A Walk in their Shoes: Attachment

DisordersPresented By:

Brandi Shinn

Above All Else Inc.

• Office Number: 501-679-5677• Email: brandi@aboveallelseservices.com

• Facebook: Above All Else Educational Services• Follow us on Twitter @AboveAllElseES

• Check out our website www.aboveallelseservices.com  • For excellent resources http://pinterest.com/brandishinn/

Attachment DisordersWhat is it?????

An attachment disorder is a general term describing disorders involving:

1. Mood

2. Behavior

3. Social Interaction

Why does it occur? ???

The lack of a normal attachment between child and the primary caregiver throughout infancy and early childhood. Most often occurs at birth and throughout infancy, but can also occur throughout childhood.

RED Flags….1. Difficulty Connecting to Others 8. Prone to Chronic Illness

2. Difficulty Managing Emotions 9. Aggressive

3. Severe Lack of Trust, Self-Worth, and Bonding 10. Disruptive

4. Extreme Emotional and Social Problems 11. Anti Social5. Behaviorally Challenged 12. Chronic Anger

6. Depressed 13. Poor Impulse Control

7. Developmentally Delayed 14. Lack of Remorse

15. Maintain abnormally high levels

of stress hormones impairing the growth

and development of their brains and

their bodies.

When????• 1980- Reactive attachment disorder of infancy or early childhood (RAD)

was introduced as a psychiatric condition in DSM-III in 1980 (American Psychiatric Association; APA)

• 2013- The DSM-5 RAD was divided into two separate and distinct conditions, Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Syndrome (DSED)

Attachment Disorders

are misdiagnosed 70% of the time as

Bipolar Disorder or

Attention Deficit Hyperactivity Disorder.

Early Trauma resulting in attachment disturbances are often diagnosed as:

• Reactive Attachment Disorder (RAD)• Post-traumatic Stress Disorder (PTSD)• Oppositional Defiant Disorder (ODD)• Attention Deficit Hyperactivity Disorder (ADHD)• Bipolar Disorder (BP)• Conduct Disorder (CD)

Characteristics of Traumatized Children• Extreme urge to control others (bossiness)• Too much OR too little affection• Lack of cooperation (especially with mothers)• Overly friendly with strangers• Emotional isolation• Lying• Stealing• Inappropriate attention seeking• Feelings of high shame / lack of empathy for others• Food hoarding

Causes • Neglect• Abuse• Separation from Caregiver• Premature Birth• Hospitalization of child• Parent Emotionally unavailable• Teen Parents• Constant change in Primary

Caregiver• Frequent Moves or Placements• Traumatic Experiences• Maternal Depression• Maternal Addiction

• Undiagnosed illness• Genetic Factors• Poverty• Exposure to Violence• Lack of Services• Isolation• Multiple out of Home experiences• High Stress• Abrupt Loss of parent• Prenatal exposure to toxins• Neurological Problems• Poor Parenting• Intergenerational attachment

difficulties

Signs & Characteristics

Emotional1. Poor emotional regulation

2. Extreme moodiness

3. Intense anger

4. Can’t handle stress5. Lacks ability to recognize emotions

Relational1. Lack of trust

2. Resists nurture

3. Avoids eye contact

4. Poor peer relations

5. Victimizes others

Behavioral1. Clingy

2. Temper tantrums

3. Property Destruction

4. Oppositional & defiant

5. Demanding

Physical1. Cruel to animals

2. High pain tolerance

3. Hoards or gorges food

4. Obsessed with fire, death, gore

5. Enuresis & encopresis prone

Signs & Characteristics Cognitively

1. Lacks understanding of cause and effect

2. Uneven learning profiles

3. Exhibits Speech/language delays

4. Difficulty with focus

5. Learning delays or difficulties

Moral

1. Limited compassion

2. Low empathy for others

3. Shows little remorse

4. Lies

5. Steals

Developmental VariationsEarly Childhood:• Delayed development of motor skills• Severe colic • Feeding issues• Failure to thrive syndrome• Resistance to being held, cuddled, or

comforted• Lacks interaction with family• Fails to response to smiles or being

talked too• Fails to seek comfort when scared, hurt,

or sick• Excessively independent

School Aged Children:• Complaints of aches & pains• Inappropriate demands of attention• Lack of interest in schoolwork/homework

completion• Inability to "think" about feelings or assess

motives regarding behaviors• Failure to see impact of behaviors on others or

self• Lack of response to consequences• Inability to focus, concentrate, or sit still• Often lacks moral compass• Has difficulty with reciprocity in relationships

with adults and peers• Frequently lies for NO REASON• Frequently steals

AdolescentsExhibits aggressive behaviors Frequent Substance AbuseAnti-Social World Disengagement

Very Impulsive Depression Risk Taker Anxiety

Demonstrates delinquent behavior

Providing Discipline & ConsequencesInsist on: • Respect• Responsibility• Gratitude• Immediate dismissal from area for misbehaviors• Directly related consequences• Physical work vs. educational or “mental’

ZERO Tolerance:• Aggression• Arguing with authority verbal or body language• Blatant disregard for direction• Helplessness

• Do not be left alone with a child with attachment issues• Consequences must be balanced with praise for

positives. Praise MUST be conditional praise such as "You are doing a great job on coloring that paw", "That was a great answer", "Thank you for holding the door."

• Avoid unconditional positives such as "you are such a good kid", "You are wonderful," "You are extra special".

• Help support the mom and not overwhelm her with the daily trails unless necessary.

• Physical affection only be given when it is given to other students in the classroom such as at the end of the day.

HELPFUL HINTS

Five questions to almost never ask…….

”Did you...?”

”Why did you...?”

“What could you have done differently?”

“Do you remember...?”

“What did you say?”

Classroom Strategies • Knowledge is powerful…

Research is your friend• Model healthy social

relationships• Teach students how to socially

interact with peers• Interact and observe students

often to monitor social interactions

• Praise student for appropriate social skills demonstrated

• Students with attachment disorder or other related issues most often act out of fear and their belief of worthlessness.

• Address inappropriate social interactions immediately but privately

• Communicate All concerns to all parties

• Make time to get to know and listening to the child

• Be empathetic and nurturing but attuned to their response

• Look for motivating factors underlying the child's behavior

• Partner with the parents or guardians and other professionals who work with the student in order to establish a strong partnership

Classroom Strategies Continued• Keep in mind students "emotional

age" may not be correlated to their chronological age.

• Be Consistent, Be Repetitive, and Be Predictable

• Provide the student with ample opportunities to make genuine choices in order to satisfy their need to control, yet with the adult limiting choices.

• Provide concrete, specific and authentic praise

• Provide rewards for all positive behaviors not just "work"

• If student says hurtful things to you or others, address the behavior and how it made you or the others feel.

• Respond consistently and calmly to unacceptable behavior

• Discipline should be natural and logical and relative to the misbehavior

• Do not give second or third chances, set expectations, set consequences and follow

• Use humor to deflect provocative behavior

• When inappropriate or bad behavior occurs do not ask "WHY did you, What did you, Did you or How come you" questions

• Avoid lecturing for social behaviors- provide suggestions of proper behavior

• Office Number: 501-679-5677• Email: brandi@aboveallelseservices.com

• Facebook: Above All Else Educational Services• Follow us on Twitter @AboveAllElseES

• Check out our website www.aboveallelseservices.com  • For excellent resources http://pinterest.com/brandishinn/