Updated: Jul 7
The day I picked my kids up from school was like any other. All of my children handed me their lunch boxes, water bottles, backpacks, pencils, and pens—anything my 11-year-old daughter Carly* could potentially use as a weapon.
Carly sat caddy-corner from me in the back seat where I could see her. If she sat behind me, she was known to use my seatbelt to choke me. And it was too dangerous for her to sit in the front passenger seat as she frequently grabbed the steering wheel.
With our safety measures in place, we were all set. Or so we thought.
It was that day that Carly decided she wanted to stop for Mexican food at a fast-food restaurant we passed. Tacos sounded like a good idea, I told her. We'd make them for dinner that night at home. But she wanted to eat out.
Within seconds, the rage began.
Our Abnormal Normal
It was just like the other experiences our family went through several times every day—scary. Carly violently kicked the seat in front of her where my 13-year-old son sat. His body flailed back and forth from the impact. She punched to the side of her. My 11-year-old son sitting next to her scooted into the corner with his hands over his head.
I tried to calm Carly with various techniques her therapist had given. And I offered her a snack from the glove compartment. That’s when she began banging her head into the window. Hard. I didn’t know if the glass or her head would crack first.
That particular rage ultimately ended with a call to the police. I had pulled over and tried to calm her. When that failed, I sat with my legs wrapped around Carly to contain her on the side of the road. She headbutt, bit, and spat at me. With one particularly hard blow to my head, I instinctively let go of her. She ran from me into traffic. When the police officer arrived, Carly calmed down instantly.
We had sought various interventions for reactive attachment disorder by that point to help Carly. She had gone through multiple therapists, evaluations, and medications. We had parent training. Nothing worked. In fact, her behaviors had only escalated.
I wish I knew early on what I know now. Parents of children with reactive attachment disorder on the severe end of the spectrum cannot do it alone or with traditional methods. We needed a higher level of care. But it didn't come easily.
We tried to place Carly in a residential treatment center or hospital several times for her dangerous behaviors. But because she wasn’t suicidal or homicidal at the time of assessment, she didn’t meet the criteria for a higher level of care.
This is one of the many traits of reactive attachment disorder that gets in the way of securing help—Carly was not the same person with other people that she was at home, particularly with me, her adoptive mom and primary caregiver.
Not a single assessor got an accurate evaluation of Carly’s regular behaviors. In front of others, Carly appeared charming, polite, and calm. The erratic, abrasive, and dangerous behaviors my husband and I reported seemed outlandish. When the police officer arrived that day of her rage, for example, she calmly told him that she was just upset because she was hungry and I wouldn't feed her.
Clinicians typically determined that my husband and I were the problem and gave us a book on parenting techniques. So we’d return back home with our book and do our best.
If I asked my daughter to do anything—say, get started on homework—she went into a rage with absolutely no warning. It was as if a switch had gone off. These episodes lasted for hours. She attacked everyone in our home, especially me, physically and verbally. She also inflicted harm on herself.
We tried various techniques to calm her. Yet the more we showed concern, the more Carly escalated. Our reaction was a sign that we loved and cared for her—the very thing her disorder rejects.
We did our best to proactively prepare for Carly’s dangerous episodes. My husband and I made sure we could see Carly at all times. We stayed alert so as to act quickly at any moment. We created a number of protocols so each of us could react appropriately and safely depending on Carly’s type of rage.
When Home is Scary
We removed knives and other sharp objects from our home. But even during her rages, she’d find other items to use as weapons that we hadn’t anticipated—heater vent covers, curtain rods and dresser drawers, for example.
We ultimately created a “safe space” out of her room—a place to go during her rages that kept everyone, include herself, as safe as possible. We took out as many potentially dangerous items as we could—which left only a mattress and blanket. We installed an alarm on her door to alert us if she left the room. It bought us time to get our other children to safety.
Our entire family lived in a state of hyper-vigilance all day, every day.
We could not realistically provide the level of care Carly needed to keep her and the rest of our family safe. It was a 24-hour, seven-day-a-week job with only two adults in the home. My husband and I both worked full-time jobs and still needed to care for the other children in our home and attend to daily life. We could not sustain the way we were living.
A Heartbreaking and Desperate Solution
It was only a matter of time before someone was seriously hurt. Once we accepted this hard reality, we were forced to get creative—we called child protective services (CPS) on ourselves.
We requested that all of the therapists, doctors and teachers involved with our family call CPS on our behalf as mandatory reporters—to say that we were ill-equipped to care for our daughter. After all, it was absolutely true.
When CPS finally agreed to get involved, they placed our daughter in a residential treatment center.
Our decision was the most difficult one my husband and I have ever made. But it was the only option we had left to keep all of our children safe, including Carly.
This is what is expected of parents of children with reactive attachment disorder—to endure independently with no good options. They must come up with creative solutions on their own accord. It is how our system sets families up for failure.
As you weigh the needs of your child with reactive attachment disorder, we at RAD Advocates suggest the following steps:
Get a thorough assessment of your child's reactive attachment disorder and where he or she falls on the spectrum.
Determine if and how your child’s behaviors pose a physical and emotional safety risk for each person in the family, including for himself or herself.
Consider your capacity to provide the level of care necessary to keep everyone in the family safe at all times.
If you realize that your child poses a serious safety risk to him or herself or others in your home, the #1 thing to know is that you cannot go it alone or with traditional methods. Seek a higher level of care.
Should you identify that your child needs a higher level of care, present supporting documentation (records, a journal of events, etc.) to the professionals who assess the needs of your child and family. Continuously use phrases that clearly state you are not capable of keeping your child safe.
Find outside care for your child as soon as possible while you secure other long-term options. “Safety for everyone in the family is critical,” said renowned trauma expert Forrest Lien, LCSW, Owner of Lifespan Trauma Consulting. “Arrange respite care with professionals, family or friends immediately. Children with RAD are triggered by their primary caregivers and, therefore, are often temporarily safer in other places as a result.”
Check to see if your insurance company has a care manager that can help you with a treatment plan.
Consider an advocate to assist you as you navigate different entities and how to access getting help for your child.
Parents can access a higher level of care in multiple ways. Ours, of course, was an incredibly difficult way and certainly not the only option.
Tara Akers understands the various pathways families can take from working with parents of children with special needs since 2004. She is a therapeutic boarding school placing therapist and is presenting at the first-ever Navigating RAD2021 conference, to be held August 20-21, in Denver.
“Finding the right type of resources for a child can be overwhelming, particularly when the family is in immediate crisis," she says. "Utilizing an advocate can provide insight as to what programs may be a good fit for the child and each family’s particular situation."
At the conference, Akers will speak to parents about seeking alternative placement when home is no longer a safe option. RAD Advocates will also guide parents to create a family plan, including a safety plan, whether the disordered child stays in the home or not.
No matter your personal decisions, remember to always put the safety of your family first. And remember that emotional and mental safety is as important as physical safety. While physical scars can heal, the emotional impacts can take a far greater toll on your family’s long-term wellness.
The earlier you seek safety for your family, the better you can protect their total well-being both now and in the future. Do not wait. Do not quit. And if you need help along the way, we're here for you.
*Pseudonym to protect the child's identity