Category Archives: Adoptive

Raising children born to other mothers.

DSM V – Reactive Attachment Disorder

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Do you know about this?  Do you have any idea what it is?  Is there anyone you may know that may have adopted out of foster care who may be suffering in their home?  It’s not just for adoptive and foster families, but this real mental health issue exists and wreaks havoc in homes in your neighborhood.  It would help us Reactive Attachment Disorder Parents out if more people knew about it and made an effort to understand the disorder that is impossible to understand.  We’d like you to try to make sense out of this disorder that makes no sense.  Please read and try to understand…if you have any questions, don’t be afraid to ask.

The DSM is a Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by health care professionals in the United States and much of the world as the authoritative guide to the diagnosis of mental disorders. It is like the check sheet that you need to have to get a diagnosis and you need to get a diagnosis so that you can get the help and services you need.  AKA – how insurance will pay and how much they will pay depending on diagnosis.

DSM-5 Criteria for Reactive Attachment Disorder (RAD)

The DSM-5 gives the following criteria for Reactive Attachment Disorder:

A. A consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers,(NOTE THE WORD CAREGIVERS – That means to everyone else this child may appear helpful, polite and pretty typical) manifested by both of the following:

  • The child rarely or minimally seeks comfort when distressed.(Is used to taking care of himself, so will do so even if he doesn’t know how.)
  • The child rarely or minimally responds to comfort when distressed.(Doesn’t respond appropriately to any kind loving attention….again….from the caregivers….he’ll let everyone else love on him, just not the ones who love him the most.)

B. A persistent social or emotional disturbance characterized by at least two of the following:

  • Minimal social and emotional responsiveness to others (might care about you, might not.)
  • Limited positive affect (refers to the extent to which an individual subjectively experiences positive moods such as joy, interest, and alertness.  Looks very distant and isn’t really joyful at typical times like birthdays, holidays, etc.)
  • Episodes of unexplained irritability, sadness, or fearfulness that are evident even during nonthreatening interactions with adult caregivers. (Just ticked for no apparent reason and the more you try to help, the more irritable he gets. At home will rage since home is his most threatening environment for him.)

C. The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following:

  • Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caring adults (Babies need someone to respond to their cries.)
  • Repeated changes of primary caregivers that limit opportunities to form stable attachments (e.g., frequent changes in foster care) Something needs to be done about this to help prevent this disorder!!!!!
  • Rearing in unusual settings that severely limit opportunities to form selective attachments (e.g., institutions with high child to caregiver ratios)

D. The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A (e.g., the disturbances in Criterion A began following the lack of adequate care in Criterion C).

E. The criteria are not met for autism spectrum disorder.

F. The disturbance is evident before age 5 years.

G. The child has a developmental age of at least nine months.

Specify if Persistent: The disorder has been present for more than 12 months.

Specify current severity: Reactive Attachment Disorder is specified as severe when a child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels.

Thank you for your interest in reading this post to the end and learning a little bit about this very real, very disruptive diagnosis.  

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The “H” Word

HIt’s the rainy Monday morning after we adjusted our clocks and lost an hour of sleep this weekend.  To say this family was slow moving is an understatement and the one who had to wake the latest was by far the slowest, yet she always is.  The 9 year old love of my life is pokey.  When out and about and playing, she is full of energy and on the go, go, go, but to get ready to go, go, go anywhere is a challenge.  Even if we are planning to go somewhere of her choosing, she just takes a long time to get ready.  The only thing that makes her move slower than the snails’ pace she is already moving at is to use the “H”  word, “Hurry.”  Add an “Up” at the end and it slows the process even more, throw in an exclamation point at the end and she may just sit down, stop entirely & have a good cry.

This has been an ongoing problem in our family and I recently attended Calm Parenting University (yes, I’m serious) for some pointers. I learned a lot, but implementing the tips and tricks is going to take an incredible amount of awareness & patience.  Though I have only briefly studied Kirk Martin’s method and cannot claim to add calm parent to my resume, he did give me some food for thought. I’ve decided to try to implement my own version of his approach.

One thing that was pointed out in class was the stress our kids are under and many times it is stressed placed on them by their parents.  I get it.  I do.  I don’t know how to fix it, but I get it.  I did become aware of some of my stress inducing behaviors.  One being the “wake-up-we’re-late-hurry-up-get-moving” morning greeting I wake my daughter up with each school day.  Yeah, not my finest moment as a mom.  Kirk suggested we just sit on the side of the bed as they begin to wake and then ask them something fun to get their thoughts headed in the right direction.  As he was saying this, I thought, as he predicted I would, “Where the heck am I going to find a few minutes to sit on the side of the bed while she gently wakes?”  However, I’m doing it and Kirk was right, I get the time back in the end as I prevent melt downs and tears.  So, I am pleased to say that I am on day 5 of my 21 days to try to develop a new habit regarding this.  As I am doing well on this front (5 days….I am doing okay) I cannot seem to remove the word, “Hurry” from our morning, even though I recognize how detrimental it is to really accomplishing the act of hurrying.  Each time she hears the word, she seems to slow down.  It’s obviously a trigger for her, so I need to attempt to remove it from my vocabulary.  What does that look like?

I don’t know if it will work, but I’m going to increase my word power and attempt to use some new “hurry” words.

  • Dear, let’s advance to brushing your teeth.
  • I like the way you expedited the dressing process this morning.
  • Wow.  You are fired up today, look at the way you threw those covers back.
  • Please quicken a bit, the bus is on its’ way.
  • Rev ‘er up girlie, we’ve got places to go and people to meet!

Thanks to a thesaurus, I could also try: Get the hammer on, hasten, lay a patch, make tracks, open up, peel rubber, & step on the gas, but somehow, I’m not sure those would be beneficial.

Actually, I’m not sure how any of those will work, but at least I’m thinking.  As I try to eliminate stressing my kid out with the hurry up in the morning, I hope you might become a little creative in your verbiage too.  Maybe if we do, we could have a better start to the day….especially the rainy Monday after Daylight Savings time.

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Nowhere To Go !

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No.  There sincerely is nowhere to go.  We have a son with Reactive Attachment Disorder.  What does that mean?  That he appears healthy and well on the outside and his inside is filled with rage and distrust of his parents.  To others, he’s a sweet, charming, polite kid.  To his adoptive parents, he’s a thief, a liar, a menace.  And we took an oath and adopted him.  Because of his early care…or lack thereof, he has decided he doesn’t want to love, so anytime, he finds himself getting closer to us, he does something off the wall to push us away.  And, each time, the push needs to be harder.

As a toddler, it was little sneaky things, an extra cookie, a stolen video game.  Now, as he approaches adulthood, it’s a stolen gun, a broken TV, and stolen car keys. No matter how much instruction he receives, it appears he will self-destruct in his own poor choices.

I’d like to say that this morning was a shocker,  but this traumatizing event was just another day.  Another day of lies, violence, screaming and a home ruled by mental illness.  I’d like to say this is rare, but quite the opposite.  This is how we live.

The aftermath leaves us bruised physically and scarred emotionally.  He rages, goes to school and I receive a message that says, “Paul has arrived safely at school.”  I reply, “Mom and Dad are traumatized at home.”

So, after a morning like this, what are we going to do?  Should we heed the advice of many caring concerned people?  “He should go somewhere.  You can’t live like this anymore.”  I agree 100%!  He should go somewhere.  Where might that be?  There is no special place for kids with RAD.  There is no known therapy that cures, there is no group home, there is no residential treatment facility with an open bed waiting for me in this moment.  In this moment, there are text messages to friends who may or may not be able to help me today.  A wait for a psychiatric bed in a hospital could be months, a call to the police would have them responding to a situation that would diffuse on their arrival.  He needs to go somewhere. There is nowhere to go!

Last week I had the opportunity to attend a RAD support group meeting where I met 8 other families with kids just like mine.  Amazing.  We are not alone though society would think we were.  We live in an isolated existence where no one knows what to say or how to help.  We laughed, we shared war stories, we understood.  Today I texted a few of those families and received cyber hugs & support.  Today’s pain is raw and feels huge….however, when I am once again in the comfort of these special people in a few weeks, we will have a laugh over my husband burning my son’s mattress.  We will joke about us finding the hidden cigarette lighters and stolen cheese. We will laugh on the outside and cry on the inside as we each lose a little more hope each day.  Oh, how I wish that didn’t have to happen.  That we could have hope.

A statement my 9-year-old reminds me of at times like these: “Mom, remember you always say, ‘You can steal my money, but you can’t steal my joy!'” Maybe I need to apply it to hope.  “You can steal my cell phone, but you can’t steal my hope.”

This morning I screamed, I cried, I raged.  Today I will post scriptures and messages about patience and will strive to look at things above.  I will try to turn the events around so that I can survive another day, another evening…even another moment.  I will search deeply for hope.  It is my HOPE that we will all make it through.  That we will somehow heal, somehow cope.  There is no place to go.  We have to figure out how to live and have hope here. “Be patient, then brothers and sisters, until the Lord’s coming.” Someday we will be able to go there.

Hope deferred makes the heart sick, but a longing fulfilled is a tree of life.
Yes, my soul, find rest in God; my hope comes from him.
Be patient, then, brothers and sisters, until the Lord’s coming. See how the farmer waits for the land to yield its valuable crop, patiently waiting for the autumn and spring rains. You too, be patient and stand firm, because the Lord’s coming is near.  –James 5:7-8

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On a Scale of 1 to 10…

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On a scale of 1 to 10 how hard is it to raise a child with Reactive Attachment Disorder (RAD)?  The obvious answer is 1,432 because it is MUCH harder than you think, however each day could be rated differently. No matter the number though, it is always HARD.

There are days that fall into the 1 – 5 category.  Days full of shirts not tucked in, fingernails dirty, teeth not brushed, food spilled, dirty dishes, homework battles, inappropriate remarks, small things broken, lies, arguing and small time defiance.  These are a given.  These are EVERY day.  Every. single. day. Then there are days that a scale of 1 to 10 doesn’t even touch the surface. These include behaviors like fits of rage, breaking banisters, pulling wall paper off of walls, reporting parents to authorities, stealing money, cutting arms for attention, stealing weapons, punching holes in walls, throwing furniture, ripping cabinets off of walls, lighting matches and dropping them inside the house, threatening classmates, shoplifting, pornography at school, etc.  These things don’t happen every day, but they happen more often than most RAD parents let on.  Generally speaking, I would say that parenting a RAD kid is usually a 5-6 with a 10+ thrown in here and there.  It is hard.  Always hard. Chronic.

When a doctor asks you to rate your pain and you have to try to figure out a number you want to just scream, “I don’t know, it’s pain!”  We wonder why we have to rate it at all.  The same is true for why you would even struggle with trying to rate your “hard” as you parent your kid with RAD.  “I don’t know, it’s hard!” It’s for perspective.  It’s to see things a little differently.  Maybe objectively instead of emotionally.

I can tell you that yesterday was a 10+, my house & heart have the scars to show it.  But, today he’s in the shower, he’ll go to school and I have hope that it might be a 2 or 3.  More than likely it will be at least a 6 or 7, but I doubt it will be a 10.  That’s something.  That’s progress. We wake each day with a new scale, yes, there is some leftover “hard” from the day before, but generally, we get to start again.  May there be some relief.  May you have a “good” day….shoot for an under 5!

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The Discomfort of the Calm

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Have you been there?  That place of quiet calm where you are just waiting for the other shoe to drop?  I’m there right now and I hesitate to even write about it.  I don’t believe in superstition, but feel like knocking on wood. Do I really want to express that things in my home are going smoothly right now?  My husband and I are getting along, good report cards came home yesterday from school and even my Reactive Attachment Disordered(RAD) son has been relatively calm.

Historically Paul has struggled the most in the month of October.  He has always said that his birthday month just reminds him that he wasn’t born into this family.  That, in turn, brings to his mind all the other unsettling things he ponders regarding his adoption and his early childhood trauma.  Poor Kid.  But this year, October was blessed.  I even re-read my journal for October and found all good comments about Paul’s behavior.  I noticed in my journal that many days he wasn’t even mentioned.  No news is good news regarding my journaling, so when I noticed he was missing, I thought I’d intentionally add the positive comments. It was refreshing to state the truth.  The honest truth and it was good.

For the parents of other RAD kids, I can almost see you rolling your eyes.  “Yeah, good for you, but we are still knee deep in garbage at our house.”  Well, let me tell you that even if we are in the calm right now, I still fear that I am just resting in the eye of a tornado. Years of abuse and unrest don’t disappear over night, do they?  And, I’m talking about OUR abuse, not his. Maybe I feel like the wife of an alcoholic just waiting for her husband to go on that next binge.  I am just not sure, but as welcoming as this time of rest is, it is unsettling.  What are we supposed to do with our hoses if there aren’t any fires to put out?  I think I’ll use mine to water the grass that I hope comes up in the spring.  What do I mean by that?  I think I’ll use this time to prepare for the next phase, whatever that may be.

I know how exhausting dealing with a troubled child is.  It is emotionally and physically draining, so in this quiet, I will rest.  I will not fill every spare second in meetings, reading parenting books or speaking with therapists about how to manage.  I’m taking a break from learning, trying, and strategizing. I’m taking a break from the grueling schedule of trying to figure it all out.  (I never did, by the way, I just tried! There is no figuring it out!)

I’m reading fiction.  Any fictional piece of literature I want.  I have a whole stack of books full of fluff calling my name. Books without indexes, pages of resources, & notes.  Books with pictures of mountains, lilies or tea cups on the front and no action plan in the back.  I will read, enjoy and even forget what it was about.

I’m going to take a walk….without my phone. No one needs me.  I can walk, enjoy the leaves on the tree and the chipmunks on the ground.  I will smile at strangers I may meet and I will not have the creases of stress on my forehead.

I’m going shopping and I’m going to shop for me.  I’m not going to try to find socks without seams, or shirts without tags.  I’m going to buy whatever makes me feel good.

I’m going to waste time on Pinterest. I may check out crafts to make out of pine branches or poems to write in calligraphy.  I am not going to research safes, weighted blankets, interior door locks or security systems.

I’m going to go out to dinner with my husband and talk about….drumroll please…..him.  I wonder what he’s been up to the last decade or so as we battled this mental illness?  I’m going to have a conversation with him that doesn’t involve discussions of IEP’s, Psychiatrists, or ISPT meetings.

I’m going to play Uno with my daughter.I will have extra time since it won’t be spent picking up debris from a melt down.

And, finally, I am going to enjoy my son.  I am going to spend time with him, talk to him and try to see what has created this calm.  Just like I didn’t know what created the chaos, I also probably won’t be able to figure out what caused the calm, but it will be nice to spend some time with him.  During the calm, he is pleasant and even lets his sense of humor break through.

I wonder what would happen if instead of expending all my energy on figuring everything out all the time, I just accepted the storms and accepted the calm.  Would not worrying about things make time in the midst of the storm for me to do all the things I reserve for the calm?  What if I ran into the storm head on just to get to the eye?  What if I found peace in whatever climate his behavior caused?  It’s definitely something I should consider.  On my next shopping trip, I’m going to buy boots, rain gear and an umbrella and I’m going to be rested and ready. Some storm chasers get bored with the calm.  I can’t say I’m one of them, but I know that if I take care of myself now, I’ll weather the next storm much better!

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In Case You Forget

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We all have people in our lives who are sometimes difficult to get along with.  Some of us have people who are chronically hard to get along with and sometimes we actually live with these people!  We know there is good inside of them, but for whatever reason, it is difficult for them to show it.  It may be mental illness, severe depression or in our case Reactive Attachment Disorder.  We love our son, but let’s be honest…he is very difficult to live with.

Years ago my father said that many people have more friends when they are dead than when they were alive.  He meant that many times people visit a funeral home and didn’t visit the individual.  He shared this when a “friend” of my cousin had died at the age of 14.  He said that many people became that boy’s “friend” the day he died.  The same is true of what we say about the dead.  What we remember.  We stop saying all the things that bugged us about the individual and we start sharing all the great memories and fun, kind things the person did.  I was reading a description of a mother’s son that the mother wrote after she lost him in a car accident.  Though her child wasn’t a difficult child, I think there is still some things she left unsaid.  Maybe we should try to do that with our living children….even the difficult ones.  That said, let me introduce you to Paul, only the good stuff.

Paul will be 17 years old soon and was born to a different set of parents than he has today. He is a remarkable young man who has overcome many obstacles.  He suffers some physical and mental limitations but has defied the professionals’ opinions in many cases.  He can ride a bike, visit a store alone, count money & is very technically apt contrary to what they thought. He is a loving and compassionate guy who sincerely prays for and encourages others in their time of need.  He spends countless hours visiting the sick and the elderly and befriends people who aren’t even aware that they are in need of a new friend.  He leaves a lasting impression with everyone he meets.  Everyone knows Paul and calls him by name.

He speaks his mind without a filter which is at times the most important thing to do.  When a friend of ours was battling brain cancer, he saw me standing at the kitchen sink and said, “Are you praying for Nicholas?”  When I responded that I wasn’t, he said, “Well maybe you should.” 

On another occasion a friend shared a story about something she witnessed at the local grocery store.  When she pulled into the parking lot, she saw Paul sitting on a display of potting soil stacked in the front of the store.  He appeared to just be greeting each person who entered.  Then she noticed a big, burly man in a beat up truck pull in and park in the handicapped spot.  She noticed the truck was in the inappropriate spot, but she said nothing.  The man exited his vehicle, threw his burning cigarette into the lot and walked toward the store.  Paul calmly mentioned, “Hey, maybe you weren’t aware of it, but you parked in a handicapped spot.”  The man shrugged his shoulders, grumbled a swear word and returned to his truck and moved it.  Upon entering the store again he looked at Paul and said, “Thanks man.”  Paul never shared these events.  They weren’t big deals to him, they just were.  They represent who Paul truly is.

We have a summer home along the Allegheny river and Paul is known as the “Mayor of Rimer.”  I know the neighbors two doors to our left and two doors to our right, but Paul knows everyone along the 1.1 miles worth of road and their friends and families.  He makes a point of greeting them and asking them about something he knows they are interested in.  When I introduce myself, it’s easier (& more advantageous for me) to refer to myself as “Paul’s Mom.”  No other explanation is needed and I am welcomed to any picnic or party along the river.

He is polite and courteous and what he lacks in intellect, he makes up for in his incredible ability to ask others for help.  He gets what he needs and he blesses others by allowing them to utilize their God given desire to serve others.  It takes a village to raise Paul and the village is a better place because of him. 

So when dealing with difficult people, in case you forget, there is goodness in them.  It may be helpful to write it down & refer to it often. Play the good things the individual does through your mind as often as you replay the bad things they have done. Also, in case you forget, you just might be the difficult person in someone else’s life and you may want them to do the same thing!

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Miracles

K is my foster daughter.  We met her when she was turning two and she is now four.  She was abused and arrived at our home with a casted broken leg and was recovering from the other leg being broken five weeks prior.  Her eye is permanently swollen from an untreated infection and the court master ruled that she was abused.  She was returned to her home because no one would identify the abuser and after ten weeks, she was injured again and returned to us.  The second time she was placed with us, I felt sure that the courts would be swift to make a decision on her behalf.  They did not. They spent months , even years, attempting to rehabilitate a couple who didn’t see a problem. A couple that took anger management classes and parenting classes, but never recognized their need for them. Court hearings were held every 3-6 months and at each one, I desperately prayed for permanency for K.  I recruited others to pray and as we prayed, we waited for the courts to make a decision for K. Should she return home or should the rights of the parents be terminated? At each hearing, my hopeful prayers of permanency for K were met with a decision to wait another 3 months and meet again.

My journey of faith took a huge walk uphill when after a year and a half in care, they decided to start a reunification plan and award the biological parents increased visits and overnights in the hopes that K would return home.  These visits were heartbreaking and disruptive for my family and even harder for her. While she had previously enjoyed her visits a day at a time, these extended visits were scaring her. She didn’t want to go. She wanted to stay with us.

Since I met K, my prayer has always been for the Lord to place her where she needed to be and to comfort my family if she needed to be reunited with her biological family . I stated many times that I felt like I was praying out of both sides of my mouth. “Lord, allow her to be part of our forever family…BUT, if you don’t, comfort us.” Many times I struggled with whether I should be grieving losing her or fighting to keep her. “Thy will be done Lord.” “Let her stay with us IF it is your will.” Though faithful in prayer, I felt like my prayers were indecisive.  What did I want? My belief that a child deserves to be with their biological mother fought with my belief that a child deserves to be safe. Enter all the other considerations of raising a 5th child when we are approaching retirement age into the mix and I almost didn’t want to know God’s will.

As time passed, it became apparent to us that K would be better off in our home. We were the only “real” family she knew, yet I didn’t feel I had the right to tell God what he should do but someone needed to do something in the this case! The courts with their overcautious behaviors were doing a disservice to us and to K. We needed a decision.

I awakened to the idea that what we needed was a miracle.! A miracle is “an event or action that contradicts known natural, scientific laws and is due to a supernatural cause.” It would take a miracle to get an overly cautious court system to make a decision. I increased my prayers and the number of people I recruited to pray. I asked them to join me in praying for a miracle.

The day of the hearing came and I immediately became the recipient of not just a single miracle, but many miracles. I had a peace that made no sense, I had friends calling me and supporting me, my other children were having a good first day of school, I wasn’t as anxious as I thought I should be, I saw two deer in my front lawn and wasn’t too preoccupied to recognize the blessing in God’s creation and the list goes on.

I received a call from the caseworker following the hearing sooner than I expected and though there was no official ruling, steps are being taken to lessen the biological mothers visits and permanency is well on it’s way for K.

Later that evening, my Pastor called and said, “Well, did you get your miracle?” I had to think about it for a bit and then realized that I had. Though the court didn’t make an official ruling that day and officially K doesn’t have permanency yet, I realized that I had received my miracle. My miracle is accepting the fact that I received a miracle by letting go and letting God decide what is best in this case. My miracle is the peace I felt. Not every item on my miracle check list was checked off, but God knew exactly which ones to check off at this point. The miracle isn’t in the change in the situation, the miracle is in the change in me.

NOTE: Originally written 9-2-10 and I am pleased to say that K has received permanency and is a true blessing to our family!

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