Attachment Disorders - Page 5

[AndVeeGeeMakes3]

Is this RAD?

This has been such an interesting thread to read. I, too, got beat up last time I posted in the adoption forum (for discussing changing my dd's name), and have been away for a while. But, lurking on this thread has actually given me some insight into what (I think) we've been dealing with for a while.

Tell me what y'all think, whether these sound like attachment issues or just 2yo issues:

DD is very reluctant to look us in the eyes when she is being corrected;
She is extremely sensitive about us touching her (particularly relative to diapering and touching her feeding tube);
She pretends not to hear us calling her;
She doesn't want to be snuggled - ever;
Although she have limited communication skills (because of a trach), she

does have some sounds. However she will not say "I love you" or any verbal approximation of it. She only will blow kisses;

At the grocery store, or any time she's riding in a cart, she will try to touch EVERYONE;
Whenever she is corrected, she just says "Hi" and waves

I don't know if I'm being too sensitive, or if it is just that she's in a stage of preferring my husband or what, but she is very eager to see me leave and throws a horrible fit when he does. She does seem to like me, but it just feels like something is missing.

Backstory, briefly: DD was taken in to foster care at 16mos for inorganic failure to thrive and systematic neglect, she is our niece and we gained full custody of her at 22 months (she's 30 months now). She has quite a few special needs and was left alone for much of the first year and half of her life.

[Suebie]

I'm not DM, either, but I can tell you how we found our therapist. I started down a long list of therapists in general, interviewing them. Finally, one said that she knew who I was looking for and put us in touch. This therapist, on top of being extremely smart, having a PhD, also parents a RAD child. She gets what kinds of systems need to be in place.
In therapy, I craddle our daughter during tough subjects. But most of it is teaching her that, regardless of her background, her behavior has to be appropriate. She needs to express herself in constructive ways. Being a member of this family is what is going to help her heal....not necessarily dredging up the past. I can tell our therapist is going to get to dealing with the past in a matter of time. But right now, she's focused on healthy choices.
It's going very well. Our daughter is responding to it...really internalizing what it means to live with a strong, healthy family...and how to be part of that. She comes home and recants it all for her brothers.
Our therapist is tough and demanding but very kind and compassionate. Love her! I get shored up by her every week.

[dharmamama]

Originally Posted by queenjane

but i would looooove to hear some "eyewitness accts" of attachment therapy, what it entails, how the child responds, how the parent responds, etc. Even in general terms.

At this point I don't feel comfortable divulging information like that because I was recently eviscerated here for sharing information about parenting a child with RAD that was not all soft-focus fluffiness.

I've read that some parents have gone through many therapists before they found a true attachment therapist, and that non-ATs just make a child with RAD worse, because they buy into the triangulation, manipulation, etc

We started with a therapist who is not an AT, but she did not buy into the manipulation. She advocated very clear boundaries and lots of structure along with lots of nurture, which is the RAD way of parenting anyway. But that was not the focus of her therapy, and Desta wasn't responding to the main thrust of the therapy. We have since moved on to that woman's supervisor, who has worked with the county dept. of social services for almost 30 years. While not an AT, per se, she has been trained in AT and has lots and lots of practical experience and a lot more practical suggestions than the previous therapist. However, she is moving us on to Catholic Social Services, where they have a specific attachment program for adopted kids. We are just waiting for information about when we can get in.

I've heard that some parents have had trouble finding ATs because they dont exist everywhere

True

and that it can be very expensive and sometimes insurance doesnt pay??

True. Insurance will pay for 20 visits for us. Visits are defined as 50 minutes. For the Catholic Social Services program, we will use up those visits in 2 weeks (the initial week is 15 hours, the second week is 10 hours, then it's an hour a week after that). We are applying for something called Post Adoption Special Support Services (or something like that), which is a program to help pay for services for families who can't afford them for their adopted children ... the kicker is that the service must be addressing a need that existed before adoption or is related to something that happened before the adoption. We are also applying for Bureau of Children with Medical Handicaps.

dm

[Momma Aimee]

OT

one therapist had a child tape a picture of his mom and dad to his desk at school, so that even when he was away from them, he could see them, and think about behaving in ways that would make them proud

That is an awsome idea for ANY kid who is feeling a lot of peer pressure at school to be cool or act out or whatever ....

ok back to the thread

[Suebie]

I forgot to address cost. The beauty of adopting through the state is that the child comes with insurance. I don't know anything about what is supposed to be covered but apparently therapy is. We go once a week for two hours. I never pay a cent or see the bill. I was told by the SW to have a therapist in place before we picked up our daughter.
We happen to be living in a great state that has pushed to make adopting US kids more "do-able" for people. The feds have picked up the rest.
Suebie

[queencarr]

Sort of OT, but I am have been talking with another Mama elsewhere about PTSD in children who are adopted recently. These are the kids who often act out similar to kids with attachment issues, but seem well attached to their parent/famly otherwise. Anyway, the picture idea is one that we used successfully with our bio child who probably had PTSD, undiagnosed, that was called an unspecified anxiety disorder, when he was having issues being in an unfamiliar place with unfamiliar people such as his SN preschool.

dharmamama, glad to see you back. I value your wisdom an observations on so many things, and I was sorry to see you go.

[Momma Aimee]

I have a question -- very basic -- about RAD

Who dx it???? I mean i hear a lot of parents talk about looking for a therpist to work with the RAD, thus the DX is already in place, so it is not the threpist who is making the DX ....

??

Aimee

[dharmamama]

Hurray! I heard back from Catholic Social Services (I didn't expect to hear from them until after the holidays) and it's all good news!

1) The woman laughed and said, "Oh, yes, yes, certainly" to everything I said when I described our issues. They know what I am talking about!

2) They are interested in working with Desta.

3) They are sending me the paperwork and ...

4) Best of all! They have a grant from the Human Services Levy that will pay for the therapy ... so it will be FREE!!

Finally I feel like I'm catching a break!

dm

[dharmamama]

Originally Posted by Momma Aimee

Who dx it????

Our first therapist's supervisor suspected it from the things the therapist told her in supervision. When we started seeing the supervisor, she made the dx.

dm

[Momma Aimee]

Finally I feel like I'm catching a break!

:::

GOODY for your family -- I am sooooooooooooooooo glad

it is a real pet peve of mine when mental health care that is needed has to be a money isseu .......


Aimee

[queencarr]

so glad that you are going to get the help you need AND that they will cover the $$ part!!! It's nice to catch a break once in a while, eh?

[vermonttaylors]

Originally Posted by dharmamama

Hurray! I heard back from Catholic Social Services (I didn't expect to hear from them until after the holidays) and it's all good news!

1) The woman laughed and said, "Oh, yes, yes, certainly" to everything I said when I described our issues. They know what I am talking about!

2) They are interested in working with Desta.

3) They are sending me the paperwork and ...

4) Best of all! They have a grant from the Human Services Levy that will pay for the therapy ... so it will be FREE!!

Finally I feel like I'm catching a break!

dm

Great News!!!!!

[Starr]

That is fantastic! I am so glad it worked out.

[sugarmoon]

Originally Posted by dharmamama

Hurray! I heard back from Catholic Social Services (I didn't expect to hear from them until after the holidays) and it's all good news!

1) The woman laughed and said, "Oh, yes, yes, certainly" to everything I said when I described our issues. They know what I am talking about!

2) They are interested in working with Desta.

3) They are sending me the paperwork and ...

4) Best of all! They have a grant from the Human Services Levy that will pay for the therapy ... so it will be FREE!!

Finally I feel like I'm catching a break!

dm

Hurray!

I think that in almost all states, if not all, you at least get continued medicaid coverage when you adopt your foster child. In my state, it is very easy to find providers (therapists, pedi, pedi dentists) who accept medicaid. I know that is not the case everywhere, but it makes things easy for me.

And everyone should ask about post adoption services. This varies greatly from state to state. In my state, they are available, free, to any adopive family, not just state adoptions, and provide case management (often in-home) and respite funding which can be used in variety of creative ways.

About the dx'ing -- I think many families do "self dx" and then go looking for the right therapist. So I do not think that all kids we hear about being RAD are meeting all diagnostic criteria, but I do think they are at least exhibiting some attachment issues, and will benefit from a therapist skilled in promoting attachment.

The hard thing about RAD is that the people most likely to see the symptoms are the parents, and often they are the only ones, at least at first.

[queenjane]

I think that in almost all states, if not all, you at least get continued medicaid coverage when you adopt your foster child.

In my state (MI)children adopted who are under age 3 generally do not qualify for subsidy (and therefore Medicaid)unless they were at a Level 2 Foster Care level (which seems like they would have some significant issues, like involved medical issues or some severe DD...because they would have to bypass Basic and Level 1 to get to Level 2)....so when i get a foster child, if that child is a baby, and i'm lucky enough to be able to adopt that child after a year or two, i'll likely lose the monthly support and the medicaid card, which kind of scares me (though i'd probably qualify for some state insurance for the child due to my lower income.)

So while i'm hoping to be placed with a younger child for adoption (would be fine with an older child too), its unfortunate that i wouldnt be getting any subsidy, its not a huge amount (like $400/mo)but would *really* help. I think its so strange...for a child under three you either get nothing, or like $700+/mo (level 2 rate)...no inbetween. I guess its because they have no problem placing kids under 3 (even those with severe issues.)

It bothers me that if i adopt a 2.5 yo, and a year later i realize the child has RAD, it will be very difficult going back to the state and asking for insurance or therapy...it can be done, but i got the impression from my worker that it was not a sure thing.


Katherine

[Rockies5]

Couldn't read and not post.

Thank you to everyone who has added to this discussion.

Thank God you aren't abandoning the forum, DM.

I'm just a mama/struggling student/adoption forum lurker and hopeful future-adoptive parent.

[Nan'sMom]

Originally Posted by Suebie

A friend directed me to this board because she felt so sorry for Dharmamama and by association, me. I live DM's life to some extent. I see she's left the thread but I plan to hunt her down.
But what I wanted to add to all the very enlightened responses (I really loved them all) is to explain in my own way what parenting a RAD child is like. My metaphore a bit crass, but I think people can grasp it.
Parenting a child who does not want to be parented is like bringing in a ferral cat. You can already imagine how different this is than picking up a kitten from a home where its been handled kindly by humans since birth.
This ferral cat doesn't trust humans. It has been taking care of itself for some time now. It doesn't trust any non-cats at all and never will if left to its own devices.
But if you take charge of this ferral cat and restructure its world so that you are the provider and nurturer, it can learn to trust and love humans in a ricipricol way.
The key is in taking charge. If you just simply felt sorry for the cat and stuck out some tuna and let it come around on its own terms, you might have a front porch cat but definitely not a lap cat.
What do you have to do? Well, first you need to cage it. (Of course you wouldn't cage a child but it's a metaphore for how small you make their world). You need to be the sole provider of its food. And you need to pet and hold it.
You can definitely count on getting scratched and bitten in the process and if you make its territory too big too soon, it will climb your curtains and pee on your bed. If it gets out, it will be gone for good. It's not personal, it just doesn't need you.
But through a slow and deliberate process, you can gain this cat's trust. In time, it will come to you for love and even give some back. But it will never happen unless you take the control.
The wonderful thing (and the reason I do what I do) is that this trust can now be transferred onto other humans. This cat will not scratch any other humans, either, now. Isn't that great?
All this applies to our children. It's the same neurological process that we are born with. Survive by trusting, or survive by your wits....depending on your environment.
How is that?

I know this is WAY off topic but I'm replying specifically to the feral cat analogy for safety reasons, in case anyone actually had the idea of trying this example with feral cats. As someone who has worked extensively with feral cats, I can tell you that it would be very dangerous to engage in forced handling of an adult feral cat. In fact, I know of several people who have almost lost hands this way (they are fine after intensive hospital stays and/or antibiotics). It would be somewhat akin to trying to handle an adult raccoon...i.e., a very bad idea. You CAN engage in forced handling of a feral kitten and cage them in order to tame them (even then, you need to know what you're doing and be very careful), but with feral adults, it works way better to let then feel safe and hidden, provide food, comfort and security, and build trust. In fact, taming tends to happen more quickly outdoors in their own environment than indoors. Some will never tame. I have heard on the internet, but do not know personally of some people who practice T-Touch (a therapeutic touch) who have tamed ferals that are confined, but they certainly didn't go grabbing them and risking being severely bitten. (Another side note is that ferals usually won't pee on your bed...they will try to use the litterbox or your plants, unless you take in a male and don't neuter him, then he may mark your house)

Sorry for the divergence from the thread. I've been following this with interest since we have some adoptive members of our extended family and I'm interested in issues that may come up surrounding adoption.

[blessed]

Originally Posted by Nan'sMom

...with feral adults, it works way better to let then feel safe and hidden, provide food, comfort and security, and build trust..

We had colonies of feral cats (as well as big horned sheep, cougars, etc) at our river canyon home. One night an injured young tom cat broke into a cracked basement window and wound up in our living room. We tackled him with using thick blankets, then took him to the vet where they put him under general anesthesia to remove his dangling eyeball and clean out the pus filled eye socket.

They had to handle him with thick gloves extending to the upper arm, lined on the outside with steel ball bearings which prevented puncture from bites or scratches. The vet tried to refuse to release him to me, convinced we would be seriously hurt trying to care for him. But I persuaded her and took him home.

Long and short, after working with him extensively for several weeks, he gradually became intensely bonded to me. He would run to me and climb on my shoulder, lay on me for hours purring, and follow me where ever I went. He remained wary and fearful of other people and never got to where he would let dh do much more than pet him while I held him in my arms and he growled defensively.

He ended up being one of my favorite cats of all time. Unfortunately a coyote took him about a year later. It's probably just as well, because dd came shortly after, and I would have been very worried about her safety around him.

[dharmamama]

Today I told Desta about the AT program at Catholic Social Services. I told her that I didn't think that we had a very good relationship and that I wanted better for both of us (that's a condensed version of the the conversation). She got irritated and rolled her eyes and said, "Why are you making me do this?"

I said, "Well, kid, we're going to turn this relationship from crappy to happy."

She couldn't help but smile and laughed in spite of herself.



dm

[Tigerchild]

Originally Posted by dharmamama

I said, "Well, kid, we're going to turn this relationship from crappy to happy."

She couldn't help but smile and laughed in spite of herself.

Ha!