Bedwetting in School-Aged Children

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Bedwetting is an issue that comes up in elementary school from time to time. Here are some resources to help support this situation for your students. The good news is that for many children the problem will resolve itself over time, or can be fixed through fairly simple treatment.

Bedwetting (also called nocturnal enuresis) is very common. As the following graph shows, almost a third of four-year-olds wet the bed. By the time they are 6, only one in 10 children wet the bed, and one in 20 by age 10. Bedwetting can sometimes continue into adolescence.

Percentage of children who wet the bed at different ages

bed wetting graph

Source

Nighttime bedwetting. This type of bedwetting is a common sleep
a problem in children ages 6–12, occurring only during NREM sleep.
Primary enuresis (the child has never been persistently dry at night)
is associated with a family history of the problem, developmental lag,
or lower bladder capacity, and is unlikely to signal a serious
problem. Secondary enuresis (a recurrence of bedwetting after a year
or more of bladder control) is more likely to be associated with
emotional distress. Interventions include the use of reinforcement and
responsibility training (such as keeping a dry night chart), bladder
control training, conditioning (e.g., bedwetting alarms), and
sometimes medication. In the case of secondary enuresis, it might be
most helpful to determine any source of emotional stress and address
it directly. (For example, if a child starts wetting the bed at night
following parents’ separation or divorce, providing counseling to
address loss issues might help alleviate bedwetting.)

Source

When to see a doctor

You may wish to see a doctor about your child’s bedwetting if:

  • your child is at least six years old (treatment for bedwetting is not recommended before this age as treatment is less effective and many children get better on their own)
  • you or your child are troubled or frustrated by the bedwetting
  • you punish, or are concerned that you might punish, your child for wetting the bed
  • your child wets or has bowel movements in their pants during the daytime.

If your child has been dry at night for six months then begins to wet their bed again, it is important to see a doctor for evaluation.

The doctor will consider your child’s details and determine if there is a physical problem that needs to be addressed.

Source
BEDWETTING

Nocturnal enuresis is the medical term for bedwetting. Most children
wet the bed occasionally or even nightly during the potty-training
years. In fact, it is estimated that seven million children in the
United States wet their beds on a regular basis. Controlling bladder
function during sleep is usually the last stage of potty-training. In
others words, it is normal for children to wet the bed while sleeping
during that learning process. Bedwetting is typically not even
considered to be a problem until after age 7.

Bedwetting in children is often simply a result of immaturity. The age
at which children become able to control their bladders during sleep
is variable. Bladder control is a complex process that involves
coordinated action of the muscles, nerves, spinal cord and brain. In
this case, the problem will resolve in time. On the other hand, it may
be an indication of an underlying medical condition, such as
obstruction of the urinary tract. If bedwetting persists beyond the
age of 6 or 7, you should consult your pediatrician.

There are both primary and secondary forms of bedwetting. With primary
bedwetting, the child has never had nighttime control over urination.
The secondary form is less common and refers to bedwetting that occurs
after the child has been dry during sleep for 6 or more months.
Secondary bedwetting may be caused by psychological stress but may be
the result of an underlying medical condition such as constipation or
urinary tract obstruction. With secondary bedwetting, contact your
doctor for an evaluation.

Commonly prescribed behavioral methods for treating the problem include:

Establishing a regular bedtime routine that includes going to the bathroom
Waking your child during the night before he/she typically wets the
bed and taking him/her to the bathroom
Developing a reward system to encourage your child, such as stickers
for dry nights
Talking to your child about the advantages of potty-training, such as
not having to wear diapers and becoming a “big kid”
Limiting beverages in the evening – even those last minute water requests
Using a “bell-and-pad” which incorporates an alarm that goes off
whenever your child’s pajamas or bed become wet during an accident.
These systems teach your child to eventually wake up before the
bedwetting occurs

As a last resort, a doctor may prescribe medication for bedwetting,
either for short or long-term use. Some examples are imipramine (an
antidepressant), which relaxes the bladder, and desmopressin, a
man-made copy of a normal body chemical that controls urine production
at night. Although medication usually helps, bedwetting typically
resumes once the child stops taking the medicine. As with any drug, it
is important to monitor your child’s response to the medication.

Coping with Bedwetting:

There are products that parents can buy for school-aged children with enuresis:

Disposable absorbent underpants
Reusable absorbent underpants
Sleeping bag liners
Moisture alarms that go off when the child begins to wet the bed

There is no reason for punishment if your child wets the bed. Your
child cannot help it. Talk to your doctor about treatment options and
following these coping tips may help:

Be patient, understanding and attentive
Do not talk about the bedwetting in front of others
Talk to your child about how the bladder works
Avoid fluids in the hours before bed

Source

Links

Bed-wetting: Tips to Help Your Child

Check Out Some of the AMAZING Resources at the IRIS CENTER

IRIS Center

IRIS Link

I ran across this site and use it regularly to help support students at my schools. I hope you like it as much as I do!

The IRIS Center offers a wide variety of resources and services to suit a diverse set of instructional needs and circumstances. IRIS is supported by the U.S. Department of Education’s Office of Special Education Programs and located at Vanderbilt University’s Peabody College, the IRIS Center develops and disseminates free, engaging online resources about evidence-based instructional and behavioral practices to support the education of all students, particularly struggling learners and those with disabilities. These resources, designed to bridge the research-to-practice gap, are intended for use in college teacher preparation programs, in professional development (PD) activities for practicing professionals, and by independent learners. The array of IRIS resources includes modules, case studies, information briefs, course/PD activities, a high-leverage practices alignment tool, and an online glossary of disability-related terms as well as supporting products to enhance their use in coursework and PD activities.Developed in collaboration with nationally recognized researchers and education experts, our free online resources address instructional and classroom issues of critical importance to today’s educators: classroom behavior management, secondary transition, early childhood, Universal Design for Learning (UDL), and many others.

In addition to our free resources, IRIS offers low-cost online professional development options: Certificates of Completion for IRIS Modules, a School & District Platform, and micro-credentials.

Since 2001, IRIS resources have been used in teacher preparation programs throughout the United States and around the world. In 2017 alone, the IRIS Website hosted more than two million visits.
Learn more about IRIS in our informative brochure.

En español

En español

En español

Student Anxiety – Tools, Worksheets, and App From “Anxiety Canada”

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Student anxiety can really impact their learning. Cognitive Behavioral Therapy and Psychopharmacological interventions are sometimes recommended when anxiety fiercely gets in the way of doing day to day activities. Consult an expert if this applies to your child. Below is a list of tools and worksheets to help address issues related to anxiety.

Tools

Worksheets

Web-­based Resources (International)
AnxietyBC
• Psychoeducational material and handouts for parents, teachers, and family and
friends of children with SM (search ‘selective mutism’ for all information on the
topic).
• Website -­‐ www.anxietybc.com
• Children’s section -­‐ http://www.anxietybc.com/parenting/parent-­‐child
• Short 11 min. video on understanding and managing Selective Mutism.
http://www.anxietybc.com/resources/video/understanding-­‐and-­‐managing-­‐
selective-­‐mutism
• Lecture on Selective Mutism given by Dr. Annie Simpson
http://www.anxietybc.com/resources/video/selective-­‐mutism-­‐giving-­‐kids-­‐
voice-­‐dr-­‐annie-­‐simpson
Dr. Steven Kurtz’s
• A treatment provider in New York. Check his website for a selective mutism e-­‐
learning website (coming soon).
• Website https://kurtzpsychologyconsulting.wordpress.com
Child Mind Institute
• Website -­‐ http://www.childmind.org/
• A treatment centre in New York that also provides webinars on various aspects
of selective mutism treatment (search ‘selective mutism’ and look for events)
Selective Mutism Group
• Website -­‐ http://www.selectivemutism.org
• Provides information, resources, and support to those impacted by selective
mutism

MindShift™ App

Struggling with anxiety? Tired of missing out? There are things you can do to stop anxiety and fear from controlling your life. MindShift™ is an app designed to help teens and young adults cope with anxiety. It can help you change how you think about anxiety. Rather than trying to avoid anxiety, you can make an important shift and face it.

 

MindShift™ will help you learn how to relax, develop more helpful ways of thinking, and identify active steps that will help you take charge of your anxiety. This app includes strategies to deal with everyday anxiety, as well as specific tools to tackle:

    • Making Sleep Count
    • Riding Out Intense Emotions
    • Test Anxiety
    • Perfectionism
    • Social Anxiety
    • Performance Anxiety
    • Worry
    • Panic
    • Conflict

 

Think of MindShift™ as your portable coach helping you face challenging situations and take charge of your life.

If you are a MindShift user, please consider making a donation to help us maintain and continue to offer the app for free.

MindShift stems from a one time joint collaboration in 2012 between Anxiety Canada and BC Children’s Hospital, an agency of the Provincial Health Services Authority.  In 2016 RBC Children’s Mental Health Projectprovided funding for an enhancement to the app.  Learn more about our privacy policy.

 

 

Nemours Has Great Resources for Reading and Health

I ran across this Nemours website by accident looking for developmental reading resources and I found so much more. I hope you find it as useful as I have in looking at reading and health subjects in a very concise and accessible format.

READING

HEALTH

TEACHERS

Teacher Site for Health Topics By Grade Level

Making the Most of Recess

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Good Reads

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What you promote by creating a positive recess experience:

Outdoor Play Allows a School-Aged Child to:
-Increase the flow of blood to the brain. The blood delivers oxygen and glucose, which the brain needs for heightened alertness and mental focus.

-Build up the body’s level of brain-derived neurotrophic factor or BDNF, BDNF causes the brain’s nerve cells to branch out, join together and communicate with each other in new ways, which leads to your child’s openness to learning an more capacity for knowledge

-Build new brain cells in a brain region called dentate gyrus, which is linked
with memory and memory loss.

-Improves their ability to learn.

-Increase the size of basal ganglia, a key part of the brain that aids in
maintaining attention and “executive control,” or the ability to coordinate
actions and thoughts crisply.

-Strengthen the vestibular systems that create spatial awareness and mental
alertness. This provides your child with the framework for reading and other
academic skills 

-Help creativity

Raise Smart Kid (2015). The Benefits of Exercise On Your Kid’s Brain.

Addressing Conflict on the Yard

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Conflict is normal

Conflict is a normal part of children’s lives. Having different needs or wants, or wanting the same thing when only one is available, can easily lead children into conflict with one another. “She won’t let me play,” “He took my …”, “Tom’s being mean!” are complaints that parents, carers and school staff often hear when children get into conflict and are unable to resolve it. Common ways that children respond to confl ict include arguing and physical aggression, as well as more passive responses such as backing off and avoiding one another.

When conflict is poorly managed it can have a negative impact on children’s relationships, on their self-esteem and on their learning. However, teaching children the skills for resolving conflict can help signifi cantly. By learning to manage conflict effectively, children’s skills for getting along with others can be improved. Children are much happier, have better friendships and are better learners at school when they know how to manage conflict well.

Different ways of responding to conflict

Since children have different needs and preferences, experiencing conflict with others is unavoidable. Many children (and adults) think of conflict as a competition that can only be decided by having a winner and a loser. The problem with thinking about conflict in this way is that it promotes win-lose behaviour: children who want to win try to dominate the other person; children who think they can’t win try to avoid the conflict. This does not result in effective conflict resolution.

Win-lose approaches to conflict

Children may try to get their way in a conflict by using force. Some children give in to try to stop the conflict, while others try to avoid the situation altogether. These different styles are shown below. When introducing younger children to the different ways that conflicts can be handled, talking about the ways the animals included as examples below might deal with conflict can help their understanding. It introduces an element of fun and enjoyment.

Conflict style Animal example Child’s behaviour
Force Shark, bull, lion Argues, yells, debates, threatens, uses logic to impose own view.
Give in Jelly fish, teddy bear Prevents fights, tries to make others happy.
Avoid Ostrich, turtle Thinks or says: “I don’t want conflict.” Distracts, talks about something else, leaves the room or the relationship.

Sometimes these approaches appear to work in the short-term, but they create other sets of problems. When children use force to win in a conflict it creates resentment and fear in others. Children who ‘win’ using this approach may develop a pattern of dominating and bullying others to get what they want. Children who tend to give in or avoid conflict may lack both confidence and skills for appropriate assertive behaviour. They are more likely to be dominated or bullied by others and may feel anxious and negative about themselves.

It is possible instead to respond to conflict in positive ways that seek a fair outcome. Instead of being seen as a win-lose competition, conflict can be seen as an opportunity to build healthier and more respectful relationships through understanding the perspectives of others.

Win-some lose-some: Using compromise to resolve conflict

Adults have a significant impact on how children deal with conflict. Often adults encourage children to deal with conflict by compromising. Compromising means that no-one wins or loses outright. Each person gets some of what they want and also gives up some of what they want. Many children learn how to compromise as they grow and find ways to negotiate friendships. It is common around the middle of primary school for children to become very concerned with fairness and with rules as a way of ensuring fairness. This may correspond with an approach to resolving conflict that is based on compromise.

Conflict style Animal example Child’s behaviour
Compromise Fox I give a bit and expect you to give a bit too.

Win-win: Using cooperation to resolve conflict

Using a win-win approach means finding out more about the problem and looking together for creative solutions so that everyone can get what they want.

Conflict style Animal example Child’s behaviour
Sort out the problem

(Win-win)

Owl Discover ways of helping everyone in the conflict to get what they want.

Skills required for effective conflict resolution

Effective conflict resolution requires children to apply a combination of well-developed social and emotional skills. These include skills for managing feelings, understanding others, communicating effectively and making decisions. Children need guidance and ‘coaching’ to learn these skills. Learning to use all the skills effectively in combination takes practice and maturity. However, with guidance children can begin to use a win-win model and gradually develop their abilities to resolve conflicts independently.

Skill What to encourage children to learn
  • Manage strong emotions
  • Use strategies to control strong feelings
  • Verbally express own thoughts and feelings
  • Identify and communicate thoughts and feelings
  • Identify the problem and express own needs
  • Talk about their own wants/needs/fears/concerns without demanding an immediate solution
  • Understand the other person’s perspective
  • Listen to what the other person wants/needs
  • Understand the other person’s fears/concerns
  • Understand without having to agree
  • Respond sensitively and appropriately
  • Generate a number of solutions to the problem
  • Think of a variety of options
  • Try to include the needs and concerns of everyone involved
  • Negotiate a win-win solution
  • Be flexible
  • Be open-minded
  • Look after own needs as well as the other person’s needs (be assertive)

Guiding children through the steps of conflict resolution

1. Set the stage for WIN-WIN outcomes

Conflict arises when people have different needs or views of a situation. Make it clear that you are going to help the children listen to each other’s point of view and look for ways to solve the problem that everyone can agree to.

  • Ask, “What’s the problem here?” Be sure to get both sides of the story (eg “He won’t let me have a turn” from one child, and “I only just started and it’s my game,” from another).
  • Say, I’m sure if we talk this through we’ll be able to sort it out so that everyone is happy.”

2. Have children state their own needs and concerns

The aim is to find out how each child sees the problem. Help children identify and communicate their needs and concerns without judging or blaming.

  • Ask, “What do you want or need? What are you most concerned about?”

3. Help children listen to the other person and understand their needs and concerns

In the heat of conflict it can be difficult to understand that the other person has feelings and needs too. Listening to the other person helps to reduce the conflict and allows children to think of the problem as something they can solve together.

  • Ask, “So you want to have a turn at this game now because it’s nearly time to go home? And you want to keep playing to see if you can get to the next level?”
  • Show children that you understand both points of view: “I can understand why you want to get your turn. I can see why you don’t want to stop now.”

4. Help children think of different ways to solve the problem

Often children who get into conflict can only think of one solution. Getting them to think of creative ways for solving the conflict encourages them to come up with new solutions that no-one thought of before. Ask them to let the ideas flow and think of as many options as they can, without judging any of them.

  • Encourage them: “Let’s think of at least three things we could do to solve this problem.”

5. Build win-win solutions

Help children sort through the list of options you have come up with together and choose those that appear to meet everybody’s needs. Sometimes a combination of the options they have thought of will work best. Together, you can help them build a solution that everyone agrees to.

  • Ask: Which solution do you think can work? Which option can we make work together?

6. Put the solution into action and see how it works

Make sure that children understand what they have agreed to and what this means in practice.

  • Say, “Okay, so this is what we’ve agreed. Tom, you’re going to show Wendy how to play the game, then Wendy, you’re going to have a try, and I’m going to let you know when 15 minutes is up.”

Key points for helping children resolve conflict

The ways that adults respond to children’s conflicts have powerful effects on their behaviour and skill development. Until they have developed their own skills for managing conflict effectively most children will need very specific adult guidance to help them reach a good resolution. Parents, carers and teaching staff can help children in sorting out conflict together, by seeing conflict as a shared problem that can be solved by understanding both points of view and finding a solution that everyone is happy with.

Guide and coach

When adults impose a solution on children it may solve the conflict in the short term, but it can leave children feeling that their wishes have not been taken into account. Coaching children through the conflict resolution steps helps them feel involved. It shows them how effective conflict resolution can work so that they can start to build their own skills.

Listen to all sides without judging

To learn the skills for effective conflict resolution children need to be able to acknowledge their own point of view and listen to others’ views without fearing that they will be blamed or judged. Being heard encourages children to hear and understand what others have to say and how they feel, and helps them to learn to value others.

Support children to work through strong feelings

Conflict often generates strong feelings such as anger or anxiety. These feelings can get in the way of being able to think through conflicts fairly and reasonably. Acknowledge children’s feelings and help them to manage them. It may be necessary to help children calm down before trying to resolve the conflict.

Remember

  • Praise children for finding a solution and carrying it out.
  • If an agreed solution doesn’t work out the first time, go through the steps again to understand the needs and concerns and find a different solution.

The information in this resource is based on Wertheim, E., Love, A., Peck, C. & Littlefield, L. (2006). Skills for resolving conflict (2nd Edition). Melbourne: Eruditions Publishing.

Web: Source

Reactive Attachment Disorder at School

Students with Reactive Attachment Disorder often need a unique plan to help find them success at school. This post aims to help bring understanding and ideas to support your students with Reactive Attachment Disorder.

What it can look like-

rad2bsymptoms

Twenty RAD symptoms by Todd Friel- Source

  1. Superficially charming. Never real. Always fake. Good enough to fool people who don’t know them well. Used extensively for manipulation purposes. Examples: I love you mommy, all super sweet, after being verbally and physically abusive to mommy for days because RAD just realized they want something only mommy can give to them. Or, charming the pants off of a stranger, then telling their “poor orphan” story so the person will feel sorry for them then buy or give them what they want.
  2. Lack of eye contact. They will not engage unless they want something. They will only have direct eye contact when they want something from you and they are trying to gauge your reaction to their request or behavior. If you begin a conversation with them they will look everywhere except at you.
  3. Indiscriminately affectionate with strangers. Ours point blank told us that they trusted the stranger they met that afternoon more than they trusted us, their parents. Hugging and snuggling with complete strangers within moments of meeting them is very common. Stroking other people including their hair and rubbing their hands over the strangers back and shoulders. They will grab and hold hands. They have ZERO natural boundaries. In fact this was a symptom of RAD we were unaware of when we met our RAD’s who were overly affectionate with us immediately upon meeting us. Red flag.
  4. Not affectionate on parents’ terms. Only when RAD wants something will they say things like I’m sorry, I love you, or show any signs of affection including using terms such as mom or dad. I learned that when I heard one of them say “mom” to be on alert because they were attempting to manipulate me. Sometimes we gave in on something they wanted simply to see a glimpse of the child/teen we thought they were all the while knowing once they get what they want they will go back to their same bad behavior and we will be disappointed once again.
  5. Destructive to self, others, animals, and material things. I could write a book about this – oh wait! I did! Self-harming is something many RAD’s do, many times to gain attention. Above all else they want all attention focused on themselves. We found the majority of the destruction from our RAD’s was aimed at hurting mom who they viewed as the enemy. Anything mom cared for became a target. That included biological children, pets, or anything that’s important to mom. If I buy the puppy a new toy it is sure to come up missing within hours. If my bio daughter gets a new notebook for school something of hers will go missing or the new notebook will have slits through it from a knife. Nothing is sacred. As mom I am very careful to what or whom I pay any special attention because there will be repercussions. If there is a baby or toddler in the home they need to be watched 24/7 to keep them from being harmed.
  6. Cruelty to animals. RAD’s can be very cruel. They love to torment those who are weaker than they are to show their superiority, and even more so if this animal is one that I, their enemy, shows any affection whatsoever. One woman who rescued cats found her adopted daughter throwing the cats against the wall to see it they would break. They did. Many of them died. There was zero remorse. She thought it was funny. And when she saw her mom crying it made her even happier.
  7. Lying about the obvious. Here is an example that happened over and over again in our home. I see RAD take something that doesn’t belong to them. I tell them to put it back because it isn’t theirs. RAD states they didn’t take it even though it is in their hand. I say there it is right in your hand. This will go on forever unless you threaten to take something of theirs from them. No amount of reasoning will do anything except add to the frustration. After putting up camera’s in my home office to keep them from stealing we showed them the video’s of them going into my purse and taking money. They all denied it vehemently even though the video clearly showed them putting the money into their pockets. They were so angry that we accused them that they slammed out the front door and we didn’t see them until the police brought them home three days later. Then adding insult to injury when brought home they told the police they ran away because we were stealing their money.
  8. Stealing. Constant. Anything of perceived value. From us. From school mates. From teachers. From stores. From gas stations. From friends. From strangers. With zero remorse or admittance even when caught. On the other hand when someone steals something from them (which happened to one of our RAD’s at school). After he noticed that $5 was taken from his jacket he blew up and screamed profanities until he had to be physically restrained and I was called to pick him up where he continued to scream at me about his $5. This was the same boy who stole hundreds of dollars from us. When I attempted to help him empathize with us who he had stolen from he simply told me it was not the same and continued to rant for hours about his $5.
  9. No impulse controls. What they want, they take. What they want to do, they do. They care nothing about consequences and in fact will be surprised if caught and then mad they got caught for something they think is no big deal. They completely turn the tables until everything, including what they did, is someone else’s fault. It is narcissism gone wild. They can only think about themselves and what they want. You cannot reason with this mentality.
  10. Lack of conscience. As stated in several examples above, they have no reality of anything ever being their responsibility or fault. They will never feel badly about something they’ve done. Sometimes they will act as if they feel badly and say they are sorry but only if they think it will get them out of trouble. Manipulation tactic. One of our adopted RAD’s is back in his home country. He messages me and tells me he is sorry for molesting our 15-year-old daughter. Then he asks me to help him get back to America. One time I flat out said to him that the only reason he was saying he was sorry was so that I would help him. He agreed then asked if I would help him anyway.
  11. Abnormal eating patterns. They can eat enormous amounts of food or no food at all for days. They will eat strange combinations like an entire container of sour cream with a cup of sugar on top. They will ask for a certain food and once made will refuse to eat it telling you it looks like garbage. They will steal food from a local store and we’ll find it rotting, uneaten, in their room. If you put something in front of them they don’t like that day (they liked it last week) they will spit on it and me, asking why I feed them such garbage. (This is homemade from scratch food.) They will take the sandwich made with homemade bread and throw it in the garbage at school and then tell everyone we are starving them. We will wake up one morning and find the refrigerator was cleaned out of all the food we planned to serve that day. Later we’ll find empty containers in their room and uneaten food smashed under their mattress.
  12. Poor peer relationships. Making friends for most RAD’s is literally impossible. It goes back to it’s all about them. No one, even another small child who starts out as a friend, will put up with that behavior for long. RAD will keep up the relationship as long as there is something in it for them. After that they will walk away without a second thought. Our RAD’s even turned on each other when it suited them. There is no loyalty. And zero understanding when RAD tries to rekindle the relationship and the other person wants nothing to do with RAD. RAD doesn’t comprehend that it was them that ruined the relationship and the other person doesn’t want to get burned a second time.
  13. Preoccupation with fire. Constant talk of burning down the house, burning the car, burning everything meaningful to the family, and even burning the house with the family inside. Playing with matches and lighters. Drawing vivid pictures of burning buildings. Filling trash cans with combustibles and lighting them on fire. There are numerous stories of homes being burned to the ground by their RAD child or teen. Fire and RAD are a dangerous mixture.
  14. Preoccupation with blood and gore. If RAD is not watching porn on their (stolen) phone they will migrate to the most violent shows possible. They spend hours watching the news and the worse it is the more they are enthralled with it. A fellow adoptive mom said that her RAD daughter would only watch the beginning of a particular show because she liked watching the murder happen. The mom said she liked watching the criminals get caught and brought to justice. RAD said, “That’s boring.” They will draw pictures with lots of blood and scenes of murder. One mom found a picture drawn by RAD daughter of RAD standing over the mom while mom was sleeping with a bloody red knife in her hands and blood all over the room.
  15. Preoccupation with bodily functions. Painting with feces is common. There are even groups on social media where this is their main focus it is so common. Urinating on things of importance, into heating vents, and on furniture and even walls to ruin them. However, this bodily function doesn’t mean they have good hygiene and in most cases they have just the opposite. They will refuse to take showers or wash their hair. If they smell at school please know we do our best to make them wash but I cannot go into a shower with an older child or teenager to make sure they wash with soap and water.
  16. Persistent nonsense questions, chatter, and senseless noises. Non-stop questions about mindless things. Constant “why” questions where they don’t care one bit about the answer but are just taking up your time. They want to be the center of attention at all times. And if it’s not questions it is meaningless chatter or noise. Imagine someone who refuses to get more than two feet from you who constantly clicks their tongue over and over for five or six hours just because they know it makes you crazy. And if you ask them to stop, they just do it louder because they know they are achieving their goal. Or how about listening to non-stop screaming. They scream until they can’t scream anymore because they lose their voice. Once healed they start screaming all over again.
  17. Non-stop demanding of attention. RAD must be the center of attention at all times. If someone or something else has your attention they will force themselves between in any way they can. One dad told this story. He was playing cards with another child at the kitchen table. RAD attempted to sit on dad’s lap – this is a 16-year-old male – and when that didn’t work he pulled up a chair so close it was touching dad’s chair and leaned heavily against dad, talking constantly and disrupting through the entire game and even putting his feet up on the table, asking dad to rub his feet. AND this was AFTER dad asked RAD to play the game with him and RAD retorted with profanity that he hates playing games and stomped off to his room. It was only after dad started playing with the other child that RAD became interested.
  18. Triangulation of adults. I wrote several sections in Adoption Combat Zone on triangulation. Most times this is pitting dad against mom but triangulation can occur with any adult who the RAD can manipulate including fellow church members, teachers, neighbors, extended family members, etc. The goal for the RAD is to manipulate someone to take their side in things. Triangulation occurs when RAD is allowed to come between adults. To one side they show their worst and the other, only their best. One person sees a sweet, adorable, perfect child/teen, the other sees someone who is trying to destroy them through whatever means possible. All this is done in order to get the life the RAD wants, one where they are in total control.
  19. False allegations of abuse. This is more common than any sane person would think and I’ve written much about it in the book. This is the number one go-to for RAD’s to get back at anyone who is not giving them what they want or to try and get what they want. We were turned into the authorities by our RAD’s several times for made-up abuses simply for not allowing them to keep a phone they stole and sit up all night watching porn on said phone. Mad at it being taken away they went to school the next day and reported us for abuse. Or when they feel threatened because they were caught doing something wrong they will turn in someone else in order to take the heat off themselves. They are fantastic story tellers.
  20. Creating chaos. RAD’s are experts at creating commotion so they can be the center of attention whether it be something like the dad playing a game above or something more serious such as starting a fire in your kitchen so they can go through your purse to steal your cash and credit cards. They will disrupt family dinners and outings. They love arguing and the louder it gets, the better.

This video by Todd Friel is a must-watch for anyone who is a friend, teacher, or family member of someone who has adopted a RAD child/teen. https://www.youtube.com/watch?v=5ypmGTGGN7A&t=2s

If you are a family with a RAD child or teen here is an excellent resource for you: http://instituteforattachment.org/

reactive-attachment-disorder-rad-infographic

Articles

AN OPEN LETTER TO EDUCATORS WHO WORK WITH STUDENTS WHO HAVE BEEN DIAGNOSED WITH REACTIVE ATTACHMENT DISORDER OR HAVE SUFFERED EARLY TRAUMA By Carey McGinn Ed.D., CCC/SLP

3 things teachers should know about their students with reactive attachment disorder By: Institute For Attachment and Child Development

Reactive Attachment Disorder – Fact Sheet

Children with Reactive Attachment Disorder FACT SHEET FOR EDUCATORS By Connie Hornyak, LCSW

Reactive Attachment Disorder: A Summary for Teachers Jessica Murphy, MSW, LICSW

Back to School With Reactive Attachment Disorder: 10 Things to do – by- JOHN M. SIMMONS

10 tips to work with school staff on an effective IEP for your child with reactive attachment disorder By: Institute For Attachment and Child Development

DEFINITIONS

MAYO CLINIC

Overview

Reactive attachment disorder is a rare but serious condition in which an infant or young child doesn’t establish healthy attachments with parents or caregivers. Reactive attachment disorder may develop if the child’s basic needs for comfort, affection and nurturing aren’t met and loving, caring, stable attachments with others are not established.

With treatment, children with reactive attachment disorder may develop more stable and healthy relationships with caregivers and others. Treatments for reactive attachment disorder include psychological counseling, parent or caregiver counseling and education, learning positive child and caregiver interactions, and creating a stable, nurturing environment.

Symptoms

Reactive attachment disorder can start in infancy. There’s little research on signs and symptoms of reactive attachment disorder beyond early childhood, and it remains uncertain whether it occurs in children older than 5 years.

Signs and symptoms may include:

  • Unexplained withdrawal, fear, sadness or irritability
  • Sad and listless appearance
  • Not seeking comfort or showing no response when comfort is given
  • Failure to smile
  • Watching others closely but not engaging in social interaction
  • Failing to ask for support or assistance
  • Failure to reach out when picked up
  • No interest in playing peekaboo or other interactive games

When to see a doctor

Consider getting an evaluation if your child shows any of the signs above. Signs can occur in children who don’t have reactive attachment disorder or who have another disorder, such as autism spectrum disorder. It’s important to have your child evaluated by a pediatric psychiatrist or psychologist who can determine whether such behaviors indicate a more serious problem.

Causes

To feel safe and develop trust, infants and young children need a stable, caring environment. Their basic emotional and physical needs must be consistently met. For instance, when a baby cries, the need for a meal or a diaper change must be met with a shared emotional exchange that may include eye contact, smiling and caressing.

A child whose needs are ignored or met with a lack of emotional response from caregivers does not come to expect care or comfort or form a stable attachment to caregivers.

It’s not clear why some babies and children develop reactive attachment disorder and others don’t. Various theories about reactive attachment disorder and its causes exist, and more research is needed to develop a better understanding and improve diagnosis and treatment options.

Risk factors

The risk of developing reactive attachment disorder from serious social and emotional neglect or the lack of opportunity to develop stable attachments may increase in children who, for example:

  • Live in a children’s home or other institution
  • Frequently change foster homes or caregivers
  • Have parents who have severe mental health problems, criminal behavior or substance abuse that impairs their parenting
  • Have prolonged separation from parents or other caregivers due to hospitalization

However, most children who are severely neglected don’t develop reactive attachment disorder.

Complications

Without treatment, reactive attachment disorder can continue for several years and may have lifelong consequences.

Some research suggests that some children and teenagers with reactive attachment disorder may display callous, unemotional traits that can include behavior problems and cruelty toward people or animals. However, more research is needed to determine if problems in older children and adults are related to experiences of reactive attachment disorder in early childhood.

Prevention

While it’s not known with certainty if reactive attachment disorder can be prevented, there may be ways to reduce the risk of its development. Infants and young children need a stable, caring environment and their basic emotional and physical needs must be consistently met. The following parenting suggestions may help.

  • Take classes or volunteer with children if you lack experience or skill with babies or children. This will help you learn how to interact in a nurturing manner.
  • Be actively engaged with your child by lots of playing, talking to him or her, making eye contact, and smiling.
  • Learn to interpret your baby’s cues, such as different types of cries, so that you can meet his or her needs quickly and effectively.
  • Provide warm, nurturing interaction with your child, such as during feeding, bathing or changing diapers.
  • Offer both verbal and nonverbal responses to the child’s feelings through touch, facial expressions and tone of voice.

Source

Diagnosis

A pediatric psychiatrist or psychologist can conduct a thorough, in-depth examination to diagnose reactive attachment disorder.

Your child’s evaluation may include:

  • Direct observation of interaction with parents or caregivers
  • Details about the pattern of behavior over time
  • Examples of the behavior in a variety of situations
  • Information about interactions with parents or caregivers and others
  • Questions about the home and living situation since birth
  • An evaluation of parenting and caregiving styles and abilities

Your child’s doctor will also want to rule out other psychiatric disorders and determine if any other mental health conditions co-exist, such as:

  • Intellectual disability
  • Other adjustment disorders
  • Autism spectrum disorder
  • Depressive disorders

Diagnostic and Statistical Manual of Mental Disorders (DMS-5)

Your doctor may use the diagnostic criteria for reactive attachment disorder in the DSM-5, published by the American Psychiatric Association. Diagnosis isn’t usually made before 9 months of age. Signs and symptoms appear before the age of 5 years.

Criteria include:

  • A consistent pattern of emotionally withdrawn behavior toward caregivers, shown by rarely seeking or not responding to comfort when distressed
  • Persistent social and emotional problems that include minimal responsiveness to others, no positive response to interactions, or unexplained irritability, sadness or fearfulness during interactions with caregivers
  • Persistent lack of having emotional needs for comfort, stimulation and affection met by caregivers, or repeated changes of primary caregivers that limit opportunities to form stable attachments, or care in a setting that severely limits opportunities to form attachments (such as an institution)
  • No diagnosis of autism spectrum disorder

Treatment

Children with reactive attachment disorder are believed to have the capacity to form attachments, but this ability has been hindered by their experiences.

Most children are naturally resilient. And even those who’ve been neglected, lived in a children’s home or other institution, or had multiple caregivers can develop healthy relationships. Early intervention appears to improve outcomes.

There’s no standard treatment for reactive attachment disorder, but it should involve both the child and parents or primary caregivers. Goals of treatment are to help ensure that the child:

  • Has a safe and stable living situation
  • Develops positive interactions and strengthens the attachment with parents and caregivers

Treatment strategies include:

  • Encouraging the child’s development by being nurturing, responsive and caring
  • Providing consistent caregivers to encourage a stable attachment for the child
  • Providing a positive, stimulating and interactive environment for the child
  • Addressing the child’s medical, safety and housing needs, as appropriate

Other services that may benefit the child and the family include:

  • Individual and family psychological counseling
  • Education of parents and caregivers about the condition
  • Parenting skills classes

Controversial and coercive techniques

The American Academy of Child and Adolescent Psychiatry and the American Psychiatric Association have criticized dangerous and unproven treatment techniques for reactive attachment disorder.

These techniques include any type of physical restraint or force to break down what’s believed to be the child’s resistance to attachments — an unproven theory of the cause of reactive attachment disorder. There is no scientific evidence to support these controversial practices, which can be psychologically and physically damaging and have led to accidental deaths.

If you’re considering any kind of unconventional treatment, talk to your child’s psychiatrist or psychologist first to make sure it’s evidence based and not harmful.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Coping and support

If you’re a parent or caregiver whose child has reactive attachment disorder, it’s easy to become angry, frustrated and distressed. You may feel like your child doesn’t love you — or that it’s hard to like your child sometimes.

These actions may help:

  • Educate yourself and your family about reactive attachment disorder. Ask your pediatrician about resources or check trusted internet sites. If your child has a background that includes institutions or foster care, consider checking with relevant social service agencies for educational materials and resources.
  • Find someone who can give you a break from time to time. It can be exhausting caring for a child with reactive attachment disorder. You’ll begin to burn out if you don’t periodically have downtime. But avoid using multiple caregivers. Choose a caregiver who is nurturing and familiar with reactive attachment disorder or educate the caregiver about the disorder.
  • Practice stress management skills. For example, learning and practicing yoga or meditation may help you relax and not get overwhelmed.
  • Make time for yourself. Develop or maintain your hobbies, social engagements and exercise routine.
  • Acknowledge it’s OK to feel frustrated or angry at times. The strong feelings you may have about your child are natural. But if needed, seek professional help.

Preparing for your appointment

You may start by visiting your child’s pediatrician. However, you may be referred to a child psychiatrist or psychologist who specializes in the diagnosis and treatment of reactive attachment disorder or a pediatrician specializing in child development.

Here’s some information to help you get ready and know what to expect from your doctor.

What you can do

Before your appointment, make a list of:

  • Any behavior problems or emotional issues you’ve noticed, and include any signs or symptoms that may seem unrelated to the reason for your child’s appointment
  • Key personal information, including any major stresses or life changes that you or your child have been through
  • All medications, vitamins, herbal remedies or other supplements your child is taking, including the dosages
  • Questions to ask your child’s doctor to make the most of your time together

Some basic questions to ask your doctor may include:

  • What is likely causing my child’s behavior problems or emotional issues?
  • Are there other possible causes?
  • What kinds of tests does my child need?
  • What’s the best treatment?
  • What are the alternatives to the primary approach that you’re suggesting?
  • My child has these other mental or physical health conditions. How can I best manage them together?
  • Are there any restrictions that my child needs to follow?
  • Should I take my child to see other specialists?
  • Is there a generic alternative to the medicine you’re prescribing for my child?
  • Are there any brochures or other printed material that I can have? What websites do you recommend?
  • Are there social services or support groups available to parents in my situation?

What to expect from your doctor

Your child’s doctor or mental health provider is likely to ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to spend more time on.

Some questions the doctor may ask include:

  • When did you first notice problems with your child’s behavior or emotional responses?
  • Have your child’s behavioral or emotional issues been continuous or occasional?
  • How are your child’s behavioral or emotional issues interfering with his or her ability to function or interact with others?
  • Can you describe your child’s and the family’s home and living situation since birth?
  • Can you describe interactions with your child, both positive and negative?

Source

RadKid.Org Directory: Reactive Attachment Disorder Sites
Reactive Attachment Disorder Informational Sites Reactive Attachment Disorder Support Forums
RadKid.Org : Provides information and resources for caregivers of children with reactive attachment disorder in particular, but also includes descriptions of other childhood emotional, behavioral, or developmental disorders. ADSG : Attachment Disorder Support Group – Information and resources relating to reactive attachment disorder, from a Christian perspective. RadKid.Org : Reactive Attachment Disorder – Moderated by the folks at radkid.org & radkid.com, this is a support forum for parents, caregivers, therapists, and others concerned with reactive attachment disorder. Access is free, but requires registration with Delphi Forums. Forest Cottage Centre : Provides specialized coaching for parents of children with attachment disorder by telephone and through in-person sessions. Tanya Helton M/Sc is a well-known speaker in Canada on the issue of attachment, providing training for parents and professionals. Located in Fort St. John, British Columbia, Canada.
ATTACh : Association for the Treatment and Training in Attachment of Children – International coalition of professionals and lay persons who are involved with children who have attachment disorders. Includes a list of member therapists and treatment centers. The Attachment Disorder Site : Information and resources for parents and caregivers of children with attachment disorder. Find information about the effects of RAD on children and adults, some suggestions on dealing with schools and teachers, as well as adoption information. Hope for Radkids : Moderated by Nancy Geoghegan, this is a long-running and active support group for caregivers of children with reactive attachment disorder. Hosted on Yahoo Groups, this site requires registration, but access is free. St. Louis Attachment Network : Provides information, education, and support to families in the St. Louis, Missouri area. Includes a meeting schedule.
Nancy Thomas Parenting : A not-for-profit service organization offering information and resources on reactive attachment disorder directed at parents and teachers. Includes a schedule of seminars. The author of at least two books on the subject, Nancy L. Thomas is a Therapeutic Parenting Specialist. Daniel A. Hughes : Offers consultation and training for therapists and parents. The author of at least two books on the subject, Dr. Hughes has specialized in the treatment of children with emotional deficit, and now conducts workshops and trains therapists throughout the country. Includes a schedule of workshops. ADSG : Attachment Disorder Support Group : Includes forums for general RAD support, for homeschooling or other school issues, for adults with RAD and for siblings of children with RAD. No registration required. WNC Families CAN : Provides information and support for families in the Ashville, North Carolina area. No online discussion forum, but you can find a meeting schedule.
Center for Family Development : Presents information about reactive attachment disorder and other developmental / emotional deficits, including interesting testimonials from patients who have healed. Evergreen Consultants in Human Behavior : Founded in 1971 by Foster Cline, a pioneer in attachment therapy, the EC site offers information on the disorder and its treatment. About : Reactive Attachment Disorder : Moderated by Judy Swarbrick, this forum relating to reactive attachment disorder requires registration with About.com in order to post.  
RadZebra.Org : Attachment Disorder Network – Offers information and resources for parents and caregivers of children with RAD, as well as articles and poems. Includes a regular-mail newsletter and a support group for those in the Kansas City, Missouri area. The Little Prince : Surviving Life with Reactive Attachment Disorder – A mother’s experiences raising a RAD child. The author offers information about attachment parenting, dealing with this difficult subject with humor and poetry. MSN Groups: Reactive Attachment Disorder : Online support and discussion group for parents, caregivers, and others concerned with attachment disorder, therapeutic parenting and the treatment of bonding disorders.  
Older Child Adoption : Attachment & Bonding Issues – Provides information on attachment issues, including parenting, and teaching children with reactive attachment disorder. Heal the Hearts Foundation : Information and resources for caregivers of children with attachment disorder.    
CASA : Reactive Attachment Disorder – Hosted on the Arizona Supreme Court site; includes a clear definition of RAD, and concludes with a quiz. Attachment Treatment and Training Institute : Defines attachment disorder and offers information on attachment therapy and training. Schedule of training seminars.    
Alaska Attachment and Bonding Associates : Find news, announcements, and a schedule for attachment support. The Cascade Center for Family Growth : Treatment center for children with severe behavioral disorders. Find information, resources, and treatment for those in the Utah area.    
Wisconsin Attachment Resource Network : Find information on attachment disorder, parenting and bonding techniques, and treatment. Foster W. Cline : Pioneer in attachment therapy. Find information on consults, a schedule of speaking/training engagements, handouts and articles.    
RadKid.Com : Maintained by our co-host in the RAD support forum we run on Delphiforums. Includes a wealth of information on therapeutic parenting, school issues, and other helpful readings. Help for Kids : Dr. Michael Katz. Video training tapes and clinical therapy program.    
  Villa Santa Maria : A residential community specializing in the clinical treatment of children and families who are suffering from attachment disorders. Located in Cedar Crest, New Mexico.    

Happy Digital Citizenship Week!

Here are some ideas from Janie Islas, PVUSD Technology Coach, on how to celebrate the week and talk with your kiddos about digital citizenship:

Elementary:

Follow the Digital Trail (lesson and video)

Brain Pop: Internet Safety (video)

Brain Pop: Information Privacy (video)

Tower of Treasure: Secure Your Secrets (game)

What Should You Accept? (video)

Secondary:

Digital Footprint (video)

Cyberbullying: Be Upstanding (lesson and video)

Perspectives on Chatting Safely Online (lesson and video)

Be Internet Awesome- Reality River: Don’t Fall For Fake (game)

Be Internet Awesome- Mindful Mountain: Share with Care (game)

If you would like to choose your own digital citizenship lesson, you can find a lot of videos on Brain Pop, you can search by grade level on our district Internet Safety page, or you can explore the following sites:

Common Sense Scope and Sequence K-12

Common Sense Media en español

Be Internet Awesome (game and curriculum)