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Reactive Attachment Disorder in Children: Behavioral and Academic issues facing adoptive families

TREATMENT:

Individuals with Reactive Attachment Disorder (RAD) typically present as having extraordinary difficulty with relationships, especially intimate relationships and parent/child bonding. This difficulty is generally accompanied by oppositional behavior, angry outbursts, attention issues, impulsivity and lack of empathy for others. A majority of children with RAD develop these symptoms as a response to trauma experienced at an early age, fetal alcohol syndrome, and/or genetic predisposition to stressors in life.

Neurofeedback therapy can produce significant improvements in clinical symptoms of RAD, such as anxiety, depression, anger/irritability, and opposition. Treatment can also reduce other symptoms or behaviors such as lying, insomnia, attention, poor hygiene issues, tendencies towards running away, and obsessive behaviors. Neurofeedback is a treatment based on neuroscience that works directly with the brain by creating better communication between lobes and networks of the brain and improved balance in brain wave activity. The result is that the child is able to recognize, monitor and self-regulate his or her emotions.

Traditional treatments for RAD such as psychotherapy (counseling, play therapy) are useful tools but insufficient in creating global changes in the child’s behavior. With the added help of Neurofeedback as an intervention, the child becomes more aware of the coping strategies that he/she has not been able to utilize. Neurofeedback works directly with the brain to allow individuals to recognize, monitor and self-regulate which leads to improvement in health and quality of life.

BRAIN FUNCTION:

Advances in understanding the nature of anxiety disorders played a key role in the development of innovative treatments such as neurofeedback. Compelling evidence shows unusually low alpha activity as well as temporal lobe abnormalities are seen in individuals with anxiety. Research has shown that alpha and theta enhancement neurofeedback training can be an effective treatments for anxiety disorders.
At BiofeedbackWORKS in Virginia, neurofeedback training is based on in-depth assessments such as the Quantitative Electroencephalogram (qEEG, or quantitative brain map), IVA test (test for auditory and visual attention and impulsivity), and regular check-ins 2-3 times per week.. Based on presenting symptoms, training is matched to the client’s needs and performed at specific placements on the scalp using state of the art S-Loretta 19 channel Z-Score, 2+ channel Z-score and amplitude technology as well as Infra Low neurofeedback (ILF) and Low Energy Neurofeedback System (LENS). Training may involve increasing abnormally low brain wave frequency or inhibiting abnormally high brain wave frequency. Although at first the changes may appear to be transient, after repeated sessions, long lasting changes are gradually achieved.

COMORBIDITY:

Studies show that anxiety disorders such as RAD are more likely to co-occur with other disorders, and this has important clinical implications in diagnoses and treatment. Examples of co-morbid disorders include depression, attention-deficit/hyperactivity disorder (ADD/ADHD), post-traumatic stress disorder (PTSD), and obsessive compulsive disorder (OCD).

GENERAL BIOFEEDBACK:

Peripheral or General biofeedback consists of traditional modalities such as heart rate variability, hand warming and breathing monitoring. The goal is to teach individuals how to activate their parasympathetic nervous system and deactivate their sympathetic nervous system thus calming themselves in what previously would have been volatile situations.

REFERENCES

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author

Beck, A. T., & Clark, D. A. (2012). The Anxiety & Worry Workbook: The Cognitive Behavioral Solution. The Guilford Press.

Beck, A. T., & Clark, D. A. (2011). Cognitive Therapy of Anxiety Disorders: Science and Practice. The Guilford Press.

Demos, J. N. (2005). Getting Started with Neurofeedback. W.W. Norton & Company.

Hammond, D. C. (2005). Neurofeedback Treatment of Depression and Anxiety. Journal of Adult Development, Vol. 12, 2/3, 131-137.

Hammond, D.C. (2005). Neurofeedback with anxiety and affective disorders. Child and Adolescent Psychiatric Clinics of North America, 14, 105-123.

Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617-627.

Myers, J. & Young, J. S. (2012). Brain wave biofeedback: Benefits of integrating neurofeedback in counseling. Journal of Counseling and Development, 90(1), 20-29.

Thompson, M. & Thompson, L. (2003). The Neurofeedback Book-An Introduction to Basic Concepts in Applied Psychophysiology. The Association for Applied Psychophysiology and Biofeedback.