Child with attachment disorder - is this right?

[joblerone1]

(Sorry, long.)

I hope someone can help me. I am trying to find out more about attachment disorder and whether or not my sister is doing the right thing, or potentially damaging a very disturbed little boy even further.

Her 7year old stepson came to live with them 10 months ago. His mother was about to put him into care. He has been diagnosed as having attachment disorder and is very difficult to live with. At worst, he exhibits behaviours such as standing in the bathroom all night, wetting/soiling the bed/himself, ignoring direct questions, avoiding eye contact, screaming in swimming lessons, not putting his clothes into the wash, losing his glasses, lying about it, etc. He gets told off a lot for things which, I feel, as a teacher of 7 year olds, are part and parcel of being a child ? most of my class do some of the things she describes. She insists it?s his way of gaining control, and nothing to do with being a ?normal? child. She gets periodical respite care (twice a month?) and our parents look after him and/or her two other children regularly. I live more than 2 hours away, so cannot help much.

She feels so much at the end of her tether that she is intending to take the rest of the family away on holiday while he goes into respite care for 2 weeks. She wants time to ?regroup? as a family and spend time with ?her girls?. Although I recognise her acute stress levels and the need for regular respite care, I can?t help thinking that 2 weeks in respite while the rest of the family are on holiday (in a caravan, which he loves) can only reinforce this child?s feelings of rejection, separation and worthlessness.
My parents have offered to look after him for the whole two weeks, but my sister says he needs firmer boundaries, and that they are too nice. They regularly look after him at weekends, or if he is home ill from school, and for 45 minutes after school one night a week when the whole family comes for tea.
Have since found out that they've said to him previously that if he didn't behave himself at swimming then he wouldn't be allowed to go on holiday - and now he's not. They are not calling it a punishment, just respite for them, but if they've used it as a parenting tool then I think it is son wrong to withdraw it.
I have read some AD websites that actually warn against the overuse of auxillary services, but feel unqualified to comment. What do people think?

Hang on, Kristina, that's very unfair.

I'm bewildered because none of the examples Joblerone reports her sister moaning about seem that extreme to me, apart from standing in the bathroom all night. Lots of children who are unhappy soil themselves, too, doesn't make them monsters whose parents need respite. Obviously the sister isn't here to post her direct experience, but it's very odd.

Poor little boy has clearly had a very troubled life, with no-one to care for him. And now his dad and stepmother are interpreting everything, including perfectly normal behaviour such as losing his glasses, nor 'not putting his clothes in the wash', for heaven's sake, as pathological.

Sounds as if the OP's sister resents him. Being a special needs teacher doesn't make her an expert at bringing up a very unhappy little boy.

Thanks danae. No, the other 2 siblings have a different father, who mistreated my stepnephew. My stepnephew had never seen a Christmas cracker, been to the seaside, seen fireworks, been on holiday. He loves the caravan where they go now. That's what makes it seem particularly harsh imo.

Smurf and edam - I agree with all your points.

of course you are entitled to an opinion - we all are

my concern was that you were about to share your opinion with your sister, who is already on the edge and probably will not welcome the advice of someone who has no knowledge or experince of the matter in question. she might just feel criticised and misunderstood by you, rather than supported

I'm sorry if i have misjudged you and you were just discussing the matter here on MN. I thought you were planning to tell you sister whethre or not she is doing the right thing

my point about your 2yo is that this is quite a small and normal parenting issue. your sister is dealing with a HUGE and intractabel problem in a child who is not even hers. a child she has given a home to in order that he is not placed in care.she has risked her marriage, her health and the happiness of her own two children to help this boy.she deserves a medal

I am heartbroken for this little boy.
How can not putting the washing in the wash or losing things be that bad?
My DS is 8 with no special needs ... EVERY SINGLE DAY I have to moan at him about his clothes and he constantly loses stuff. It is just a 'kid' thing and possible a 'boy' thing.

I think your sister should go away with her daughters and her husband should take the little boy off on a camping holiday or something - some real Dad and Son stuff. The mother has let the boy down completely and the step mother is doing her best but she can't be expected to fix it all herself.
Little boys need love but also they really really need their dads. The father of this child should get a grip and take responsibility for this and give the boy time and love.

Oh joblerone, that is heart-breaking. Poor lad.

edam - respite isnt for " monsters" its for children whose families are under stress. particularlt SN kids or other familes affected by disability

the child has a dx of RAD - its in teh OP. thsi is a very serious mental health disorder

It's the OP's sister who is treating respite as punishment, not me! I'm horrified at the idea. And she seems to be treating him as a monster.

Kristina, I want to stop her from going away without him. I am trying to find out as much as possible so that when she tells me how normal this is I can respond in full possession of the facts. I wanted to find out if this is normal, which is why I've posted a comprehensive description of his beahviour (which is not violent, and he doesn't soil himself at the moment).
That's a good idea, ghosty. Although I can't see her going for it as that would be unfair on 'her girls'.

with respect edam, i think you need to learn a little about RAD. I'm not sure why you are questioning the dx of the professionals involved

most of what jobeleron is saying is entirely consistent with this dx and also of best practice when parenting a child with attachment disorder

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joblerone, your sister doesn't like this poor little chap and has found a stick to beat him with.

Children are not meant to be tidy, they do lose things and do have toilet accidents. They should be encouraged to run around, play, explore and scream in other words have a childhood - it is about building dens, climbing trees and eating big hearty meals all together. Boys are not meant to be be putting dirty clothes away they are meant to be getting them dirty in the first place! I don't want clean perfect children but ones with colour in the cheeks and in dire need of being hosed down before bed!

Good God what sort of word do we live in when little lives are broken before they have begun?

No, I don't think any of them did nice things. But he would be made to stay in his bed until a certain time, even if he wanted to go to the toilet, was hit, etc.

KristinaM, you are so rude, edam hadn't questioned the diagnosis!

Kristina, I want to stop her from going away without him. I am trying to find out as much as possible so that when she tells me how normal this is I can respond in full possession of the facts. I wanted to find out if this is normal............

She is bringing up a SN child. you have admitted that you have no knowledge or expeince in this field. If you want to be in " full posession of teh facts" then you need to walk in her shoes - take on a child like she has and then you will be able to judge and tell her what to do.

You cant possibly find out all the facts from reading a few websites and posting here on mn. its like saying you are in full posession of the facts about being a parent or giving birth becase you have read a book and spoken to a few parents

its like the men who say to their partners in labour

"do you really need that pain relief? It doesnt seem that bad to me"

you dont knwo until you have been through it

just becase YOU managed in labour with G&a doesnt mean its not "normal" for me to have an epidural. Just becase you don't imagine that you would need 2 weeks respite in thsi siutaion, doesnt mean that she and her family dont need it

by edam

I'm bewildered because none of the examples Joblerone reports her sister moaning about seem that extreme to me, apart from standing in the bathroom all night. Lots of children who are unhappy soil themselves, too, doesn't make them monsters whose parents need respite. Obviously the sister isn't here to post her direct experience, but it's very odd.

Poor little boy has clearly had a very troubled life, with no-one to care for him. And now his dad and stepmother are interpreting everything, including perfectly normal behaviour such as losing his glasses, nor 'not putting his clothes in the wash', for heaven's sake, as pathological

At least I'm in good company, joblerone, she was bloody rude to you, too!

If 'best practice' in dealing with a child who has suffered from severe neglect is punishment and separation from the family, I'd hate to think what 'worst practice' is.

Oh Kristina, this thread is about me, or you, it's about this little boy! And plenty of other posters have said the specific examples the OP's sister reports are not that extreme - not putting the washing on has been mentioned several times, for instance!

I'm not disputing the diagnosis, I am saying the examples the step-mother is giving her family are bizarre and suggest she is interpreting EVERYTHING this child does as pathological.

joblerone - i understand that you find my views upsetting because they are diferent from yours and most ( if not all) of the other posters on the thread.

its easy to react at gut level without knowing much about this complicated disorder

you asked for information about RAD and i am suggesting that everything you have said about this family are very typical of thsi dx, in other words, its " normal"

i am not here to win an arguement - i feel full of admiration for your sister and had hoped that i coudl help you understand more so you coudl suport her and not criticise her

i see i have failed to do so and so i will bow out. i hope this family find the help they need to survive

Attachment Disorder.
Is that what we used to call 'starved of affection'?
I don't like 'attachment disorder' it seems to put the fault with the child. 'starved of affection' puts the blame on the parents/adults doing the starving.

I read a lot about attachment disorder before adopting my 2, and had a few sleepless nights about it too.

This little boy has had a troubled life, and the only thing that will help him is a strong, loving, therapeutic relationship with his new mother. If she can't cope, he never will. She is doing a brave and fantastic thing, and 10 months is very early days. You really have to trust her judgement together with the professionals who are treating him.

Children with attachment disorder are not like normal children - their brains are wired differently due to their early years experience, so even if some of the behaviours don't seem serious, the reason for doing it might be completely different.

I would really recommend you try to get hold of a copy of Dan Hughes "Building the Bonds of Attachment" - it's written as a story with a commentary but illustrates how children develop attachment problems through early neglect/abuse, and how they might be treated.

I'm sure it's not a decision taken lightly to leave him out of the holiday, and it's very sad, but he might actually do better in the familiar, structured environment of the respite carer than with too much excitement and change.

I've only skim read this thread but I have to say that this child must be exhibiting pretty strong behaviour to have been diagnosed with AD. My understanding is that iits bloody difficult to get a diagnosis and even more diffiuclt to get help.

Reactive attachment disorder is very very misunderstood by the general public and I have to say it seems by many on here. It is not about being cuddly or hugging a child etc. RAD is brain damage. Please be very clear about his in your mind Joblerone, this child has brain damage and the chances of being "cured" of serious RAD are minimal (I hesitate to say non-existant becuase I'm not sure if clinically that would be admitted), it is more a case of managing your life and the child to help them (and the rest of the family) to cope.

He isn't going to be made better or worse by a two week holiday away from them though I know that sounds harsh and it may give your sister a chance to refresh her batterries.

The dependance of a baby on a primary carer to supply it with food, warmth safety etc and the gradual realisation that if baby needs (ie cries) caregiver will provide = attachment. This attachment process helps lay down neural pathways in the brain with subsequently allow us to form "normal" relationships and have appropriate contact with other people. If there is no attachment happening then the pathways don't form properly and the brain is permanently damaged. There is a window of opporunity to correct attachement problmes but it is generally accepted that a child who has not attched properly by 2yrs is likely to have some degree of RAD. The degree is dependant on many things to do with the nature of the child and the degree of neglect most commonly.

Your sister may not be coping with this situation perfectly (eg threatening to wihtdraw the holiday if he doesnt behave) but in her shoes I wouldn't take any advice from someone who hasn't direct experience of the problem. I'm afraid that the only thing you can do is to be as supportive of your sister as you can - I expect that the more supported she feels (including this break) the most likely she is to have a half way decent attempt at dealing with these challenges.

My heart goes out to her (and him) it as one of my biggest fears that DS would have RAD.

cross posted with granny ther

Sorry my post is so long - I suspect that most adoptive parents will have a very different perspective to the majority.

Fipperty - no RAD is not "starved of affection" you can be raised by someone who shows minimal affection and provided they competnantly cared for you, you will attach fairly normally to them (even if you don't send them Xmas cards and no I'm not syaing you would not hve "issues" but you aren;t likely to be left brain damaged) RAD is normally caused by severe neglect - baby crying in pain/hinger/distress and not seen to. Not once or twice or over a few weeks nor probably even over a few months but years.

Not caused by with-holding affection but basic hiuman rights to food drink warmth safety.

Reactive Attachment Disorder and Its Treatment

The following information has been taken from "Adopting the Hurt Child", by Gregory C. Keck, PhD, and Regina Kupecky, LSW, Pinon Press, Colorado Springs, 1995.

The types of problems that adoptive parents see in their children are most likely the result of breaks in attachment that occur within the first three years. They are problems that impair, and even cripple, a child's ability to trust and bond - or attach - to other human beings.

These issues with attachment are the ones that cause the greatest problems in adopting a child with special needs. As adoptive parents attempt to attach to a child whose attachment ability is impaired by developmental delays, the attachment will either be nonexistent, distorted, or focused around negative behaviors.

Children who have suffered abuse or neglect severe enough to bring them into the foster care/adoption system may meet the diagnostic criteria for Reactive Attachment Disorder. This clinical diagnosis identifies children who have not been able to attach appropriately to a caregiver in a meaningful way.

We continue to hear complaints from adoptive parents that many mental health professionals blame them for their child's current problems. It is an unfortunate fact that many of those who attempt to provide treatment to adoptive parents with disturbed children know very little about issues related to adoption.

This is particularly alarming when we realize that they not only fail to provide effective therapy, but also solidify the child's existing pathology and complicate subsequent therapeutic efforts. It is not unusual for us to work with families who have seen four to six other mental health professionals without results.

Since many children who have experienced neglect, abuse, and abandonment have not yet developed an internalized set of values by which they judge themselves and others, they are not able to receive and experience empathy, nor can they develop insight.

They project blame onto others and onto objects. They blame their adoptive parents for causing their anger, and they blame toys for breaking. They blame things that could not possibly be responsible for anything!

Most often, children or adolescents who engage in projecting blame are those who have not yet developed a conscience. These same children are adept at engaging others in a superficial manner, thus therapists, teachers, and outsiders to the family feel that these children are easy to be around, and that they are truly misunderstood by those who should know them best -- their parents.

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