FASD-RAD dx
These are the diagnoses of the little I am hoping to adopt (if ICPC goes through). I know a little about each one separately, has anyone dealt with these issues together?
I am sure several people will reply. I don't have direct in-house experience but I have a friend who had a placement with FASD and RAD and she ended up disrupting. He was VERY VERY delayed and very hard to soothe and attach. He was tantruming all of the time and believe me she was extremely therapeutic toward him, he just was a very tough case. She has his two younger sisters and worked hard to preserve the placement, but it wasn't going to work.

This may not be the case for your little one... but I know she had a terrible time with him.

He was moved to an only child home the mother is a therapist, the father is a special education teacher, and I know is he doing VERY well there.

Best wishes to you in your journey! We're all here if you need us!
My DD has FAS and RAD. She is significantly behind in school and struggles with communication. She also has PDD(mild autism).

It is difficult because she has RAD and also learning delays so she is a double whammy. She struggles to understand what we are saying and communicate and that just makes her attachment tougher and it tougher for us to get through to her.

It isn't impossible depending on the severity of the FAS and RAD, but it definitely will be a tough road. Make sure you have a lot of help and resources if you move forward.

Good Luck.
One of mine is probable FASD (we don't have written documentation from Biological mom re: if she drank during pregnancy, so were told they won't consider FASD....) and for whom we did get a dx of RAD. Tough, tough, tough. Whatever you think you know, throw it out the window, go put on thumb screws, and try to function normally through the day. That should give you a taste of parenting a child with an emotional trauma and a brain trauma.

Then, the next day, put thumb screws on your hands, and feet, too, and try to get through a normal day. That's how the CHILD feels.

I found that once we got the sensory integration component understood (we had more than 'just' attachment and FASD) it helped. It was difficult to get through to the attachment because the FASD hampered comprehension and understanding - compounded by tactile defensiveness (the SI that we were trying to deal with). Our kiddo was young (2.5 yo) and so we were able to do a lot of attachment stuff like rocking and using a sippy cup, lots of one-on-one time and cuddling.

This child is happy and attached now, but still struggles with some daily function stuff, likely due to FASD, and residual problems from neglect. (Neglect isn't an emotional OR physical abuse, it's totally and completely both, with roots that go deep and probably never go away.) It took us about 4 or 5 years to reach a place where life wasn't totally consumed by this child alone. Multiple daily tantrums that lasted a couple of hours each. Total line of sight supervision, 24/7. Day care would have been totally out of the question, and in fact is one reason this child was matched with our family. This child can now function in a room with peers, but that would not have been possible before about age 7 or so. Between his inability to tolerate touch (dysfunction of sensory integration issue), his OCD tendencies, his intolerance of any changes in the routine (ANY change brought about a meltdown - we're talking minutest change), and his need for total supervision would just have not worked in a traditional daycare/classroom setting.

It looks like this little one is 3 yo? You will likely be in for many, many years of trying to parent a child who will try you to your breaking point. My kiddo needed almost total parental involvement for every waking moment (and some sleeping). I had one other child at the time and that child did get short changed. If you have more kids, consider long and hard what time you have available for this child. If you don't have other children, consider how much time you have to devote daily. Young children need constant attention; children with attachment issues require more than constant attention. FASD brings about complexities due to brain processing differences, so when you put them together it can become...interesting.
I totally agree with Barksum!!

I have two children with RAD and FAS. (One of which also has SI and knowing that helps a lot.) These two also have PTSD because not only were they neglected but then for three months before coming to me were tortured by some drug addicts. These kids are amazing at how strong they are, but they still have a long way to go. The younger one was 17m at placement so he has come so far from his RAD dx. My other one was 4 at placement and now at 8 is better but it is still daily. The meeting and appointments are alone enough to make you crazy, then adapting a therapeutic parenting style you can get worn out really fast.
Read as much as you can, and try to determine where on the spectrum of RAD do they fall, if it is on the higher end, know that you will be entering into an abusive relationship. It can get better for some, but unfortunately not all.
Thank you for your candor. Yes, the little is 3. Unfortunately his foster parents currently are already burnt out. There are other children in the home, but I feel as if they are trying to skirt around the issues with him. I get a lot of " but he has the loving type of RAD His attachments issues are he attaches quickly he will be fine". I have no other children, a large reason we were matched with the little... we want no other children right now either. My concern is the FAS issues with comprehension and cause and effect mixed with RAD... especially disinhibited. Also he has other genetic issues going on so I am cautiously excited. If the ICPC goes through I imagine I will be asking for loads of help. Thank you again for being so honest, I will need that from someone Smile.
akg1229 said...
I get a lot of " but he has the loving type of RAD His attachments issues are he attaches quickly he will be fine". I have no other children, a large reason we were matched with the little... we want no other children right now either. My concern is the FAS issues with comprehension and cause and effect mixed with RAD... especially disinhibited. Also he has other genetic issues going on so I am cautiously excited.


One RADlet can burn parents out quickly.

A child with disinhibited attachment is NOT attaching quickly. He's not attaching. Period. He's surface shopping for the adult who will best meet his demands at the current point in time. This is very dangerous, on various levels, for various reasons. Kids with RAD will say and do whatever it takes to control their environment. The closer to feeling emotional attachment to their main caregiver that they get, the more fearful they become, and the harder they work to control the environment.

When you compound this with the fetal alcohol issues, which often includes lack of stranger awareness, lack of ability to predict outcomes, being able to Say The Rule, but not Do The Rule, etc. etc., this child is going to need constant supervision.

Now, having said all that...RAD and FASD have an almost 100% overlap in symptoms. It has been difficult for me to differentiate between RAD/attachment motivated behaviors, and FASD driven behaviors. One is purposeful, in order to gain control (RAD), while the other is because the world is perceived and processed in an entirely different way than the neurotypical person (FASD). Many times (most?) with FASD it isn't that they WON'T do something, but rather that they CAN'T. What often looks like rebellion to someone watching some of my kids is their way of saying, "Wait. I don't understand what you want me to do, and I don't know how to do it." They just would never actually SAY that, so their behavior speaks for them. -- And no, this is NOT an excuse to get away with behaving poorly! They don't get away with that, but I do often word things so that I know they understand, and start the project with them, actually helping them to get started, because they can not do this themselves.

There's something about RAD that you can recognize (often), whereas with FASD I still don't get it, exactly, but I know that if I give a direction, "Hang up your coat", I have to stop what I'm doing and make it happen because between my saying to 'hang up your coat' and their hearing is a gap, and then there's a gap between them understanding that they need to hang up their coat and actually doing it. So it takes lots of direct supervision. :D
akg1229 said...
I get a lot of " but he has the loving type of RAD His attachments issues are he attaches quickly he will be fine". I have no other children, a large reason we were matched with the little... we want no other children right now either. My concern is the FAS issues with comprehension and cause and effect mixed with RAD... especially disinhibited. Also he has other genetic issues going on so I am cautiously excited. If the ICPC goes through I imagine I will be asking for loads of help. Thank you again for being so honest, I will need that from someone Smile.


"loving type of RAD" "attaches quickly" -- Oh. My. Gawd. I can't believe someone said that to you. Without the FASD (I think), I had a child like that, 3, almost 4 on arrival. Would go up to 5 different adults on the playground in one visit to take food or toys from them. That is *not* attaching -- as you obviously know. The fact that he would be the only child in your home is a very good factor. Gives you the ability to create a therapeutic environment just for him. Your saying "disinhibited" is a good sign; it's accurate vs "loving type RAD".

Help you will need, in my experience: at least 2-3 people who you can call at the end of the night when you wanted to wallpaper him, and have them listen and be compassionate. Good advice would be a bonus. One needs to reset every day to start fresh the next day with RAD, venting helps. You will need a rocking chair or two, I had one in living room and one by child's bed. Greatest chance of success is stay-at-home parent. At least 6 months - 2 years. At least.

May I suggest anything by Daniel Hughes. He and his therapy are the real deal, most sophisticated for RAD/ PTSD / foster / former orphanage children I've seen in the USA. "PLACE" = his acronym for the attitude needed to heal these children at home. (Playfulness, Love, Acceptance, Curiousity, Empathy). Start with: Building the Bonds of Attachment: Awakening Love in Deeply Troubled Children. Find the nearest therapist who's trained in his modality: Dyadic Developmental Psychotherapy. [url=http://www.dyadicdevelopmentalpsychotherapy.org/]Dyadic Developmental Psychotherapy Institute[/url] Good articles there, too.

Second: Kate Cairns: Attachment, Trauma and Resilience: Therapeutic Caring for Children. From the UK. Fostered many w/ DH. Incredible book. (Good price at Amazon now.) She has charts of things to do to help children. Invaluable.

Read Peter A. Levine to understand the trauma dynamic in both body and mind. Isn't this a gorgeous title: Trauma Through a Child's Eyes: Awakening the Ordinary Miracle of Healing by Peter A. Levine & Maggie Kline.

FASD children can be bright. Many variations on the theme. If you get this child, and he starts to heal, he will experience joy -- a miracle to see. Validation for all your hard work, and there will be more than you can imagine. Worth it.
There is no such thing as a loving type of RAD. The quick attachment they see is fake. It's not real attachment. It might be the anxious kind where the kid will freak out when you leave thier sight, but it's not a true attachment, even with a healthy kid true attachment takes time.
Yahoo group
This is not something we deal with, but there is a very active Yahoo! list serve group specifically for this: [FONT='Calibri','sans-serif'][url=http://groups.yahoo.com/group/RAD_FASDkids]RAD_FASDkids : RAD_FASDkids[/url][/FONT]
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[FONT='Calibri','sans-serif']Mary[/FONT]
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