What is Attachment Disorder?

I imagine a lot of people have wondered why our boys need such an extreme form of therapy right now.  In fact, I'm actually sure of it as I sit and recall a lot of the things that have been said to us over the years as we've voiced our fears about many of the behaviors of Jack and Hank.  We've heard things like, "boys will be boys," "all kids do that," "just ignore it," "well, my kid does...," and a lot more.  While these comments were always meant to be harmless and most likely helpful, to me they just always showed that people truly didn't understand what was taking place in our home, the grave concern we had for our children, and how difficult things were really were.  But how can anyone truly understand who isn't in the midst of it and experiencing it?  Heck, we didn't even know all the problems our boys had or how to help them for so long, so how would others really know the gravity of it all?  I'm definitely not an expert in this area, but I'll share a little of what we learned at camp and have continued to learn since we've been home. (All this information is obviously not my own but taken from notes from camp and from DVD's and CD's we watched and listened to since being home.  I know that's not proper MLA citing, but will hopefully free me from any plagiarism. I digress...)

An attachment disorder can occur in a child when there is a bond that has been broken between that child and his or her primary care giver, usually within the first 36 months of that child's life.  When a child has an attachment disorder he then has difficulty forming true and loving relationships.  This child will usually be unable to be GENUINELY affectionate with others ("genuine" being the key word here).  He will be very sweet and charming to strangers, but unloving to his own parents.  Often times this child does not develop a conscience and does not trust others.  Because he does not trust others, he does not allow others to control (parent) him.  A child with an attachment disorder will lack empathy, cause and effect thinking, and the ability to feel the consequence of his actions.  As a young child this is difficult enough, but to think of a child growing into an adult who lacks empathy and does not have the ability to care about what his actions do to others is beyond scary.

There is a list of risk factors that can cause an attachment disorder and then there is a list of symptoms that will appear in these children.  To be diagnosed with attachment disorder a child needs to have been exposed to one of the risks and have at least half of the symptoms, obviously not just one or two of them.

The list of risk factors is:
     -Maternal ambivalence toward pregnancy
     -Inutero trauma, drugs, alcohol exposure
     -Premature birth
     -Abuse
     -Neglect
     -Sudden separation from primary caregiver
     -Undiagnosed or continual painful illness
     -Inconsistent or inadequate day care
     -Chronic maternal depression
     -Several moves and/or placements (such as foster care or failed adoptions)
     -Unprepared mothers with poor parenting skills

There could be more from this list than I remember, but of these risk factors Hank checks off nine of them and Jack has eight.  Again, just one is enough to put a child at risk.

The list of symptoms in children is:
     -Superficially engaging and charming
     -Lack of eye contact on parents' terms
     -Indiscriminately affectionate with strangers
     -Not affectionate on parents' terms (not cuddly)
     -Destructive to self, others, and material things; accident prone
     -Cruelty to animals
     -Lying about the obvious
     -Stealing
     -No impulse controls
     -Learning Lags
     -Lack of cause and effect thinking
     -Lack of conscience
     -Abnormal eating patterns
     -Poor peer relationships
     -Preoccupation with fire
     -Preoccupation with blood and gore
     -Persistent nonsense questions and chatter
     -Inappropriately demanding and clingy
     -Abnormal speech patterns
     -Triangulation of adults (putting mom and against dad, or parent against teacher, etc.)
     -False allegations of abuse
     -Presumptive entitlement issues
     -Parents appear hostile angry

Jack has consistently shown he has 14 of these and for Hank right now I see about 10.  Again, in order to be diagnosed with attachment disorder a child needs to have half of these symptoms.  As kids my older siblings and I were often outside trying to find something to burn and my younger brother could out talk anyone, but that didn't mean we had an attachment disorder.  Many kids may show one of these things at some point in their lives, but a child who consistently shows a majority of them is a completely different story.

Of the previous list Hank falls a couple short of having half the symptoms, but when looking at the symptoms in infants he checks off every single one.  The list of attachment disorder symptoms in infants is:
     -Does not use crying appropriately to get someone to address a need
     -Often does not settle when needs are met by primary caregiver
     -Over reacts or often startles to touch, sound, and/or light
     -Listlessness/infant depression
     -Limited holding onto or reaching for caregiver
     -Lack of appropriate stranger anxiety between 6 and 9 months
     -Shows minimal interest in interacting with people
     -Does not smile back or respond with activity to smiles or baby talk
     -Does not follow human movement with their eyes
     -Avoids eye contact
     -Self-abusive behavior (banging head, self biting, etc.)
     -Resistant to cuddling (stiff)

When Hank was a baby he consistently showed every single one of these symptoms for quite some time.  I know he is no longer an infant and has been in a loving home for several years now, but being that he had all these symptoms for so long and we didn't know how to help him at the time, I know it still affects him in huge ways.  

The relationship between the risk factors and the symptoms is highly connected.  Trauma that is done to a child early on in life, not only effects the child's heart but physically effects the brain.  Due to all the trauma a young child may experience, that child's brain learns to function differently than a "normal" child's brain.  Most of these children now function out of the fight or flight part of the brain rather than the part of the brain that allows them to reason, think, or even laugh.  We saw actual scans done of a child's brain who had been through major trauma compared to a healthy child and the differences in the parts of the brain that were and were not functioning was astounding.  Doctor Bruce Perry, who specializes in child trauma, says that "experience changes the brain."  The point in doing attachment therapy is that although these children's brains have been so negatively changed by the horrible experiences they have encountered, that all they are positively and lovingly experiencing now will help their brains change for the better heal.

So why do I share all this?  First of all so that people may start to understand what's been going on and why we're doing what we're doing.  Second of all, which has always been my hope in this whole entire process, is that someone will benefit from what we have experienced and are going through.  Like I said before, we had no idea what our boys were really dealing with when they came to us three years ago and therefore we didn't know how we could best help them.  My hope is that maybe a few people would see that a child they have been struggling to raise, love, and understand, isn't just a "bad" child but may have an attachment disorder.  Also that these parents would see that they aren't bad parents and alone, but are among many parents who are trying to raise kids with these issues.  Throughout these past couple months I just keep asking why I didn't know all this before we adopted, and while I can't live in guilt or stay stuck on that question, I do hope that we can somehow or someday help and inform parents early on in their journey.  Thirdly, for people who have "normal" kids or don't yet have kids, but may know a parent who has adopted, does foster care, or has a biological child who has attachment disorder, my hope is that they would know this is not easy.  Now I know parenting in general is hard, no matter what kind of child you have or how many.  It's hard in different ways for every parent and I know that and acknowledge that.  However, looking at the list of symptoms and knowing that a parent is not just dealing with a child who has shown one of them (such as lying, stealing, or being awkward around others), but is trying to raise and help and heal a child who regularly acts in a way that shows over half those symptoms, my hope is that people would be understanding, gracious, and supportive to these parents.  Obviously one of the things we saw at the camp we went to is that we are not alone and that our children are not the only ones who had a rough start at life.  There are so, so many hurting, abused, neglected, children out there and there are therefore a lot of parents who are trying their best to raise these kids.

If you're a parent and see some of these risk factors and symptoms in a child of yours, it's never too late to get help.  I know it may feel like it, I know you are exhausted and hurt and tired of trying, but there is help out there.  I know it may seem like your child is beyond healing, but that isn't the truth and we heard story after story about kids much older than ours who were able to get help and heal and who now live normal and healthy lives.  If you're someone who knows a parent raising a child with these issues, just know that what you may see outside the home may not be a true picture of how difficult things are inside the home.  Know that parent is exhausted and scared and trying to do all he/she can do for that child.  Don't invalidate that parent or dismiss his or her concerns.  Just encourage that parent and ask how you can support his or her family.

For us personally what we are also finding out is that this journey of getting the boys help and trying to help them heal is far from over.  Not only does Jack have all these issues with having an attachment disorder, but he also has a mild form of cerebral palsy as well as fetal alcohol syndrome.  A lot of the attachment and bonding issues we're trying to work on during this time of "pouching," but we're seeing there is still a lot going on with him.  This could be from the cerebral palsy, or the fetal alcohol syndrome, or still some issues that are affecting his brain from his past.  We just don't know, and we're far from done, so we know the road ahead is still long.  Many of Hank's issues have actually gotten worse over the last few weeks as things have been different here and I'm sure it seems his brother is getting so much more love and attention (although we're obviously still trying to give just as much to Hank).  I know when it's time to start all this with Hank it will be a lot more difficult, but it just proves to me even more how much all this is needed and how crucial it is to get him all the help we can now.

I know I went on and on and I know my brain is very foggy, but there is a whole lot of information out there on attachment disorder.  The woman who runs these camps is Nancy Thomas and her website is attachment.org and she has a wealth of information on it as well as several books, cd's, dvd's, and more that can be purchased.  Again, if you're a parent wondering if your child has this then her website would be a great place to start.  If you know a family with a child with attachment disorder, or if you plan to do foster care or adoption, I can't express enough how important it is to educate yourself in this.  There are so many hurting children out there, but what we found at camp and are continuing to learn is that there is help and healing for them all.  They just need the adults to help them get there.

Well, I'm all out of brain power for the night.  Of course I may not have had much to begin with but oh well.  Also, I see a big spider I have to figure a way to get rid of without it making a squishy sound.  Just when you think your work for the day is done...