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Normal Infant Trust Cycle Parent responds with food, comfort, nurturance, eye contact, sound, rocking motion, & warmth of human contact Child learns adults.

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Presentation on theme: "Normal Infant Trust Cycle Parent responds with food, comfort, nurturance, eye contact, sound, rocking motion, & warmth of human contact Child learns adults."— Presentation transcript:

1 Normal Infant Trust Cycle Parent responds with food, comfort, nurturance, eye contact, sound, rocking motion, & warmth of human contact Child learns adults can be relied upon to meet his needs Trust Development Unpleasant Arousal Need Satisfied Need Action to Address Need Recognition Completed Cycle Decreased Arousal Baby Cries

2 Infant Trust Cycle ATTACHMENT DISORDER Infant rage Rigidity Extreme dependency Suppressed abilities Lack of foundation Lack of Trust Unpleasant Arousal Infant’s Needs Not Met Need Lack of Adult Response to Infant’s Needs Recognition Cannot Recognize Own Needs Cycle Incomplete Baby Cries

3 Early Childhood Trust of Limits Cycle Unpleasant Arousal is Continuous Needs = Control Action— “I must take care of this myself” Limits = Obstacle Reinforced Arousal—“ I knew I had to do this myself” No Trust of Limits- Attachment Disorder Unpleasant Arousal Reinforced Arousal Need Placement of Limits Action to Meet Need Needs Never Totally Met

4 Dynamics of Attachment Disorder Attachment Figure Unavailable Negative Response Cycle Self Protective Distancing Loss of Caregivers Unmet Needs Lack of Pleasure in Relationships

5 Traumatic Stress Leading to Attachment Disorder Denial of pregnancy Dislike for father of child Substance abuse Prematurity risk factors Variable family support Inadequate diet; poor self-care Resentment Pre-Natal Factors

6 Traumatic Stress Leading to Attachment Disorder Lack of parenting skills Various caregivers Ongoing substance abuse “Mechanical parenting” Neglectful/Abusive parental reactions Prematurity factors Undetected/Unrelieved pain in the child Post-Natal Factors

7 Behavioral Checklist Indiscriminate affection towards strangers, willingness to go with them Face to face compliance with passive- aggressive resistance Absence of guilt; no remorse; lack of conscience development Provoking of anger in others almost continually Lack of ability to give and receive affection unless on their terms

8 Behavioral Checklist Chronic, non-sensical lying - “crazy lying” Theatrical displays of emotion Stealing or hoarding food; food refusal or gorging Cruelty to animals and/or children, especially younger children Firesetting - “controlled” fires Preoccupation with blood, fire, gore

9 Behavioral Checklist Lack of cause & effect thinking - does not learn from consequences Poor eye contact Denial of accountability Self-injurious behavior Refusal to answer simple questions Unusual speech patterns or problems Poor peer relationships Learning disorders Theft, vandalism & destructiveness Seductive behavior or clothing Toileting issues

10 Attachment on a Continuum Attachment Issues Overindulged Unattached Child Healthy Attachment- Trust Development

11 Emotional Makeup of Attachment Disorder Hopelessness Loss Abandonment HelplessnessNo Trust Anger PROFOUND SADNESS FearRage

12 Parenting a Child With RAD

13 Post Traumatic Stress Disorder In Parents Repeated rejection by child—no reciprocity Personal and family changes out of control Avoidance of thoughts and feelings Decreased affect— detachment from others Psychological and physical distress Relentless control battles—constant self-control Primary Symptoms Causes Secondary Symptoms Sleep problems; hypervigilant, irritable, angry Victim identity; fatigue and depression; loss of security Feeling unlike others; emotions out of control Hopelessness Helplessness ANGER RAGE

14 Adult Characteristics for Successful Parenting of Children With RAD Healthy sense of humor Consistency with behavior management, yet flexible Ability to handle interruptions to social schedules Understanding that one parents a needy child, with parent’s personal needs met elsewhere Ability to advocate for child in a positive manner Ability to promote positive growth Sense of hope for the future, plus tolerance and perseverance

15 Support in the marital relationship; communication and belief in what the other spouse says Ability to react calmly; ability to display parental control of attitudes and abilities in the presence of the child Ability to accept appropriate confrontation if it promotes positive changes Ability to constantly redefine parental goals and expectations for the child; able to redefine “success” Ability to withstand criticism & condemnation from family, friends and community Adult Characteristics for Successful Parenting of Children With RAD

16 ATTACHMENT DISORDER Parental Response Cycle The cycle is solely dependent on adult reactions Child’s response is directly relevant to degree of adult’s commitment & amount of consistency in terms of non- abusive or rejecting reactions Building Trust Capabilities Unpleasant Arousal CONFUSION Need RAGE Consistent Inconsistency COMMITMENT NON ABUSIVE Support Response Supportive Control

17 Child’s View of Adult-Child Interactions Someone wins; Someone loses Adult doesn’t take charge when child is out of control Child senses this and becomes frightened Child continues to set up opportunities for adult to take charge When adult is unwilling or unable to take control, child’s out of control behavior escalates

18 Adult Attachment Disorder Progression Unstable and Impulsive Self Absorbed Emotional and Attention Seeking Disregard for Others BORDERLINE PERSONALITY DISORDER ANTISOCIAL PERSONALITY DISORDER HISTRIONIC PERSONALITY DISORDER NARCISSITIC PERSONALITY DISORDER

19 The Child Welfare SYSTEM State Child Welfare Agencies Local Child Welfare Agencies Private Service Providers Courts Medicaid Public Agencies Welfare, Public Assistance Substance Abuse Treatment Mental Health Counseling

20 Foster Care Statistics Million referrals made to CPS 900,000 children found to be victims of maltreatment 290,000 entered the foster care system 800,000 children spent some time in the foster care system 540,000 children in foster care at any given time* * The Future of Children Winter 2004

21 Foster Care Statistics 2001 * The Future of Children Winter Nearly one-third of maltreated children were under the age of 3 Forty percent of all child fatalities due to child abuse were infants under age 1 Over the past 10 years, the number of infants and toddlers coming into foster care has increased by 110% Approximately 1 in 5 of the children entering foster care for the first time are infants under age 1*

22 Is Uncle Sam a Good Parent? When the state assumes custody of a child, in effect the government is stating that it can do a better job of protecting and providing for this child than his or her birth parents can.* * The Future of Children Winter 2004

23 Assessing the Degree of Attachment Damage * The Future of Children Winter To uphold the government’s responsibility to children in foster care, addressing children’s needs must begin at entry with initial health screening and continue with regular assessments throughout a child’s time in care.*

24 Pay Now or Pay Later * Juvenile Offenders With Mental Health Disorders Who Are They and What Do We Do With Them? By Lisa Melanie Boesky, Ph.D. There is clear evidence that a significant number of youth in the juvenile justice system are suffering from serious emotional and behavioral disorders.*

25 Diathesis-Stress Model of Illness *Hakim-Larson & Essau, 1999, Juvenile Offenders With Mental Health Disorders… Who Are They and What Do We Do With Them? By Lisa Melanie Boesky, Ph.D. “Diathesis” = Being vulnerable to, or having a predisposition to, develop a particular disorder. Psychopathology is thought to result when a diathesis interacts with stressful life events, unless there are ample protective factors or resources to offset it.*

26 Diathesis-Stress Model of Illness Juvenile Offenders With Mental Health Disorders… Who Are They and What Do We Do With Them? By Lisa Melanie Boesky, Ph.D. Mental health disorders are likely the result of a combination of juveniles’ : Inherited biological or psychological vulnerabilities Environmental stressors Environmental supports Particular abilities and coping skills

27 Post Traumatic Stress Disorder Juvenile Offenders With Mental Health Disorders… Who Are They and What Do We Do With Them? By Lisa Melanie Boesky, Ph.D. Biological influences = MR or ADHD Environmental influences may be more significant for youth suffering from Post-traumatic Stress Disorder.

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