Day to Day Life Parenting a Child with Reactive Attachment Disorder

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The alarm on Princess' bedroom door always sounds the loudest in the morning when it's time for her to rise and shine.  It's my daily wake up call to realities of life parenting a child with Reactive Attachment Disorder.

Why is there an alarm on Princess' door?

Children with Reactive Attachment Disorder often display unsafe behaviors in the night when others are asleep, or when they think no one is watching.  These behaviors can include sexual victimization of others in the home, self injurious behaviors, behaviors that may injure others including adults, siblings and animals, stealing, destruction of property, and/or the use of weapons, or other harmful substances and objects in the house.  An alarm on the door protects everyone in the home, including Princess.

Once greeted, Princess is then escorted to the bathroom to complete her morning routine.  She is supervised by an adult the entire time.

Why does Princess require supervision in the bathroom?

Children with Reactive Attachment Disorder, when left alone can cause significant damage to property or themselves.  Bathrooms in particular can be a trigger, and may be very unsafe due to the contents of the room.  Princess has shown increased maturity while using the bathroom but has requested that we continue to supervise her so she won't be tempted to revert back to earlier behaviors.

Breakfast comes next.  Usually it's the most enjoyable meal of the day, but one can never tell.  Princess' meal is selected and prepared by an adult, measured carefully.  If there is to be a battle, the adult wants to make sure their energy isn't wasted.

Why can mealtime turn into a battleground?

Food usually is a trigger for children with Reactive Attachment Disorder.  Most often this is a result of past trauma and/or neglect.  Some refuse to eat for hours.  Others gorge, over stuff, and/or over eat to the point of vomiting.  Meals are best selected and monitored by caregivers as many children with Reactive Attachment Disorder can not identify when they are hungry, full, or feeling ill for quite some time.

Once breakfast has been eaten, Princess completes morning chores and homeschool responsibilities all within arm's length of an adult.  It is her responsibility to remain with Jason or myself, not the other way around.

Why must Princess stay within arm's length of an adult while completing daily tasks?

Children with Reactive Attachment Disorder will take advantage of any opportunity to cause chaos, and/or engage in destructive or harmful behaviors that involve objects or people in the home, school, or other community places.  They enjoy the art or sabotage.  If they can manipulate someone they'll do it.  And triangulation, especially with parents is their specialty.  It takes only seconds to create a dangerous situation.  Putting the responsibility on the child with Reactive Attachment Disorder to remain with the parent encourages responsibility of one's actions and consequences.  If the child is unwilling to comply with the safety plan, the parent can then reach out to therapists and doctors with documentation, and seek a higher level of help and/or care for the child.

Lunch follows learning.  The same rules that are in place for breakfast apply to lunch as well.  This meal poses a higher threat of battle, but there are days when it runs quite smoothly after years of hard work.

The afternoon kicks off with some form of physical activity.  If the weather is nice, we try to go for a walk at the very least.  Princess is required to hold hands with an adult while on our walk.

Why must Princess hold hands on walks?

Children with Reactive Attachment Disorder tend to have a very high flight or fight response to stress.  Anxieties often increase when the child leaves the home, as fears of the unknown are confronted, and when the child is unable to control the environment around them to feel safe.  Most often the children feel safer when close to their caregiver, even if they express the exact opposite with their behaviors. In so many situations their fears and anxieties get the best of them, and they can not self-regulate.  When this occurs negative behaviors increase.  Keeping the child close with physical contact in some cases can help the child be successful outside of the home.

Depending on how long lunch time is extended due to food issues, and the length of our walk or other choice of physical activity, we may be able to sneak in some family fun before the nightly news and dinner.  Princess' emotional state and behaviors determine her participation.  If there have been issues throughout the day, this is usually the time when they come to the forefront and I fulfill the motherly role that Princess needs. Most often this consists of a backwards approach to parenting.  Some days this ends with both of our faces tear stained.  Other days, I sit with her in her room, listening to her scream, while I try to keep her safe.  And then there are those days, when all we can do is crank the speakers to maximum volume, turn on our song, and dance, singing our guts out, hoping that by songs end, we've released enough emotions, we can both make it through the rest of the day.  A child with Reactive Attachment Disorder may be chronologically 6 years old, cognitively 9 years old, developmentally 4 years old, and emotionally 2 years old.  Coping with emotions, sensory stimuli, and anxieties can be rough to say the least.  We have learned when it comes to our expectations of Princess, we must always factor in her emotional age.

The nightly news provides respite, as it's part of a consistent routine that helps everyone wind down before dinner and bedtime routines.  Though grim at times, it encourages the discussion of emotions and opinions, which is important, as many children with Reactive Attachment Disorder can't recognize emotions, let alone express them appropriately.  Princess is permitted to sit on the floor with a blanket and pillow as long as she keeps her hands where adults can see them at all times.

Why must Princess keep her hands visible at all times?

Children with Reactive Attachment Disorder often act out sexually, sometimes this means with only themselves, other times these children can target others.  It is normal for some children to act out sexually in public.  These behaviors are often a result of sexual trauma they experienced in the past.

Dinner is prepared and served.  This is usually the most difficult meal of the day, but we are always hopeful that the current day will be a good one and we'll get lucky.  After dinner, Jason grabs the prescription lock box from the shelf in the kitchen and gives everyone their nighttime doses of medication, one child at a time,while I'm supervising the others in the living room.

Why do we use a lock box for medications?

Children with Reactive Attachment Disorder often steal and can engage in a variety of self injuring behaviors.  Many suffer from other mental health illnesses.  Depression is not uncommon.  Others enjoy the thrill of stealing and selling items for money to engage in harmful behaviors.  A lock box is used to keep everyone safe, especially our children with Reactive Attachment Disorder and demonstrates appropriate safety plans put in place.

Once all medications are locked away, Jason and I sweep through the downstairs, in search of any sharp objects that we may have used during dinner preparations and mealtime, washing them and returning them to their places in our lockable kitchen tool box.

Why do we lock up sharp objects?

Children with Reactive Attachment Disorder often engage in dangerous activities, using sharp objects to injure themselves, others, animals, and to cause destruction to property, etc.  Locking up sharp objects protects everyone in the household, including caregivers, as they're demonstrating appropriate  safety plans put in place.

Bedtime routines follow.  Princess continues to be supervised 100% of the time, unless she is in her room with her door shut and alarm on.  Before tucking her in each night, Jason or I do one final search through her room.  The search takes five minutes or less, as it only contains a mattress on the floor, covered with a fitted sheet, one blanket, one pillow, and one stuffed animal.  She has a forward facing book case with six books and one set of shelves where her clothes are neatly folded and visible at all times.

Why must Princess' room be searched each night?

Children with Reactive Attachment Disorder often steal and/or hoard food and other objects in their bedrooms.  Some hide weapons, including sharp objects.  Other children tend to destroy walls, doors and household furniture.  There are also many children with Reactive Attachment Disorder who may cover their floors, walls, clothes, etc. with bodily fluids and feces.  Daily checks confirm that you're not missing something, and also help you to remain vigilant at all times.

Why does Princess have so few items in her room?

Children with Reactive Attachment Disorder become overwhelmed easily with too many things.  They often destroy items given to them or use them inappropriately while self harming, etc.  Daily, weekly, and/or monthly searches take time.  The fewer objects and furniture in the room  the easier it is to do routine searches.  There are also fewer places to hide things.

Princess' bedtime routine ends with hugs, kisses, and I love you's before her light is turned off and her door is shut, with the alarm on.  Then it's time to finish documenting any incidents that may have occurred during the day in Princess' "special book," to report to members of Princess' therapeutic treatment team during upcoming appointments.  Emergency situations are reported immediately by phone.

Why do you document incidents that occur in a notebook?

Children with Reactive Attachment Disorder often engage in bizarre and dangerous behaviors that threaten the safety of themselves and/or others.  It is crucial that these behaviors be documented and reported accurately and in a timely manner to help the children in the home, and to also protect the parental rights of caregivers.  Children with Reactive Attachment Disorder often put on "artificial charm" for others outside of the home. It is completely normal for them to lie about incidents that have taken place and accuse others of maltreating them.  Documenting behaviors also helps the caregiver feel validated and provides a constant reminder that behaviors are not just figments of the imagination, but instead very real, especially when so many others doubt a child could actually be capable of what you're experiencing.

It is then that Jason and I are finally able to relax and take a much needed respite after another stressful and exhausting day.  Day to day life parenting a child with Reactive Attachment Disorder can easily be compared to being a combat soldier in the middle of a war zone.  Studies have shown that the stress experienced by a parent of a child with Reactive Attachment Disorder is equivalent to that of a combat soldier.  Except that you're alone.  The loss of friend and family support a caregiver experiences due to the behaviors of the child, the need to protect and keep everyone safe, and the backwards parenting techniques that must be used is unimaginable.  It takes it's toll, in one way or another.  For me, it's affected my weight and sleep patterns.  For others it causes anxiety disorders, sleep disorders, PTSD, and/or depression.  The constant prison guard like patrolling to ensure safety never ends.   Down time on a regular basis is crucial to keeping your sanity.

When Jason and I go to bed, we turn on our ADT alarm system downstairs, with alarms on each of the doors and a censor in the living room, making it impossible for anyone to exit the house, or enter the kitchen without tripping the alarm and immediately initiating safety protocol.  And then we sleep, wake up and do the same things all over again because we love our daughter.  We want her to succeed and are willing to do whatever we must to make that possible.  There are precious moments when all is well.  She is smiling and happy.  Everyone is safe.  Reactive Attachment Disorder seems to have disappeared.  It's those moments that keep us fighting.  

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This post is part of the Parenting Children with Special Needs Series. For more posts about daily living with various special needs, please enjoy the links below!
Life with Trauma ~ Living in the shadows‎ | STEAM Powered Family
A Day in the Life of a Special Needs Mom| The Chaos and The Clutter
One Simple Trick to Connect with Your Child - Even on the Rough Days| Parenting Chaos

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