[janeliz]

We are going through a discouraging time. Our daughter has recently been diagnosed with RAD. She went through a public school evaluation (full) and will be transferring in a week from private Christian school to public school kindergarten. She has had massive attention and behavioral problems in school, not to mention a lot of stomach upset and stress related physical problems.

Our therapist opened the door to thinking about meds to help Emily short-term as she is really anxiety-filled and school is so tough for her, and she is working through a lot of adoption issues. I am generally an alternative medicine type, especially since my daughter is allergic to many of the substances used in prescription drugs (corn and its derivatives, mainly). Anyway, our therapist has suggested short term use of some anti-psychotic drug to help her calm herself. She seems to be "triggered" at school and her response is inappropriate behavior that she cannot seem to turn around.

If anyone is familiar with using this kind of drug for RAD and would be able to point me any kind of direction, that would be helpful. I want to research this on my own via internet and also to explore the use of herbs as a possible alternative.

Thanks in advance - Jane

[lucyjoy]

Medications are not affective for RAD although may doctors are more then willing to try out 10 or 12 kinds at a time. If at all possible, it would be better to remove the school issue and teach her at home until she has healed enough to handle school. Nancy Thomas has good information on RAD and changes in parenting that facilitate healing.

My RAD kids all showed up here on enough meds to stock a pharmacy and not one of them was effective. Also, anti psychtics are not for anxiety. If the doctor feels the problem is anxiety, an anxiety drug should be used.

[Sabra]

Dear Janeliz:

Thank you for posting your question. things may be hard at this time and it is so wise to ask questions. I feel for your situation with your dear daughter. Others may have a related situation that come to this forum. They may be able to tell you about their experiences. It would be helpful to know some background information about your dear daughter. The information that would be helpful would be regarding her age now, age adopted, how many homes she lived in prior and the types of homes.

It sounds like you are very involved and caring toward your dear daughter. We have an attachment therapist that treats children with RAD on our Parenting the Older Child & Behavioral Issues forum at: http://www.adoptionforums.com/f50.html

His name is Dr. Art. He may be able to give you some input on the medication aspect. He may also suggest what would be helpful for your daughter. Please post a question with some of the background information I mentioned above.

Keep your dear daughter in prayer. We have several chats that would be helpful to you. You may see the schedule by clicking on the words "Entire Chat Schedule" after clicking on the tab that says "Chat" at the top of the page. There are directions for entering the chat at: http://www.adoptionforums.com/t85161.html

Best to you this holiday season as your build positive memories of loving gentle moments together.

Warm regards,

[Dr. Art]

Sabra is correct, there are no medications to treat Reactive Attachment Disorder. This condition is a psychological condition caused by a significant history of abuse, neglect, or institutional care in the first two to three years of life. Now, that being said, it is VERY important to get a thorough evaluation by a competant and fully trained mental health professional...someone with experience and training in evaluating and treating attachment disorders. You can find people like this at www.attach.org which is the website for the Assoc in the Treatment and Training in the Attachment of Children. Many children with attahcment disorders also have sensory-integration disorders and need to be evaluated and treated by an OT who is certified in sensory-integration (no med treatment for this either). However, about 50% of children in the U.S. fostercare system who have RAD also have Bipolar Disorder and that should be treated with meds...the correct diagnosis is important since common medications for depression can be harmful for children with Bipolar disorder. Finally, children who have RAD often have symptoms of PTSD....any way it is really vital to get a thorough and competant assessment.

Regards

[Georgia Mom]

I am an "alternative"medicine person myself when possible, but be careful. Just as many pharmaceuticals have not been tested for safety in children, the same is true for herbal remedies. One website you might look at for info is www.drweil.com. He, too , generally advises against herbs for children.

BTW, our 14 y-old DD has been given a tentative diagnosis of bipolar , and Dr. Art hit the nail on the head when he mentioned meds for depression being harmful for bp kids. We had a clueless psychiatrist at the time, and she was not too keen on even considering bipolar in our daughter. We tried DD on an SSRI for depression, and I thought we were going to have to hospitalize her. She went NUTS! Fortunately, she came back down to earth after we DC-ed the meds. It has been quite the journey to find meds that have stabilized her. ( We have a new psychiatrist now. Having a competent doctor is SO important.)

Dr. Art, the statistics about RAD concurrent with Bi-polar are very interesting. Our DD came to us with severe attachment issues, if not full-blown RAD, was diagnosed ADHD, and I never realized until recently how her behaviors (even the cravings for carbs) fit the bi-polar diagnosis. I think we have a correct dx now. Thank you so much for your input and wisdom.

Janeliz, best wishes to you as you traverse this difficult time.

[janeliz]

Dr. Art, I've been a bit reluctant to post because I don't believe my daughter fits RAD under your criteria. She was adopted at 3 days, she's only been with us. She did have a lot of stuff during pregnancy (substance abuse as well as rejection) and severe birth trauma (almost died due to lack of oxygen). Most people don't think RAD can come from this set of circumstances, and frankly I was in disbelief when it was suggested to me. However, after reading The Primal Wound and 20 Things Adopted Kids want Their Adoptive Parents to Know, I just know in my gut that attachment disorder fits my 5 year old.

We do have a very good therapist who is adopted herself and has worked through her own attachment issues. She never brought up the issue of medication - it came up because her new school wants her on Ritalin due to her attention problems at school. Both us and the therapist agree that Ritalin is no answer, that Emily does not really have ADD it just appears that way right now. I think what the therapist is after is something that can help her get through the school day so she can function better. It appears that Emily is in "fight or flight" mode at school and has a very hard time thinking and learning and not reacting to everyone around her.

Thanks for your input, everyone! I am just a parent seeking out the best solution, and we are just taking one step at a time.

Jane

[Dr. Art]

Dear Jane,

You are right that often children adopted at such a young age do not have Reactive Attachment Disorder...but that is not always the case. The Primal Wound is an excellent book and helps explain how and why a child adopted near birth may experience difficulties. Many children with RAD are misdiagnosed with ADD or ADHD. In additon, many children with Sensory-Integration difficulties are mis-diagnosed with ADD. My current evaluation and treatment protocol now calls for having children evaluated by an OT who is certified in sensory-integration if the child presents with ADD-like behaviors and also had attachment issues or RAD and/or a history of maltreatment. Frequently these children have SI difficulties that respond well to SI-OT interventions and the ADD-like behaviors dissppear.

Regards