Video instructions and help with filling out and completing Who Form 5495 Attach

Instructions and Help about Who Form 5495 Attach

Hey everybody today I'm going to talk about reactive attachment disorder what is it and what are our treatment options now reactive attachment disorder falls under trauma and stress or related disorders and I'm looking down because I got my handy-dandy DSM and as you know as I always say it's not the end-all be-all but it helps us categorize things that we may be feeling and experiencing and it helps us get covered by insurance so it's under trauma and stress-related disorders I think that's important to mention because reactive attachment disorder is something that happens to children who have witnessed or been in a very traumatic either one experience or upbringing as a whole now I'm just going to read you some of the diagnostic criteria for reactive attachment disorder and then we'll kind of get into the nitty-gritty about why it happens where it comes from and what we can do to fix it so the diagnostic criteria starts out with a consistent pattern of inhibited emotionally withdrawn behavior towards adult toward adult caregivers manifested by both of the following so you have to have these the child is rarely or minimal minimally seeks comfort when distressed or the child rarely or minimally responds to comfort when distress so the best way that I can describe this is children who may like let's say fall down and bump their knee and they start crying and they don't want anybody to help them they don't want the parent to come at the parent does they like they withdraw they usually don't want any comfort which as we know from if you've been around children is is not the normal experience and that's when as a clinician we would consider looking into this and maybe getting the family some help the second criteria is a persistent social and emotional disturbance characterized by at least two of the following so there are three and they have to have two of these the first is minimal social and emotional responses to others like I said it's like withdrawing and looking away they don't want to connect with people to is limited positive effect now positive effect is like all these happy positive expressions that's what we call effect is like how we express ourselves to others blunted would be nothing makes sense the third is episodes of unexplained irritability sadness or fearfulness that are evident even during non-threatening interactions with adult caregivers I think of this kind of is like that hyper vigilant feeling that a lot of children will have they've gone through things like this and they'll all of a sudden feel really irritable and agitated and they won't know why number three rearing in unusual settings that severely limit opportunities to form selective attachments the examples that they give our institutions with high child to caregiver ratio so they don't really get much attention maybe no attention at all even if they maybe fall and hurt themselves maybe nobody sees that that has happened and the other important criteria I'm going to discuss is the fact that the criteria cannot be met for all an autism spectrum disorder the disturbance is evident before the age of five and the child has a developmental age of at least nine months so between nine months and five and they can't be on the autism spectrum and I think those are really important as a clinician I'm always looking for age ranges and also limitations so if there's already a diagnosis diagnosis of this does that you know rule out that and we call that kind of like differential diagnosis in the therapy world but it just means we're making sure that we're giving you the diagnosis that best fits your symptoms also it's important to note that the it says that the disorder must have been present for more than 12 months so more than a year and also I want to read this little cap list kind of caveat because it says it's unclear whether reactive attachment disorder occurs in older children and if so how it differs from its presentation in younger children so if even if it happens in older kids does it look any different than this maybe not because of this the diagnosis should be made with caution in children older than five years so that's just telling us it's almost like personality disorders we're not supposed to give that diagnosis before someone's 18 but some people do but they do it with intense caution because they feel like they do meet the criteria and there's been you know consistent symptom ology things like that but just something to consider or when we're talking about this diagnosis so now I just want to have a little real talk reactive attachment disorder is something that usually occurs in physically or emotionally abusive family systems not always this can happen like we said from foster care there can be a lot of other situations and scenarios that cause children to develop this but that is you're going to see what the treatment options are and I just want to put that out there because it's children who are usually helpless to their environment can't do much to get out of it and so they kind of take it inside and often you know we'll just cut off from people though they might not even cry when they hurt themselves they'll just curl up and they want to look away they don't want to attached to anybody because it's not safe it doesn't feel safe because maybe they've been abused or maybe they've seen someone be abused or maybe they've seen something that's really traumatic that no one talked about no one explained but they just didn't feel safe so a lot of the treatment options you'll see fall under like familial support and parent training and all of those things and that's really why because it