As you can imagine, each adoption brings with it a unique set of circumstances that can affect children and families in various ways. We share openly here about the challenges we’ve experienced, in the hopes that we might help someone else along the way. Some of the challenges we’ve faced have been profoundly isolating, so we realize there are probably many families out there feeling like they’re on their own and don’t know what to do or where to turn. If you’re in that situation, please let me know how I may encourage you because I have so often danced close to the line of being tempted to give up, and then at just the right time, God sent someone to reach out and encourage me. We are so grateful for our adopted daughters–despite the challenges, we would gladly do it again–just because something’s hard doesn’t mean we shouldn’t do it! It’s been profoundly challenging for each of our older children, too, but we know this is one of the reasons they are each such strong, kind, patient, hardworking, responsible, fun, funny, wonderful adults today!
2 Timothy 1:7–“For God did not give us a spirit of timidity, but a spirit of power, of love and of self-discipline.”
Our number one challenge by far has been Reactive Attachment Disorder. I will go into great detail on that further down this page, and first mention briefly the smaller challenges we’ve faced.
Strabismus
Because K and E had been in a terrible orphanage where they were likely never picked up, stimulated, or given toys to play with, K had a very severe case of double strabismus (crossed eyes). She had a one-hour eye surgery in June 2001 which immediately corrected her vision! Since we had gone through this identical surgery (same surgeon) three years earlier with our son M, we felt very comfortable with the procedure. Her eyes have functioned completely normally ever since, and she has 20-20 vision. If she had stayed in Romania, the chances are she would have been institutionalized for life since with crossed eyes and lack of educational funding, it is almost impossible for a child there to learn if they have strabismus. We were very saddened to learn in a documentary of a 20-year-old girl in Romania who has been institutionalized for her entire life because of this easily correctable condition.
Flat Head
E’s head is very flat at the back, likely due to the fact that she was not picked up or moved for the first 6 months of her life. In fact, under very similar circumstances, it’s surprising that K ended up with a roundish head. We had E evaluated by a neurosurgeon upon her arrival, and he said that although her head will never perfectly round out, her brain development is normal, and has not been impaired in any way. We praise God for her full head of curly hair! Her head shape improved little by little over the years, and is only noticeable now when her hair is wet, and then only if you know what you’re looking for.
Developmental Delays
Both girls had significant developmental delays when they came home. At 13 months of age, neither one could swallow anything except infant formula, gagging on raisins and cereal. E could not sit up; neither could crawl. Neither had any speech at all in Romanian (as reported by their foster family), although they both began saying “mama” and “dada” immediately. As part of the “Americans with Disabilities Act,” every child under the age of 3 was eligible for free evaluation and treatment of any developmental delays. In our area, the program that covered this was “Babies Can’t Wait.” We had the girls evaluated when they had been home for 9 months, and were so grateful to have these early intervention diagnoses. Both girls had significant speech delays, and E also had cognitive and gross motor delays (along with extreme fear). We started down the pathway of having therapists come to our home, but because of the girls’ significant attachment issues, and after each therapist agreed that it would help their attachment issues to have fewer adults in their lives, I took over the role of physical, speech, and occupational therapist (going as far as studying these fields using university textbooks – no YouTube videos in those days!) The best tool for helping E with her gross motor issues and fears was the purchase of a full-sized trampoline (completely enclosed by a safety net). All six children spent much of their recesses, lunch breaks, and free time on there, and it helped E learn to relax and play and be more in touch with her body. By age three, both girls were right on track in their evaluations, and were even advanced in many areas, I suspect largely due to having four older siblings who were boundless in their energy and enthusiasm and not afraid to try new things! K was especially well-developed physically for a three-year-old. E’s speech was phenomenal–she got all her pronouns correct, even, and was able to string sentences together like a pro! K’s vocabulary was more advanced, but her speech was not as clear as E’s. We believed this was due to oral sensory issues–her tongue was especially sensitive to any kind of touch, including her own palette. (Early on, this resulted in her stashing food in various states of mastication in the corners of her mouth, so we got in the habit of doing a mouth swipe after each meal. Specialists told us this was likely a deep-seated fear of not having enough to eat.) Close friends told us that by age 4-1/2, they could no longer notice any developmental delays in either girl. This is truly a miracle!
Sensory Integration Disorder / Dysfunction (SID)
About a year after our girls came home, we began to notice that E was hyper-responsive (over-responsive) to sensations, and K was hypo-responsive (under-responsive) to sensations. Both of these reactions affected virtually every area of their lives. Here’s a brief excerpt from a wonderful Sensory Integration website:
If they are oversensitive to touch sensations (tactile defensiveness), they will avoid touching and being touched and will shy away from messy play, physical contact with others, pets, certain textures of fabric, many foods, bumpy sock seams, etc. On the other hand, if they are under-responsive to touch sensations, they’ll crave touching and being touched. These children will be finger-painting their arms, stuffing their mouths with too much food, shouting indoors, turning up the volume and bumping and crashing into people and furniture.
Our girls were evaluated with “Babies Can’t Wait” and diagnosed with SID, as we had expected. We decided not to pursue outside therapy, primarily because the therapy involved copious quantities of time doing artificial-type activities, which just didn’t seem possible for anyone with more than one child! It turned out to be a good decision, because the natural activities that we worked into our days did wonders for their sensory issues. We noticed a significant improvement within 6 months for E as we could almost visibly see her gain trust and confidence.
Sleepless in Atlanta
Bless her heart, but E just simply did not sleep for the first 18 months we had her home! She was filled with anxiety about so many things. The doctor described her as being hypervigilant, so sleeping did not come easily to her. Sleeping with E was like sleeping with a tornado (actually, a talking tornado–very sweet, but I didn’t get much sleep either). After trying every non-medicinal route imaginable, as a last resort we turned to a narcotic sleep aid. We wished we’d done it sooner–after only 6 weeks with the artificially-induced deep sleep, her body kicked in, and she began sleeping like the proverbial baby most nights, and even snored! This is the child that at any time of the night would be found wide awake and often wandering dangerously around (or outside) the house.
Reactive Attachment Disorder (RAD)
The many doctors, social workers, psychologists, counselors, and psychiatrists with whom we’ve consulted over the years confirmed the condition of attachment disorder in both E and K. This widely misunderstood (or not understood) condition primarily results from extreme neglect and / or abuse. In our early post-adoption meetings with our social worker, I was asked to consult to give advice to other frustrated families whose children displayed attachment disorder, as it was very difficult to obtain information or resources in the early 2000’s.
The symptoms of Reactive Attachment Disorder accurately describe what we experienced in an extreme way with E in early childhood, and to a more moderate extent, with K. Even though we had some information at the outset, we didn’t figure out fully what was going on until the girls had been home for about 7 months. Then ensued a very difficult 2 years with E (more detail follows). We could tell that K internalized a lot of her struggles, and anticipated (correctly) from our extensive research and parenting intuition that they would both go through a more intense period of development during adolescence. Adolescence can be a difficult period for a healthily attached child, but is exponentially more challenging for those with attachment disorder and their families. (More on that later.) From age three or four until early adolescence, both K and E had a very happy childhood, with very few issues of any kind. When they entered the early stages of adolescence, their RAD symptoms manifested significantly (something we had braced ourselves for and known about prior to adopting – we went in with our eyes wide open knowing this was likely). We occasionally affectionately referred to K & E as “our little RADishes”. They sure were cute little veggies!
There is much recent research that indicates that extreme neglect (or abuse) results in a brain injury or trauma. But the good news is that brains can heal – there is also much recent research in this area, and we are encouraged to know that there are pathways to healing, something that was not believed to be possible just a few short decades ago. Even though the girls are finished developing physically, their brains can continue to change, depending on the choices they make and the things they choose to believe. Breakthroughs in neuroscience have been very encouraging to Paul & me and helped us to parent our children with greater compassion, knowing that their behaviors can often be attributed to the brain injuries they received in early childhood. We have sought to live with balance by holding our children accountable for their actions while at the same time having compassionate understanding that brain injuries can have devastating consequences for individuals and those close to them. For this reason alone, we consider each of our older children to be among the most compassionate, caring, kind, and understanding people we know. Certainly, we nurtured these traits in them, but they each chose to respond daily with grace and love to their deeply loved but wounded little sisters – by the grace of God, each of us helped K and E to heal and grow and develop, to be able to receive love and give love.
Statistically speaking, children adopted at > 12 months of age are at high risk for attachment issues, and the risk is especially high for children who reside in institutions with a high ratio of children to caregivers (for example, Romanian orphanages at the time we adopted tended to have 1 caregiver for each 50 children; in contrast, Vietnamese orphanages at that time had 1 caregiver for each child). Our girls were 13 months old at the time we brought them home and were in a terrible orphanage even by Romanian standards. In early childhood, K’s symptoms were fewer, but she tended to hold her feelings inside at the time, so was more passive-aggressive about the way she expressed them. E expressed her feelings in either a passive-aggressive or just plain aggressive manner. Both of them were deeply wounded by neglect and possible abuse in the early part of her life. 🙁 This broke our hearts, but we put our hope in God in this as in every other circumstance in our lives, and firmly believed (and continue to believe) that over time, through prayer, Jesus will heal E’s & K’s hearts, and they will be able to give and receive love as God intends. Every relationship over the course of their lives is affected by RAD, whether consciously or subconsciously.
Note: we saw many improvements over the course of time, but it was very slow progress at times and we often saw regression back to behaviors that we had thought were a thing of the past, especially during stressful seasons. Looking back over a period of years to see how far we had come brought much encouragement to us. It’s been the most difficult experience of our lives (for Paul & me and our four biological children, all of whom admirably chose to love unconditionally right from the start), but so worth it! It’s taught us more about unconditional love, endurance, and forgiveness than anything we could have ever imagined 🙂 We are extremely proud of our four biological children, who each opened wide their hearts and time and shared and loved so very well, expecting nothing in return. Loving RAD children into life is often a thankless task, and often evokes the exact opposite of gratitude. We don’t do what we do for earthly reward, but for the glory of God and the good of the adopted children, who don’t always realize what they’re doing or why (We pray along with Jesus – Father, forgive them, for they don’t know what they’re doing!)
Examples of RAD symptoms:
- Extreme rage, often lasting for hours
- Rigidness of body; inability to relax (hypervigilance)
- Constant noise-making or talking
- Refusal to give eye-contact
- Not shy of strangers; will go to anyone
- Hurts self and others
- Prefers self-comfort to comfort from others
- Lashes out primarily at mother; prefers father in a superficial way (it was a breakthrough in our parenting when we realized this was happening. This one realization more than any other has helped us to parent in complete unity!)
- Doesn’t sleep well; thrashes around
- Problems with eating; cannot tolerate certain textures
- Sensory issues
- Very controlling of every situation
- Superficially charming; often others don’t see any problem
- Tolerates holding for a brief period, but strongly avoids real intimacy
- Very clingy, but resists affection if you get too close
- Speech delays
- Refuses comfort when hurt
- Unexplained withdrawal, fear, sadness or irritability
- Sad and listless appearance
- Not seeking comfort or showing no response when comfort is given
- Failure to smile
- Watching others closely but not engaging in social interaction
- Failing to ask for support or assistance
- Failure to reach out when picked up
- No interest in playing interactive games
Inhibited type RAD is also characterized by:
- Detached
- Unresponsive or resistant to comforting
- Withdrawn
- Avoidant
- Shuns relationships with everyone
Disinhibited type RAD is also characterized by:
- Indiscriminate sociability
- Inappropriately familiar or selective in choice in attachment figures
- Seeks attention from anyone
- Displays inappropriate childish behavior
- Frequently asks for help doing things
- Violates social boundaries
Additional symptoms:
- Relationships: In relationships, a person who has RAD may be bossy, distrustful, manipulative, and controlling. They may have challenges giving or receiving genuine love and affection. Their unstable peer relationships are tenuous at best, as children and teens with RAD blame others for their mistakes or challenges.
- Behavioral: Destructive, irresponsible, impulsive, and defiant behaviors. Children or teens with RAD may steal, lie, abuse others, start fires, behave cruelly to animals, or act in a self-destructive manner. They also may avoid physical contact with others, and engage in drug or alcohol abuse.
- Moral: Teens with RAD may lack faith, compassion, and remorse for their actions.
- Emotional: Children who have RAD may feel sad, moody, fearful, anxious, depressed, and hopeless. These children may display inappropriate emotional reactions.
- Thoughts: Children and teens who have RAD may have negative beliefs about themselves, life, and other relationships. These children and teens are unable to understand the concept of cause and effect. Additionally, they may experience inattention and challenges with learning.
How do you live with RAD?
- Prayer
- Encouragement
- parental unity
- structure (in those early years, we set aside one evening a week for Paul-Karen date night, one evening a week for family night out, one evening a week for Daddy-child date night, and one evening a week for Mummy-child date night; we also had our usual school schedule, church services, sports schedules to keep us fairly tightly scheduled, which helps a lot in coping with RAD children)
- rest (we are all better versions of ourselves when we get enough sleep!)
- take care of yourselves
- sense of humor (this is vital, really!)
Methods used with normally-attached children do not work with children lacking attachment. e.g. time-out is futile, because the non-attached child wants to be left alone and will often try to produce this result. There are many ways to help children into attachment, one very important one being “holding time.” We found this to be a wonderful way to help with attachment, and used it for several years on a daily basis (for 1/2 to 3 hours per day). While physically and emotionally exhausting, the process of loving them to life is *so* worth it!!! We tried to look towards the goal, rather than present circumstances, to see them as attached, healed, and whole, and able to form other meaningful relationships, with God and others! We also co-slept with our girls (alternating nights so we had only one in our bed each night, so that we could actually sleep, too!) I usually slept well with K, since she slept like a rock, but with E it was a different story (little Miss Wiggles).
Update at 10 months home:
E had a major breakthrough over a period of a week: three main things stood out in my mind–she started coming to me for comfort (this was HUGE–previously she would hit herself on the head, or ignore any hurts); she started asking for things (previously she would ignore her own needs); and she started imitating words (this of course jumpstarted her speech). Yay God–we were really beginning to wonder if these things would *ever* happen!! Over the years she has regressed to these places many times, but each time she is able to take a step forward, we are encouraged, because her brain traumas are beginning to heal, one good choice at a time.
Update at 1 year home:
RAD symptoms sometimes seemed to have decreased, but there were still recurring issues on many of them. There seems to be a cyclical nature to these things–2 steps forward, 1 step back, 2 steps forward, 2 steps back, etc.–learning to trust can take a very long time. Some days the symptoms seemed to have evaporated; other days the symptoms are there in full force. On some days, E could go from one extreme to the other (even in a matter of seconds).
Update at 2 years home:
If E was really tired, she would begin to disconnect. Often she would lie on the floor and bend her legs together toward one side in a rocking motion, a form of self-comfort. Since she was much more verbal at this point, we could usually invite her to engage in relationships again most of the time. We could see her make steady progress month by month. We still shielded her from most other adults, in order to teach her little by little how to determine who to trust and how much (RAD children tend to trust people indiscriminately, and can’t distinguish between intimate and stranger relationships. This dangerous behavior results in frequent changing of entire friendship groups / communities, something we saw persist even into adulthood). K did not demonstrate RAD behavior to the same degree in early childhood, but nevertheless had many of the symptoms, mostly masked. She started to deal with her issues more around age 3, and we expected the process to continue for some time yet.
What about parenting teens with RAD?
This is the most difficult challenge we’ve faced (we said the same thing during E’s early childhood). Our girls were both very happy and well-adjusted in their middle childhood years, enjoying close relationships with both Daddy and Mummy and each of their older siblings. We did notice they had trouble forming close friendships, but since we had so many immediate family members with whom to develop loving relationships, it didn’t seem to be as huge of an issue. The challenging part about parenting teens with RAD is that the breakthroughs and good behaviors you see in childhood seem to explode in adolescence. It’s a well-known turbulent period for all kids, but for kids with RAD, it can be devastating for everyone in the family unit. Each teen makes choices that can and will affect them for a very long time. The most important thing is to cultivate a soft heart (this applies to both parents and teens) because we all make mistakes. Forgiveness, keeping short accounts, refusing to grow bitter, learning to ask questions instead of making accusations, calling for help when needed (whether prayer warriors, encouraging friends, counselors, pediatric and mental health professionals , law enforcement personnel) – these are all essential tools for coping with this extremely difficult and widely misunderstood challenge. In our particular situation, both of our daughters have experienced much of what’s described in this helpful excerpt (below) from an organization called Liahona Academy.
RAD manifests in a variety of ways ranging from withdrawal and isolation to severe aggression and a compelling need to be in control of every situation. All RAD sufferers feel a lack of trust and an inability to connect or properly bond with others. Early intervention gives RAD kids the best shot at a healthy future, as the older an individual gets, the more complexly the disorder can affect every phase of life. Unfortunately, once RAD has been inflicted and diagnosed, there is no cure. However, through therapy, RAD sufferers can learn to manage their symptoms and live healthy, happy lives. Teens with RAD are particularly susceptible to risky behaviors as the adolescent years are a tricky time for even healthy teens. Most teens yearn to feel included and accepted, however RAD teens have an even more intense craving for approval and love, but don’t trust it when it is given. Because one of the symptoms of RAD is a decreased sense of guilt, teens with the disorder are at much higher risk for behavior such as substance abuse and sexual activity. Suicide, running away and cutting are all very common among RAD teens. At this time, kids are learning enough about social rules to mimic healthy interactions, but underneath, the problems remain and if left untreated, will affect all of their future relationships. RAD is not something an individual grows out of or learns to handle on their own. It is a condition that requires constant treatment.
Some of our greatest concerns about our adopted daughters’ well-being have resulted from the simply dangerous aspects of RAD, which are much harder to put boundaries on as they approach legal adulthood. Lifelong family friends have frequently observed that their emotional development lags significantly behind their physical development. In other words, they may be adults physically and numerically, but in many ways may remain stuck emotionally at age 11 or 12 on the inside. Coupled with that, RAD teens tend to overestimate their own maturity, which places them in great danger in very real ways. One of the riskiest sets of behaviors we’ve noticed (not only in our own kids but in other adoptive families) is the tendency to live in a fantasy world of their own creation, by removing the usual safeguards of community and accountability, even to the point of revising their personal or family history to fit their created fantasy. We have become convinced (through study, the counsel of medical experts, and experience) that living in a mental fantasy over a prolonged period of time may actually contribute to mental illness, causing the mind to become detached from reality.
Ways in which we have sought to help our RAD teens have included:
- being unshockable
- offering unconditional love
- offering support in practical and other ways (whether it is received or not)
- providing a structured environment
- maintaining important family traditions / connections
- inviting each one into deeper relationships on a regular basis
- allowing each one to experience some or all of the consequences of their own choices (not rescuing or enabling unwise, unsafe, or unhealthy choices)
We are continuing the process of loving our girls to life! Once they’ve passed into the teen years, each individual’s process of emotional healing seems to largely depend on their willingness to engage in the process and a genuine desire to be well. There needs to be a laying down of the victim mindset and a conscious choice to forgive those who abandoned / hurt them, coupled with a choice to live in the reality of their circumstances in truth and freedom. As I wrote earlier, one of the barriers to healing in individuals with attachment disorder is the mindset that accompanies constructing an alternative reality in which they are the victim. It’s only when we choose to live in the reality of our lives as they actually are (not as we wish they were, not as we hope they will be “some day”) that we begin to experience true freedom in every part of our lives. Our hearts cannot be divided and thrive at the same time. If we open our hearts to God and to people in love and forgiveness, we can receive love and healing and give love and life. If we close our hearts to God or anyone, we will end up closing our hearts more and more even to the ones we want to love. If we dwell on negative things, they will end up consuming us from the inside out.
There are so many other components of our journey that I can’t write here. If you are on an adoption journey and want to talk, please let me know how I may encourage you!
