Advice please for aunt of adopted 6 yr old

I don't know, how bad are things for her I guess My son sure has a lot of RAD like behavior and we at his forever family are the only ones who get to see all the sides of it. I would at least try to keep up with them and be as supportive as I can. I RAD kid really should not be in a day care in most cases. If she does go to disrupt the adopt, you can apply to get him if it come to that and would have a really good chance. Maybe ask her is you could participate in therapy with him in her and not do the over nights but do things together with him. Let her know how much you care by supporting him. If what she said is true, then he really just maybe playing you---you would be amazed at how well these kids are at that. RAD is such a complex issue. The school system thinks my son does not have it, but is just retarded, but you should see the things he can do when he is not at school conning people (take a clock apart and put it back together, read all the instructions to a train set and put it together right, count and spend money correctly, etc....) When we are some places he acts just fine, at others he will start to walk like he has CP and slur his speech, and at other times and places he is a wise-cracking smart-elic, etc... I don't know, go figure. Good luck and do try to support your sister.

You're probably not going to like what I have to say, but I'm going to say it anyway. Children with RAD are abusive and with hold love from their mothers and appear sweet and loving to everyone else. If I were his mother, I would cut you out, too. Her son may have found you as an easy target. He can make himself look sweet and innocent to you and make his mother appear to be a monster. I'm betting she's a good mom. With RAD, the rules should be consistant, but the discipline should not. This prevents the child from controlling the rules. Triangulation of adults is a big issue with kids with RAD. They love the adults to be arguing and against each other because it takes the focus off of them where it belongs. I had a child who won the good citizenship award at school and everyone thought he was delightful and I was the mean mom. The child was busy setting fires, abusing his family, trying to kill us, and making a "hit list" of people who'd "wronged him". I'd bet this child's mother knows what she's doing. It's best to eliminate most adults while working with the healing of a RAD child. If the child is able to manipulate adults, he"ll just get sicker. Sorry, I know that's not the view you wanted, but in my opinion, it sounds like what's happenning.

Wow Lucy! Thank you! You said that all so well I didn't even feel the need to respond. I am only posting to agree with you 110%

Thanks for all your replies! I still think it's easy to label a child as a RAD kid when he isn't. My sister tends to blame things outside herself. My nephew isn't sweet with me and horrible to his mom. He's either sweet with both of us or horrible with both of us. With strangers he's usually at his worst, because he's insecure. He does well at day care because the woman who runs it is a very solid, nurturing person with a lot of experience handling children. She's taken care of him five days a week for two years. She says a lot of day cares won't take boys because they're so much more difficult than girls, and that my nephew is a high-energy, normal 6-yr old boy. I hate to see him labeled, and I hate to see him blamed. If I saw my sister handling him in the same way the daycare provider does and he wasn't bonding with her, then I'd say, okay, maybe it's RAD. But I see her doing things that would cause any child, even if he had been born to her, react negatively. I mean she's inconsistent, doesn't follow through, constantly changes plans, sets up lessons, then only takes him once in a while, is always late. She's corrected him so much he no longer listens to her. She 's lost her credibility. I don't mean to be facetious, but if you handled your dog that way, he wouldn't behave either. I've suggested parenting classes, and she says she's read some, but she does things haphazardly. On the other hand, she's wonderful at finding the best classes for him, the best schools. But she's also changed her mind at least five times about the schools. In the last 2 1/2 years she's lived in three different homes and owned three different cars. I like Rindava's advice to try to stay in touch, and being supportive. (I just find it hard to be supportive when she behaves the way she does.) She's threatened several times to give him up, and if she does, I'll try to adopt. Thanks again, and good luck with all your kids!

Still sounds like RAD to me. It's necessary for mom to be more strict and normal parenting doesn't work with RAD, although it probably works real well for the daycare provider because he doesn't have to have a real emotional connection to her. Hope everything works out well.

If your nephew has Reactive Attachment Disorder, certainly very possible given the history you outlined, then his behavior is typical...distancing Mom and making her look "cracy" while being sweet and charming with anyone with whom he has a superficial relationship. The best advice I can give you is to support your sister AND to suggest that since things are not improving, it is obvious that attachment-based parenting is not enough, so she should have her child evaluated and treated by a therapist who can effectively make a good differential diagnosis and provide treatment. You can find one in your region at [url]www.attach.org.[/url] Such a person will be able to determine whether the child has RAD, if other conditions are present, and whether there are parenting difficulties involved. Best regards,

I agree that RAD is way overdiagnosed, and is kinda a shaky concept. The two psychologists attached to my medical group looked over a thread I wrote on my own child in this forum, interviewed us both separately, and had both of us fill out a bunch of forms. Dx is she is actually pretty normal. The ifso here was that she was in serious need of counselling. On the other hand, you as an aunt have NO relationship in law to this child. Think of it as a divorce situation; if you want to have a relationship to the kid you are going to have to go through the parent, UNLESS you think that the parent is abusive enough to warrant calling social services. This doesn't sound like the case here.

"RAD is way overdiagnosed, and is kinda a shaky concept" It always confuses me that rad could be consider a "shaky concept" When a baby is born, it cries and a good mother meets its needs. (I've often heard mothers say they can tell a wet cry from a hungry cry etc.). When a neglected child cries, sometimes it gets hit, often times nothing happens at all and the child's need stays unmet. The baby with the good mother learns to trust that when he cries for mom, she comes.(trust is develop and the seed for cause and effect thinking is laid). The neglected child learns that the world is a scary place and he is on his own.(NO cause/effect or trust). The early brain connections are altered. Left alone and untreeted, these children will fail to develop a conscience or to feel empathy. Thus, they don't attach to anyone. The neglected child grows up and is often moved around to other caregivers. Thus learning everyone goes away. The children then feel like they have to be in control of everything and push away closeness in order to survive. MOM(anyone in that role) is the unsafest person in the world to them, so they attack there first. In my opinion, this all makes perfect sense. Many psycologists, who do not work with foster children on a continual basis, do not recognize attachment disorder or if they do, expect normal behavioral therapy to work. It doesn't. Normal therapy requires a patient to form a bond of trust with the psycologist. If a child is unable to do that, the therapy goes nowhere. The kids control the session.

Lucyjoy is quite right. Reactive Attachment Disorder is hardly a "shakey" concept. Attachment Theory forms the cornerstone of all credible infant mental health research and practice. Attachment theory has over fifty years of time-tested research with valid predictions supported by empirical research. RAD is most often under-diagnosed and misdiagnosed. I do find that some people have some knee-jerk aversion to the ideas, usually because of some negative experience. But it is important to not let such things color clear and helpful thinking or actions. Regards,

I posted most of this information before but the moderator apparently saw fit to delete it. It is true that kids with institutional syndrome have been known about for years, and have been effectively treated by such techniques as _Instrumental Enrichment_. Reuven Feurenstein is probably the single greatest authority on this subject; as most of the USEFUL work on institutional syndrome came out of Israeli work with child survivors of the Nazi death camps. Reactive Attachment Disorder on the other hand, was only DEFINED as a disorder in 1994, and there surprisingly little empirical research on the phenomenon. The descriptive criteria being used for diagnosis is extremely vague and the validity of the criteria used is considered questionable because there is so little systematic study on the subject. The most concerning consequence of the RAD diagnosis is the emergence of novel treatments that lack a sound theoretical basis or empirical support, and may potentially be traumatizing and dangerous to the child. Therefore the position of the American Psychiatric Association on this subject is as follows: I posted this information before but the moderator apparently saw fit to delete it. Reactive Attachment Disorder POSITION STATEMENT May 2002 "Reactive Attachment Disorder (RAD) is a complex psychiatric condition that affects a small number of children. Itis characterized by problems with the formation of emotional attachments to others that are present before age 5. A parent or a physician may first notice problems in attachment with the caregiver that ordinarily forms in the latterpart of the first year of the child's life. The child with RAD may appear detached, unresponsive, inhibited or reluctant to engage in age-appropriate social interactions. Alternatively, some children with RAD may be overly and inappropriately social or familiar, even with strangers. The social and emotional problems associated with RADmay persist as the child grows older.Children with RAD have had problems or severe disruptions in their early relationships. Many have beenphysically, emotionally or sexually abused. Others have experienced episodes of prolonged isolation or neglect. Some have had multiple or traumatic losses or changes in their primary caregiver.Children who exhibit signs of RAD need a comprehensive psychiatric assessment. Particular care must be taken to distinguish RAD from one of the Pervasive Development Disorders, such as Autistic Disorder. These conditions are known to be neurodevelopmental in origin and are not caused by problems in early parenting.Children with RAD will benefit most from an individualized treatment plan that will usually include work with the child's family to help them foster an attachment to their child. Except when complicating factors arise, hospitalization is generally contraindicated since the treatment goal is fostering an attachment between child andparent.While some therapists have advocated the use of so-called coercive holding therapies and/or "re-birthingtechniques", there is no scientific evidence to support the effectiveness of such interventions. In fact, there is a strong clinical consensus that coercive therapies are contraindicated in this disorder. And unfortunately, as recent events attest, such unproven and unconventional therapies can also have tragic consequences.Parents and caregivers of children who show signs or symptoms of RAD should:*seek a comprehensive evaluation by an appropriately trained, qualified and experienced mental health professional prior to the initiation of any treatment plan,*ask questions about the results of the evaluation,*make sure they understand in detail the risks as well as the potential benefits of any intervention, and*feel free to seek a second opinion if they have questions or concerns. Evaluating and treating children with complex child psychiatric conditions such as Reactive Attachment Disorder is challenging. There are no simple solutions or magic answers. However, close and ongoing collaboration betweenthe child's family and the treatment team will increase the likelihood of a successful outcome. The DSM-IV criteria for RAD are as follows: Reactive Attachment Disorder DSM-IV (313.89, p. 116) A markedly disturbed and developmentally inappropriate social relatedness in most contexts, beginning before age five, as evidenced by either: Inhibited Type: persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions, as manifest by excessively inhibited, hypervigilant, or highly ambivalent and contradictory responses (e.g. responds to caregivers with approach, avoidance, and resistance to comforting, or frozen watchfulness); or Disinhibted Type: diffuse attachment as manifest by indiscriminate sociability with marked inability to exhibit appropriate selective attachments (e.g. excessive familiarity with relative strangers or lack of selectability of attachment figures). Experts in the field of attachment make reference to particular characteristics, or symptoms found in children with RAD. They are as follows: 1. Superficially charming; uses cuteness to get his/her own way. 2. Cruel to animals/people. 3. Fascinated by fire/death/blood/gore. 4. Severe need for control over adults or even minute situations. 5. Manipulative -- plays adults against each other. 6. Difficulty in making eye-contact. 7. Overly affectionate to strangers. 8. Bossy. 9. Shows no remorse -- seems to have no conscience. 10. Lies and steals. 11. Has difficulty making and keeping friends. 12. Speech and language problems. 13. Overall developmental delay. 14. Demanding/clingy. 15. Incessant chattering/non-stop question asking. 16. Hoards/sneaks/stuffs food. 17. Emotions don't match the situation and are unpredictable. 18. Overly sensitive to sights/sounds/touch/smells. 19. Exhibits hyperactivity. 20. Exhibits impulsivity. 21. Dysregulated eating/sleeping/toileting patterns. Many children exhibit some of the above behaviors, but it is the intensity, frequency, and combination of behaviors that separates out children who have attachment issues. There are no standardized measures of attachment, but many use either Jane Ainsworths Strange Situation Assessment or E. WaterҒs Q-Sort. A good review article on this subject is Hanson RF, Spratt EG. _Reactive Attachment Disorder: what we know about the disorder and implications for treatment._ Child Maltreat. 2000 May;5(2):137-45. You can get it from the National Library of Medicine at [url]www.pubmed.com[/url]

"and there surprisingly little empirical research on the phenomenon. The descriptive criteria being used for diagnosis is extremely vague and the validity of the criteria used is considered questionable because there is so little systematic study on the subject." If you would like to study RAD and gather empirical evidence, I have a child you are more than welcome to! He has all but two of the 21 chararistics. his behaviors are severe and constant. The two he lacks are speech and language problems, and developmental delay. ( unless you consider his social interactions deficits, but I belive they fit in elsewhere on the checklist) "The descriptive criteria being used for diagnosis is extremely vague " All I can say is...symptoms are not vague when you live with a RAD child. Proven treatment...well...I have yet to find it.

Thanks, Ramani, for all the good information. I have to say I'm a little surprised at the vehemence with which some of the responses attacked any questioning of a diagnosis of RAD. It seems like some people have a lot invested in it. What bothers me is that it's so easy to label a child, with this or any other disorder. The child is adopted and having bonding problems; it must be RAD. I see my nephew wanting to trust my sister, and my sister having such a hard time with parenting that it's just about impossible. She doesn't do such a good job of bonding, herself, either. But it's easier and less humiliating for her to say it's his problem. I feel for her, but she's an adult; she can protect herself. A child from an orphanage is reasonable, in my view, to be careful about who he bonds with. Children born to their parents don't have a choice; they bond with their parents even if the parents are psychopaths. Adopted children feel they have a choice. Their trust has to be earned. Also, it seems to me that if an adoptive parent cares about the child, and he's not bonding with the parent, the parent needs to make sure the child bonds with someone else, so that he has the experience of loving someone and being loved. Forget what the reason for not bonding with the parent is; if he's able to bond naturally with someone else, he should be allowed to do so. Forcing a child to bond with the parent by isolating him, essentially in a hostage situation, if that parent has problems, could destroy the child's ability to ever trust anyone, or worse, cause him to mistrust himself. Thanks, again, Ramani, for the information. I'm going to e-mail it to my sister and hope she reads it. I'm so glad you seem to have found a solution for your child!

Things are not always what they seem. You may be right about your sister's situation, but there is a chance you may be wrong. I would suggest that you listen with an open mind to your sister and check her info with professionals. I have spent the last year of my life with friends and family criticizing me, treating me like I was crazy and that I was a bad parent. Come to find out, my child was officially diagnosed with RAD and we are now in therapy with him. The therapist has reassurred me that all my thoughts were right on target and that family and friends were "dead wrong." The damage that my friends and family have caused me and my husband with their criticism is almost unbearable. It haunts us, even now that they are starting to understand. The sad part about this is that all of the hurt has only caused my son more pain, because he ends up being the one to suffer if his parents are put down to the point that we are bitter and exhausted. Lukily we were smart enough to remove ourselves from a bad situation. We left our dream home and pulled our children from a good school to find a place where we could get the support we needed to help our child heal. Just be careful!! This is a very complex disorder!!

All advice about letting the child bond with the parents first, and initially excluding other relatives, and extra outings, can and should be applied to any older child adoptee first entering a new home environment. The first 6 months my daughter was home, everyone else thought she was an angel, she saved the flipside for me at home.

It is vital that parents not avoid facts or be lulled by misinformation. Children do not "choose" to bond or attach. It is a biologically driven process. Children do not "bond" to psychopaths. The research eveidence is clear, a maltreating parent, one whose on state of mind with respect to attachment is "disorganized" (as measured by the Adult Attachment Interview, Mary Main, et. al) will have a child who has a disorganized attachment (most often diagnosed as RAD). Many parents who are borderline personality disorder will have such children and even parents who are healthy and sound, but have a child who has had significant painful illness in infancy and spent significant time in NICU. Effective Treatment for RAD has been in existence for over Thirty years. So, I can only conclude that R is misinformed. As I said in a previous post, if you've had some bad experience with treating a child with RAD, I am sorry for you and your family, R, but the fact remains that there is effective treatment, that it is a diagnosis that has been around for many years, and there there are quite reliable ways to measure attachment and RAD. It is important that parents not ignore or be put off by wrong information as this is only prolong your difficulties and lenghen the time it takes to get the proper help for your child. RAD tends to be underdiagnosed as most mental health clinicians are not trained in this and so are not aware of it. Over 80% of the children we treat had many previous diagnoses of things like ADHD, ADD, ODD, etc. etc. This makes is somewhat understandable when you consider that only 1 to 2 % of the population is adopted and betwen 50 and 80% of maltreated infants and abused/neglected children (who make up the vast majority of children in US foster care) have sympmtoms of attachment disorder (according to two well done studies). Over 80% recieved over three previous episodes of treatment (most of which was by competant therapists who delivered good treatment), but with no effect because the only effective treatment for RAD is attachment based treatment, such as Dyadic Developmental Psychotherapy. Once these children recieved proper treatment, they responeded quite well and for over 90% there was positive clinical and statistically significant improvements in all symptoms. Too many parents are misdirected and then are burned out by the time they finally get to the right place. As the parent respones to this threat show, the condition is real and there are real treatments. Susan, I hope you take the message of the real parents who've had real experience, and accept your sister's understanding...and encourge her to get a good assessment and treatment for a therapist who can help (see [url]www.attach.org[/url] for the names of some good therapists). regards