Rewriting Parenting for Kids with RAD and ODD - Free Webinar

Bryan Post is a psychologist who does ground-breaking work with families of kids who have severe behavior problems, mostly as the result of early trauma from adoption or spending time in the foster system. 

His approach takes into account the dynamics of the whole family, recognizing that a parent's anger or inability to connect can further traumatize the child. Post was himself an adopted and disruptive child. Now, at the Post Institute for Family-Centered Therapy and in workshops around the country, he helps parents learn to provide the brain-shaping experiences their children missed.

Bryan thinks that a parent's own attachment issues can get in the way of seeing that a child's out-of-control behavior comes from fear, not, as it often seems, from maliciousness, defiance, or an evil nature.  Once parents can remove their own fears from the relationship, it's easier for them to heal the child's fear. Sessions with parents begin with whatever behaviors or problems seem most critical to them. While the end goal certainly is to help the child develop into a loving, happy, and responsible member of the family, these first steps are as much about guiding the parents into a deeper understanding of themselves.In interviewed Bryan and included his work in my book. Since then, his model has evolved to include the new science of oxytocin and bonding. In fact, he and I are collaborating on a new book, tentatively titled Oxytocin Parenting.

Whether you are parent to a child who's been diagnosed with a disorder like RAD or Oppositional Defiance Disorder, or are looking for a better way to parent, Bryan has practical approaches that help you create better bonds with your children -- which leads to better behavior and a happier home.You can learn how to use the new science of oxytocin and attachment to help your kid in a free webinar next Thursday, April 8, at 9 p.m. EDT. To reserve your spot, register at http://postinstitute.com/webinar/.

Bryan is an inspiring, emotional teacher. Joining him will be Helene Timpone, LCSW, who's an expert in parenting teen-aged girls. I highly recommend this event. And I'm honored that they will feature my book. 


Welcoming an Older Adopted Child

I came across Adopting the Older Child, a terrific blog from Robin Hayes, a psychologist and the mother of three children, two of whom were adopted at around four years old.

In a post on helping new siblings learn to get along, she outlines steps in a program to make sure that they have time to get used to each other and accept each other, without beginning to re-enact abuse or trauma.

For example, as the kids get used to each other, she advises:

Over time, build on success. Slowly extend the allotted time for play. When they can play successfully for about 20 minutes one-on-one, add one 10 minute session where all the children play together, supervised by an engaged, involved parent.  Again, keep it positive and end on a happy note.

In the past, adoptive parents were often not given much information about attachment and behavior issues that children might suffer from, let alone clear directions on how to deal with them.

Robin is a heroine to me for welcoming into her family older, hard-to-place kids. I always thought that if the time came for me to have kids, I would adopt one with medical problems; that as a society, we should only adopt until all the orphanages were empty. (The time to have a family never came for me.) But Robin is doing it.



Neuroscience in the Age of Miracles

It really does seem like science has pulled aside the veil of emotion. And brain scanning can point the way to therapies that can alter the brain's workings to make it healthier. A two-day seminar at Chico State University promises to provide a terrific overview. This is part of the annual "Children in Trauma" Conference, designed for social workers, law enforcement, therapists and others who work with kids. I attended two years ago and it was well worth it.

CSU, Chico to Host 7th Annual Children in Trauma Conference – Neuroscience and the Age of Miracles

California State University, Chico, Continuing Education, in partnership with the Superior Court of California, presents Children in Trauma 2009: Neuroscience and the Age of Miracles. The two-day professional development conference will be held Jan. 16-17, 2009, at the Bell Memorial Union Auditorium on the CSU, Chico campus.

The 7th annual Children in Trauma Conference will provide an intensive two-day practicum focusing on how traumatic stress can alter early child development and how professionals who work with children can recognize this problem and learn how to apply the emerging intervention and treatment protocols.

The conference will feature nationally recognized practitioner Richard Gaskill, Ed.D., Child Trauma Academy Fellow and Clinical Director at Sumner Mental Health Center in Wellington, Kansas.

Gaskill is well respected in the field and has developed many successful programs for children and their parents, including child development classes, parenting classes, child-parent relationship training, attachment enhancement treatment groups, therapeutic alternative schools, therapeutic preschools, after-school programs and juvenile offender programs.

Marriage and family therapists, social workers, psychologists, educators, school and family counselors, attorneys, law enforcement professionals, mediators, child custody evaluators, behavioral health professionals, nurses, physicians, psychoanalysts, emergency responders, children’s advocates and concerned individuals are encouraged to take advantage of this continuing education opportunity.

Participants will gain a greater understanding of difficulties and challenges children who have experienced trauma face and an improved ability to intervene successfully with children and youth adversely affected by severe trauma and post-traumatic stress disorder. In addition to learning from a recognized practitioner, participants will walk away from this conference with an array of professional contacts and practical treatment tools.

Participants may earn 12 hours of BBSE (Provider PCE 799), BRN (Provider 00656), MCEP (Provider CAL123), and MCLE continuing education credit.

In addition to the featured speaker, exhibitors from public service agencies and other resource providers will be on hand to share a wide array of information and discuss their services. Exhibitor space is available.

Early registration fee for the two-day conference is $295 per person (includes continental breakfast, lunch and materials). Group rate discounts are also available.

To enroll or for more information, please call CSU, Chico Continuing Education at 530-898-6105, e-mail rce@csuchico.edu, and visit the Web site http://rce.csuchico.edu/inservice.


Conference with Victor Carrion on Child Trauma

Victor Carrion is a Stanford researcher who's shown via brain imaging how trauma affects the brains of children. This is the cutting edge of psychiatry; the work of Carrion and others shows that the roots of criminal or antisocial behavior may be in damage to the normal development of the brain.

For more on this, see Gray and White Matters.

Dr. Carrion will give a two-day seminar at Chico State University, in Chico, California in early January. This is an annual conference on children in trauma, designed to educate those who work in the social and legal systems. I attended the conference last year, when Allan Schore presented, and it was a valuable opportunity to learn about advanced brain science presented in an understandable way.

Here are details about the 2008 Children in Trauma conference:

California State University, Chico Continuing Education, in partnership with Butte County Family Court Services, Superior Court of California, presents Children in Trauma 2008: Helping Children Survive Trauma: Early Life Stress, Brain Development and Effective Interventions. The two-day professional development conference will be held January 11-12, 2008 at the Bell Memorial Union Auditorium on the CSU, Chico campus.

The 6th annual Children in Trauma Conference will provide an intensive two day practicum focusing on how traumatic stress can alter early child development and how professionals working in the field can recognize this problem and learn how to apply the emerging intervention and treatment protocols.

The conference will feature internationally recognized researcher and educator, Victor G. Carrion, MD, Associate Professor, Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences and Director of the Stanford Early Life Stress Research Program.

Victor Carrion’s research looks at the interplay between brain development and stress vulnerability via a unique multi-method approach that includes psychophysiology, neuroimaging, neuroendocrinology and phenomenology. Dr. Carrion is a noted practitioner, known for his development of successful individual and community-based interventions for stress related conditions in children and adolescents that experience traumatic stress and post-traumatic stress disorder (PTSD).

Marriage and family therapists, social workers, psychologists, educators, school and family counselors, attorneys, law enforcement professionals, mediators, child custody evaluators, behavioral health professionals, nurses, physicians, psychoanalysts, emergency responders, children’s advocates and concerned individuals are encouraged to take advantage of this continuing education opportunity. In addition to learning from a recognized scholar and practitioner, participants will walk away from this conference with an array of professional contacts and practical treatment tools.

Participants may earn 12 hours of BBSE (Provider PCE 799), BRN (Provider 00656), MCEP (Provider CAL123), MCLE and CME continuing education credit.

In addition to the featured speaker, exhibitors from public service agencies and other resource providers will be on hand to share a wide array of information and discuss their services. Exhibitor space is available.

Early registration fee (received before Jan. 4, 2008) for the two-day conference is $279 per person (includes continental breakfast, lunch and materials). Group rate discounts are also available.

To enroll or for more information, please call CSU, Chico Continuing Education, 530-898-6105, email rce@csuchico.edu, or visit the conference website.

 


Gray and White Matters

There seems to be a flood of brain research lately that helps illuminate how the brain responds to social stimuli.

An intriguing new area is looking at two kinds of tissue in the brain: white matter and gray matter.  We usually think of gray matter as the stuff we use for cognition; more grey matter tends to equal a higher IQ, for example. White matter, on the other hand, is the connective nerve tissue thought to be used for "wiring together" different parts of the brain.

Of course, it's not that simple.  Too much gray matter in some regions has been linked to trauma.

Two studies released today looked at the relationship between volume of white or gray matter and behavior.

First, a team led by Manzar Ashtari of the Children's Hospital of Philadelphia in Pennsylvania looked at the brains of autistic kids. They found more gray matter than normal in parts of the brain dealing with social interactions. They think this could be related to abnormal function of the mirror neuron system.

Mirror neurons are thought to be special kinds of nerve cells that fire when we watch others. It's still speculative in humans, but they've found that monkeys have what they call mirror neuron regions that fire when the monkey watches a researcher pick up a cup. This might be related to empathy, the ability to literally put oneself in another's place. See Mirror Neurons, Oxytocin and Autism for more.

According to the Science Daily story,

"In the normal brain, larger amounts of gray matter are associated with higher IQs," Dr. Ashtari said. "But in the autistic brain, increased gray matter does not correspond to IQ, because this gray matter is not functioning properly."The autistic children also evidenced a significant decrease of gray matter in the right amygdala region that correlated with severity of social impairment. Children with lower gray matter volumes in this area of the brain had lower scores on reciprocity and social interaction measures.

Another study by James Cantor of the Centre for Addiction and Mental Health in Toronto  found significantly less white matter in the brains of pedophiles than in the brains of non-sexual offenders. The article says,

The study, published in the Journal of Psychiatry Research, challenges the commonly held belief that pedophilia is brought on by childhood trauma or abuse. This finding is the strongest evidence yet that pedophilia is instead the result of a problem in brain development.

I don't understand why they draw this conclusion. Plenty of studies have shown abnormalities in brain development in children who've been neglected, abused or traumatized. In fact, Victor Carrion of Stanford has found more gray matter in the prefrontal cortexes of the brains of children with PTSD. He's also found decreased total volume in the PFCs of adults and children with PTSD.

He recently told me that it's difficult to identify exactly what these differences mean when it comes to brain function and behavior. He said, "It seems like in some regions, there's a problem if you have more volume ...  in others, it's problematic if you don't have enough."

It seems to me that Cantor's study provides further evidence for two things: that early trauma affects brain development, and that this abnormal brain development leads to abnormal behavior later.

I've contacted the Centre for Addiction and Mental Health to more information on this statement. I'll post if and when they get back to me.

 


Retraining the RAD Brain

I published a story today in the East Bay Express, called When Love Is Not Enough.

The story uses the experiences of two local families who adopted children from overseas to discuss some of the therapies being used to retrain the brains of kids with attachment disorder, PTSD and other abnormalities of brain development.

I didn't get into the oxytocin response too much -- it's too complicated and not the focus of the story. But you can look at the therapies discussed -- attachment therapy, neurofeedback and neurodevelopmental reprogramming -- as ways of building the oxytocin response in the brain.


When Does Attachment Disorder Happen?

In an interview with Babble.com, Jane Aronson, the pediatrician known as the Orphan Doctor, talks about foreign adoption, something she strongly advocates. Aronson is pediatrician to movie star adopters including Angeline Jolie.

In the interview, Aronson points out that adoptions of older foreign children can be very successful when the child was raised by a family, but then lost his parents to AIDS, war or other misfortune. She gives a helpful analysis of adoption services in various countries.

Aronson certainly is highly experienced in overseas adoption, through her organization, Worldwide Orphans Foundation. She makes one strange and really inaccurate remark, however: She claims the science shows that attachment disorder is mostly the result of brain damage or brain chemistry imbalances in the womb.

She told the interviewer,

And attachment likely has more to do with brain damage that occurs during the pregnancy, due to malnourishment, exposure to toxins in the environment, infections during the pregnancy, exposure to alcohol and drugs and smoking. All of that conspires to cause damage to brain structures that are involved in the actual chemistry and physiology of attachment. So when people use this sort of artificial convention of saying, you know, "You gotta get 'em by three, or else they're ruined," I think that's also not taking into consideration that attachment likely has to do with brain chemistry during pregnancy.

While it's accepted that a hostile womb environment -- a mother who takes drugs, who doesn't want the baby, who's being abused -- can make the baby hyper-vigilant and hyper-reactive before he's born, neuroscientists like Bruce Perry who study disordered kids are convinced that not only abuse but also neglect and simple lack of attention after birth can create post-traumatic stress disorder, or PTSD.

In the comments on a blog summary of the interview, most people think Aronson is full of it.

For the perspective of a neuroscientist who studies traumatized children, read this interview with Michael de Bellis of Duke University.

See also RAD Epidemic in Russian Adoptions?


Saving a Troubled Adoption

When I started this blog more than two years ago, the severe behavioral problems that adopted kids and their parents struggle with was really under the radar. Reactive attachment disorder, PTSD and other ills that affect children who were traumatized by, if nothing else, being separated from their mothers, are becoming mainstream concerns, thanks to articles like this one from the Boston Globe.

In "Choices of the Heart," Patricia Wen tells the story of a family that almost relinquished their son when he was 15. Luckily, as a last resort, they found an attachment therapy center that, after months of intensive work, allowed him to heal -- and return to the family.


The Foster System Damages Kids' Brains

The CBS affiliate in Miami, Florida, has an excellent story today about the problems created by our foster care system.

Reporter Michelle Gillen writes about  the growing awareness in the Miami court system that efforts to help kids by taking them out of abusive or danger situations can be permanently damaging their brain development, and to conditions such as reactive attachment disorder, or RAD.

Cindy Lederman and Steven Leifman, two Miami court judges, are using new information about brain development and how important connection with the mother or other primary caregiver is, to help kids at risk for this.  According to the story:

Leifman says the latest research is staggering because it means juvenile court systems around the country have unwittingly damaged children in foster care by purposely preventing attachments.

“It is particularly acute in the foster care system and one of the things that we realized, again, the court in advertently contributed to the problem, because we felt that we didn’t want children to become too attached, that it would do more harm than good if they got attached then we’d move them. So for a long time we kept moving the kids around the foster care system.”

Miami is trying to intervene early to help kids at risk that come through the court system with an early intervention center. It's opened the the Linda Ray Intervention Center, a therapeutic home where babies up and toddlers up to three years old can attach to a warm and caring person.

In Miami alone, some 9,000 children enter the foster care system each year.  And 27 percent of the children in foster care are under five years old.  As the article points out, this is many more children than can be helped by the Center but at least it's a start.


Generation Alienation Is a World-Wide Problem

It's easy for those of us living in the dysfunctional United States to blame our indigenous culture on the growing crisis in attachment. But this story from the Bay of Plenty Times in New Zealand shows that country is experiencing a similar attachment crisis.

Writer Elaine Fisher quotes psychotherapist Augustina Driessen, who predicts that child abuse will worsen in New Zealand as kids who have been neglected, abused or ignored grow up to become parents themselves. Driessen says,

  "To break the cycle we must teach many parents how to parent, to stop them bringing up their children as they were brought up.

  "It is a privilege to have children. In extreme cases, some parents should never be allowed to have children again."

I agree. In modern society, having children shouldn't be considered a human right. It should be a privilege reserved for those who can prove they can provide for a child's emotional needs, as well as the most basic physical needs, that is, enough to eat and secure shelter.

For more on this, see "A Generation in Pain."