There is a unique kind of grief that comes along with being the parent of a child with special needs. For me, the grief comes in waves, sometimes threatening to overtake me while at other times ebbing and allowing me the chance to breathe. 

Maybe you find yourself feeling this grief too. You may feel guilty for the conflicting feelings you have. I want you to know that it’s okay to grieve.

Before you had your child, you probably had an idea of what it would be like to watch them grow up. Maybe you imagined being at their baseball games cheering from the sidelines or pictured moments snuggled up on the couch together reading a favourite story. You may even have projected things far in advance such as their wedding day or high school graduation. No doubt you also imagined what you would be like as a parent and what you would teach your child.

The dreams you had and the vision in your mind of what your family would be like probably looked quite different from how the average day plays out in your home.

And while normally, I am here to give you tools to help you better meet your child’s needs or better understand them and I’m here to help you champion your child, today, I’m here to say that it’s okay to grieve for what you thought would be and isn’t.

Do any of these apply to you?

• your child’s behaviours sometimes have you in tears
• you question your ability to adequately meet their needs
• you’ve received a diagnosis for your child
• your child rejects you
• you feel like your friends with “neuro-typical kids” just cannot understand
• you feel isolated or alone
• your home is more chaos than peace
• you sometimes think about the dream you used to have for your child
• you think about “before” your child’s illness or diagnosis and feel sadness

I need you to know that feeling these things does not make you a terrible parent. These feelings do not make you an awful person. It makes you human. It is normal to grieve the loss of something. Having a child who struggles is the loss of the dream of how you thought things would be. It’s okay to grieve that loss.

To be clear, grieving the child you thought you would have does not mean that you do not love the child that is.

Give yourself the time, space and care to be able to grieve what is a very real loss. That means allowing yourself to cry, talking to others who do understand (find those who have walked this road themselves), self-care, self-care, self-care, and possibly even going to therapy to help process and work through your emotions.

The grief doesn’t end. It comes in waves. Sometimes I’m fine for months, and then BAM, I’m a puddle of tears in the fetal position on my bathroom floor holding a chocolate bar!

Seeing my daughter grieving her hearing loss, my son not having friends to invite to his birthday party, even something like reading the posts of friends on Facebook can ignite my grief anew. The waves can build up over time or swell quickly spurred on by an event or milestone. 

I used to feel so guilty for these feelings. I felt like I had no right to be feeling sad myself when my child was the one being directly affected by their challenges.

But then I came to accept that it’s okay to acknowledge those feelings and to really feel them. It’s okay to admit that my dreams need to be different now. It’s okay to grieve.

Of course, it’s also important to push through and find those new dreams and new ways to create joy in your life and your child’s life. It’s about balance. You’re not going to be any good to anyone if you are crumpled on your bathroom floor clutching a chocolate bar every single day, but your family will survive if you go for a drive and have a good cry once in awhile.

If you’re looking for support or information, join me for a free 5 part email series, Little Hearts, Big Worries offering resources and hope for parents. 

You may also want to read:

Special Needs Mama, You Are Amazing!

12 Things That Special Needs Mom Needs from You 

Special Needs Parenting Resources 

There are several treatment options for Reactive Attachment Disorder. In most cases, a combination of treatments is used. Love alone is not enough to cure RAD. Please remember that I am not a therapist or official expert in the field of Reactive Attachment Disorder. I am a mom. Two of my kids happen to have the diagnosis. This article is based on the current research into the treatment for RAD as well as my personal experience. I have not tried everything on this list.

There is no “one size fits all” treatment package I’m afraid when it comes to RAD. What works depends on the child, the family, and a variety of other factors such as other diagnoses.

In many cases, a diagnosis of RAD is not an isolated diagnosis. It often comes alongside other diagnoses such as Sensory Processing Disorder, Post Traumatic Stress Disorder or developmental trauma disorder, ADHD, an anxiety disorder, depression, cognitive delays, or FASD.

In fact, it is not uncommon for kids to have several diagnoses on the list. This is one of the reasons why a treatment plan needs to be customized to the child.

TBRI:

The treatment that we have found the most effective for our kids with RAD was TBRI (Trust Based Relational Intervention). It is based off this theory; “Our children were harmed in relationship and they will experience healing through nurturing relationships” ~ Karyn Purvis.

We used TBRI along with some of the other treatment strategies listed in this article.

The main principles of TBRI include:

• Safe and Structured Environment
• Sensory Needs
• Nutrition
• Empowering Principles
• Connecting Principles
• Observational Awareness
• Self-Awareness
• Skills of Attachment
• Playful Engagement
• Attunement
• Correcting Principles
• Proactive Behavioural Strategies
• Responsive Behavioural Strategies

The abbreviated program activity list here (near the bottom) is very helpful.

Medication:

Choosing to medicate a child is a very personal decision. I share some of our experience with that here. There is no prescription that will magically cure RAD, but there are some that will treat some of the symptoms such as anxiety, aggression, trouble sleeping, and difficulty focusing.

It is certainly more complicated than just treating a symptom with a pill. There are many factors to consider. I suggest consulting a paediatric psychiatrist who specializes in or is at least very familiar with treating attachment and trauma disorders.

Choosing to medicate is a big decision and one where it doesn’t hurt to get a second opinion.

Counselling:

Whether you choose individual and/or family psychological counselling, it is very important to choose a therapist who is trauma informed and experienced in attachment disorders.

If you seek the help of a therapist who does not have experience with Reactive Attachment Disorder, they can be distracted by the child’s coping skills (which can come across as charming) and not recognize the signs of RAD.

Parent-Child Attachment/Trauma Program:

With each of our kids, I attended a one year long program specific to attachment and trauma. I feel so fortunate that our area has such a program.

If you are fortunate to have one in your area, be sure that it is based on the current science of the impact of trauma on the developing brain and the science of attachment.

Play Therapy:

Play therapy can be particularly beneficial for kids who were very young (babies or prenatally) at the time when their trauma or neglect occurred.

Talk therapy is often not as productive for kids who were preverbal at the time of their abuse or neglect because they hadn’t developed language at that time in order to be able to discuss it later.

The use of sand trays in particular can be useful in helping kids play out some of their past and better process it.

Art Therapy:

Art therapy can help children process what happened to them. It is a non-threatening approach that works very well with some children.

There is more and more research being done in the area of art therapy. It is becoming easier to access. Again, it is best if you can find a therapist who is attachment and trauma informed.

Animal Assisted Therapy:

One of our sons did animal assisted therapy for over a year. It was extremely therapeutic for him. Where the love of another human can feel so threatening to kids with RAD, allowing themselves to love and be loved by animals can sometimes help bridge that gap.

It is also wonderful for them to build confidence in themselves by taking care of an animal. Therapeutic programs use a variety of animals including horses, dogs, chickens, llamas, donkeys, and even pigs.

Important note: There are some kids with RAD who harm animals. If this is the case with your child, inform the therapists ahead of time. They may not feel that your child is a good fit for the program or they may be willing to have them attend but offer increased supervision.

Neurofeedback:

Neurofeedback is a type of biofeedback that uses real-time displays of brain activity to teach clients self-regulation. It is not something suitable for young children or those with severe cognitive delays. Most commonly, it uses EEG.

Neurofeedback is still a fairly controversial approach. The scientific data at this time points to more of a placebo effect. Neurofeedback can be expensive as well.

EMDR:

EMDR on the other hand has more and more scientific data backing up its effectiveness in treating PTSD. As many of “our” kids with attachment issues also have a trauma history, it stands to reason that EMDR can be an effective treatment for them at least where the root of their trauma is concerned.

This article on adapting EMDR specifically for children with RAD has some excellent suggestions.

EMDR stands for eye movement desensitization and reprocessing. It works best in adults or older children who were verbal at the time of their trauma, so it may not be as effective if the abuse or neglect happened during the very early months or years.

We have found EMDR gives good results. We also use bilateral stimulation with the kids at home if they are having a hard time calming themselves down.

Residential Treatment:

In some cases, it is no longer safe to have a child in the home, either because they are a danger to a parent, a sibling or themselves. In these cases, a period of removing the child from the home for a period of time may be necessary.

Obviously, residential treatment is more of a last resort option. It can further compound the belief the child has that they are not loveable or that anyone who is supposed to love them will eventually leave them, but others in the home deserve to feel safe and sometimes, there really is no alternative.

Sometimes residential treatment can compound the rejection and abandonment issues for a child while other times, it can actually lead to tremendous healing.

Other possible options of treatment for RAD:

• circle of security intervention
• vision therapy
• QEEG brain map
• neuro-reorganization exercises

Important note: Avoid any attachment therapies that involve forcibly holding or physical discipline.

More information about Reactive Attachment Disorder:

What is Reactive Attachment Disorder? 

Recognizing the Signs of Reactive Attachment Disorder 

Is there Hope for Reactive Attachment Disorder?

One of the questions I hear a lot is “What is Reactive Attachment Disorder?”

I remember sitting in one of my first adoption and foster care classes and having the instructor take out a packet of Post-It notes. She gave one to each of us and asked us to stick it to one surface and then another and then another. She encouraged us to stick it on surfaces such as a blanket or clothing where it would pick up lots of gunk or on the floor where it would pick up pieces of dirt as well as sticking it to smooth surfaces such as a table.

Then she pointed out that as we moved our Post-It note from one place to another, it became less sticky, particularly after it was placed somewhere that it picked up a lot of stuff that stayed with it.

She used the analogy of that Post-It note to explain how children have a harder time attaching the more placements they have been in or the more trauma they have experienced.

Just like how the sticky part on the Post-It note didn’t adhere as well with more moves or more gunk, the child would also have a harder time attaching after multiple moves and having picked up some “yuck” along the way.

While it’s not a perfect analogy for RAD, it’s one of the best ones I’ve ever come across.

What is Reactive Attachment Disorder?

Attachment issues fall across a spectrum. Reactive Attachment Disorder is the most extreme in that spectrum. Children with RAD feel unsafe attaching to a primary caregiver or parent.

These children were unable to form a healthy attachment due to neglect, early childhood trauma, insecure or disorganized attachment style in the parent, multiple placement such as foster care or multiple caregivers such as in an orphanage, or abuse.

Reactive Attachment Disorders and other attachment disorders take place when a child has been unable to form a consistent connection with a parent or primary caregiver.

If a young child feels that their basic survival needs are not met, they perceive that they cannot depend on others.

The child feels threatened by attachment and that people who are supposed to love you are not to be trusted.

If you suspect that your child or a child you know may have Reactive Attachment Disorder, you can read how to recognize the signs of it here. Of course, that is just a stepping off point. You will need to consult with a professional in order to get an official diagnosis. 

Risk Factors for Developing RAD:

• neglect
• loss of a parent at a young age
• early and lengthy hospitalization due to prematurity or health concerns
• severe postpartum depression in their mother
• living in an orphanage or institutional care
• bouncing around from one home/foster home to another
• physical, emotional, or sexual abuse
• early childhood trauma

Regardless of what the cause of Reactive Attachment Disorder is, it requires treatment and the development of trust within a nurturing relationship in order to heal.

You may also want to read:

Is there Hope for Reactive Attachment Disorder? 

Books for Reactive Attachment Disorder 

For many kids, making eye contact comes fairly naturally. For kids who are on the autism spectrum or for kids who lacked nurturing in the early years or have experienced early childhood trauma, eye contact is far from natural. Some kids find it uncomfortable while others can find it downright painful. If your child struggles with eye contact due to RAD, autism, SPD, or FASD, there are some simple activities you can do that help promote eye contact in a non-threatening way.

I want to share one comment before I get started with the activity ideas. It’s important not to say “look me in the eye” during these activities. You are looking to foster natural connection and get your child comfortable with eye contact.

You are wanting to get your child used to eye contact and build up their tolerance for it. It is important not to increase their anxiety or make them feel like they are in trouble for not complying.

I remember well the days when making eye contact was painful for one of our sons. It was hard to watch. It’s so much easier for him now, but it will likely never be as easy as it is for most people.

But there has been tremendous process. I really believe that much of that progress was due to us repetitively doing many of these activities.

Activities to promote eye contact:

Face painting – This is my favourite one. It is so subtle. While painting your child’s face, you will create natural proximity and be looking into each other’s faces. Try having them paint yours (that takes courage, but mama, I believe in you)! Be sure to use washable face paint.

Silliness – Make funny faces or use silly getups such as clown noses, glasses with funny noses attached, or stick-on moustaches. Those pictures above are from a Family Fun Night we had. You better believe there was a lot of eye contact practise happening that night even if the kids had no idea there was a purpose beyond laughter! 

Stickers – Put stickers or googly eyes on your face. Gradually put them closer to your eyes.

Peek-a-boo – Even with older kids, this game works. With older kids, you’ll have to infuse more silliness to get them to play along. Another way is to teach them to play peek-a-boo with a baby. Ask them to entertain a baby this way and they will be rewarded by smiles and squeals from the baby.

Push them on a swing – Stand in front of them while pushing them on a swing. This encourages eye contact and is great vestibular sensory input.

Secret handshake – Inventing a secret handshake with your child fosters connection and family identity. It also encourages eye contact. Major bonus points if your secret handshake ends with your foreheads touching!

Butterfly kisses and Smurf kisses – Butterfly kisses are when you touch your eyelashes together and blink quickly like butterfly wings flapping. Smurf kisses are when you rub noses. These will obviously be too vulnerable for kids who are at heightened stages of their attachment journey (?).

Board games – Connect 4 is the best one for this if you sit on opposite sides of the board. Because of the level of the board, accidental eye contact is inevitable!

Bubble gum – This is a trick I learned from the late great Karyn Purvis. Bubble gum is good sensory feedback both for proprioception and gustatory (taste). Keep hoards of bubble gum in your child’s favourite flavour. To get a piece of gum, all they have to do is ask “may I please have some gum?” with some degree of eye contact and the answer is always “yes”.

Count freckles – If your child has freckles on their face, count them and assign names to them. Or have them count and name yours. There’s bound to be some eye contact here and there.

Have a staring contest – For kids who are older or further along in their eye contact progress, a staring contest can increase their tolerance for it in a fun way. Don’t attempt with kids who are

Play an eye signal game – Have your child stand a few feet in front of you (or closer if they’ll allow). Signal to them with only your eyes to move to the side (by looking to that side), the other side, stepping back (eyes up), or taking a step forward (one blink).

Join me for a free 5 part email series, Little Hearts, Big Worries offering resources and hope for parents.