining room.  I allowed him to help out by cleaning and decorating those areas as well, since he enjoyed these activities.

He would move things around, exerting some controls on these environments. Again, these were not things I appreciated, per se, but I allowed it for the time being to give him a feeling of ownership and make him feel safe and secure. He would put trinkets and decorations around the house that were childish, but they made him want to spend more time in the common areas, so I allowed it.

This also gave me more control over him in the kitchen, for example. If he was getting out of hand, I could suggest that I take the room back from him, meaning he would have to clean all his stuff out of the kitchen.

This would usually be enough to turn his behavior around because he would want to keep his stuff where it was, because it made him feel comfortable.  Just by telling him we might take the room back, he would be able to calm himself down and we could work through his behavioral issues.

Of course, he was still hypersensitive, had anger issues, yelling, all the regular symptoms, so anything I could use to control him I would use.   Allowing him to spread his roots by decorating the house had duo purposes.  

Allowing him to create an environment that he is going to attach to means allowing him to take some ownership by decorating and assisting in the cleaning of the space. This helps foster the increased feelings of safety and security in the home and in you, and is the foundation for personal trusting relationships.

 Slowly, as he felt more confident, I could begin to take back my common spaces and reduce the amount of “control” he had in those areas without making him feel anxiety.  I  found that he began to remove items and return them to his room on his own and that the importance of having his decorations distributed throughout the house diminished over time. This is a great indicator of growing attachment.

This was only one attachment “string” or method we used with this child in the home. I hope that by seeing an example of how this works in the "real world" you'll see how you can use it with your older RAD or foster kids to help build your foundations of safety and security.

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Tuesday, January 28, 2014

The Photo-Link: A Vital Keepsake/Tool for a RAD Child (or Any Foster Child.)

By John and Diane

With the advent of digital photography, we all take a lot more photos...but how many actually get printed?

Not so important to most of us. Really, we post our faces on social media, we email pics to relatives who save them to a hard drive or turn them into a screen saver.
But.
Photos that document events, big and small, are vitally important to the development and foundation for a child with an attachment disorder or reactive attachment disorder (referred to both as RAD in this article from now on.)

Photos that show any of my foster kids enjoying family events, achievement awards, holidays and any Firsts are always printed out and placed in a photo album for each child I have in my home.The importance of the photo album goes beyond just a keepsake of childhood memories.  For kids who may have a childhood that is scattered over many homes, many "families" and much sadness, a photo album that they can add to,  provides a timeline of happy memories to share as they later raise their own families.

For RAD kids, I cannot stress enough how important a photo album is.  Not only for the purpose of documenting their lives as is a normal part of most modern cultures, but as a TOOL.

A RAD child's photo album is an effective tool to use because:

*  It gives you a reference to go to when you need to PROVE that you have provided certain good things to the child. (Those carrots we've talked about in the past...)  For example, the child refuses to do anything for you, or says that you do nothing for him or her.  You go to the photo album and show him photos of family parties, vacation, trips to the roller rink, he with a new toy for a holiday...etc.  RAD kids NEED constant Proof, and a photo album is a great way to REMIND them that you do things for them.

* They need to be able to view the photos (documentation, per se) of themselves and other family members having fun together and enjoying each others company.  Without evidence of happy times together, the child will forget they love you.    This is especially important for families who are separated from their RAD child for a while - maintain the connection you have begun to build via a photo album.

* Refer to the album when the child is in a "funk" to remind them that they do enjoy their family, brothers and sisters in the house etc.  They need to see concrete evidence of things, so that they can come to their own conclusions about whether or not they were happy etc.


*Observe how the child uses the album. I am so happy when I see some of my longer -term kids show off their photo albums to new foster children. Not only does it allow me to see how that child is doing in my home, but if the child does have RAD, I can get a sense of their building attachment, or lack there-of. (Do they show any interest in the album, are they connected to the images there? )


It really doesn't take much to put an album together. It doesn't have to be fancy, and it can start today. The kids love putting new photos in their albums, adding stickers, or writing in them. I am sure many of you have a lot of other great ideas along these lines.  Please share them here in the comments section.

(suggested reading:
You and Your RAD Kid: The Importance of the Trust-Building- Honeymoon Period )

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Friday, January 10, 2014

Is Moderation the Key - Even with Praise for Kids Who Need It?

When working with hurt or traumatized kids it's easy to fall into the habit of trying to re build their self esteem by heaping on the praise every chance you get.   Recent studies show that for kids with low self-esteem, the Over-the Top praise you might think is helping, is actually backfiring on you!

According to the study done at Ohio State, inflated praise put too much pressure on kids with low self-esteem, and therefore translated into the children being afraid to fail at subsequent efforts. 

How does this effect you? Well, It means that when working with your kids with low self-esteem, keep your praise positive, encouraging, and realistic.

Check out the article below to learn more about the study:  from Psych Central

Inflated Praise Can Harm Kids With Low Self-Esteem

By Associate News Editor
Reviewed by John M. Grohol, Psy.D. on January 4, 2014 
New research suggests that parents and adults who heap the highest praise on children with low self-esteem are most likely hurting the children with their over-the-top compliments.
Researchers found that while children with high self-esteem seem to thrive with inflated praise, those with low self-esteem actually shrink from new challenges when adults go overboard on praising them.
“Inflated praise can backfire with those kids who seem to need it the most — kids with low self-esteem,” said Eddie Brummelman, lead author of the study and a visiting scholar at The Ohio State University in autumn 2013 and now a doctoral student in psychology at Utrecht University in The Netherlands.
For this study, scientists identified inflated praise as those including an adverb (such as “incredibly”) or adjective (such as “perfect”) signaling a very positive evaluation. For example, “you’re good at this” was simple praise, while “you’re incredibly good at this” was considered inflated praise, the researchers explained.
In one of three related studies, Brummelman and his colleagues found that adults gave twice as much inflated praise to children identified as having low self-esteem compared to those children with high self-esteem.
In another study, 114 parents (88 percent mothers) participated with their child. Several days before the experiment, children completed a measure to determine their level of self-esteem.
Then, during an observation at their homes, the parents administered 12 timed math exercises to their child. Afterwards, the parents scored how well their child did on the tests. The sessions were videotaped, and the researchers were not in the room.
Watching the videotape, the researchers counted how many times the parent praised their child, and classified praise as inflated or non-inflated. The most common inflated praise statements included “You answered very fast!” and “Super good!” and “Fantastic!”
The most common non-inflated praise statements included “You’re good at this!” and “Well done!”
Results showed that parents praised their children about six times during the session, and about 25 percent of the praise was inflated, the researchers reported.
The parents gave more inflated praise to children with low self-esteem than they did to children with high self-esteem, the researchers added.
“Parents seemed to think that the children with low self-esteem needed to get extra praise to make them feel better,” said Brad Bushman, Ph.D., co-author of the study and professor of communication and psychology at Ohio State.
“It’s understandable why adults would do that, but we found in another experiment that this inflated praise can backfire in these children.”
In this other experiment, 240 children drew a famous van Gogh painting, “Wild Roses,” and then received inflated, non-inflated or no praise in the form of a note from someone identified as a “professional painter.”
After receiving the note, the children were told they were going to draw other pictures, but they could choose which ones they would copy. They were told they could choose pictures that were easy to do, “but you won’t learn much.” Or they could choose to draw more difficult pictures in which “you might make many mistakes, but you’ll definitely learn a lot too.”
According to the researchers, children with low self-esteem were more likely to choose the easier pictures if they received inflated praise. By contrast, children with high self-esteem were more likely to choose the more difficult pictures if they received inflated praise.
These results suggest that inflated praise may put too much pressure on those with low self-esteem, Brummelman said.
“If you tell a child with low self-esteem that they did incredibly well, they may think they always need to do incredibly well,” he said. “They may worry about meeting those high standards and decide not to take on any new challenges.”
The lesson may be that parents and adults need to fight the urge to give inflated praise to children with low self-esteem, Bushman said.
“It goes against what many people may believe would be most helpful,” Bushman said. “But it really isn’t helpful to give inflated praise to children who already feel bad about themselves.”
The study was published in the journal Psychological Science.
Source: The Ohio State University

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Tuesday, December 31, 2013

Can Your Troubled Kids Make A Resolution? Goal Setting for the New Year

By John and Diane

New Year Resolutions are part of many people's traditional celebration, but are troubled kids able to make a resolution?

New Year's Eve is a great time to talk about resolutions - which are, after all, just another word for "goals."  Sitting down with your foster kids and discussing where they think they'd like to improve themselves in the new year can be a great way to begin an open conversation about where their behavior needs additional support, and what steps can be taken to do that. 

They key is to allow the child to identify their own issues and to brainstorm together on solutions that will be followed up on with counselors, teachers or with additional support within the household in the new year. 

Make this a family discussion, preparing action plans for everyone in the family; we all have things to work on, after all. 

Of course, many of our troubled kids will have difficulty sticking to their resolutions, and may fail in spite of every one's best efforts, but does that mean the discussion of goals was a waste of time?  Not really.  Even seeing others in the family work toward their goals, stick with their plans, fail, and retry, will serve as a good example for the child throughout the year.

Give your child the very best chance to meet his or her goals however. If you have a support team (counselor, social worker etc,) get them in on it and make a concrete action plan that can get your kid excited.  Break down the goal into easy to achieve steps and mark successes on a calendar.  Set milestones and celebrate reaching them.  Don't lose focus or enthusiasm.

What do you think?  What are some of the resolutions you and your family are making?  Here are some more articles on making resolutions with your kids.

Parents.com:  8 Ways to Help Kids Make New Year's Resolutions


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Tuesday, December 17, 2013

Are You Anxious Over Your Child's Anxiousness? How to Deal

by John and Diane

We all experience anxiety at different times for different reasons and foster and adopted kids are no different. Their anxiety may be triggered by extraordinary circumstances like family visits or PTSD type flashes, or can be related to very normal triggers such as having to run a mile in gym class or visit the dentist. 

Helping to soothe the anxiety is a natural instinct, but helping a child gain more confidence and overcome their anxiety is a long term solution you should aim for.

The below article from PsychCentral.com has some terrific ideas on how to help your child cope with anxiety and overcome it. Keep in mind while reading it, however, that some of the advice may not be quite right for your child, dependent upon their specific circumstance and diagnosis, but it is a great place to start. 


Helping Your Anxious Child Become More Assertive

By Annabella Hagen, LCSW, RPT-S

Helping Your Anxious Child Become More AssertiveThe other day, I heard a grandfather talk about a phone call he received from his daughter. She told him how his elementary school-aged grandson had been teased and bullied at his local church when he wore glasses for the first time.
We often hear national news about bullying-related youth suicides. And frequently, many of my clients suffering from anxiety mention that they were bullied at some time in their middle school or high school years.
Do kids who get bullied become anxious, or are anxious kids more likely to get bullied? The truth is, it can be both. Children who are bullied experience trauma. They will develop anxiety and may need professional help to overcome that negative experience.
Some youngsters are genetically predisposed to becoming anxious. When they get bullied, not only do they have to work through their trauma, but their anxiety is triggered and they become more anxious.
What can parents do?

Be aware.

Parents need to recognize their children’s needs and fears. Consider modifying your teaching and discipline skills if your child experiences the following symptoms: long and intense temper tantrums, extraordinary stubbornness, meltdowns for no apparent reason, medically unexplained physical pains, body-focused repetitive behaviors (e.g., nail biting, skin picking, hair pulling), eating and sleeping difficulties.
If you don’t know your family mental health history, it’s a good idea to find out what type of mental health challenges your parents, grandparents, and other family members have experienced or are still experiencing. You don’t want to label your child with a diagnosis, but it’s a good idea to know what you may be dealing with, and to consult a mental health professional so they can evaluate your child and provide advice.

Adjust your parenting skills.

Sometimes children suffer from anxiety or experience other psychological challenges. Parents may not realize it until negative events occur, or their children are refusing to go to school.
We often hear parents say, “I love all my children the same.” The only problem is they also want to treat them and discipline them equally. This doesn’t work because each child has his or her own personality and disposition. What works for one may not work for the other.
Parenting books and advice abound and quite often parents get conflicting advice. For example, if you have a child who experiences anxiety, some parenting advice will simply not work. An anxious child who is sent to timeout may feel horrified sitting alone in a room.

Cultivate your children’s emotional intelligence.

When children are able to comprehend their own emotions and find positive ways to manage them, they are able to overcome stressful and challenging situations. This doesn’t happen overnight. We need to help them understand other people’s emotions. We need to model how to empathize with others. Research indicates that the ability to empathize and communicate with others can make a big difference in the quality of one’s life.
Children who experience anxiety may have difficulty understanding other people’s feelings because they are too busy trying to figure out their own. However, it is possible to help them develop empathy and manage their own emotions.
Parents can teach communication skills to their children. They can set the example by talking about their own feelings. They can teach them it’s okay to feel sad, mad, or scared.
It’s important to help children recognize their thoughts. I often meet adolescents, young adults, and even adults who have difficulty recognizing their thoughts and expressing them. Encourage your children to verbalize their thoughts and feelings, and to see how these affect their behavior.

Don’t tell them how to feel.

Quite often we say things like, “Isn’t this fun?” “Aren’t you excited about this?” What if they are not excited or having fun? You can express how you feel and ask them how they might be feeling. Ask them genuine questions to help them develop their own opinions and not to be afraid of stating them.

Build up their confidence.

Help your children recognize their strengths. Acknowledge their weaknesses and point out that everyone has weaknesses and that it’s okay. Help them understand that we learn from our mistakes. They need to understand that you love them and accept them for who they are, not for what they do and accomplish.
Children who develop confidence in themselves accept who they are, and recognize their strengths and weaknesses. Sometimes children who experience anxiety can be quick in accepting defeat and get into a helpless mode. Frequently parents will be harsh and scold them and order them “to try, or else!” This parental attitude will exacerbate their child’s anxiety. On the other hand, some parents feel guilt and are sad about their child’s fears. They tend to quickly rescue them and inadvertently reinforce their child’s sense of helplessness.
When your children experience anxiety and you push them, they will clam up and your strategy will backfire.

Read more here: 

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Monday, December 9, 2013

Is Your Foster Child SAD?: Identifying Seasonal Affect Disorder

By John and Diane.

It might be hard to tell with your foster kids, but at this time of the year if they are especially anxious, grumpy, sleepy and have difficulty concentrating they might be suffering from symptoms of SAD: seasonal affect disorder.

 When days get shorter and the amount of sunlight exposure your kids have because of school and time spent indoors because of the weather changes, a study by the National Institute of Mental Health showed that three percent of kids may suffer from seasonal depression or SAD.

Now, with foster kids, who may already have many of the issues that are part of the seasonal affect disorder symptomology, more notably a change in eating (a craving for sweets)  or sleeping patterns may be the key to determining if your child is also affected by the seasonal light changes.

Treatment for SAD is usually non-drug related and focuses on light-therapy, including dawn-simulating light alarms that gradually increase the light in the child's room to simulate a normal summer sunrise. Increasing outdoor winter activities to spend time in the sun and a healthy diet also help seasonal depression.

For more information check out the below article:

Seasonal Affective Disorder in Children

By Deborah Gray

Did you know that children can suffer from SAD (Seasonal Affective Disorder)? I'm embarrassed to admit that I just found this out recently, after years of writing about mental health. Seasonal Affective Disorder is a condition that can cause depression, fatigue and overeating, among other things, and it is brought on by the change of seasons. According to Winter Blues by Normal Rosenthal, M.D., a survey done by the National Institute of Mental Health (NIMH) showed that about three percent of children suffer from SAD, with a greater incidence occurring in the last three years of high school.

I'm surprised that it hadn't occurred to me before. After all, if children could have clinical depression and other depressive disorders, why not SAD? Apparently even animals can suffer from SAD. Of course, it's worth nothing that all creatures on earth have a tendency toward SAD symptoms in the winter, but when normal functioning starts being impaired, it's time to take a closer look.

So, is there a chance that a child you know has Seasonal Affective Disorder? Well, if he starts off the school year doing well, but his grades start dropping after the holidays, it's possible. If she bounces out of bed after eight to ten hours of sleep in the summer but can barely drag herself out of bed after more than twelve hours of sleep in the winter, it's worth looking into.
SAD in children can go undiagnosed fairly easily, especially in adolescents, who are expected to be moody and have trouble getting out of bed. A few seasons may need to pass before anyone notices a seasonal pattern in behavior.

Symptoms of SAD in Children

  • A change in appetite, especially a craving for sweet or starchy foods
  • Anxiety
  • A drop in energy level
  • Irritability
  • Fatigue
  • A tendency to oversleep
  • Difficulty concentrating
  • Avoidance of social situations
  • As with diagnosing SAD in an adult, the single biggest clue is whether the symptoms are seasonal.
    It's important that your child be evaluated by a qualified professional. If you think that your child has SAD, chances are good that your instincts are correct. But she still needs to see a doctor and have other possibilities eliminated first, and any treatment should be under a doctor's care, even if the treatment is purely non-drug.

    Treatment...

    Read more at :  Health Central.com

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    Tuesday, December 3, 2013

    Are Adopted or Foster Kids More Vunerable to Stranger-Danger? New Term: "Indiscriminate Friendliness."

    by John and Diane

    A recent UCLA research study has found something that many of us that work with children who have been in foster care or institutionalized in infancy already know and see everyday.  Kids who are separated or neglected by their parents or primary caregivers  early in life are prone to what they are calling "indescriminate friendliness" towards strangers - and anyone really, which can continue throughout their life.

    What does this mean? It means that these children, (often your kids with reactive attachment disorders) approach all adults and strangers in somewhat the same manner - with an inappropriate  willingness and outward friendliness. These changes are not simply a habit they picked up to survive in an ever changing world of adults, but actually have a foundation in physical brain-changes that occur due to social neglect.

    According to the study, " The early relationship between children and their parents or primary caregivers has implications for their social interaction later in life, and we believe the amygdala is involved in this process," said Aviva Olsavsky, a resident physician in psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA and the study's first author. "Our findings suggest that even for children who have formed attachments to their adoptive parents, this early period of deprivation has led to changes in the brain that were likely adaptations and that may persist over time."
    Indiscriminate friendliness is in some sense a misnomer. The behavior is not characterized by a deep friendliness but simply by a lack of reticence that most young children show toward strangers."

    The study, based on MRI examinations in part, raises many additional questions, " What, if any, effects does early maternal deprivation has on children as they move into adulthood? And do these findings also apply to less severe forms of deprivation, such as neglectful home environments? The researchers are continuing to use fMRI to examine the role of parents in brain development and the contribution of early experiences to mental health outcomes later in life."

    What do you think?

    Read more on the study here at Science Daily

    and be sure to read our post : http://fosterparentrescue.blogspot.com/2012/03/why-kids-that-hug-everyone-trust-no-one.html

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