Attachment disorder - is this treatment reasonable? (Long)

[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. I have read some AD websites that actually warn against the overuse of auxillary services, but feel unqualified to comment. What do people think?

I have a friend whos adopted daughter also suffers with AD, and from conversations i have had with her about her DDs condition i can honestly say that i agree with totally.

Any child would feel rejected if the rest of their family went on holiday without them. The will obviously just add to this little boys problems. How on earth is he ment to feel wanted, if they intend not include him. Im amazed that (whoever funds the repite) have agreed to let her do this.

Thanks, twocute, I'm amazed too. Is there anyone else with experience of attachment disorder who can comment?

joblerone1,

It might be a good idea to post this on the adoption board. I remember my friend saying that AD is something that quite a few adopted children can suffer from.

I know that it can be an extremly complexed condition that can lead to a whole host of problems if not handled correctly. Including various mental heath issues.

Hi,

Sorry for being so late in to this one.

If you, as a teacher think this is "normal" then i would tend to go with your feelings.

As for sending him away when the familly are on holiday, thats a really dodgy one. What sort of message is that sending him?

Of course there is respite and respite. If he was booked on to some sort of activity holiday that he viewed as special to him that would be one thing.

If he was viewing it as being dumped whilst everyone else went off on a jolly then the feelings of rejection would be natural and understandable.

The thing is with attachment disorder is that there is a whole industry out there around it that will tell you it is a condition with characteristics as well understood and a physically based as meazles.

It is not quite that simple.

If the young mans behaviour is out of control suggest your sister gets an American book.

"Try and make me" by Bill O'Hanlon. Not dear and an easy read.

I have found it a great help managing childrens behaviour and a numer of others likewise.

The chapter on use of physical pindown should be ignored though.

HTH

Thanks, Tailies. The holiday is to the caravan we all use, all the kids love it including my nephew. He will know they are there without him.

Not good then!!!

You would feel rejected yourself never mind if you were 7 and possibly a bit confused by a lot of change in your life.

I know absolutely bog all about attachment disorder.

What does strike me though is this is a clear case of the needs of 2 sets of kids being in direct conflict. If the stepson is so very difficult to live with they must have been having a bad time recently and I suspect this is as much (or more) about respite for them as respite for your sister. But if respite for them will be taken as rejection for him and that would make him worse...

Is there some compromise? How long can your parents cope with him for? If everyone went to the caravan for a week, and then he got to have a week's "special" holiday with granny and grandad, would that work? Or if your parents can't cope maybe a week all together and a week in respite would still be better because then he wouldn't be rejected, he'd just get a shorter holiday.

Of course, this is assuming the caravan is in the UK and such a swap is practicable. I have to say I can't imagine taking a child who wets/soils to a caravan so I don't know how practicable that is.

Re: how far his behaviour is "normal" - that's another tricky one. It's commonplace for people without SN kids to tell you "oh, yes, little Billy does that, it's normal" when of course little Billy may do that - but he doesn't do it for 6 hours on end every night or in completely inappropriate circumstances or putting his own life in danger or whatever. Many SN behaviours are normal on paper and you have to live with them to see how they are qualitatively different. Of course I can't say whether that is the case here, but don't be surprised if she is a bit short about it. Well-meaning suggestions that the child is more "normal" than the parent thinks are intended to be helpful but often come across as undermining. That sounds like I'm having a go - really not, I'm just saying if she is grumpy, cut her a bit of slack, she probably isn't in the right place to hear it the way you are saying it.

I'm in a similar situation with a child who we have been told has an attachment disorder.
When he first came into our house it was complete hell for months and months...screaming, shouting, swearing, mega tantrums, destroying toys, hurting other children.
He took up 99% of my attention night and day.
In the end i kept a log of behaviour, put in very firm boundaries and stuck to routines as if i had aspergers, praised, praised and more praise. Felt like i had a fixed permenent smile (probably did from clenching my teeth together)I desperately tried not to be drawn into negative behaviour...i didn't always suceed!
School said he would never have friends, was too difficult to deal with in the clasroom was destructive and constantly seeking attention.In factthey excluded him several times.
We worked together on the routines,backed eachother up, targeted one behaviour at a time.
5years later we still desperately need time away from him as a family and we are lucky he can go to grans but we have never not taken him on holiday with us.
However all the other children in our family have at one time or another expressed a strong desire to be on holiday without him.
He is much nicer to be around now and has matured considerably but i do wonder at what cost

It might be worth mentioning that many children diagnosed with attachment disorder by one clinician would be diagnosed with an autistic spectrum disorder by another. Many of the observed behaviours can be very similar. The management of the child's behaviour and expectations of their treatment would vary massively according to diagnosis.

Thank you for your replies, they are very helpful.

eclipse thanks, will post it there.
r3dh3d 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.

www.portsmouthcf.org.uk/data/professionals/guidelines_att_disorders.pdf

is a really helpful site, as is the Oassis site.

I totally understand needing a break from a child with AD. My son is 11 and has just been diagnosed, much to our relief, his symptoms tick all the boxes.

M was so controlling and unable to cope with change that his behaviour was and still is a 24/7 challenge. The before, during and after of every holiday was a nightmare as it presented him with more change than he could cope with.

He hasn't been able to bond with us as his adoptive parents very easily, and he is not a child who we find easy to love.

Knowing more now about AD, I understand that he feels so negative and chaotic about himself that that is how he behaves.

We are not sure if we will ever get beyond the constant lies, stealing, cheating, manipulating, controlling, playing adults against each other, working the home/school situation, soiling, aggression etc, but my gut instinct is that regardless of all of that, he has had so much change and instability in his life that he deserves a crack at having some positive family time. We occasionally get a glimpse of that after 6 disastrous years and just as many holidays. And he is finally starting to build up happier memories.

We now have excellent support from CAMHS and are looking forward to the challenges of moving into secondary school...more change...more people to 'work'! Any advice very welcome!