Thursday, May 08, 2008

"Did you hear me when I....?" Parenting Kids with ARND

When we were working hard with some of the Reactive Attachment Disorder (RAD) Attachment Therapy (AT) things the goal was often to teach our child she needed to respond to us, as the RAD Cult claimed "Fast and Snappy". The problem is that if a RAD child is also a child with Fetal Alcohol Spectrum Disorders (FASD) or Alcohol-Related Neurodevelopmental Disorders (ARND) fast and snappy may be an unrealistic expectation.

In fact, it was in part because of our efforts as parents to work on the AT that brought out what appeared to be more intense RAD symptoms when in fact once we learned more about FASD and ARND we also discovered that Fast and Snappy won't work for a child with brain damage--and expecting it to work may actually cause secondary conditions. The hard part is the fact that many of the secondary conditions just look like more RAD.

While reading as much as I could about FASD and ARND I realized one important fact about my own child... I realized that she literally was not able to react Fast and Snappy and expecting her to do so only brought out the "Fight or Flight" feelings.

Children with FASD and with ARND in particular often lack short-term memory recall and one of the huge hallmarks is delayed "Processing"

The idea that a child with difficulty processing and a lack of short-term memory could hear a command and respond fast and snappy is UNREALISTIC. As a parent doing our best to work with AT and help our child overcome RAD we were viewing her response to our expectation as continued RAD type behaviors.

However, once we recognized that her inability to respond when we made a request had far less to do with RAD and much more to do with FASD and ARND we were able to change our approach.

We have learned our daughter may appear to hear what we say, and we understand that just because she can hear our voices and may even tell us that she had--does not always mean she processed what we said or will remember it in 5 minutes. In the past we may have responded with authority and started the "get to it" attitude or reprimanded her for not minding our words. Often feeling she was in trouble for something she didn't process--or can't actually remember would lead to the rages or the defiant behaviors.

If you think about it then it's easier to understand. The child hears a command, repeats it and then needs the additional processing time required in order to respond. Expecting fast and snappy did Not allow any time to process new information and the next thing the child knows they are in some kind of "trouble". On top of it all the fact the child had no time to process--means the odds are the original information isn't even in short term memory and if it is an upset parent demanding compliance fast and snappy makes it impossible to retrieve.

Once we learned to reconsider how our child's disability played into the RAD symptoms and the fact that fast and snappy has nothing to do with RAD in our child's case things have changed for everyone.

As parents we make a lot of statements such as:

"In an hour we are going to need to leave for the store."

Generally we will ask a few minutes later, "Hey kiddo, did you hear me when I said we will need to leave for the store at 1:00 p.m.?

During the next hour we may offer a few more prompts such as:

"do you have your shoes for the trip to the store we will be leaving in a half hour?"


"did you want to bring your allowance to buy something when we go to the store in 15 minutes?"

The simple act of changing our expectations and finding ways to help our daughter process what is going on as well as keep things in her short-term memory have literally been one of the single most helpful steps we have taken in order to help our child cope with the issues she has.

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