e Attachment Disorder and Ending the Cycle of Violence Tabitha D. MooneyCJUS 400-D01Liberty University OnlineAbstract Reactive Attachment Disorder (RAD) in children is caused by a gross amount a negligence by their parents or their primary caregivers. This can be a result of the parents or caregivers dealing with their own mental health issues, substance abuse problems, or incarceration. The parents have often faced mental, physical, or sexual abuse of their own. They may not have had the help they needed to recover or come to terms with the abuse.
RAD children are then forced to endure the same neglect their parents or caregivers faced thus continuing the cycle of violence. Often the children are removed from the abusive home and placed into foster care or adopted. The symptoms of RAD normally show themselves after the child is adopted or put into foster care. This can cause serious issues with the adoptive family. The issues that arise can exacerbate the symptoms of RAD which makes it even harder for a healthcare official to diagnose and effectively treat.
When the RAD child is left untreated they then head down the path of antisocial and criminal behavior. The families of RAD children need more options and caregivers and law enforcement officers that are educated on RAD. Only then will the cycle of violence be broken. Keywords: Reactive Attachment Disorder (RAD)Reactive Attachment Disorder and Ending the Cycle of Violence How does the cycle of violence relate to Reactive Attachment Disorder (RAD)? Reactive Attachment Disorder (RAD) is a condition found in children who may have received grossly negligent care and did not form a healthy emotional attachment with their primary caregivers ” usually their mothers- before age five ( Do children with RAD continue the abuse that they were subjected to or does the violence and neglect end with them? Can RAD children be treated and rehabilitated? Can RAD children go on to lead healthy and productive lifestyles? Our textbook defines the cycle of violence as a hypothesis that suggests that a childhood history of physical abuse predisposes the survivor to becoming violent themselves in later years. With RAD being a fairly new discovery in the healthcare world there is a lack of proper research and training. If that training and research is conducted the likelihood of these children being treated properly increases. This, in turn, decreases the likelihood that they will end up in the criminal justice system. The link between the cycle of violence and Reactive Attachment Disorder will help us to better understand the disorder. RAD children and their families are in dire need of help. The treatment of this disorder would significantly decrease the violence that the affected child displays. (Please note not all children who are exposed to maltreatment, abuse, and violence will develop RAD or a condition as severe as RAD.)What is Reactive Attachment Disorder? What are the symptoms of RAD?As stated above Reactive Attachment Disorder (RAD) is a condition found in children who received negligent care from their primary caregivers. The parents or caregivers of RAD children often neglect the children because they are incarcerated. Incarceration of parents results in the child bouncing from home to home or foster care during infancy. This is not conducive of the health and growth of an infant or toddler. The parents or caregivers may have mental health issues of their own such as depression. The parents or caregivers may have substance abuse problems that causes them to focus on their drug use and not their child. Parents that do not know how to care for their child or have no desire to care for the child leading to negligent care. A lack of stimulation as an infant can also lead to RAD. This is because babies need to bond with a caregiver that gives dependable and loving care. A lack of stimulation impedes the growth of an infant’s brain and can result in RAD, slower intellectual abilities, difficulty integrating into society, poor management of emotions, or lack of self-control. When they struggle to form an attachment to a stable caregiver they may develop RAD and in consequence will find it difficult to form healthy and loving relationships throughout their lives. Research has demonstrated that repeated violent traumatization of children in the absence of parental protection can permanently rewire their brains, which do not become fully developed until early adulthood. (Dudley, 2015) Anti-social behavior is common in RAD children. Seeking comfort when they are upset is very rare and normally they do not respond to the comfort that is provided. Outburst of irritability, sadness, and unexplained fear during non-threatening situations are often exhibited. These symptoms will be present before their fifth birthday. The similarities of RAD, Post-traumatic Stress Disorder, and Autism are very high. This makes it increasing difficult for mental health professionals to diagnose in a timely and efficient manner. Another issue that holds back timely and efficient diagnoses is RAD children exhibit behaviors that can be mistaken for incompetency of the parents. This can lead to the whole family becoming anti-social because they feel judged. The family can also become extremely overwhelmed and can lead to the termination of the adoption. This feeds the attachment disorder and often worsens the symptoms. In children, excessive stimulation of this hormonal response for prolonged periods of time- due to the combination of repeated trauma and the absence of parental intervention that helps the child manage or calm the response-eventually impairs regulation of the response. (Dudley, 2015)How does RAD effect the families of children with this disorder? RAD children have oftentimes faced violence and neglect causing them to be removed from their biological parents and placed in foster care and/or adopted out. If these behaviors are severe enough, parents can become emotionally and psychologically incapacitated, rendering them unable to provide adequate caregiving. Studies have shown that children with RAD who live with an adoptive family can develop more stable attachments than children who continue to reside in an institutionalized setting. (Barth, Crea, John, Thoburn, & Quinton, 2005). However, when the adopting families have no knowledge of the abuse, neglect, and resulting psychological disorders that they will have to handle they are done an injustice. They will face struggles when adopting a child with special needs. These children need caring families the most but they are at the highest risk of losing them. Given the proper resources and care before, during, and after adoption the RAD children and their new found families have a better chance of forming a healthy family relationship. This in turn helps the child flourish and become functioning members of society. Families of children with RAD are under extreme amounts of pressure and stress because of the uniqueness of this psychological problem. What treatment options do the families have? The lack of information and resources for the diagnoses and treatment of RAD has led to unusually high number of children being misdiagnosed. Because the symptoms of RAD are also associated with PTSD, ADHD, ADD, and Autism. The children being misdiagnosed and treated for those mental health issues is counteractive and does not help anyone involved. This can lead to the families becoming frustrated, discouraged, and angry. Children with RAD need a safe, stable living situation, positive interactions, and a strong attachment to parents and caregivers. The treatment strategies that are normally put into place for them are: Encouraging the child’s development by being nurturing, responsive and caring Providing consistent caregivers to encourage a stable attachment for the child Providing a positive, stimulating and interactive environment for the child Addressing the child’s medical, safety and housing needs, as appropriate Individual and family psychological counseling Education of parents and caregivers about the condition Parenting skills classesThese treatment strategies are rarely effective and normally need to be combined with several treatments (Reactive Attachment Disorder, n.d.) There is also a very controversial treatments. They are as follows: holding therapy, rebirthing therapy, compression holding therapy, corrective attachment therapy, holding time, and rage-reduction therapy. They are often filled with coercive, restraining, and aversive procedures. They are very controversial because they involve holding the children down, forced eye contact, tickling, and pinching. This has resulted in the death of some children and there is no proof that these have any benefit to the children.What treatment options do the families need and want? RAD families believe that the children benefit the most from therapeutic family style homes. This is also called Family-Style Residential Care. These locations have treatment parents that act as the caregivers during their stay. They are trained in developmental and attachment disorders and know how to work with RAD children. The closest family-style residential care campus to the author’s home is in Clinton, SC. This particular location has a cottage for each child and boasts a real family feel. Each child has family dinners, homework, chores, their own room to decorate, a family room, and a large kitchen table for the family to enjoy meals. The children also go on vacations and attend summer camps. The Institute for Attachment also has treatment plans for children with RAD. They also have treatment parents who oftentimes have their own children with developmental trauma disorders. The benefits of using a location like this is that the children can live a normal life and learn to develop healthy family attachments. This treatment is also beneficial to the parents who are oftentimes emotionally exhausted from trying to help a child who continues to push them away. The parents are then able to recharge and get help of their own. Parents are also involved in the treatment and taught how to handle the issues that come along with the care of a RAD child. This type of treatment can be very expensive if insurance doesn’t cover it. For treatment at the Institute For Attachment (normally 6-9 months) it cost between forty-five thousand and sixty-eight thousand dollars. The fact that these families have to worry about insurance covering this treatment is absurd. If the treatment is showing high turn around rates for these children it should be top on the list for these families. In the long run the money that is wasted giving improper treatment and care adds up to at least this amount. How does the public, healthcare, and law enforcement handle cases of offenders with RAD and what can be done to handle them more effectively? RAD children can have trouble processing normal childhood feeling of joy, anger, or fear. A child without RAD has had the opportunity to go to a parent for help when they are scared. A child with RAD may have been scared of their parent and unable to go to them for help. Parents and caregivers teach children how to handle those emotions. The RAD child has not had that care. Much like PTSD this can lead to the child being overly aware or concerned of their surroundings. They may also over react to situations and have angry outburst and violence. If this is allowed to continue (either due to lack of care or inability to care due to misdiagnosis) the symptoms worsen and will eventually become permanent. This leads to an increased involvement in criminal activity. When law enforcement become involved with them the officers often have little to no training for encounters with individuals with mental health issues. This can lead to aggression and violence from both parties. Interventions involving displays of aggression such as yelling, rough physical contact and intense eye contact (the stare), though meant to curb aggressive behavior, and may provoke aggression. (Dudley, 2015) In development of trauma-related disorders, police officers can learn more about traumatized children when regularly called to investigate alleged cases of domestic violence. (Dudley, 2015) Law enforcement officers responding to alleged domestic violence calls are basically the first line of response for the children who are involved. If these officers are trained to recognize that the children may need help beyond the response and then acting on that they can decrease the child’s exposure to childhood trauma and decrease the likely hood/development of RAD. Law enforcement agencies and individuals with RAD would greatly benefit from the implementation of protocols that should be used when interacting with possible individuals with mental health issues on calls. These officers should be trained to familiarize themselves with childhood trauma, and the effects it has on those children, both short and long term. Carrying out therapeutic, neuropsychiatric, and psychiatric care will also reduce the symptoms and lessen the chance of the child carrying RAD into their adulthood. ReferencesBarth, R. P., Crea, T. M., John, K., Thoburn, J., & Quinton, D. (2005). Beyond attachment theory and therapy: Towards sensitive and evidence-based interventions with foster and adoptive families in distress. 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