In the tolerance thread, I mentioned "Reactive Attachment Disorder" or RAD. Since some others asked about it, I promised I would talk about it in another thread - so here we are.
(Someone else asked me to talk about my experience as a foster parent, but I'll put that in a different other thread.)
As a foster parent, we were required to take, IIRC, about 30 hours of training. Talking about RAD was the focus of at least one of our training classes because it was so common amongst their foster children. In Kentucky, foster children are rated from 1 to 5 based on how much extra care they would require in terms of therapy and extra assistance - 1 being a child with the least issues and 5 being a child with the most issues. The agency my wife and I dealt with only dealt with kids rated 4 or 5. I bring this up because I don't want to give the impression that all foster children are like the ones I have experienced. Not all of them have RAD issues. Also, I am not a psychologist or a social worker or a mental health expert. I am only presenting information as it was presented to me and how I understood it.
RAD
When a child is first born, there a cycle of dependency that happens between it and it's caregiver (mom, dad, daycare worker...).
The process is very simple:
1) Baby senses that something is wrong (hungry, thirsty, stinky, in pain...)
2) Baby cries
3) Caregiver arrives
4) Caregiver addresses and fixes the problem (feeds baby, changes diaper...)
5) Baby senses that everything is OK and stops crying
6) Time Passes
7) go to step 1
This cycle repeats thousands and thousands of times in a babies life in its first months of life. Through this process, the baby learns several important lessons:
1) I can effect the outside world (when I cry things happen)
2) Grownups are here to help me
3) I am worth being taken care of
This assumes that the caregiver is doing a good job and the babies needs are being met. People are human and make mistakes, so caregivers don't always get it right the first time they show up, but in general, they are always making things better for the child.
However, if the caregiver is doing a poor job, the cycle starts to fall apart in step 3. The caregiver may ignore the baby, stop trying to help too soon, or, if they are physically abusive, hit the baby, shake the baby or yell at the baby. When this happens, the baby never gets to step 5. Obviously, if the caregiver NEVER did the right thing, the baby would die. But, what often happens is that the caregiver does enough to keep the baby alive but fails so often that the baby doesn't learn the lessons that the good caregiver's baby learned.
An abused/neglected child might learn:
1) Nothing I do effects the outside world (crying may bring help, harm or nothing so it is not effective)
2) Grownups are here to harm me as much as help me
3) Grownups are not predictable
4) Grownups cannot be trusted
5) I am not worthy of being taken care of
It is especially important understand 1). If a baby thinks it cannot effect the world around it, it does not learn about cause and effect. The world is just a series of unrelated events that happen for no reason. As they get older, they can't help but get past some of this when dealing with the physical world (gravity is pretty constant
), but when dealing with people, the lessons they learned as a child are very hard to change. It's much easier to learn a new behavior than to replace an existing one. RAD sets in when they cannot learn to properly attach emotionally to another person.
Complicating things, children have a built in attachment to their parents, even abusive ones. Their distrust of adults often gets worse when child protective services enters the picture. From the child's perspective, a bunch of adults come in and take them away from the only adults they know, the abusive parents they are attached to. Most of the time, it is not discovered that a child is being neglected until it is 5 or six years old. Younger children can be shielded from the outside world. It is generally not until they go to school and their teachers see them and know that something is obviously wrong. So, you have a child that has been living in a highly dysfunctional environment for 5 or 6 years and then a bunch of other adults take it away from its parents. A daycare worker might also recognize the symptoms of abuse but these kids generally don't end up in daycare. They are generally left alone for hours on end while the parents (or parent) goes out and does whatever they do.
Because the child has been neglected, they have had to learn to do things for themselves. Their primary concern is for themselves. They care nothing for other people other than as a means to obtain what they want. RAD kids will steal and lie and think nothing of it. They place no value in other people. There is no such thing as "right" and "wrong" there is only "what is good for me" and "what is not good for me."
If there are multiple children involved, very often the oldest is made responsible for the younger ones. This sense of responsibility may take hold and the child will work very hard to take care of younger brothers and sister and will become attached to them. The child is doing the parent's job. It has become "parentified." If the older child does not take that responsibility, or worse, treats their siblings as their parents treat them, you could have children abusing their younger siblings when the adults are away. One of my foster kids was in charge of her 4 younger brothers and sisters when she was only 5 years old. She was 8 when she came to us and she was often worried about how here brothers and sisters were doing. (They had all been adopted into good homes.)
Dealing with RAD children is very difficult. All therapy is based on a level of trust between the child and the therapist and when the child cannot learn to trust an adult, it makes therapy a challenge.However, children have a deep-seated need to be loved and accepted that directly conflicts with their RAD. RAD kids will often sense that they are getting close to someone and then try everything they can to push them away. Since they feel they are not worthy of being loved, they often harm themselves in order to scare people away or as a form of blackmail with the adults they have to deal with. You have probably heard the expression "tearing your hair out." I had a foster child that actually did that. When she was upset, she would sometimes grab locks of her hair and rip them from her head. She would also bite herself and destroy things that she valued, like breaking toys, tearing up pictures. She would purposely soil herself so that she would smell bad in hopes that we would send her away. She would refuse to take a shower or lie and say that she took one, including going through all the motions of going into the bathroom and tuning on the water...
RAD kids are often developmentally behind other kids their own age, not just academically, but also socially and at with their level of maturity. It is not uncommon for a RAD 10 year old to frequently throw a temper tantrum like a two-year old - including getting down on the ground and kicking and screaming and hitting, etc...
RAD kids are master manipulators. They view people as things and have spent their whole life getting those things to try and do their bidding.
Never get in a battle of wills with a RAD kid. They may not have a limit as to how far they will go to get what they want and if they do, it is almost surely farther than you are willing to go to stop them. Remember, if they don't respect you as a person, they have no problems with hurting you or destroying your property. And because they have no sense of consequences, they won't feel bad afterward.
Having said all that, RAD can be overcome. It just takes lots of patience, lots of work and lots of love.
For more information about RAD, there is an excellent website here:
http://www.radkid.org/index.html