The first 36 months of a human’s life are most critical for developing a base of attachment from which a unique identity is developed. For this secure base to develop, an infant’s needs must be met (over and over) each day on a timely, appropriate, and consistent manner. Through this a child learns cause-and-effect (I have a need, let someone know it, and it is resolved), resulting in a sense of relief, release, and gratification, reciprocal connection with others, and trust. When their needs are consistently NOT met (neglect, abuse), he/she feels a deep sense of terror, anger, and shame. They feel as though they might die. As a result of this cycle continuing day after day, while the stress hormone cortisol runs through their veins, they learn NOT to trust, that they must rely on themselves, developing a false sense of power and control, and a bit of narcissism. This is why your child might be telling you how to drive, or make a sandwich…at 3 years old, or 10. Why they might be stealing things they could’ve had permission for. Why they feel a need to do a “payback” when they didn’t get their way. Despite how long this child has been in your loving and committed home, if they haven’t had the appropriate treatment for Reactive Attachment Disorder, when they are trying to get their way, or haven’t gotten their way – they regress….Cortisol running through their veins, feeling as if no one cares, no one understands what they need, no one loves them (shame), there is no one they are able to trust, they are on their own to get their needs met – or they may die. By now this may be over a new pair of sneakers, or a second helping of ice cream. We understand how a child with RAD thinks and feels. We understand that as adoptive parents of a child with RAD your dreams of adoption have been shattered, you’re likely feeling beat-up by unknowing professionals/system, and you’re feeling isolated and misunderstood by relatives and friends who don’t ever see it. We get that at AATC of Iowa, and we can help.

This is how we are able to help. For a list of symptoms, scroll down.
• Specialize in Reactive Attachment Disorder – we don’t just understand what it is, we know how to heal it!
• Team of 5 specialists; 3 Clinicians and an Administrative Assistant trained to handle Lobby.
• Each Clinician has well over 250 hours of specialized training in Attachment Treatment.
• Private Domestic, and International Adoption Home studies and post placement services.
• Unique Therapeutic Parenting Program that provides 70% relief of Parent’s own symptoms in living with a child with Reactive Attachment Disorder within 4 months of treatment initiation.
• Highly skilled at Differential Diagnosis; Autism, Nonverbal Learning Disorder, Learning Disabilities, Aspergers, AD/HD, Anxiety, Depression, Child Onset Bipolar, Sensory Integration Disorder, Oppositional Defiant Disorder, Conduct Disorder, Post-Traumatic Stress Disorder.
• Provide Outpatient Family Attachment, Outpatient Individual and Marital, 1 or 2 week Family Intensives (to jump-start Attachment treatment), Social Skills Training Groups for children, Adoptive Parent Support Group, Online Private Support Group for Adoptive Parents, One of a kind Therapeutic Parenting Training.
• Assessments for Attachment difficulties; for placement recommendations, sibling placement recommendations, and treatment recommendations.
• EMDR (Eye Movement Desensitization and Reprocessing) for resolution of trauma.
• We are conducting our own research on our own Treatment Protocol efficacy, and Denise has a book forthcoming for parents of children with RAD.

At AATC of Iowa we do NOT use any form of coercive therapies! We do not entice anger intentionally, hold children to entice emotion (parents are trained to contain the child safely for their and/or the parents’ safety if the child becomes aggressive), or roll children up in carpet! All sessions are recorded for this very purpose - everyone’s safety. We respect the basic human dignity of these hurt and untrusting children. We utilize empathy AND accountability, we hold the bar of expectations high AND utilize humor. Our practice is to have the child leave each session feeling strong over their own life and self, practicing trust (this often means they might be at our clinic for a couple of hours)! “Try again!” with an empathetic tone is heard frequently at AATC.

Symptoms

Acts overly charming to get their way: often these children are stellar students and the teacher’s best "helper"...and at home, where there is an expectation of emotional reciprocity/being part of a family, their behavior couldn’t be more opposite. They are excellent actors at "playing dumb" and soliciting the help of instructors when they don’t need it.

Poor eye contact, unless they’re lying.

Indiscriminate affection towards strangers; getting needs met "sideways" - safer than the real thing - true, recipricol love.
Affectionate to parents only on their own terms (usually to butter them up) and/or rejects affection from parents (in infants/small toddlers they are stiff, rigid, squirm to get out of hug).

Can argue for long periods of time; truly believe they are smarter and stronger than any adult.

Tremendous need to control people and situations (especially parents, smaller children, animals).

Acts incredibly innocent, even when caught in the act.

Daredevil, risk-taking behaviors.

Deliberately breaks things, and doesn’t appear to miss them.

Poor impulse control - often mistaken for ADHD...is really anxiety over losing sense of control.

Steals: Feel that they can trust no one to meet their needs, no matter how long a placement, so they take it.

Demands things instead of asking for them; sense of control, and assuring their needs are met.

Doesn’t appear to learn from mistakes (lack of cause-and-effect) thinking; which I believe is really a reflection of their perception of being stronger and smarter than anyone (authorities): as one child put it, “I know when (foster mom) tell me to make good choices when I leave, and I go do the opposite, I’m probably going to get caught, and yet when I come home and I’ve been caught, I’m still shocked”.

Makes false allegations of abuse/maltreatment; I had a child in foster care who had a foster mom who had them dressed in designer clothing. To get sympathy she told her boyfriend's parents she wasn’t provided the basics, like underwear. She was wearing Tommy Hilfiger underwear! On a more serious note, they are infamous for alleging abuse as a "payback" for not getting their way (which may be as significant as not getting a second helping of ice cream).

High tolerance for pain and/or refuses to let anyone help or comfort them when hurt - would be a sign of vulnerability & helplessness, which is intolerable to a child with RAD.

Sneaks things when would’ve been given permission had they asked (assuring needs met).

Lies - crazy made up stories, to get out of trouble, to get others in trouble.

Food issues: hoards, sneaks gorges, more commonly in my experience, eats very slowly.

Very poor Social Skills; often plays with younger children (to control), or has volatile relationships (love/hate).

Temper Tantrums that can last up to 2 hours. These children are so emotionally developmentally delayed; it takes nothing more than a toddler takes to be completely dysregulated; overly tired, overly stimulated (especially from overseas orphanages), illness, hunger, etc. Their tantrums look like a 2-year-olds tantrum, even when they may be 10 years old. It is SO important the child not be shamed by this; they are unable to self-regulate – and the truth is you don’t want them to figure this out on their own (time-outs, isolated in their room)! This is how RAD developed in the first place – they had no one safe to help them co-regulate their emotions, provide a sense of relief, release and gratification that they were truly going to be okay.

Non-stop chattering or asking questions they know the answers to: My favorite is "Why is he weed-whacking?” that emerged in a series of questions as they were driving. This is power/control, attempting to engage the parents.

Some have preoccupation with fire and gore; wars, abusive to small animals and children, etc.

Other important clinical information

Miscues: Since feeling vulnerable due to having a need is too difficult for these children to manage, they will miscue to send you a message that they don’t need you anyway, don’t need that privilege or item. We teach parents how to read these more accurately so that the child’s needs can be met when it is too hard for them to ask for it.

Impact of Neglect and/or Abuse on the Brain and the Body: When an infant is born their brain is not fully developed. Extreme neglect and abuse have many differing degrees of impact on the development of the brain, and the body. We will help you understand why your child does, or doesn’t do things they might be expected to do at their age. Differential Diagnosis is an important element of our treatment – knowing when to refer for healing specialties beyond the scope of our clinic (Sensory Integration, Physical Therapy/Occupational Therapy, Psychiatric Medication, etc.).

LINKS
www.attach.org (National) Association for Treatment and Training of Attachment in Children. Yearly conference for parents and professionals, national and state resources – including Registered Clinicians and Organizations, Information.

www.radzebra.org Attachment Disorder Network. National Network of adoptive Parents for support, resources, information. Developed by 3 incredible women who’ve adopted, and devoted their lives to helping other adoptive parents.

www.loveandlogic.com Love and Logic Parenting; Resources, books, information.