
The moment our journey of actively parenting a child with reactive attachment disorder (also known as developmental trauma) ended, I started to reflect on all the things I wish I’d known sooner. Turns out, I’m not alone. When RAD Advocates asked other parents to share what they wish they’d known sooner, they shared a long list of thoughts.
Wherever you are in your journey — whether you’re considering adopting or are actively parenting a child who has been traumatized — we hope this information helps. If we had learned these secrets earlier, we may have had a less confusing path. We may have even preserved our physical and mental health and safety, family stability, financial security, and freedom from legal action. RAD Advocates exists so that, one day, this is the case for all families of children with developmental trauma.
Here are the things parents of kids with reactive attachment disorder, also known as developmental trauma, tend to learn the hard way —
1. An accurate diagnosis is tricky.
Many parents shared that they wished they’d known what developmental trauma disorder/reactive attachment disorder was and received an accurate diagnosis earlier in the parenting journey. This issue is exacerbated by the fact reactive attachment disorder is wrongly considered rare (see below), is poorly understood by even most professionals and has a limited definition in the “Diagnostic and Statistical Manual of Mental Disorders,” or DSM. In recent years, there’s been a push to add “developmental trauma disorder” to the DSM as a more encompassing diagnosis. Much of the work around developmental trauma disorder and the effort to include it in the DSM has been spearheaded by Dr. Bessel van der Kolk, famed psychiatrist and author of “The Body Keeps the Score: Brain, Body, and Mind, in the Healing of Trauma.”
Nothing in the DSM currently describes the pervasive effects of trauma on child development. This is why our kids end up with a laundry list of other diagnoses and a handful of medications that may or may not provide some minor benefits. Of these comorbid diagnoses, van der Kolk notes: “None of these do justice to the spectrum of problems of traumatized children, and none provide guidelines on what is needed for effective prevention and intervention. By relegating the full spectrum of trauma-related problems to seemingly unrelated ‘comorbid’ conditions, fundamental trauma-related disturbances may be lost to scientific investigation, and clinicians may run the risk of applying treatment approaches that are not helpful.” A developmental trauma disorder diagnosis would include the child experiencing or witnessing multiple or prolonged adverse events over at least one year as well as a variety of resulting dysregulations and impairments.
If we had learned these secrets earlier, we may have had a less confusing path. We may have even preserved our physical and mental health and safety, family stability, financial security, and freedom from legal action. RAD Advocates exists so that, one day, this is the case for all families of children with developmental trauma.
Most of our kids get new diagnoses all the time, and those diagnoses change over time. A diagnosis is not a cure. However, an accurate diagnosis can be important for insurance and treatment purposes. RAD Advocates and other parents dealing with DTD/RAD can suggest professionals who may be able to give your child an accurate diagnosis. If the information you read on this site fits your child, learn how to proactively keep your family safe and seek effective approaches to parenting and treatment, regardless of their current diagnosis.
2. Reactive attachment disorder is on a spectrum.
Before I adopted, I associated reactive attachment disorder with orphans left rocking in their cribs. I thought only of the severe cases — where the child stiffens to touch, won’t meet your eyes and is violent. Because I didn’t realize there was a spectrum — and like all disorders, not all symptoms have to be present — I missed many valuable years not understanding what our son was dealing with or how we should approach it.
Not all kids with reactive attachment disorder/developmental trauma disorder are violent or dislike hugs. The severity can help determine what treatments and approaches will work best and whether the child can be treated successfully in the home environment. Read more about it here.
3. Reactive attachment disorder is not rare.
Experts and parents alike are told that reactive attachment disorder is rare. But childhood trauma is not rare. Attachment issues are not rare.
As cited in the article Childhood Attachment by Corinne Rees in the British Journal of General Practice, 40% of the general population is categorized as having one of the insecure attachment styles. She states: “Dysfunctional childhood attachment is of major public health importance and underlies many of the difficulties of contemporary society. Its under-representation in medical training, practice and research needs to be rectified.”
In one study of toddlers in foster care who had been maltreated, 38-40% of the children met the diagnostic criteria for reactive attachment disorder. I’m sure if older children from foster care were included in a study, and the criteria were used for developmental trauma disorder diagnosis, the number would be even higher. Read more here.
Need help navigating developmental trauma and the frustrating systems that go with it? Consider support memberships.
If you’re parenting a child with a history of trauma or caregiver interruptions/inconsistency, even if that child was adopted at birth or born to you, it’s important to educate yourself on developmental trauma disorder, symptoms and treatments.
4. The system is broken.
Most of us who adopted from foster care come away with the feeling that the system is broken. There is great variation between offices, states and even counties, and between individual social workers. But in many cases, the full extent of the child’s needs and issues are not shared with the family or were never fully investigated to begin with. Once the adoption is finalized, most of us find the support to be lacking. Worst of all, some of us are criminalized by the system for not being able to handle our child’s severe mental health issues — issues that even professionals are at a loss to address.
5. Most professionals don’t get it.
Unfortunately, reactive attachment disorder/developmental trauma disorder is not thoroughly covered in many graduate programs. Aspiring therapists, doctors and educators typically graduate with little to no information about the realities of the disorder. And because of the complicated family dynamics, it’s also hard to fully understand if you haven’t lived it. Most of us feel better educated on the topic than the professionals our children see.
RAD Advocates can provide recommendations, but the pool of experienced professionals is small. At the least, try and find therapists, psychiatrists and others who understand you should be present in your child’s therapy and are willing to listen and to learn more. For friends and family who also don’t get it, there are many resources and shareable blogs on the RAD Advocates site.
6. Out-of-home placement may be necessary.
While it’s hard to accept, in severe cases of reactive attachment disorder/developmental trauma disorder, the child may be better off in an out-of-home placement. Children with reactive attachment disorder view their primary caregiver — usually the mother — as a nurturing enemy. Attempts at attachment and closeness are subconsciously triggering to them, as their earliest attachment figures hurt or abandoned them. In addition, if parents have developed post-traumatic stress disorder from parenting a traumatized child or being the victim of that child’s abuse, they may be unable to therapeutically parent them.
Out-of-home placements include residential treatment centers, boarding schools, living with another family/placement or relinquishing custody. If an out-of-home placement becomes necessary for your family, your RAD Advocates advocate can help you learn about appropriate options.
7. Legal issues are common for those parenting children with reactive attachment disorder.
Whether you think you’ll need it or not, document everything. Document what treatments you’ve tried, what behaviors you’re seeing, if you call the police, etc. Also keep all medical/psychological records. Unfortunately, it’s very common for children with reactive attachment disorder/developmental trauma disorder to make false accusations. You may also need this documentation for out-of-home placements or other treatments.
8. Treatment is tricky for reactive attachment disorder.
Unfortunately, there’s no easy cure or treatment for reactive attachment disorder/developmental trauma disorder. However, some modalities and approaches have definitely helped folks, especially if the child wants help and is willing to participate (that’s a big if!). This blog details paths parents have found helpful and not helpful. I also highly recommend reading “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma,” referenced earlier.
As for parenting approaches, it depends on the child — their age, the severity of their reactive attachment disorder/developmental trauma disorder, their other issues, etc. But one thing is for sure: Parenting a traumatized child is not the same as parenting a neurotypical child.
Unfortunately, reactive attachment disorder/developmental trauma disorder is not thoroughly covered in many graduate programs. Aspiring therapists, doctors and educators typically graduate with little to no information about the realities of the disorder.
Some parents whose children are argumentative and like to get a rise out of them have found it helpful to use the “gray rock method,” which involves giving short or canned responses and not becoming emotionally engaged or hooked in conversations.
You’ll likely have to try several parenting approaches/techniques to find the one that works best for you, your child and your family.
9. Reactive attachment disorder can impact your family/marriage.
Many of us parenting traumatized children end up with post-traumatic stress disorder ourselves. You can’t help your family if you are in crisis. That’s why it’s key to take care of yourself — find a great personal therapist and/or marriage therapist, find respite care for your child, create a safety plan for your family, etc. The same goes for couples. It’s very important that the two of you get on the same page and prioritize your relationship. None of this is easy, but the RAD Advocate site provides many blogs and resources to help you in these areas.
Another thing RAD Advocates can help you feel is community. Finding support and understanding is key, whether that’s with nearby folks or an in-person support group, on an online community or with other parents you meet at the biennial Navigating RAD experience.
10. Life looks different for kids with reactive attachment disorder.
Last but not least, set realistic expectations. For example, maybe all you can focus on is keeping the family safe right now. You might have to give up expectations around grades, jobs, stellar manners or healthy eating. You may even need to give up the dream that your child grows up at home with you. You’re doing the best you can, and that’s all anyone can expect.
We're rooting for you.
I hope that those of you just learning about developmental trauma disorder/reactive attachment disorder have found this blog helpful. These are the things many of us veteran parents wish we’d known sooner. We hope to share these “secrets” far and wide so they aren’t secrets anymore. Because every parent deserves to raise a healthy and safe family. We hope you find this early enough to make a difference in your home.
On behalf of parents who've walked the reactive attachment disorder parenting journey before you — we're rooting for you. We continue to advocate on your behalf in our own ways, all over the world. Although it may feel isolating, know that you're not alone.
Sadly it is all too rare to be knowledgeable about RAD until you are impacted. If it's mentioned at all during foster training, you're likely to shrug it off as, "it's rare," and it's glossed over. This should be the MAIN topic during training and there should be resources provided immediately. Not every situation will involve RAD, but it is definitely not as rare as they want you to think.
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