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Interview III 1

Running Head: LIFE-SPAN PORTFOLIO: INTERVIEW III

Life-Span Portfolio: Interview III

University of Phoenix

Team D:

This exploration does a great job investigating all aspects of RAD. Your application of

research is expert. You provide a great deal of information here that is very thought-

provoking. The inclusion of some headings throughout the paper would help guide the

reader (me) to significant development themes that you’d like to emphasize.


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Life-Span Portfolio: Interview III

A family at a preschool was interviewed about their son Daniil, who was adopted from

a Russian orphanage when he was just over a year old. The mother reported (personal

communication, June 22, 2008) that their son’s biological mother abandoned her baby in

a hospital after he became sick with pneumonia at nine months and the hospital sent the

baby to the orphanage after he was well. Daniil spent six months in the orphanage before

this family adopted him. Daniil is now five years old and has been a student in the

preschool for the past year. Prior to attending his current preschool, his parents were

asked to remove their child from three other preschools due to their son’s early behavior

problems including tantrumming, hitting, kicking, biting, spitting and eloping. The

family was then referred to California First 5. A psychotherapist from First 5 referred

Daniil’s parents to a psychiatrist who diagnosed Daniil with reactive attachment disorder

after completing a thorough assessment and several observations.

The American Academy of Child and Adolescent Psychiatry (2008) defines reactive

attachment disorder (RAD) as a psychiatric illness characterized by serious attachment

problems. RAD is a childhood disorder that can cause numerous emotional, social and

behavioral consequences. According to the Mayo Clinic website (2007), children with

RAD typically were neglected or abused as babies, passed through several foster homes

or had inadequate care in an orphanage. A child cannot be given this diagnosis without a
thorough evaluation from a medical Specialist. According to the American Academy of

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Child and Adolescent Psychiatry (2008), some symptoms of RAD include failure to gain

weight, detached and unresponsive behavior, defiant behavior, inhibition in social

interactions and difficulty being comforted. Without treatment, Daniil and other children

with RAD will suffer socially and emotionally. Daniil’s parents said (personal

communication, June 22,2008) that he shows signs of each of these symptoms and for

this reason they are seeking medical treatment.

In July 2007, when Daniil began attending his current preschool, his parents

hired a psychotherapist, and it was recommended that they implement a psychotherapy-

based approach, including play therapy, holding, and access to a box full of preferred

items and pictures of family members. The purpose of this special box with photos was

to address attachment and other emotional issues. This psychotherapist referred the

family to a psychiatrist at UCLA who diagnosed Daniil with attention deficit-

hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). In an article

about attachment, Shaw and Paez (2007) stated, “In our experience, nearly all children

with disordered attachment or RAD have been given the diagnosis of ADHD at some

time”. They also stated that oppositional defiant disorder is also a common diagnosis.

This psychiatrist prescribed the medication Concerta, to help Daniil with behaviors

resulting from his ADHD.

According to his father (personal communication, June 22, 2008), Daniil presented
significantly disruptive behavior at the preschool, including teasing and taunting other

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children, annoying children and staff purposefully, refusing to participate in circle time or

other daily activities, and running away from staff. The interviewee reported (personal

communication, June 22, 2008) that Daniil once said to child, “I’m going to make you

cry and then call you a cry baby.” Daniil would then run if a teacher attempted to stop

his behavior, and became physically aggressive when he tantrumming. In their journal

article, Hall and Geher (2003) stated that children with RAD are often mean and

destructive. They feel no remorse for the injury and pain that they have caused. The

preschool staff and parents complained that this was the case with Daniil. According to

Schwartz and Davis (2006), a key factor in a child’s social and emotional development is

self-regulation. This is also an important factor in school readiness. Teacher-child

attachment is another key factor. Daniil did not seem capable of forming a typical

relationship with his peers or teachers. Daniil’s inability to pay attention, follow teacher

directions, behave well with his friends or to regulate his emotions was a sign to the

preschool staff that Daniil did not possess the social or emotional skills to demonstrate

that he would be ready for kindergarten in the following fall.

According to Shaw and Paez (2007), the environment can be blamed for RAD unlike

other disorders that can be blamed on genetics, biochemical, or other physical factors. If

Daniil had grown up in a safe, secure, loving and supportive environment, Daniil would

not be having these attachment problems. According to the American Academy of Child
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and Adolescent Psychiatry (2008), without treatment, RAD can permanently affect a

child’s social and emotional development. The boy’s father said (personal

communication, June 22, 2008) that Daniil is having problems making friends and

relating to teachers. He is also unable to express his emotions in an appropriate way,

even with prompting from teachers. His teachers report that he has difficulties initiating

play and with conflict resolution. Daniil’s young age at the time of adoption, made it so

that his acculturation into his American Jewish lifestyle is not a contributing factor to is

RAD. Daniil’s mother (personal communication, June 22,2008) told the interviewee that

they contacted the local Autism Center for Treatment (ACT) to seek help with Daniil’s

behavioral and social problems.

To help Daniil work on this social and emotional development, ACT in March 2008,

put into place a behavior plan including classroom rules, a choice list, sensory activities,

functional communication training, and a positive reinforcement system. According to

mother (personal communication, June 22, 2008), by early April 2008, Daniil began

participating in all activities during the school day and regularly earning his daily good

behavior stickers. He was also making some social advancement in the areas of

initiating, remaining engaged and resolving conflicts with peers. ACT provides a daily

classroom aide for Daniil. Overall, Daniil has responded very well to this behavior plan.

His teachers report that he is playing with a variety of children and engages in group play
often and with success. Positive reinforcement, a daily schedule, and consistent routine

have benefitted Daniil by providing his with a safe, secure and loving environment at

school. At home, the parents are also following through with his behavior plan and

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positive reinforcement at home also. Daniil continues to demonstrate a quiet and anxious

personality. He comforts himself by sucking his thumb and sitting with his arms around

his legs. Santrock (2007) describes Erik Ericson’s theory stating that the first year of life

is an important time for children to develop attachment, the development stage of trust vs.

mistrust. Daniil’s first year of life left him with no attachment or trust and a strong sense

of fear and apprehension of his world. Daniil’s father believes that his son’s issues with

emotions and attachment are variables that directly impact his behavior. He believes that

his son is benefiting from regular counseling to address his attachment issues and he is

working on developing coping and anger management strategies.

Although no cures have been found for RAD, quality treatment of the social,

emotional and behavioral problems will help meet the needs of children with RAD.

Treatment can include medications and parent education about the disorder. The goals of

the treatment should be to give the child a sense of safe and secure care, positive

interactions with parents and teachers, and most likely psychotherapy. According to the

Mayo Clinic (2008), the symptoms of RAD can last into adulthood, so treatment may be

long-term. Santrock (2007) states that adults with insecure attachment find it difficult to

have meaningful relationships, are less trusting, and can be very emotional and angry.

The parents both told the interviewer (personal communication, June 22, 2008) that their
psychiatrist recommended that they find a support group to connect with and to share

stories of their adopted child and to obtain more information on attachment resources.

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Daniil’s father said (personal communication, June 22, 2008), at a recent

individualized education plan (IEP) meeting at the elementary school, a school

psychologist reported that Daniil tested above grade average and in the superior range on

his cognitive and language tests. The school agreed to provide a classroom aide to help

Daniil’s transition into kindergarten and to address his sometimes, aggressive behavior.

Daniil has demonstrated a very positive response and substantial benefit from this type of

intervention in his preschool class. It has significantly impacted his ability to engage

with peers and access his education. Daniil’s parents believe that the proper care,

treatment and love that Daniil is being given now will benefit his emotional and social

development through adolescence and into adulthood.


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References

American Academy of Child and Adolescent Psychiatry. (2008). Facts for Families.

Retrieved June 20, 2008 from http://www.aacap.org

Hall, S. E., & Geher, G. (2003, March). Behavioral and personality characteristics of

children with reactive attachment disorder. Journal of Psychology, 137(2), 145.

Retrieved June 20, 2008, from Ebsco database.

MayoClinic. (2007, July). Reactive attachment disorder. Retrieved June 20, 2008, from

http://www.mayoclinic.com

Santrock, J. W. (2007). A topical approach to life-span development. New York:

McGraw Hill.

Shaw, S. R., & Paez, D. (2007, April). Reactive attachment disorder: Recognition, action,

and considerations for school social workers. Children and Schools, 29(2), 69-74.

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