[rag16]

We are parenting a 7 yr old girl diagosed with RAD. She came from a 20 month, pre-adoptive disruption. We are working very hard to adopt.

Our child, K., has recently begun escalating her typical behavior - refusing to do something, having trouble letting us care for her, ommanding us to follow her orders, hitting and kicking etc. We have been approaching these issues with "time in" on a sitting rug or in her room (we tell her she is not being safe and that we are going to stay with her until she is better able to control herself), practicing good behavior, chores for wasting our time, and a far amount of distraction. We also reduce her ability to control us by suprising her with fun. We also give her tons of hugs, keep her in our presence, rock her to sleep. In the past we have picked her up when she is flipping out and talked to her about loving her even when she is mixed up inside. She has usually struggled for a few seconds and then broken down, sobbed, and eventually derived comfort from being in our arms.

The issue that is concerning us is that she has begun to try resist being held and now tries to hurt us. She has recently tried to hit or kick us when we give her unexpected/unwanted hugs or when we pick her up as she is flipping out. She also is trying to do this when we have her sit in her room with us or on her sitting rug. We will set her on her bed and she will reach across the room to push us away with her feet. I think she is testing to see how far we might go in "making" her stay. At this point, her actions do not hurt us, but looking ahead we can see two things: 1) she might try harder to hurt us 2) she seems to be trying to get us to react physically and harshly to her and so we need to stay clear of that.

Does anyone have suggestions for dealing with the beginnings of violence towards a parent figure?

Since she is a foster child, we must stay within the bounds of DSS approved discipline and thearpy. This means that until we can addopt her, attachment therapy is out. We must also avoid physical discipline. Our county interpreted as meaning that we cannot hold K. against her will (ie. pick her up, hold her arm to guide her to a safer space....I'm not sure whether this means we can or cannot grab her hands if she is hitting us).

The siguation is mild at this point, but we would like to have a game plan for avoiding future escalation and for dealing with escalation if it is unavoidable.

[lucyjoy]

Is attachment therapy illegal in your state? My kids recieved attachment therapy well before finalization paid for by the state.
If her diagnosis is RAD, they cannot refuse her treatment simply because she is a foster child. Raising a child with RAD is expensive. Will you be able to afford it on your own after finalization? It needs to be included in her subsidy agreement.

There is nothing you can do for her until she has the proper therapy. All suggestions for dealing with this problem are theraputic. She needs a safe way to release her anger and fear so she can allow you to love her. This cannot be done with anything other then attachment therapy.

Focus on bonding things and things that encourage touch and eye contact. Fight for the right to get appropriate treatment for this child.

www.radzebra.org www.attachment.org

[L-A-J-C-R-C]

Hi,

I'm really hoping Lucyjoy responds to your question as she is very knowledgeable on RAD issues.

Physical punishment is never a correct form of punishment for any child, much less a child with RAD.

As far as holding her against her will, my understanding is you cannot restrain her by holding her down, tying her up, taping her arms, legs, etc. together. I don't see a problem with holding her with her arms at her side to move her to a safer place. Please ask your child's worker about this as I am NO expert on this subject. I'm not exactly sure why you say attachment therapy isn't a choice until adoption. We're foster parents in KY an our fd is about to be tested for RAD. If she has RAD we will be starting therapy on her immediately upon diagnosis and she won't be adopted til sometime next year.

Have you spoken to her worker to see what you can and cannot do for her? If she's not willing or able to give you sound suggestions maybe you need to speak with her supervisor. I, at this point, know very little about RAD as we are in the early stages of diagnosis, however, from the research I've done, the earlier it's addressed the better the possibility to heal the child.

Hang in there, someone will post to give you some sound advice.

Michelle

[Lorraine123]

I questioned the same thing - why do you have to wait until finalization for therapy? With my daughter, attachment therapy was a condition of placement.

Much of what you said reminded me of myself. My daughter has recently begun escalating physical ways of fighting back. She hits and kicks and recently, bites. We have teeth marks on our arms. I can't believe the state won't let you restrain her. We MUST restrain my daughter, otherwise she is a danger to herself. She needs to learn that we keep her safe and often restraint is the only way to do that. Ask your worker again about that.

She is scared and hurt and angry. I find that whenever my daughter's behavior escalates, thats a sign that something is going on inside her. She may be feeling a closeness that hurts her.

Lucy is right in that you need to have this therapy in place prior to finalization. It needs to be part of her subsidy. Don't take no as an answer.

[rag16]

Everyone agrees that she has RAD and that she needs to be in therapy. However, there is an elderly couple who knew K. when she was young . They are petitioning to adopt but are totally inappropriate parents for a young kid with RAD. DSS is in our favor and so is the law guardian, however, it is still very much up in the air. There is simply no guarentee that we will be able to adopt.

Our social worker and her supervisor are not willing to start attachment therapy with her UNTIL this other petition has been denied.

They have allowed us to seek parenting thearapy (with someone who deals with attachment but not RAD) and now want us to put her in grief counceling. We are pretty clear that this is going to be ineffective but DSS wants it to happen to make our case stronger.

We are both totally in agreement that physical punishment is NEVER appropriate for K. But how do we address a situation when she is seeking us out and trying to hurt us?

I will talk to the case worker and our therapist again about appropriate behavior. We are under an incredible microscope right now. I remember the conversation in our certification classes about not ever using physical cooersion. From what I remember, it seemed that they wanted us to keep a child safe, but not touch them when we disciplined or redirected them. The example was that if a child is hurting another child, we should get between them, even get a beating ourselves, but not actually constrain the violent child.

[L-A-J-C-R-C]

Rag,

From what I understand that is for the typical child in foster care. Children with RAD have totally different issues and "normal" parenting techniques will not work with these kids (I am learning that the hard way). Their entire being feels THEY have to be the one in CONTROL. It's important as their parents to take that control away from the to show them you can and will protect them and take care of them in everyway. We need to rewire their brains to trust us.

You must be soooo totally frustrated having to wait for DSS to make a decision! I know I would be. Especially not being able to help your fd. I would video tape her and have them watch the behavior you are telling us about and have them recommend what they want you to do. IMHO, they are not working in partnership with you if they are not seeking help for your fd! Social workers KNOW ABOUT RAD, know how important the proper therapy is, they need to move faster with their decision regarding this other family - your fd is suffering and they need to get in gear and help her!

Best of luck. I will pray you get to adopt her. By reaching out for answers, I can tell you love her and will always do what's in her best interest. She's where she needs to be as far as I'm concerned.

Michelle

[lucyjoy]

Never heard of a therapist trained in attachment but not RAD since the treatment is the same for both. Find out where they were trained and check them out. A bad therapist can do more harm then good. Grief counseling is useless without attachment therapy as she can't grieve what she hasn't bonded to. Until she bonds somewhere, she cannot understand the losses.

Never in any class anywhere was I told to allow a child to hurt me. We were taught proper restraint. I don't believe in punsihment of any kind. Consequencing needs to be as logical as possible(Parenting with Love and Logic).

If a child breaks something-their money or toy goes to replace it or they can do a chore for whoever the item belonged to.

Can she exercise when angry or is this considered wrong by the CW? Having kids run or jump on a mini tram when they are angry helps release the pent up anger and energy so they can calm and breathe better. We also used a form of strong sitting(not to be confused with time out or punishment). The child sits striaght and strong allowing proper oxygen flow. I also teach them how to breathe. I have them do this a few times a day at first and once they get the hang of it, I have them do it when they seem to be out of sync-never when they are angry.

I hope this is resolved quickly as this child is losing time she cannot get back. The sooner her treatment toward healing can begin, the better her life will be.

[Just Julie]

Can you hold her through a thick comforter for your protection while she is kicking or trying to hit you?

[Dr. Art]

You really should not be trying to manage this without the support of an appropriate, licensed mental health professional who is trained and experienced in treating children with trauma-attachment disorders. Such a person is either a Registered Clinician or meets the criteria to be one and is a member of The Association for the Treatment and Training in the Attachment of Children. If you are getting other treatment or treatment by someone else, then it likely will be a waste of time. There really should be no problem with beginning such treatment. In addition, if you have signed an intent to adopt, then under federal law you can add the child to your health insurance and get therapy that way. I see many foster children who are on their foster parent's health insurance providing coverage for the treatment.

regards

[rag16]

Just as an update:

After a couple days of really focusing on conntecting and creating a positive environment with her, K. has been returning to a much less defensive interaction with us. Even though we didn't consider the behavior difficult to handle or even hurtful, its nice not to have it be an issue for now.

We have spoken with councelors, support groups, caseworkers, etc and come up with good suggestions to try if and when K. is distraught and starts flailing/kicking/hitting in our direction. She seems to get upset and want to have physical contact with us, but not know how to ask for positive contact or how to initiate it. So, we are going to make sure we aren't making a confrontational issue out of the flailing arms and legs and instead continue our approach of acting out and talk about better ways of getting that contact. "Seems like you are really upset and want to be near me, sitting in my lap/letting me give you a hug is a good way to do that". We've also talked about and had her draw pictures about what she can do when she is mixed up. We're hoping that verbal and visual cues might reinforce better ways of getting out her emotions. Finally, if she really does not seem to do anything but flail/kick at us, we will place a pillow between her and us. Then we can give her two choices: you can stop hitting or you can hit. At that point, either way, she is doing something we want and we can praise her for it. We're hoping that this will help total divert the hitting/kicking from a power struggle.

Finally, we did talk with a thearapist about working with Kady and us together. We're looking positively at it. While the caseworker doesn't want us to focus specifically on attachment issues until its clear that we will be able to adopt (reasonable request), we can work on other issues (which there are) and move it towards permanency/attachment issues when things are more certain. Hopefully, decisions will be made soon. We'd both like to be able to tell K. that its permanent no matter what.

[Lorraine123]

While the caseworker doesn't want us to focus specifically on attachment issues until its clear that we will be able to adopt (reasonable request),

I respectfully disagree. If she does have RAD, then that needs to addressed sooner rather than later. The longer you wait the worse it will get. You can't work on other issues until the attachment part is healed.

My fear is that they don't want a diagnosis of RAD and that way they don't have to include it in the subsidy.

JMO.

[Dr. Art]

There is no valid clinical reason to not begin attachcment-facilitating therapy now. The long you wait, the more incideous the damange and the more difficult it will be to treat...the longer everyone's bad habits will have been in place. I do treatment with foster children in placement all the time...even when there is a possibility (or plan) for the child to return home. For the sake of you child you really need to push this and get treatment ASAP. You should add her to your health insurance and begin treatment now.

regards

[rag16]

Thanks everyone for your concern. A high substidy is already in place so that is not an issue and DSS is bending over backwards in many ways.

My most recent posting was not to suggest that we, the caseworker or the therapists are avoiding any attachment issues. Everything is moving very rapidly indeed and we all know this will be resolved shortly.

There are now two court dates scheduled in the next two weeks. We might have a strong indication on the direction it will go very soon....maybe even before K. first appointment with the therapist. If so, we can work even more directly on these issues in therapy. We continue to do as much as we can at home for the time being and simply wanted attachment based parenting techniques for dealing with this issue in that setting.