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Self-Test for Reactive Attachment Disorder [RAD]

How can you know if your RAD teenager needs to be placed in a residential treatment program?

Take the self-test below. If your RAD teen has 10 or more of the following symptoms/conditions, then chances are he/she is in serious need of residential treatment for RAD-related issues:

1. "I hate you," attitude
2. "You can't make me," attitude
3. Abrupt Change in Personality
4. Abusive Behavior
5. Academic Problems
6. Alcohol Abuse or Addiction
7. Anxiety
8. Argumentative
9. Attempted or Threats of Suicide
10. Attention Deficit Hyperactive Disorder
11. Authority Problems
12. Avoidant Behavior
13. Bipolar Disorder
14. Blames Others for His/Her Behavior
15. Blames Others for His/Her Mistakes
16. Blatant Disregard of Rules
17. Can't Accept "No" For an Answer
18. Can't Accept Feedback
19. Can't Keep Friends
20. Clinging Behavior
21. Conduct Disorder
22. Cutting
23. Danger to Self or Others
24. Demonstrates Poor Impulse Control
25. Depression
26. Difficulty Coping with Stress
27. Distant or Aloof Behavior
28. Drug Abuse or Addiction
29. Easily Misled
30. Eating Disorder
31. Family Conflict
32. Grades Have Fallen
33. Has a Preoccupation with Blood and Gore
34. Has a Preoccupation with Fire, blood and gore
35. Hoards or Gorges Food
36. Is "Above the Law"
37. Is Cruel to Animals
38. Is Cruel to Siblings
39. Is Developmentally Delayed
40. Lacks Motivation
41. Lazy
42. Learning Disabilities
43. Low Self-Esteem
44. Lying
45. Manipulative
46. Never at Fault
47. Oppositional Defiant Disorder
48. Peer Problems
49. Persists in Steady Nonsense Questions or Chatter
50. Pits Parents Against Each Other
51. Poor Choice of Friends
52. Poor Emotional Control
53. Poor Relationships with Others
54. Poor Self-Image
55. Resentful
56. Resists Tasks
57. Risky Behavior
58. Runs Away or AWOL
59. School Suspensions
60. Self-Harm or Mutilation
61. Sexually Active
62. Shifts Blame to Others
63. Shows Indiscriminate Affection Toward Strangers
64. Shows Poor Eye Contact
65. Skips School
66. Smoking or other Tobacco Use
67. Sneaky Behaviors
68. Stealing
69. Superficially Engaging and Charming
70. Uncontrollable Anger

Parenting Defiant RAD Teens

Control and Limit-Setting for RAD Children & Teens

Parenting a youngster with Reactive Attachment Disorder (RAD) is extremely challenging, intense and exhausting, but the rewards are equal to the difficulty of the task. Not all attachment therapists agree on the details of how to parent RAD kids, but most experts agree that “control and limit-setting” should be a primary focus.

One thing that many RAD kids have in common is their extreme need to be in control of their environment and of the people in it, especially their moms and dads. When they were young kids in the orphanage or foster care, they didn't have an opportunity to complete the bonding cycle, which is where trust develops. Perhaps the move to their new adoptive home interrupted that cycle, and therefore they don't trust grown-ups to take care of them. In addition, when the grown-ups were in charge, the youngster was abandoned, neglected or possibly hurt. So these very smart kids have figured out that to feel safe, they need to be in control. But this, unfortunately, is a no-win situation. Why?

The youngster wants to be in control to feel safe. But a youngster who is in control is, by definition, not safe, because he doesn't have the cognitive capabilities or the experience to be the care-taker. This need to control can manifest in defiant behavior (e.g., not obeying requests, talking back, arguing, constantly interrupting, demanding attention, etc.). Even refusal to eat or toilet train can be efforts at maintaining control at all costs.

RAD children need to learn that to follow a parent's direction is safe. They need to know ¬ that to yield, to cooperate, to surrender, and to follow does not signify weakness. It is only then that they will be able to learn about:

• being contained
• being directed constructively
• being nurtured
• being safe
• being valued
• cause-and-effect thinking
• reciprocity

Some moms and dads start out by setting firm limits, but the defiance of their RAD youngster may lead them to back-off so that every interaction with their youngster is not a fight (sometimes this becomes necessary just to get out of the house and get to work). Some moms and dads believe it is so important to encourage the youngster's independence that they should be very careful about forcing their will on him or her. Other parents are afraid that their RAD child will throw a temper tantrum in public and cause them embarrassment.

Unfortunately, those care-takers who have extremely kind and gentle temperaments have the most difficulty being firm “limit-setters” because they hate to see their adopted youngster unhappy – and setting a limit for a youngster is going to make that youngster unhappy, at least temporarily. Thus, moms and dads should be mindful of their temperament, and when in doubt, they can safely assume they are inclined to be overindulgent, and should therefore try to draw the line a bit more firmly.

Parents should also take into account the child’s point of view about limit setting. Moms and dads have no problem setting limits when danger is involved (e.g., a youngster running into the street). A very young child doesn't know the difference between running into the street and running into the living room. All he experiences is a mother or father preventing him from doing something he wants to do. When a youngster insists on doing anything at all - in spite of the parent’s serious opposition - the parent’s response should be consistent, regardless of the reasons, whether we're talking about eating cookies on the coach or playing with a razor blade.

Also, the adopted RAD youngster has experienced what attachment therapists refer to as the "eternal no." Birthmother said "no" by giving the youngster up for adoption. It's permanent and it's the ultimate "no." So when mom or dad sets a limit and says "no," the adopted youngster often equates that with "You don't love me" and responds with defiance. The adoptive moms and dads get the anger that rightfully belongs to the birthmother. It is therefore important for parents to lovingly enforce limits. This may require simple holding and comforting and/or consequences when the youngster acts-out.

Parenting Defiant RAD Teens

Reactive Attachment Disorder: Self-Test

Does your child or teenager have Reactive Attachment Disorder? Take this test to find out:

1. Avoids or resists physical closeness and touch   Y/N
2. Bossy with peers   Y/N
3. Cannot be trusted   Y/N
4. Complains frequently    Y/N
5. Cruel to animals   Y/N
6. Destructive to self, others, and property    Y/N
7. Gorges or hoards food    Y/N
8. Has frequent or intense angry outbursts    Y/N
9. Has little or no conscience    Y/N
10. Has poor peer relationships    Y/N
11. Inappropriately demanding and clingy    Y/N
12. Indiscriminately affectionate on parents’ terms    Y/N
13. Is an angry child inside    Y/N
14. Is emotionally phony, hollow or empty   Y/N
15. Is impulsive or hyperactive    Y/N
16. Is manipulative or controlling    Y/N
17. Is oppositional, argumentative, defiant   Y/N
18. Is superficially engaging and charming    Y/N
19. Is unable to cry about something sad    Y/N
20. Lack of eye contact on parental terms    Y/N
21. Lacks cause and effect thinking   Y/N
22. Lies about the obvious    Y/N
23. Low self-esteem   Y/N
24. More disobedient toward mother than father   Y/N
25. Not affectionate on parents’ terms   Y/N
26. Persistent nonsense questions or incessant chatter    Y/N
27. Preoccupation with fire, blood, or violence   Y/N
28. Seems unable to give and receive love   Y/N
29. Sexual acting out    Y/N
30. Steals    Y/N

If you answered ‘yes’ to any 3 of the statements above, it should be a red flag that your child may have attachment issues.

If you answered ‘yes’ to 5 or more, then it is highly likely that he/she has Reactive Attachment Disorder and should be tested by a Child and Adolescent Psychiatrist.

Parenting Defiant RAD Teens