Attachment therapy? What is it? Do all adopted kids need it?

[pepperidge]

I got a comment from school wondering whether we had had attachment therapy as a family for my fetal alcohol kid.

-Aside from not appreciating comments from school that imply that we need to be doing certain things in family therapy (and no none of the ten plus mental health providers we have seen since he was 16 mos have put that forward as an issue for this child)

- aside from having had a bad experience early on in our therapy career for my oldest from a young therapist just completing her thesis on how all adoptees suffer from attachment issues caused by the trauma of mother child bond being disrupted from day one,

and aside from thinking this kid had clear identifiable brain damage issues so attachment issues seem somewhat second order, can someone enlighten me as to what attachment therapy is for non Reactive Attachment Disorder (RAD) kids?

And yes, I believe that adoption is a difficult thing for many adopted kids and that it is something they must come to terms with often with the aid of therapy at the appropriate time in their lives, but for those of us with adopted kids with clear mental health or other challenges, I amt tired of the "adoption must be the root cause of all adopted kids issues" that I hear sometimes.

Sorry just venting, please enlighten me about attachment therapy.

 

[HaoZi]

I'm adopted. I went through 3 psychologists/therapists/shrinks whatever they were before I was 18 (I was labeled as "borderline hyperactive" and had rages and... well, yeah, I'm a difficult child myself). I never heard of attachment therapy until I started seeing it mentioned here. Do I have trust/attachment issues? Yep. But I also drew away from my adopted mom because I knew at the age 6 that she was dying and wasn't expected to be around long, and I spent an entire decade in that state of being. Add in one broken engagement and two broken marriages, with good reason for me to have trust issues with male loyalty, and I think that explains a lot more of it than being being adopted does for me.

Edit: If you want to print my response out and show them, I wouldn't mind a bit.

 

[TerryJ2]

Wow, I didn't realize how rough you'd had it. So, your mom lived for another 10 yrs?

 

[TerryJ2]

Pepperidge, fwiw, the psychs who say "All adopted kids have attachment issues" are painting them with-a broad brush, totally ignoring the fact that adoptees, like any other human being, are invidivuals. Some only feel a twinge of regret, others go off the deep end. It is irresponsible for that student to have made that statement and written her thesis as though it were fact. It was a thesis. Period.
Google "adoption attachment studies" and look up the differences between open adoption and closed adoption. Look up the differences in at-birth adoptions and middle school aged adoptions. There are so many factors ...

Go ahead and vent away. I hear ya!

 

[HaoZi]

Wow, I didn't realize how rough you'd had it. So, your mom lived for another 10 yrs?

Yes, she had her first heart attack when I was 6, and I was told to "prepare myself". Another one when I was 8. A stroke later on, then a silent stroke after that (which made it like living with someone with early onset Alzheimer, total Jekyll/Hyde). I remember being dragged out of bed for ER trips. Or when she tried to kill herself when I was 13/14. I remember her asking me to help her die.
I graduated HS early, at 16. Not long after that her mom, the only grandma I really knew, died. Mom totally lost her will to live at that point, stopped eating, stopped taking her medications (she was insulin dependent on top of the heart disease, hypertension, etc.) and died about two months later.
I saw a number of people into the ground before I was 18 (figuratively, I didn't make it to most of the funerals), most of them not from natural causes.

 

[barneysmom]

I have my own ideas about attachment issues -- many of us do here, and we are diverse -- which are aside from the fact that I definitely don't think it's a question for a school to ask. in my humble opinion it's inappropriate (none of their business).

Jo

 

[BusynMember]

Almost all (I won't say all) adopted kids have "issues" like wanting to know who they look like. But not all have trouble attaching. None of my infant adopted kids had any trouble attaching and I am very close to them. My son who came at two is very attached to us too...that is luck and the fact that his first foster parents were wonderful and loved him enough for him to trust. My son adopted at six had serious attachment issues. He had lived his early years in an orphanage.

Some biological kids have attachment issues, especially if t hey come from broken homes.

 

[susiestar]

From what I have seen/heard, it is NOT something that all adopted kids need treatment for at 12 and 15. If NONE of the outside school tdocs/psychiatrists/neuropsychs have said it, then it likely is NOT an issue school needs to stick their noses into. in my opinion, of course. Reactive Attachment Disorder (RAD) is a "hot" diagnosis for adoptees and MANY people want to make it out that all adopted kids have some "degree" of Reactive Attachment Disorder (RAD). They also want to apply it to ANY child who had health problems before age 3. Unless EVERYTHING else has been ruled out first, a diagnosis of Reactive Attachment Disorder (RAD) is not appropriate. We had a couple of tdocs and psychiatric nurses and one quack psychiatrist (for other reasons than just this) who wanted to diagnosis Wiz with Reactive Attachment Disorder (RAD) because he had severe ear infections as an infant and he woke up in the OR right after they started urinary surgery because the anesthesiologist gave the wrong medication to him (and he remembered it). Even with THAT trauma Wiz still did not have Reactive Attachment Disorder (RAD). My mother tried to say it was because we moved him away from her that he had Reactive Attachment Disorder (RAD) but that wasn't true either.

I would tell school that if there are attachment issues it is NOT a school matter and they need to focus on what is in his neuropsychologist evaluation and other problems. What has he done that they think justifies trying to diagnosis him with attachment problems or Reactive Attachment Disorder (RAD)? Why do they think htey are better than all the other docs etc.. who have not found this? Has he told them something or is this some school counselor who wants to find something that makes the problems a home issue and not their problem and an excuse for making him the problem instead of changing how they approach him?

 

[TerryJ2]

I would tell school that if there are attachment issues it is NOT a school matter and they need to focus on what is in his neuropsychologist evaluation and other problems.

I agree.

 

[toughlovin]

I think it is ridiculous to generalize about all adopted kids having attachment issues. We adopted both of our kids at birth. My son, (difficult child) was definitely attached to us when he was young. There is no question in my mind about that, although my therapist has said it migth have been insecure attachment because he was fairly needy, more clingy, etc. But the attachment was strong. I just know it was. He was always a challenge though. I think most of his issues are just in his wiring and I do think that adoption issues probably played into that as he became a teen. So I think adoption issues are a factor but definitely not the whole story and I have also had many people ask me about the possibility of some kind of attachment disorder. From what I know of him and his early childhood i just don't buy that. My daughter who is very together and definitely a easy child clearly does not have attachment issues. She is clearly attached to us and also is very independent and has a healthy outlook on life. I can't say she doesn't have some issues because of adoption but they are not overwhelming issues... just things in her life she will continue to need to come to terms with.

It sounds like the school is trying to figure stuff out and so is bringing up terms they have heard but don't necessarily know much about.

 

[TerryJ2]

Pepperidge, considering that your kid is Fetal Alcohol Syndrome (FAS), I don't think the school system can use "regular" psychology anyway, because you don't know how much neurological damage was done, Know what I mean??

 

[susiestar]

If they are using info off the internet about attachement disorders, they could be wanting to blame all his problems on this. I pulled up this article while trying to see if there was any data on the % of adoptees who had attachement disorder. Going by this article, almost every single adhd, autistic, or otherwise mentally ill child/disturbed/diffeerent wired kid could have attachment disorder instead of whatever else is the problem.

in my opinion the school has seen a list like this and is trying to say all his problems are from home issues and so they don't need to do anything different because the family is the problem. Which is pure hogwash. I would make sure they have plenty of Fetal Alcohol Effects (FAE) info and if possible find an Fetal Alcohol Effects (FAE) expert to write them a letter.

One thing that I find interesting is that while you hear about attachment disorders and it sounds like there are quite a few types from the articles, etc..., the only types of attachment disorders that I can find are subtypes of Reactive Attachment Disorder (RAD). I have tried several different ways to search for them on google and the ONLY things that come up are inhibited and disinhibited Reactive Attachment Disorder (RAD). I can find nothing that lists any other kind of attachment disorder. NOT that I am the perfect searcher or even looking in the best places. Just that given the interest in attachment disorders and attachment therapy, surely there are more than just types of a disorder that can ONLY be diagnosis'd when everything else has been conclusively ruled out??

I think many are ignoring the part of the diagnosis that says that you look to Reactive Attachment Disorder (RAD) after you rule other things out and instead are applying "attachment disorder" and "attachment therapy" rather willy-nilly in very irresponsible ways.

I would print out the DSM guidlines for Reactive Attachment Disorder (RAD) and tell school to move on because your child just doesn't fit this diagnosis and unless he fits that diagnosis this is NOT an appropriate avenue for them to explore.

 

[pepperidge]

wrote a long reply and lost it. Maybe just as well as I am very stressed out and anxious about the whole thing--not my characteristic mode as I have generally had good relations with Special Education teachers etc.

I figured that if any one had some non Reactive Attachment Disorder (RAD) type of experiences with attachment therapy you guys would have.

I am feeling really stressed about it because I am getting this feeling from FBA and principal people that they think I am exaggerating my son's issues. I wish. So I am thinking they will just be in the punishment mode. Fetal Alcohol Syndrome (FAS) is curious in that kids typically present as higher functioning than they are and my son is reasonably high functioning cognitively (normal IQ) though not without issues there even.

I just hate hate it when someone comes in without any training and starts qustioning therapy and medications. I mean how many hours I have spend reading about medications and in doctors offices over the last thirteen years? And then when I ask if she has training to assess attachment issues she says no, when I ask what training she has in Fetal Alcohol Syndrome (FAS) I get a very evasive answer and then a comment well of course anyone can tell looking at my son that he has Fetal Alcohol Syndrome (FAS) (funny experts can't --typically the features need to be carefully examined when children are young because as growth occurs the distinctions go away--he was dignosed at 14 mos in a child development clinic).

Anyway here i am worried about what we are going to do with this kid inHS because he needs constant supervision and structure and positive role models) and all they can think about is sending him the 45 day behavior school placement with the conduct disorder kids because they don't believe he has a disability. I dont' think we will end up with that recommendation -- I have alot of faith in his Special Education teacher who knows him and us well but she is low man on the totem pole).

I want to maintain a very cordial relationship with the school but right now am finding my anxiety is over the top.

so I appreciate your reactions, they validated some of what i was feeling.

Thanks!

 

[susiestar]

I am not surprised that they are not telling you what training they have in this stuff. Our middle school tried to tell me they had an "Asperger's Specialist" on staff. When I FINALLY ogt her qualifications she had a degree in education (not sp ed, jsut reg ed and reg teaching certificate) and wasn't fully certified for secondary schools yet, but she did a college research paper on Asperger's for a psychiatric class (undergrad psychiatric class 1 level above intro to psychiatric) and she went to a conference on Aspergers two years before she graduated college. She had never read a book on Aspergers since the college paper (was surprised that I had 3 of them with me for the meeting) and didn't know who Tony Atwood is, or Temple Grandin either. Mostly she had a title so that she could help bully the parents into shutting up and going away and leaving the school alone. (The district sp ed supervisor's secretary told me this - I caught her on a day when she was fed up with the middle school and their sp ed shenanigans.)

Have you posted about all of this on the sp ed forum to get them to help you figure out a plan of action? They will probably be a big help. Also keep asking what this person's training is as you can clearly tell that she doesn't know her ear from her dog when it comes to attachment therapy or to Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE).

 

[timer lady]

PPRidge, I've read this thread with interest....

I'm surprised to the lengths that your SD is sticking their nose in places they do not belong. I don't believe that SWs at school or school tdocs have the wherewithal nor "permission" to make diagnosis nor treatment recommendations. I have never allowed the SD to "test" my tweedles other than for various school & academic related issues. AND I always have a 2nd opinion to give to SD.

Saying all of the above, no, not all adopted children need attachment therapy. There are very specific criteria for the diagnosis of attachment disorder & the diagnosis is given after all else is ruled out. Unfortunately, attachment disorder can & does look like many other disorders out there including Pervasive Developmental Disorder (PDD), Aspergers, etc, etc, etc.

I've spent endless hours educating the educators on attachment disorder & PTSD; they only knew those diagnosis's because of the level of interference those disorders played out in the academic setting & because kt & wm were interfering with the education of others in their classrooms.

https://web.archive.org/web/20130525042659/http://www.attachmentdisorder.net/overviewforteach.htm This is the handout I gave to everyone of the tweedles teachers & SWs; anyone involved in their education process.

As I said, not every child needs attachment therapy. This one is on you sweetie ~ you know in your mother's heart whether your child has issues in this area. Please know that attachment therapy is incredibly intense for all involved, should never be attempted with-o the parent involved (no matter what age of the child), & is an intensely private time. All the school needs to know is how, if you feel it's warranted, it will affect your difficult children academic/educational experience.

I hope this makes sense ~ feel as tho I'm rambling tonight.

 

[pepperidge]

Linda and others--thanks for weighing in. Do I think we have attachment issues--I would seriously doubt it given the environment these kids have had from day 1. They seemed pretty attached as babies and toddlers to me and within generally normal behavior aside from impulsiveness and total lack of speech of Fetal Alcohol Syndrome (FAS) kid. Though at adolesence and with all their antics sometimes I have to wonder what goes on in their brains and whether they love us at all. I suspect I am not the only one to wonder that. But I think my kids problems' have been pretty circumscribed to some pretty specific areas and that with appropriate medications and modifications in their environments we have made tremendous progress.

Linda if it is not too personal can you give me a general idea of what a therapist might do in attachment therapy that is different than other therapy--I have read about the controversy with Evergreen ? etc but am curious if that is what it is all about or whether there are other schools of thought on what actually is attachment therapy.

Thanks you all for validating my sense that the SD has overstepped its boundaries on this one. The other thing the FBA lady wanted to know was about what medications he was on what the side effects were when they were changed (perhaps not out of bounds since we did tell the SD that we thought some of his bizarre behavior in DEc was to bad side reaction) but then she made a comment about how kids need medication adjustments in puberty. Maybe it was just a general comment but I am afraid that I inwardly reacted to that comment as if we were not on top of his medication game. Now I have been living in the psychiatrist office this fall ...lol.

Now my job is to convey my reactions in an appropriate and professional manner that does not get me labelled as a defensive b####. Actually feel like you all have helped by telling me that my reactions are not out of line. Thanks!

 

[HaoZi]

I do keep the school nurse up to date on any medication changes kiddo has because of side effects. I bring her in all the paperwork that comes with the medication, and since some of her medications have involved the possibility of over-heating I also catch her gym teacher and let her know to watch for it. Kiddo has a history of nasty side-effects from her medications, though.

 

[barneysmom]

pepperidge,

I think it's a great strategy to use a calm and professional manner (as you have already stated). I have honed mine over the years. I try to maintain my dignity and use a kind voice and calm eye contact while I am saying exactly what I need to say. If I need to, I take a little time to answer. If someone has said something I don't like, I try to address it before I leave, even if the meeting is over, and in the same calm, kind voice.

About the medication adjustments in puberty -- she probably uses the same lines, same context on every parent -- but that would have rankled me. She needs to say stuff like "You probably know about the medication adjustments needed during adolescence . . .", otherwise you could bring her attention to all the time you've already spent in the psychiatrist's office. She needs a context for whom she's talking to.

You're doing good and you know this already -- just my 2cents. It's almost as though the parent needs to establish him/herself as the leader of the team, or at least co-leader, not just the passive receiver of services. We are the educators.

Jo

 

[Frazzledmom]

A therapist we work with says that adoption counts for 10% of issues (of course depending on the kid) - not sure where she got that number. Anyway, she means that if a child has issues anyway that 10% that is adoption could send them over the edge so to speak. It makes sense to me. It's not entirely responsible but certainly can contribute, particularly if there are underlying issues. Good luck!

 

[pepperidge]

frazzled--As people have talked about on another recent adoption thread, at a minimum most adoptees have self esteem issues stemming from the fact that they were placed that need addressing at some point. Whether or not such issues contributed to dysfunctional behavior is another whole ball of wax, and those self esteem type issues (for lack of a better word) are certainly not the same as attachment issues.

This whole experience has thrown me for a loop not sure why. A bunch of different actors in the school system with different agendas that I only half understand, lack of understanding on part of school district, patronizing/anger on part of district, and then underlying all that real worry about what the future holds for my son. I think actually the school district has done a pretty good job on the education front, but as we get closer to adulthood and kids start having much more independence and maturity and I see my son lagging, I think how are we going to negotiate this so that he stays out of trouble but has a reasonable adolesence with friends and activities with the supervision he needs.

You know I am thinking about a possible private placement -- but don't want him to be with conduct disordered kids, what I want is for him to be with "good" kids who just need more supervision and help negotiating social challenges but in ways that he can have still have normal fun. Right now we have a kid that isn't in trouble, isn't doing drugs, is doing well enough at school, but isn't anywhere near as mature as his peers and isn't certainly being granted the same freedoms.

So I will have to summon my courage and best behavior --calm voice and eye contact as Jo has said to deal with the uninformed and patronizing school. REally I am too old for this.