Rad?

[MissinNYC]

Hi, we have a possible placement with RAD. I have some knowledge of this, but I am wondering if you seasoned mamas can pass along any information, resources, sites, experiences, or tips when dealing with RAD in a young child (5-8). Thanks!

[MissinNYC]

Bump. None of the 37 of you lurkers have any help?

[Jenne]

http://www.radkid.org/
http://www.mayoclinic.com/health/rea...sorder/ds00988

I'm hoping you have some basic info. I've not btdt in fostering/adopting but I was a special education teacher and had several children with this diagnosis. To be honest they were tough. With the kids I had, who were in a special school for emotional/behavior disorder, there was a constant "come here, go away". Lots of inappropriate (for school) hugging, laying on, "I love you" type behavior coupled then with lots of inappropriate negative behaviors for these kids things like tantruming to the extent of destroying the classroom, aggression, self-injury. This DOES NOT however mean this will be *your* experience.

With patience and the ability to not take it personally when the "I hate you!" words and behaviors come out will take you a long way. To help with that, I would highly suggest looking into dialectical behavior therapy for yourself. NOT because I think you need therapy, but DBT will help you recognize when your emotions are interfereing and help you to remain calm and mindful. It could give you a concrete set of tools to use when the child is having difficulty emotionally/behaviorally.

Last, I want to say that some of my most rewarding teaching experiences were with kids with RAD who were able to attach appropriately with adults and go on to be relatively happy, functional kids.

I wish you the best!

Jenne

[MissinNYC]

That is really helpful, thank you. I do have some basic stuff, but I was hoping to hear the BTDT experiences like yours! Thanks!

[AllyRae]

Our 3 year old, adopted from Vietnam, has RAD with selective mutism. My best advice is to find a professional who knows what they are doing. Early intervention couldn't help us, the first child psychologist we saw couldn't help us, our agency couldn't help us. We kept looking and finally found someone who can help us, and our little girl is doing much better now. It's still not great....she will still have 3 hour aggressive rages, but now instead of daily, it's every other week (with daily aggressive rages that are much less than 3 hours. She used to have daily 3 hour ones).

I guess a little background--she was institutionalized in a rural Vietnamese orphanage, her first 3 days with us were her hospitalized near death due to severe dehydration, she had burnt vocal cords due to having formula given to her with water that had *just* been boiled, and she had a severe dairy allergy nobody knew about (so had constant horrible reflux because the orphanage had her on dairy based formula). It was also untreated reflux. These are the issues we know of. There are likely other ones that happened before we got custody of her.

For the first 18 months we had her, she did nothing but scream and rage at us. We had her hearing tested 4 times because she never responded to any sounds and her pediatrician thought she was deaf. She never made a sound that wasn't screaming. She didn't want us to hold her, wouldn't let DH change her diaper, and screamed & raged hours daily. At 18 months of age, she had the expressive & receptive language equal to 0-3 months old according to her speech therapist.

Fast forward to 2 years old--she was so aggressive and violent that early intervention dismissed her saying they couldn't help her. She still isn't saying one word. Still won't give us hugs or anything. Doesn't like to be held. Afraid of other adults, will hide or act aggressive in playgroups (either she'd hide under the table, or target and attack younger children). If I so much as took a shower (with a clear glass shower door and her in the bathroom), she'd turn pale as a ghost and have a panic attack.

2 1/2 years old, finally started letting us hold her which also correlated to her finally saying a couple words to us. Still very aggressive, angry, raging daily, can't discipline (time outs didn't work because she was thinking she was being abandoned, wouldn't listen to redirection, would rage against anything that disagreed with her). Couldn't be around other children because she'd target them.

Now, at 3 1/2, she finally gives us hugs and kisses, but it *must* be on her terms. She doesn't talk in public at all (she does talk to us). She won't eat in public. She won't socialize with other children or adults--still hides or withdraws. She still rages at discipline, especially against me (the hallmark of RAD is that they will rage against their mom more than the dad because young children usually attach to the mom first, and that's the bond that is usually broken in abandonment). She also has huge food issues--she steals food and hides it. She's very aware if someone gets even 1 more pretzel stick than her. I can't give the baby a snack without making sure she has one at the exact same time or she tantrums. She is very withdrawn in public. BUT, this is actually a huge improvement over the first 2 years...she can attend gymnastics and karate and function, and she does show some beginning attachments to us, even though she's very insecure (she is constantly "checking". She must know where everyone is every minute of the day. If we're in the car, she has to know where we are going and she has to always ask if we're taking her in. She seems to think she will be left in the car when that is never the case).

So, that's our story. We have had her seeing a child psychologist for a year now (he's actually an autism specialist that has seen my asperger's son since he was 2 years old, and since he already knew DD, as a personal favor he is working with her since he typically only works with spectrum children). We are seeing huge strides with her but we still have a long way to go... We love our little girl and wouldn't trade her for the world. It is devistating to see her so afraid and angry, but we will do anything we can to help her. We have in the past considered moving across country to find someone to help her (until we found someone locally, which saved us from having to move). There's no "putting her back on a plane and sending her to her birth country" for her. This is our girl, and we will do everything we can to help her. Because she's so young, she has a good prognosis at having a normal adolescence and adulthood. I know it sounds scary...terrifying. But really, when you think of it, this is the chance for these kids who would probably have a very rough adulthood and end up in the "system", to instead learn to love and trust and learn that THEY are loved, to work through their issues, learn appropriate behaviors, and end up having a great chance at functioning typically.

[MissinNYC]

Thank you so much. What a good story to hear- the good and the hard bits. Blessings to you and your girl!

This part- is this usually the case? The boy we are thinking of is a domestic child, not from an orphanage or anything, so I am hoping it's slightly better. Is it true that there is a light at the end of the tunnel? All the resources I've read have seemed pretty pessimistic about chances for healthy adult relationships. So glad to hear how much progress your DD has made!

Because she's so young, she has a good prognosis at having a normal adolescence and adulthood. I know it sounds scary...terrifying.

[Polliwog]

How old are your other children? What are the reasons that the identified child is in out of home care?

[MissinNYC]

They are young, all under 10. He is in care for neglect and the mom gave him up voluntarily. He apparently had been in 5 foster homes, one of which was also apparently neglectful and/or abusive. He has never been violent with anyone, and never been sexual.

It's so hard to make this decision (about whether to take him) based on a profile on paper, you know? I feel like I'd need to meet him to know how it would be.

[queenjane]

Originally Posted by MissinNYC

They are young, all under 10. He is in care for neglect and the mom gave him up voluntarily. He apparently had been in 5 foster homes, one of which was also apparently neglectful and/or abusive. He has never been violent with anyone, and never been sexual.

It's so hard to make this decision (about whether to take him) based on a profile on paper, you know? I feel like I'd need to meet him to know how it would be.

If he has RAD, meeting him wont help. You'll probably think he's wonderful, wonder how he got the diagnosis, and think it was probably just a problem in THOSE homes. My new daughter doesnt have a RAD diagnosis, and i wont say thats her issue...but she DOES have "issues"(and i suspect some level of attachment issues)...when i had her the first night she stayed with us, i thought it was great, couldnt imagine what "behaviors" her FM was talking about. Later, i had her a longer period of time, eight days, and i began to see some. Now that she has moved in with me, i realize how much work it is to parent her, way more than my two little ones or than my bio son ever was. And she is fairly "mild" compared to my friend's new daughter (age 4, who can scream for hours, be overly charming, smears feces, hurts the animals, etc etc).

I am having to be WAY (way) more strict than comes naturally to me. I have to stay on top of her constantly, even to the point of watching her brush her teeth because she will put toothpaste on the brush, dab her tongue and then "prove" she brushed by saying "smell my breath!" (but if there isnt a huge mess in the sink, i know she didnt REALLY brush)...she lies, big lies and small lies. Even though she is very good with the small boys, she can be emotionally immature (fighting with them over a toy, teasing, instigating them) compared to my friend's typical (bio) child who is just a bit older. She has had two incidents of "flashing" her privates to my friend's son. She can veer off into weird/silly behavior that is nonsensical. She has NO sense of boundaries whatsoever (invades your physical space, talks about body functions, gets way too chatty with strangers)....she is obsessed with being the center of attention in every situation, but no matter how much you give her, its never enough. No matter how much you buy her no matter how many fun places you take her, she still pouts or whines or complains or cries when she doesnt get more more more. She begs for stuff constantly.

It can be emotionally exhausting to parent her (WAY more work than my two 2 yr old boys!)...and her issues are probably so MILD compared to what they could be (she isnt violent, her sexual issues seem mild/she isnt a predator type of child, she doesnt abuse animals, she doesnt have any issues with inappropriate urination/defecation, etc)....in some ways i'm actually enjoying the challenge of parenting her because i do feel VERY well prepared after so many years of talking to experienced adoptive parents online and reading the books i've read. What has helped tremendously is to have very clear logical consequences, but this is parenting in a way that i generally dont "believe" in (i am usually very laid back, unschooling, consensual living type of parent)...i almost completely stopped the begging for stuff by giving her an allowance and every time she said "can i have this? can i have that?" i'd say "do you have the money?" (she spent her allowance on candy the first day she got it. that will hopefully get better with time.) There were several instances of her giving candy to her baby brother when i specifically said "no", so my car is now "candy free" and i told her it is because i cannot trust her. She knows i often think she is lying, and that the consequence of being someone who lies, is that even if she is telling the truth, i probably wont believe her, and she has to earn my trust back (she has gotten better.) I've made some headway with the whining/pleading/pouting crap (which annoys the HECK out of me!) by making it worse if she begs..(for example, if i say two minutes and then we have to go home, and she does this eye rolling "i never get to have any fun!! cant we stay longer please???" stuff, i say "L has made the choice to leave now instead of two minutes, cmon boys lets go"....she is learning.

I think in her previous homes she was just on punishment all.the.time. So i am trying to avoid things like sending her to her room. And make it more logical (like, if you are stressing me out with your behavior, you'll probably have to go to bed earlier so i can relax by myself. but if you control your behavior and chill out, then we will be able to have fun after the little boys go to bed!)

I dont know if any of this has to do with RAD...sorry! I guess my point is....please know that it will be ALOT of work, and the child may honeymoon for a long time before you even see the behaviors. And attachment is a spectrum, but on the more difficult end, it can be SO hard on the family. One big thing is that often the other kids in the family really can't stand the kid with issues. So thats something to consider.

I havent read the other replies yet, but i'd recommend any book by Keck, esp "Parenting the Hurt Child" and anything by Dan Hughes.

[Teensy]

Do you have the latest issue of Brain, Child magazine? There is an article on adoption you might find interesting.

Best wishes in this matter.

[Jenne]

Yeah, as QueenJane said, meeting him won't help. I'm not trying to dissuade you but I found myself nodding along to both AllyRae and QueenJane's descriptions of the behaviors...the honeymoon phase (which comes and goes), the lieing- about nonsensical stuff...like I ask the child, "Did you answer question #1?" I can see on the paper that #1 is answered. The child would get praise and attention for telling the truth (and having done the work!) and *STILL* looks me dead in the eye and says, "No." And then continues to insist that they haven't done the work. Why? I have no real explanation other than RAD- and the having to maintain constant vigilance.

I guess I would just suggest that if you are going to go down this path which can be tremendously hard work (but also very rewarding) that you make sure you are completely committed to it. Things may go great. But my best guess would be you would see a sweet, charming little boy for the first bit--some kids it is an hour, some several weeks--and then it will be like a punch to the solar plexus from nowhere as the disorder clicks on and they do everything they can think of to seperate from you, push you away, to protect themselves. I guess what I'm saying is, can you look deep inside of yourself, your partner (if you have one), and your family and say that all of you have the time, energy, and resources to dedicate to this kid?

There is a place called the Evergreen Institute that has some effective therapy practices for attachment disorders. I'm not sure where you are or if a visit there would be feasible. They may be able to recommend someone in your area. You will need someone right from the start though to support you and the child.

If he is 5 I'd be more optimistic. If he is closer to 8 having not had a stable, loving, bonded home...gosh. What has been his longest placement so far? Why did he leave there? Can you speak with or do you have notes from that placement? Was he able to bond appropriately with the foster parent(s)? Was he neglected from birth or did it start when he was older? These are questions I would want to know the answer to if I could. Did he hit developmental milestones appropriately? What is his cognitive level? How does he do in school? How do his teachers feel about him? Is he in a regular school, special education, does he have an emotional/behavior disorder label at school? How many schools has he been in?

The older he was when the neglect and bouncing homes started the better off he *may* be. If his mother or other reliable caregiver was able to care for him for that first year or two, that is a good sign! If all he has known consistently is neglect and abandonment that is a much tougher road.

I wish you sincerely the best with this decision.
Jenne

[MissinNYC]

I don't know a ton right now, I am only in preliminary talks with the social worker. As we go forward, we will have access to the case file and all the history. From what I know, he is 6ish, went into care at about 3 or 4, from his mom, who gave him up voluntarily due to lack of housing. The worker did mention food hoarding but said it had stopped. I think he's had 3 or 4 placements, and has a TSS worker in school. She specifically said no violence or sexual acting out, not a danger to small kids in any way, but that he doesn't play appropriately.

Thanks for all this help, I think it really helps. We are still thinking and praying!

[mamarhu]

http://www.adsg.org/forum/index.php

This is a forum specifically for parenting kids with RAD and the related spectrum of issues. They are very frank and direct. Remember that people often only post when they have problems - rarely does anyone say "we had a quiet day around here ". Wouldn't make very interesting reading!

My daughter with attachment issues (no RAD dx, but only because I haven't pursued it) has been a handful, but so worth it. She has been in my home 3 years, and is almost 10YO. We have constant, low-level issues now, like lying, stealing, and snotty attitude, bur rarely the rages and extreme behaviors of the past. I am 100% bonded with her, and she is with me, in her way.

Her brother, 8YO, has only been here 1 year, and also is pretty RAD. His behavior, while considerable (they are both therapeutic level foster children), has been far easier to manage. For some reason though, I am not as bonded with him as with her. He grates on my nerves and I find his "charming" ways annoying. It feels like a thin veneer of cute, over deep resentment, hatred and anger, and frankly he scares me. His behavior is more minor, and yet he sucks the energy out of me.

My advice, if any, would be to get to know the kid(s) ahead of time if at all possible. Kids are so much more than their diagnoses.

All the best

[AllyRae]

Rhu...thank you!! I didn't know about that site!

OP: I don't know if everyone's prognosis is so good. I know because our daughter was adopted prior to age 1, we had her in therapy for her RAD at 2 1/2, and because she has shown such huge progress, *her* prognosis is really good. (And in fact, when we have to fill out paperwork for our state, her therapist put her prognosis as "Grim/guarded" last year, and she's made so much progress this year, that the paperwork we sent in for this year said her prognosis is "excellent". So, that's pretty awesome!

But each child has a different prognosis due to their access to help, their age, their severity, and their history...

And this...

Kids are so much more than their diagnoses.

is absolutely 100% without a doubt true. My little girl *HAS* RAD and selective mutism. My little girl *IS* smart, beautiful, funny, strong willed, a fighter, a great big sister, my little helper, a gifted gymnast, rambunctious, energetic, athletic, observant, awesome, and above all, one of the greatest blessings in our lives. And all of that is far more than her diagnoses.

[queenjane]

I would make sure you dont operate with a "best case scenario" attitude though...you need to think "what if this never changes?"...what if the behaviors (whatever they may be) never improve? what if they worsen? can you deal with that?

I assume you are disrupting birthorder...i dont think that in and of itself is a huge issue...but even if the child is "good" with other children, there can be issues there...my new daughter is pretty good with the boys (who are 2), but lots of times she drives me crazy because much of the time she is jealous and will play like a peer with them (meaning, if my son takes a toy from her, she whines and cries how its not fair, even though he is a toddler and she is 8. or she'll snatch stuff from him and say "mine!" just to piss him off, she thinks its funny.) Even though i know intellectually its normal for her to be that immature, it still sometimes brings out my mama bear instincts and that may not be exactly fair to her.

Also, even though they say no sexual abuse or aggression, i'd try to think about what i'd do if those issues do crop up. Sometimes there isnt any sign of those issues but they are there. (My new daughter has now twice exposed herself to a friend's son, but denied it,and im faced with having to closely moniter her interactions with kids her age which isnt always easy.)

If the child has RAD he will likely need lots of therapy, and "regular"therapy doesnt usually cut it (often will make the child worse, and some kids are really good at manipulating therapists)...i've heard good things about Theraplay (not to be confused with "play therapy") for kids with attachment issues. You would probably want to look up therapy options in your area, if he doesnt already have something set up near you. Do you have the time in your schedule for weekly therapy, possibly for years? Will you be able to give him the individual attention he may need to focus on attachment with you? (this is something i feel bad about w/ my new daughter, she craves attention and yet with two 2 yr old boys its really hard for me to provide it.)

I hope i dont sound too negative!

[MissinNYC]

I would make sure you dont operate with a "best case scenario" attitude though...you need to think "what if this never changes?"...what if the behaviors (whatever they may be) never improve? what if they worsen? can you deal with that?

Yes, I am definitely thinking this way, too. I was just pleasantly surprised to hear something positive, since about 100% of what I had heard and read until this thread was negative and pessimistic and acted like kids with RAD were totally hopeless for any kind of functional life. I certainly assume that things would be very rough at least for a few years, and that they may continue to be forever, but it's nice to know that there's some hope for change and improvement!

No, you don't sound too negative, it's good to know the risks and ask these questions. It's not something to take lightly or carelessly. My son now does have SN, so we are used to weekly (3x week) therapies and yes, we have time for it. So that's good. We've been thinking about what changes/sacrifices/flexibility we can build into our schedule to accomodate this child, if need be. Like getting some regular mother's helping for the other ones or hiring a housecleaner to free up some of my time for him, or getting DH some flextime, etc.

Thanks for the help, it all is really helpful in thinking and praying about this.

[Polliwog]

The hard part is that you won't know what's really true until you're already in. And so much of what is diagnosed as RAD these days may not actually be RAD. Which could be a good thing or it can be really bad. You just don't know.

For ME, I could never take in a child who has been already diagnosed with RAD. Not with children in my home. I just couldn't do it. Maybe when my children are grown.

[bella99]

I would recommend looking into the writings of Dan Hughes. He does a lot of work with attachment and adoption in children with disordered attachment (RAD or otherwise).

I'd just google his name and attachment.

ETA: I work in foster care, therapeutic foster care to be exact. I am working with a young man who is a young teenager. He has been in 12 or 13 different homes since the age of 3. He has had foster parents bail on adoption at the last minute. And now? He is a month away from being adopted by a couple with a lot of fostering and adoption experience who are fully committed to him. For sure, he has tested and he is terrified that this will fall through. We continue to work with him and the foster parents on healthy attachment and boundaries, but I can honestly say, that through a lot of therapy and hard work on everyone's part, he is showing and feeling a lot of healthy attachment.

[heatherdeg]

Originally Posted by MissinNYC

The boy we are thinking of is a domestic child, not from an orphanage or anything, so I am hoping it's slightly better. Is it true that there is a light at the end of the tunnel?

I think it's a misnomer for people (not you, but those who advise) to claim that domestic kids are "less severely RAD" by virtue of the idea that it's just not that bad in the U.S. That's absolutely not the case. And while not being from an orphanage is hopeful, it's by no means an indicator of anything.

Also, kids with different developmental and health issues can have attachment problems just because their issues interfered with healthy attachment. We had this issue with my bio (who had no clue I was in the room with him until he was 15mo even though I was a bfing SAHM ). So he wasn't RAD, but his behaviors were so outrageously severe that absolutely NO mainstream parenting technique or book was ever going to help. Now let's say this child had something similar which was compounded by their living situation... that could be bad. Unfortunately I think Polliwog nailed it in that you're really NOT going to know until you're knee-deep into it.

Originally Posted by MissinNYC

All the resources I've read have seemed pretty pessimistic about chances for healthy adult relationships. So glad to hear how much progress your DD has made!

I think a lot of the resources MIGHT not be accounting for the things that make a difference: how early it's identified, what kind of help can be gotten for the child, how that particular kid has been affected by their situations and therefore how they respond to the help offered, etc.


I have to agree with Polliwog in that I know I could never take a child dx'd with RAD while I have other children in the home. It was hard enough to take in children who were not RAD and still manage to tend to my kids. In fact, at one point, I had a kid that was not RAD, but DEFINITELY belonged in therapeutic care and he had to be removed from my home because there was seriously no possible way to manage him and keep the other two kids safe. This child didn't have ANY aggression issues at home with his 4 siblings and no fights at school... no indication of a problem that way anywhere else. And although he desperately wanted to be in the company of others, he had no clue how to accomplish that--and resorted to all the negative attention-seeking habits that got him negative attention in the past. This child was 12yo and able to be reasoned with. I can't imagine with a 5-8yo that may not be able to rationalize... ya know? If nothing else, I would make sure that the RAD child was the youngest (which is usually what they suggest when you're taking kids in anyway--that you always go younger and smaller than your youngest/smallest). It's not that I think RAD children shouldn't be adopted; but I DO think that there are some homes that shouldn't be taking it on. Mine would be one of those homes: I already have a 6yo & 19mo. There's no way I could manage the two I have and add a RAD child. Mine just are NOT self-sufficient enough or able to understand (maturity-wise) well enough to handle the potential issues that would pull me from them or what they might see during times of tension. And I say that having a WAH husband who is COMPLETELY equal-opportunity, hands-on parent. I'm only giving this information so that nobody on this thread thinks that I'm anti-adopting-a-RAD-child.

Also, I realize your kids are under 10yo, but are they old enough for you to explain what the issues could be like and get their feelings on dealing with it? And having to potentially be without your attention for a while so you can work with the new child?

[mojobin]

I am assuming and hoping that this child will be receiving therapy and that you will have ongoing support and training as well? I too am a teacher and have had at least one child with RAD every year. All of the students I have had have been very challenging. But with the right interventions most make huge strides. Here are some tips/tricks that I find helpful when working with children who have RAD. These children need soooo much patience. They are untrusting of adults because they have had horrific life experiences. They will push every single limit to see how far they can go before they are gotten rid of, abused again, etc. So the caring adult has to be very no nonsense and follow through with EVERYTHING. You have to set up that you can be trusted from the beginning. For example if you say we are going to the park after dinner, you had better go to the park after dinner. If you say no dessert unless you eat such and such, they better not get the dessert unless they have eaten. I would suggest you establish a predictable routine and follow it. Make a visual schedule so your child can 'see' their day and know what to expect - first you will eat breakfast, then you will get dressed. Let the child feel like he/she is in control of situations. Offer choices but make them very simple...you can wear jeans or shorts, use the red cup or the blue, have cereal or toast, read a book or color. The child is making the decisions, but you as the adult is still in control. Also give clear simple directions. No fluffy stuff. Use if/then: If you do this/ then this will happen. EX: If you destroy your toys then you won't have any to play with. If you take a bath then you can have a snack. Yes the child may throw huge fits, wipe feces, destroy objects, etc. He/she is testing the limits. You must stay calm and in control during episodes - no yelling, no getting upset. Again I am hoping you will have support in learning how to help the child. Once the child knows that you mean what you say and that you can be trusted he/she will settle in and become more predictable. These children need strong caregivers who don't give up so they can learn that adults can be trusted to provide for their needs. Best wishes to you! Don't give up if the going gets tough. It always gets worse before it gets better. I have never worked with a child with RAD who I didn't end up adoring!