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Why New Trouble Surfaces in the Teen Years for Youth with Developmental Trauma Disorder


Although your child, their physical size, and the complications might grow over the years, the root of the problem remains – developmental trauma.
Although your child, their physical size, and the complications might grow over the years, the root of the problem remains – developmental trauma.

When my son Joe* was in elementary school, I calculated that we spent an average of 22 man hours each week to manage his severe reactive attachment disorder (RAD), also known as developmental trauma disorder (DTD). The time was split between me, his teachers and school staff, therapists in and out of our home, caseworkers, and the occasional law enforcement personnel or hospital staff. 



At that time, we had two professionals warn us that if Joe’s disorder continued on its current trajectory, he’d need out-of-home placement by the time he was a teenager. I didn’t understand. In fact, I was highly offended.


Everyone told us we were doing all the right things when Joe was younger. Even though his behaviors were barely manageable in our home, I stilI held onto hope. We took it one day at a time with our strong boundaries and age-appropriate consequences and privileges in place. While I certainly didn’t think Joe was thriving (or that anything we were doing was even working), I thought we were at least surviving. 


I failed to recognize at the time that my ability to contain or avoid Joe’s more severe behaviors was entirely dependent upon the fact that I was bigger than him. He also knew that he needed me to get what he wanted. I continued to search for answers to heal him. But I didn’t acknowledge Joe’s role in his own healing until it was too late.


Joe quickly reached an age and size when he realized that he could hurt me and obtain his desires without my help. Joe’s unhealed trauma behaviors posed a real safety concern in our home. His trauma had trickled down into each member of our family


Our only option by then was to find out-of-home placement for the safety of everyone, including Joe. It was certainly not the adoption story I had dreamed of when he first entered our home. Our family was safe, but it was heartbreaking.


What I Learned Too Late About Developmental Trauma as a Mom


Reactive attachment disorder/developmental trauma is a serious brain disorder caused by early life trauma or neglect that damages a child’s ability to trust others. The child develops a heightened sense of self-sufficiency and rejects attachment. In fact, an attempt to nurture a child with RAD/DTD triggers them. The child lies, manipulates, and triangulates those around them. They are emotional volatile or physically violent to maintain a sense of control and emotional distance from those who attempt to get close to them, especially the primary caregiver.


Unfortunately, the diagnosis is largely unknown and misunderstood even in professional circles. Many families run through a gamut of therapies that fail to properly treat the disorder at best, exacerbate the disorder at worst or come to the diagnosis too late.


Forrest Lien, LCSW, a nationally-recognized expert in developmental trauma, notes that most of the children he has worked with over his 40 years have been teenagers. They and their families had been suffering through the wrong therapies for years, often making the disorder worse. He hopes more education on the disorder will help families to seek proper treatment earlier, ensuring better outcomes for children and families.


Even when the proper intervention is found, the child must take part in their own healing journey. For a child with RAD/DTD to heal, they must first experience something Lien calls “buy-in.” The child has to have the understanding that their life can be better and that they can heal. They must then have a desire to participate in their healing.


Joe quickly reached an age and size when he realized that he could hurt me and obtain his desires without my help. Joe’s unhealed trauma behaviors posed a real safety concern in our home. His trauma had trickled down into each member of our family. 

While factors come into play during the teen years that can complicate matters, Lien says the disorder itself has always been there. “Kids who don’t heal from developmental trauma don’t have behaviors reemerge in their teen years. The disorder and other issues surrounding it is simply getting worse,” says Lien. Below are the issues he says can magnify or complicate developmental trauma by the teen years.


Issues that can magnify developmental trauma in the teen years:


1.  The onset of co-morbid mood disorders complicates developmental trauma.


RAD/DTD often presents with co-morbid mood disorders like bipolar disorder, according to retired psychiatrist and childhood trauma expert Dr. Alston whom Lien has worked closely with throughout his career. Children with co-morbid mood disorders are the hardest to treat, Lien says, because the mood disorder poses an additional challenge in helping the child to gain a grounded perception of their reality and restore a sense of felt safety.


2. Teens with reactive attachment disorder/developmental trauma have the emotional maturity of much younger children but desire the same privileges as other adolescents. 


While most children with developmental trauma argue incessantly, the symptom often increases even more so during adolescence. Parents who understand their teen’s limited emotional maturity use strong boundaries, similar to limits common for children of younger ages, to keep their adolescents safe. However, this further locks the parents and teens in a battle for control as the teens are aware of and want the privileges that their neurotypical peers are enjoying.



Unlike neurotypical children, children with developmental trauma disorder have a gap between their chronological age and their emotional maturity. It is developmentally appropriate for neurotypical adolescents to begin to seek independence through responsibilities and privileges that require less adult supervision. A child with RAD/DTD who is chronologically a teenager, on the other hand, has the emotional maturity of a much younger child. If given typical privileges for their chronological age such as their own phone, a driver’s license or less adult supervision, teens with developmental trauma will often misuse those privileges, putting themselves or others in harm’s way.  


3. Teens with developmental trauma often have unrealistic perceptions of what success entails, leading to more conflict with parents.


As adolescents begin to think beyond high school, conversations about next steps can lead to increased conflict between parents and the teen with RAD/DTD. Lien notes that teens with RAD/DTD hold fantasies about how successful they will be once out of the “control” of their parents without understanding the effort needed to obtain those goals. This level of fantasy applies to the effort needed to graduate high school, keep a job or earn a driver’s license. They often will not take the appropriate steps to gain healthy independence.


When we discussed Joe’s future with him in his teens, he was adamant that he’d become a professional athlete one day. However, he had been kicked off every team he was part of either because he was failing classes or because he refused to participate in practices and follow the team rules. He stated that his previous coaches simply cannot appreciate his greatness and that’d he’d succeed as a professional athlete. Any mention of practicing, respecting coaches or completing school work was met with arguing, blaming, and accusations of “not believing in him.”


4. Teens with developmental trauma struggle with healthy peer relationships which can lead to bigger issues.


Joe made “friends” quickly but, based on his ulterior motives, didn’t keep relationships with healthy peers for long. Teens with RAD/DTD often rely on peers to attain privileges their parents have not yet allowed them. They tend to become infatuated with peers in an effort to get what they have. They may make friends with someone who has a car, get someone to complete their homework or get someone to give them a cellphone. The peer relationships often fail when neurotypical teens get frustrated with maladaptive RAD/DTD behaviors. 


Forrest Lien, LCSW, a nationally-recognized expert in developmental trauma, notes that most of the children he has worked with over his 40 years have been teenagers. They and their families had been suffering through the wrong therapies for years, often making the disorder worse.

Teens with RAD/DTD ultimately tend to gravitate toward other peers who match their negative self-perceptions and engage in similarly dysfunctional behaviors. When this happens, they are surrounded by peers who encourage and enable their behaviors. These relationships only amplify the concerning behaviors and negative consequences of their actions. 


5. Teens with developmental trauma want independence at any cost and will attempt to expedite the timeline with concerning behaviors. 


Neurotypical teens fear their impending independence. Home for them represents a safe environment with reliable and safe people that will be missed. Going off on your own is a little scary. However, because teens with RAD/DTD inherently do not feel safe anyhow, they are eager for independence. In fact, a healthy home is scarier to them than independence as it represents the attachment and nurturing that triggers them.


As adulthood approaches, teens often escalate their behaviors to get kicked out or removed from the home prematurely. This may look like running away, finding a “rescue family”, or false allegations of physical or sexual abuse against family members.


6.     Youth with developmental trauma have poor personal boundaries with increased exposure to others as teens.


With the increasing prevalence of cellphones and social media, teens with RAD/DTD struggle to have appropriate boundaries around both personal information and sexual content. Cellphones and social media allow a level of access both to inappropriate material and potential audiences that teens with RAD/DTD have trouble navigating safely. “Youth with RAD/DTD become overstimulated with sexual material and often they will either become a predator or a victim, especially if they have a history of sexual abuse,” says Lien.  This either allows the disorder to take a stronger hold over the child or creates more trauma for them.


Love and Time Won’t Cure Developmental Trauma. Don’t wait.


Although your child, their physical size, and the complications might grow over the years, the root of the problem remains – developmental trauma. It won’t go away with time or love. Time only brings more issues and love only triggers their fears. 


Don’t delay in finding effective and early intervention for your child. It’s far from easy, but essential. Do everything you can as early as you can. The earlier a diagnosis is made, the earlier treatment can begin and the more likely your child and family will have more positive outcomes in the long term. 


If you’re currently struggling with a teen with developmental trauma, you can still forge a pathway through for your family. It might not look the way you had hoped years ago. Success often looks different for teens with developmental trauma than it does for neurotypical teens. Start with making sure you, your teen and everyone else in the home is safe. Sometimes, that alone is success. And that is okay.  



*name changed to protect identity


About the Author:


After parenting a child with developmental trauma, the author is passionate about furthering advocacy and education for families like hers. She hopes that, one day, other families will receive more support, understanding, and empathy than hers did. For now, she chooses to remain anonymous until that time comes. But she continues to volunteer for RAD Advocates in their mission to educate and advocate to equip families, communities, and professionals to effectively support children with developmental trauma.


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