What happens to a child who grows up with virtually no parenting, love, affection or human touch? “Nearly everything we learn about being human—how to speak, how to walk, everything—comes from the people who raise us,” Oprah says. “Today, we’re going to look at what happens when nobody does.”

This was my son.

Dr. Bruce Perry, a Child psychiatrist featured on the Oprah show states that neglect is the absence of necessary stimulation in order to build a certain part of the brain. In order for children to learn, to stimulate areas of their brain they NEED stimulation. Without stimulation they will learn to stimulate them themselves or retract into themselves. Your brain will form differently.

Dr. Federici calls this Institutional Autism in Institutionalized children. But, what about biological children?

Dr. Perry calls this total global neglect.

But, can you make a child autistic by neglecting them so thoroughly because they never, ever come into contact with humans? That they are so globally neglected that they retreat so thoroughly into themselves that they can’t get out.

Can neglect cause mental retardation?

Absolutely.

Danielle, one of Florida’s most shocking cases of neglect was not only malnourished but also so severely neglected that when she was admitted to the hospital for a physical her appearance wasn’t what shocked Dr. Rodriguez most. The most profound effect of her neglect was how she reacted to human beings. “She wouldn’t make eye contact. She frequently pushed us away, kicked us away,” Dr. Rodriguez says. “[She] would snarl at us, frankly. She behaved like an injured animal. We realized the safest place would be one of the caged cribs.”

If there is little or no stimulation, if there is no human contact, if there is nothing there what else is there? Little development. Danielle, at the age of 9 years old, was determined to be 2 months old developmentally. AJ, at his adoption (26 months), was determined to be between 12 and 18 months, depending upon the skill.

Parents are powerful. If you look at this picture (and I am linking to this picture because it is SO extremely important to see) you will see the difference between a normal three year old child and an institutionalized/neglected three year old child. Perry indicates in his interview that the neglect specifically affects sleep, anxiety, and mood regulation, all of which AJ has problems.

So, in our case, is it an issue more with neglect and institutionalism than with medical issues? I am hoping so because I know that children have an opportunity to rebuild some of those synopsis (some) with care.

Yes, back to that nature vs. nurture. Which one wins?

We know that AJ had a very traumatic life in the orphanage but we don’t know why. Sometimes, we all know, it just happens. When we visited him he seemed happy, content, very excited to see us and comfortable with his caregivers, although they were rough with him. We do know that he spent almost 3 months in the hospital directly after birth before being transferred to the orphanage and that he had transferred orphanage rooms several times since his arrival. This, by itself could lead to trauma because of the consistency issues.

The American Psychiatric Association’s Diagnostic Manual of Mental Disorders (DSM-IV) for the diagnosis of PTSD is that “the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others. The person’s response to the event must involve intense fear, helplessness, or horror.”

Daniel Hughes, PhD, and author of several attachment books including Building the Bonds of Attachment: Awakening Love in Deeply Troubled Children and Attachment-Focused Parenting: Effective Strategies to Care for Children (Norton Professional Books)
says that the most common cause of PTSD is abuse and neglect. He calls neglect “the trauma of absence.” While many assume that abuse is far more traumatic than neglect, we now know that neglect is equally harmful. We also know that the combination of abuse and neglect can be shattering to a child’s psyche.

So could this be where AJ’s PTSD stems from? And is this where his Institutional Autism stems from? Is he so traumatized that he retreats?

The same article states that children resort to a fight or flight response but if they can’t flee they go internal. We see this often with AJ, especially if he gets in trouble. We often see his eyes glaze over and he retreats into his “autistic state”…using echolalia and a retreat and repeating nonsense words to escape from reality.

But, he also becomes hyperactive before bedtime because we know that that was a very scary time for him the orphanage. He avoids sleeping at all costs.

Interpersonal trauma (such as abandonment, neglect or abuse) is experienced as more severe than trauma of nonhuman origin (such as a car accident). In interpersonal trauma, the severity increases with the closeness of the relationship. Thus abandonment or violence inflicted by her mother would be experienced by a child as extremely devastating. Secondary adversities, such as displacement or relocation after the traumatic event add to the likelihood of developing PTSD. Therefore, an infant who has been abandoned by her birthparents, traumatized by a stay in an orphanage, and is then adopted by strangers is at exceptional risk for dissociation and chronic PTSD.

PTSD can also has an effect on the development on children, including delays in cognition, gross and fine motor, and language development. Children can relieve trauma in any number of way, though nightmares and sleep (AJ did this through night terrors every night for two years), through flashbacks, through imaginary play, through hyperarousal, (another one of AJ’s issues) or by shutting down (which AJ never does).

Treatment? Some suggest Holding Time but our attachment therapist said this was not something for sensory hypersensitive children and for adoptive children who don’t trust. They only time I hold is when he is not being safe (but that is another topic).

reprinted from 2007

By now we know that most of his issues stem from neurological brain disorders like Sensory Processing Disorder, Early Onset Bi-Polar, and possible Fetal Alcohol Syndrome, the most prevalent of which seems to be the Bipolar because of the success of his treatment. After reading The Bipolar Child: The Definitive and Reassuring Guide to Childhood’s Most Misunderstood Disorder , I knew that most of AJ’s symptoms were there from the time of adoption, some of them masked by his trauma. As he came out of his orphan shell the layers of the onion metaphorically peeled and the real person started to reveal himself.

As hard as his behavior was to witness, it was harder to know that he was struggling and I could not help as much as I wanted. I had to stand next to his crib at night and watch him scream in terror because he wouldn’t let anyone talk to him or touch him during his 20-30 minute night terrors. I had to withstand hours of restraint holds to calm him when he raged. And when he threw tantrums when there was too much noise or someone touched him I just scooped him up and held him.

I didn’t care that people saw him belt me in the face or kick me in the shins.

They didn’t get it. They didn’t get him. Some still don’t. But, does it really matter if they do? We get him.

The first time I saw this I was so saddened that it was all I thought about all day. The images flooded my mind when I lay my head down to sleep.

Some,

It makes me think that AJ was one of the lucky ones to be placed in the orphanage. When you watch you will see that so many of the children are actually abandoned on the streets by their biological parents and know their parents don’t want them. What that does to their emotional state I can’t imagine. like Slava, run away because of the home-life; alcoholism, violence, neglect.Some are left without papers, which I can only assume means they can’t travel anywhere or ask for help from an orphanage (without proof of identity how can you prove who you are?). One child stated that at age five his parents left him on the street with this papers and he was able to make his way to an orphanage. Lucky kid.Most of these children endure harsh temperatures in the winter, little food, and most turn to prostitution and drugs early to make money.

In the 1990’s Russia noticed a vast increase in these street children and has done a tremendous amount to reduce the number of children on the streets. However, in 2007 there were 10,000 children living in Moscow. he official number right now is about 700,000 but most feel the real figure is between 2 and 4 million.It really makes me feel that AJ was lucky to be placed in an orphanage. I still don’t feel like we “saved” him from a street life. Most importantly, Russian Social Services did that when they intervened on the day of his birth.And you know what? I am beginning to think that that is there was someone very important looking after him that day.

When a mainline child makes a bad choice, parents seem to fall into two camps.  Camp one is of the belief that a child should learn from their choices and have natural consequences.  This would follow the love and logic approach.  If you are running late and forget your coat, you’ll be cold at recess.  No child has ever died from being cold at recess.  Pay the price while it’s lowest…the younger you are the more you can learn about decision making skills.  This is the camp that my DH and I fall into with DS1.  Camp two seems to believe that children should be bailed out.  Now, I quite honestly cannot speak to the beliefs of this camp – I’ve never been a member.  But, from the outside, I generally label these folks as helicopter parents.  They hover over their child at every stage and want to take away all the bad things that ‘might’ happen.

A real world example is a lady in my neighborhood who petitioned our county to close off a cut through that middle and high schoolers take to walk to school.  Why? She would not allow her daughter to take it and just wanted it gone.  That’s not me.

So, where does a diagnosis of attachment disorder leave me as a parent?  In a very weird place.  It is not their fault.  Bad things happened to them and they were unable to reconcile those things because they were so young.  Therefore, their brains don’t react like a mainstream child.  If I’m being honest – I don’t like that.  I understand it…really, I do.  I mourn for what happened to my children, I mourn for who they may have been with a different start in life…maybe even a start with me.  But, I don’t like to blame.

Upfront, let me say that I’m not politically correct about their first parents.  I don’t like them.  I don’t have a soft spot in my heart for them.  They hurt their children.  Yes, my children were their children first…they screwed up.  You do not do those things to kids…but, they did.  I’m happy to not know them and I hope my children can find peace in no longer knowing them.

There are some differing approaches to raising children with attachment disorder.  One is called Beyond Consequences founded by Heather T. Forbes and Dr. B. Bryan Post.  The front page banner on the site reads “Love Never Fails”.  I never really got past that – perhaps because I’m not sure it’s true.  This approach has worked miracles for some families and I know some of them.  It irks me quite honestly.  Again, I’m not in deep study, but what I know seems so patronizing.  The premise, as I’ve gathered, is to love your child through it.  If they choose to not follow a rule, hug them and cuddle them and tell them how much you still love them.  I guess I’m simply foolish to expect my children to follow guidelines for their safety and well-being.  Of course, I still love them…but I don’t coddle them.

It’s interesting to read the BC website – it’s seems like it’s set up to sell…and yes, others are too.  But, if I’m a really struggling parent and read the articles (which I did today in the pursuit of knowledge) and get to the end with NO practical advice…I’m frustrated.  Most parents of AD kids are already frustrated.

When DS2 or DD screws up – should I always just say “Oh, they are adopted and have AD?”…I guess as a way of saying it’s ok.  I can’t do that.  I can’t let them do that.  A pastor once said something that stuck with me years later.  “You must raise future adults.  If kids go out into the world knowing nothing of how to live there…their choices will be driven solely by serving self.”  In this moment, he was preaching of teaching God to your children – but it can be taken into practice in my life today raising AD kids (and really, raising any kids).  I do them no favors by not teaching accountability.  I am not helping by giving them excuses to not be the best they can be.  What that means for us each day differs.  I’m proud of what they are learning – both in attachment:  I get spontaneous “I love yous” now and DD actually fell asleep on my shoulder the other day – and in life:  I have responsible, polite, generally fun to be around kids!  So, nope – I won’t blame it all on adoption…instead my family and I will keep adoption as a piece of the future picture…a piece that will NOT define us.

Sometimes Voni jumps off her soapbox and blogs about life at her own blog.