Tuesday, January 14, 2014

Attachment Tuesday

Another good/long article on RAD is below (and here is the link).  This is written to the teacher of RAD child but also applies to those of us parenting these challenging kiddos.

I especially relate to and appreciate the following quote:  "Just at the point when the teacher (or parent) thinks he/she has developed a relationship, out of the blue the child may go and do something very damaging or hurtful."  So true.

Our good moments are follow by especially challenging moments.

When Lexa has fun, she will always ruin the next activity.

It is a roller coaster of normal followed by behavioral extremes.  Not the fun type of roller coaster you hope to go on with your kids.  Unfortunately, there is no appealing way off the ride.

I have highlighted some of my favorite points.

-------------------


 Strategies for Classroom Teachers 
Of Students with Reactive Attachment Disorder 

As a teacher, you may have had the opportunity to work with children who are quite damaged emotionally. Many teachers have had the experience of working hard to develop a sense of trust with such a child. Just at the point when the teacher thinks he/she has developed a relationship, out of the blue the child may go and do something very damaging or hurtful. The teacher may feel both hurt and mystified by this seemingly calculated attempt to sabotage the trust relationship. From the perspective of the child, though, this makes perfect sense, because this is a child who learned in the beginning years of life that as soon as you trust or care about someone, that person will then hurt you very badly. Children like this have come to associate trust or care with vulnerability and pain, and they will make sure to put anyone at a distance when they feel that they are getting too close. This is the central characteristic of Reactive Attachment Disorder. 

Reactive Attachment Disorder is usually associated with some form of abuse or neglect in the first two to three years of life. This normally involves physical or emotional abuse, abandonment, a drug-addicted caregiver, a sequence of foster placements, or similar emotional trauma. In some cases, children may have symptoms of an attachment disorder if they have experienced divorce, long periods of hospitalization, a parent with chronic depression, or if their brains were altered by the mother's substance abuse. The most common factor for children with attachment disorders is that in the critical first years of life, either the child did not have the opportunity to bond emotionally with any single individual and maintain that bond, or the child did experience an emotional attachment and then was separated from the caregiver. 

A key logical formula that often plays inside this child's head is this: 
1. I like getting attention. Getting people to respond to me feels good. 
2. If people are responding to me, I feel in control, and that feels good too. 
3. It's hard to get attention and to get people to respond to me when I'm just sitting somewhere being good. 
4. It's really easy to get attention if I can get people mad at me. 
5. When I can make people lose it, then I'm in control and that feels good. 
6. That negative attention is much more high-voltage attention than the positive attention and it's more exciting. 
7. The best way for me to get attention (and get my adrenalin fix) is to create a crisis, so everyone is reacting to me. 

This is the kind of child that will keep you up at night; the kind that will enter the most unpleasant of your "teacher-dreams". Learning how to work with this child may be essential to your own personal health and the continuance of your career in education. 
Symptoms/Indicators 
Aggression 
Anger 
Attendance – may miss a lot of school 
Behaviour – outwardly charming 
Behaviour – inappropriate demanding and clingy behaviour 
Behaviour – will have problems with those closest to him/her 
Behaviour – hurtful actions, violence, cruelty, fire setting, vandalism 
Behaviour – oppositional and defiant 
Behaviour – stealing/theft 
Behaviour – threatening others 
Behaviour - lying – especially lying when the truth is clearly obvious to all 
Cause and effect thinking – impaired 
Conscience – a lack of conscience 
Control – acute need to control people and situations 
Emotional – inability to form relationships 
Emotional – inability to trust 
Empathy – lacking 
Eye contact – may have difficulty with eye contact 
Hyperactivity 
Impulsivity 
Manipulativeness – pits one person against another, pushes people's buttons 
Preoccupation with blood, gore and violence 
Sexual development – may act out sexually, use sex for manipulation 
Social skills – can be very charming, especially with strangers 
Verbal – persistent chatter and nonsense questions 

Accommodations/Interventions 
Keep in constant contact with the parent(s) or caregivers. This child can very effectively play a game of "victim, persecutor, and rescuer", in which the child as victim will pit one person off against another. It may involve telling you about bad things about the parent, or telling the parent bad things about you. This kind of triangle game can put teachers, aides, classmates, parents, principals, and anyone else in either the persecutor  or rescuer role to suit the child's needs. The child, however, will always have the victim role. If the child accuses anyone of anything, check it out with that person first before saying or doing anything. 

• An agenda book or day planner is not a recommended way of communicating with the parent(s) of this child. Communicate directly by phone, in person, or by email, so the messages are not being filtered or manipulated by the child. 
• This student will often try to start power struggles over assignments, homework, directions, or any number of things. Don't let yourself be taken there. 
• A structured environment with extremely consistent rules is a must. 
• Avoid demonstrations of affection with this child. You will be forcing the child to hurt you. 
• Since this child will need a sense of control, you can provide him/her with choices, but the choices will be provided by you, the teacher. The child must know that you are the one in charge at school. 
• Getting you to lose your temper will be a major goal for this child. No matter how cruel he/she has been, or how hurt or angry you are, maintain the clinical distance and stay in control of yourself. If you are not in control of yourself, then it is the child who is in control of you. 
• The child may test you by calling you by your first name, trying to talk about your family or personal life, or pointing out things that you may be self conscious about. The best response is calm and firm direct instruction. Teach, and be prepared to re-teach again what is right and wrong, appropriate and inappropriate for a student to say. 
• Above all, maintain your boundaries. Keep a professional relationship and avoid any actions that would create any sense of friendship or intimacy with this child. The parents will be trying very hard at home to fulfill this role in the child's life, and they need to be the only ones in that role at this time. 
• Communicate directly, positively, and firmly, and use eye contact when talking with this child. 
• A behaviour rewards program will likely fail painfully with this child. Use logical consequences instead, so if the child has flushed his/her mitts down the toilet, no mitts will be provided for him/her at recess. The child will either have to go without, or if the weather is too cold, stay in at recess. 
• Cause and effect thinking is impaired with these students. Therefore, you need to use direct instruction to teach what you may think is painfully obvious to everyone. Remember that it is not obvious to this child. You will have to state directly to the child what will happen as a result of each action the child may try, for example, "If a person stabs someone else with a pencil, then X will happen." 
• When teaching and implementing consequences you must avoid any signs of anger or frustration and keep the interaction unemotional and either neutral or positive in tone. For example, you might say, "If you can finish this work before the bell, then you can go out for recess. If you can't, you can have whatever recess time you need to get it finished." 
• When teaching consequences, state the positive alternative first. 
• When implementing consequences, remain unemotional and assume a tone that says, effectively, "That's just the way business is done – nothing personal." An example of this is to say, "It's too bad that you got in that fight with Alison. That means that you'll need to stay in at recess time." Make it as much like a simple business transaction as possible. 
• When giving positive feedback, always focus on a measurable achievement, for example, a good drawing, a neat assignment, or a trouble-free group interaction. Avoid any generic compliments like, "You're a good kid." 
• If the child is going to have a physical meltdown in your classroom, speak calmly and provide the choices and consequences. "If you want, you can go to the Counsellor's office and take a few minutes to get relaxed. If you don't want to do that, and you decide to 'lose it' here, you know that I'll have to call in the crisis team to help you get settled. Take a minute and see what you'd like to do." 
• These kids may see getting 'kicked out' as a reward and a sign that they are in control. Avoid time-outs as a disciplinary strategy. If the child is disruptive, get in direct contact and use the opportunity for direct instruction on how to do the activity correctly and appropriately. Again, maintain the professional teacher stance. When you meet resistance on this, provide the student with choices and consequences. Remember that the first choice mentioned, and the one with the most positive consequences, should be to remain here and do the task as requested. 
• If the child complains about his/her mean parents, take a matter-of-fact and businesslike approach. Tell the child that he/she will have to discuss this matter with the parent(s) and work it out with them. You cannot get involved in conflicts at home. Once this discussion is finished, contact the parent(s) and give them a heads-up about the conversation and particularly about what it was that you said to the child. Remember that the child may go home and claim to the parent(s) that you said many different things. 
• Don't allow a situation to occur in which you and the child are alone. You may be setting yourself up for an allegation of abuse. 
• This child will only work with someone that he/she respects, and he/she will not respect any person that he/she can manipulate. If you are going to work with this child, you must never let yourself be manipulated into losing control of your temper or your professionalism, no matter what. 
• Remember that whatever frustrations you are experiencing at school are quite small when compared to what the parent(s) are experiencing at home. Try to give this student's parent(s) or caregiver(s) every possible break you can. 



Recommended Resources 
Association for the Treatment and Training in the Attachment of Children. 
http://www.attach.org/ 
Attachment Center West: Fact Sheet for Educators. 
http://www.attachmentcenterwest.com/for_educators.shtml 
Brady, Stacy. Helping Students with Attachment Disorder: A Complex Situation for Families and Teachers. The University of Maine Center for Community Inclusion and Disability Studies. 
www.ccids.umaine.edu/resources/facts/facts6_2/attachment.htm 
Nancy Thomas – Families by Design: Teachers. 
www.nancythomasparenting.com/ArticlesTeachers.htm 
RadKid.Org – An Overview of Reactive Attachment Disorder for Teachers. 
http://www.center4familydevelop.com/helpteachrad.htm 
This factsheet for educators has been prepared in the Faculty of Education at Brandon University with the contributions of students in our Bachelor of Education program and working teachers in the field. We hope you find this helpful in your professional practice. To make this a living and growing resource, we encourage you to send suggestions, comments, and ideas on strategies you have found effective, or resources you have found helpful to Dr. Cam Symons at symonsc@brandonu.ca
Disclaimer 
This factsheet is intended to provide information only, not to diagnose or propose specific treatment options. It is not intended to replace consultation with your student support team and other relevant professionals. While care has been taken in preparing and assembling the information on this factsheet, Brandon University and its Faculty of Education make no representations, and do not warrant or guarantee the accuracy completeness, currency or usefulness of any of the information or recommended resources, and disclaim any and all express, implied or statutory warranties and conditions regarding the information provided including, without limitation, any and all warranties that the information is accurate and up-to-date. In no event will the Faculty of Education, Brandon University, or those persons involved in compiling this information be liable for any damages of any kind, howsoever caused, resulting from the use of this information including, without limitation, for any error or misstatement that may exist on this factsheet. Links to recommended resources are provided solely for the convenience of readers and do not constitute an endorsement of those resources and do not constitute any representation as to the accuracy, completeness, currency or usefulness of the information supplied by them. Any user of this factsheet may reproduce and distribute this factsheet for free distribution to colleagues, provided that Brandon University is acknowledged as the source on all reproductions and copies of the factsheet. Care has been taken to provide proper acknowledgement of original sources and to comply with copyright law. If cases are identified where this has not been done please notify Dr. Cam Symons at symonsc@brandonu.ca