[Dr. Art]

Hi, I am Arthur Becker-Weidman, Ph.D. I will be moderating this forum.

I have been a Moderator for a few years now. I have a Master of Social Work degree. I also have a Ph.D., from the University of Maryland’s Institute for Child Study. I have been helping adoptive and foster families for over twenty-five years now. I am the Director of The Center For Family Development, www.Center4FamilyDevelop.com, which specialize in evaluating and treating adopted and foster families and children with attachment disorders. On a personal note, I was adopted as a child, a “kinship” adoption, and am the parent of three children, one of whom was adopted.

I would like to see an open and free ranging discussion on this Forum. I am happy to answer questions and would like to see others contribute their experience and expertise. I hope that, even when the topic generates strong feelings, that everyone will remain respectful and avoid personal comments against others. I will lend my expertise as an expert on attachment, attachment disorders, mental health issues, and about adoptive and foster families. As a licensed mental health professional in several states I will provide information about treatment, effective strategies, and what the professional literature may bring to bear on questions of interest to participants of this Forum.

[kellyjane]

Dr. Art, We met our hopefully soon to be daughter last thursday. I say hopefully because we have not given the workers a definite "yes" yet. This beautiful little girl is 1 1/2 and HIV+. We have three biological children and also plan to adopt more than once in the future. We do not have any personal experience with HIV/AIDS and are trying to educate oursevles as much and as quickly as possible. We fell in love with her and would only need three more visits before she could come home.There are no other families being considered and she has been in shelter care for the last year because there are no foster families willing/able to take an HIV child. She is extremely healthy and has been on medication since last December. She has never been hospitalized and has no symtpoms. We need to make an informed decision and would appreciate any and all insight as to the medical and emotional aspects of this disease. Thank you.

[Dr. Art]

Dear Kelly,

You are to be commended for considering adopting a special needs child. She needs a home and you seem willing to consider giving her one.

I'd strongly urge you to talk with a pediatric infection specialist. I'd contact your regional pediatric hospital and find out who treats children with HIV and make an appointment to see that person. That person will be most helpful to you. He or she can review the medical records and give you a realistic picture of what to expect.

best wishes,

[nrj]

I am having my future 15,( will be 16 in May) year old daughter at my home this weekend as I email this board. I've posted on the "over 40 adoption" board, but someone suggested I ask this question here. She is a sweet girl, really wants to please and desperately wants a mother and a forever home. I had two visits at her foster home and she is here with me now and until tomorrow when I take her back to her foster home. The first day we met she asked "what do you think I should call you"? I said what ever you'd like to call me. She said "could I call you mom"? I said yes she could. She has been affectionate, happy, obedient, helpful, neat, polite, and communicates very well. She has been in shelters and group homes and is currently in a very good older parent foster home. This mother tells me that she does her chores and is usually well behaved. She has had a disruption this past January, and this disappointed her greatly. Naturally she thinks that this will probably happen with us and she says that she's afraid that her heart will be broken again like the last time. I've been waiting for a child since lasy July and now that it is really happening , the reality has set in and yesterday I had the feeling of doubt for the first time. Today is much better though. Last night while she was getting her things ready for bed she started talking in baby talk. I ignored it and wasn't sure what to do. Today was the same thing, off and on saying her sentences as if she were about 5 years old. I couldn't reach her caseworker and I did want to be very careful of what I said, because I dont want to hurt her of make her think that I'll not go through with the adoption. I addressed the talking and she said thats because she is around her foster mothers grand babies and she's used to talking to them like that. Than may be partly true. She said that she would work on it. The rest of the day she was fine and I complimented her on it and said "you really are working on it arent you? She replied, "I said that I would and I am". I am wondering whether I should have said anything about it to her? Did she need to do that as a part of the bonding process? Should I have treated her more like a young child? She was taken out of her home because of physical abuse by her mother at 11 years old. I hope that I didn't make a mistake by saying something about it. She also talked like that when I introduced her to some friends. She really wants this to work and so do I. I feel much better tonite than I did last night. I feel that this is such a huge responsibility and undertaking and yesterday really scared me. My children are grown and I am single so I am totally responsible for her. Has anyone out there had the same experience with an older child. I really like this kid! I don't want to do anything to set her back again. She has had a very rough life so far, but still has a good outlook on her life and a good relationship with God. Sorry this is sooooo long. Nanci

[Dr. Art]

With the history you describe, it is extremely probable that the child has Reactive Attachment Disorder (11 years of maltreatment, multiple placements, a disruption, etc). Given that, the only way you will be able to make this work and help her heal is with professional help. First of all, you should be getting a special adoption subsidy rate, at the minimum. For many of the families with whom I work, I am able to do an evaluation and help them receive the extraordinary rate, because of the mental health needs of the child. You should have the child in your home as a foster to adopt placement first, and then, once the child has been in the home long enough that you have "rights" (6 months in NY), then make you demands. You will need the financial help to ensure you can afford to get her the help she needs.

Now, what help is it that she needs? She needs an evalution by a licensed mental health professional who has substantial experience and training in evaluating and treating adopted and foster children with trauma-attachment disorders. At a minimum, the person should meet the criteria to be a registered clinicain with The Assoc for the Treatment and Training in the Attachment of Children .

The therapist will advise you and train you on appropriate parenting methods. Generally, you will probably find that the parenting does involve a lot of structure for the child and encouraging and allowing regression. High nurturing within a highly structured environment is healing.

regards,

[nrj]

Thank you so much for your response. I will certainly take your advice. I went into this as an adoption and I can't change to foster adopt. Thanks, Nanci

[nrj]

Dr Art, Now I do understand what you said regarding foster adopt for the first 6 months. We went over the paper work last week. They have not yet assigned a therapist for us. I did address the childlike talking with her and she says that she is "working on it". I do believe that she getting it under control. I have had her about ten days and things are going alright so far. She is really trying hard to belong to our family and really wants this to be permanent. She will finally begin school on Tuesday and I feel hopeful that that will go alright. She will listen to my opinions on certain things. She can communicate very well and expresses her thoughts also. If we have a little disagreement I just say to myself "THIS IS A TEST" like when they break in on television with that special announcement. It really helps me remain calm. I sometimes end up laughing to myself. She is usually quick to make up and asks" do you really want me to stay here"? I always say "I sure do". She smiles at that, and I know she needs that reassuring. I have to remember that she has been sheltered since she was eleven yrs old and is not emotionally near her age of soon to be 16. She is taking horseback riding lessons and does very well , so her instructor informed me. We do have horses and thats something we share. We spend a lot of time at the stable together and both enjoy riding. She is also very caring with cats, dogs, and even the chickens. I know that this is the honeymoon time, but I seriously can't see things getting too bad. Do these children always get "horrible" after the honeymoon??? Are there some kids who want a permanent family so bad that they can actually make it through without too much trouble. I feel like she will, but then maybe every parent at this stage feels like this. I guess time will tell. No matter how things become, she is here for keeps. I've already made that decision. I am fortunate to have her as my new daughter. Nanci

[Dr. Art]

Will power won't heal years of maltreatment, neglect, and feeling unloved and unloveable. For proof of this, use your will power and hold your breath.

For children with attachment problems, it is easy at first to be in a family because there is no intimacy and no relationship at first. As the intimacy grows,their distorted Internal Working Models begin to become evident and problems develop. For some, the problems may be acting out...for others, they remain "as-if" children: seemingly compliant and pleasant, but with no emotional depth or authenticity to their relationships. They are so focuse on providing what they think you want that they have no real sense of self.

Good intentions and love just won't be enough. You and your daughter need appropriate professional support, guidance, and therapy. Find some who isa registered clinician of ATTACh

regards

[preed]

What is your experience with passive agressive behavior in adopted children? Do you find it difficult to diagnosis? What type of treatment? The Angry Smile somewhat mimics RAD. You do not see the anger until it's too late....Yikes.

Our daughter suffered sexual abuse 0-3by bio parents; State foster care 4 homes; Sex abuse in foster home by children 1.5 years; adopted at age 7. She feels compelled to hide her anger, and frustration at all times. Regular therapy suggested I was too dominant & controlling. Yes, I live by rules, structure, and routine which allow her to feel safe.

The sun does comes out now and again, lately more than not....she is such a ray of sunshine!

Thoughts?

[Dr. Art]

Passive Aggressive behavior is not "diagnosed" it is not a discrete conditon. The issue is the mental health condition causing it. Given your child's history, I'd be very concerned about Reactive Attachment Disorder. Passive aggressive behavior is often seen among children with RAD.

The only evidence-based treatment and effective treatment for RAD is something like Dyadic Develomental Psychotherapy. On my website we completed a follow-up study demonstrating the effectivness of this treatment and the ineffectiveness of such things as family therapy, and play therapy. We also have a RAD checklist you might want to look at.

I'd try to get help asap from a registered clinicina of ATTACh.

regards

[zaftra]

I have a child on the autistic spectrum and this really really helps me! He is 8 and he relates to me as a much younger child when he is seeking affection, which I looked at as a red flag...and now I know why.

Thank you!!

I am going to have him see a therapist as well.

[Dr. Art]

I'm glad the post was helpful.

good luck

[tutsieroll]

I need help. We adopted an older child 2 years ago. He was fine for the first year he was in our home. We had him for 1 year before the adoption went through. He will be 18 this September and is now back in state custody because of his skipping school and his verbal and agressive behaviors. I was so verbally abused by this child that I almost lost my mind and then the verbal abuse went to physical aggression. I want to relinquish all rights to this child but the state says no. I really need to talk to someone.

[Dr. Art]

I'd suggest you find a good therapist who specializes in work with families such as yours. You need someone who is a licensed mental health provider who has had specific training in evaluatinga nd treating older adopted children. You can find such a person at ATTACh on their Registered Clinician list.

regards

[nrj]

We finally have our first scheduled therapy appointment two weeksfrom today. I have had my new daughter in my home for 9 weeks. It certainly has been an experience . She is mild emotional, and Im glad that I didn't consider anything more because she needs and wants so much attention. That has been the most difficult for me to give her. It seems that I can "never" give her enough. Every thing has to revolve around her. She over reacts to get attention. For example, at her job in a fast food restaurant she had a stomach ache and called me to come and get her(10 minutes befor her quitting time). I was there in 5 minutes to find her lying on the floor in the kitchen of the restaurant shaking and crying and choking with everyone hovering around her. I meanshe was really shaking. I thought it was an act, but wasn't 100% sure at that point. I was told that she has done this in every place that she has been. The workers were very concerned and called 911. The paramedics came and checked her to find nothing. The said that it must be something more than a stomach ache and that I should just take her home, they couldn't see anything wrong with her. Honestly, she could have won an academy award. I called her caseworker and she said that it was something that she does for attention. It was not an anxiety attack. I was very upset about it and embarrassed for her. She had everyone so concerned all for nothing. I explained that I have given her 2 months of my complete attention and there was no reason to do what she did. Im not exactly sure why she does this, hopefully her therapist will explain it. I kept her in her room the rest of yesterday (she made a complete recovery after being home for 20 minutes), and also had her stay in her room all of today. She did admit that she over reacted. I explained that I wasnt going to put up with that kind of thing and that I was very upset by it. If it happens again she will be grounded much longer than a day . She loved the attention of everyone around her and the ambulance being there. She was begging at the time "please dont take me to the hospital". Then afterward when she was in the car with me going home she said" arent we going to the hospital"? That is exactly where she wanted to go. She did cry after and make the comment" if you're going to send me back, just do it now so I don't think Im staying and be hurt later. I am her first preadoptive placement, all of the others were fostercare. Frankly, I felt so awful about this incident that I did think of disrupting. To watch her shaking on the floor and knowing that she was faking made me sick inside. I never did tell her that I wasnt going to send her back, which I should have. It would have been the right thing to say, and what she needed to hear, I just couldn't get the words to come out. She comes out with these questions unexpectedly, and at that instant, I wasn't sure of anything. I have four more months till finalization and if today was the signing day, I wouldn't be able to. I don't feel close to being ready to adopt her. I am very thankful for the 6 months required waiting time. Maybe the incident was not as bad as it seems, but It was terrible to experience. I was beginning to bond a little with her and this set me back to day one. I didnt even feel like being in the same room with her. Well, tomorrows a new day!