Beruflich Dokumente
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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
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
The American Academy of Child and Adolescent Psychiatry (2008) defines reactive
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
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
In July 2007, when Daniil began attending his current preschool, his parents
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
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
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
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
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
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
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,
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
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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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
References
American Academy of Child and Adolescent Psychiatry. (2008). Facts for Families.
Hall, S. E., & Geher, G. (2003, March). Behavioral and personality characteristics of
MayoClinic. (2007, July). Reactive attachment disorder. Retrieved June 20, 2008, from
http://www.mayoclinic.com
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.