CLASSROOM INTERVENTION FOR CHILDREN WITH SPECIAL NEEDS

1. THIS POWERPOINT IS INTENDED FOR THE SOLE PURPOSE OF THE CHILD STUDY CENTER TEACHERTRAINING PROGRAM. ANY OTHER USE IS STRICTLY PROHIBITED.

2. CLASSROOM INTERVENTION FOR CHILDREN WITH SPECIAL NEEDS

3. Attachment & Reactive Attachment Disorders

4. Attachment is the deep connection established between a child and caregiver that profoundly affects your child's development and ability to express emotions and develop relationships. If you are the parent (or teacher) of a child with an attachment disorder, you may be exhausted from trying to connect with your child.

5. Attachment is a reciprocal process by which an emotional connection develops between an infant and his/her primary caretaker. It influences the child's physical, cognitive, and psychological development.

6. It becomes the basis for development of basic trust or mistrust, and shapes how the child will relate to the world, learn, and form relationships throughout life.

7. Healthy attachment occurs when the infant experiences a primary caretaker as consistently providing emotional essentials such as touch, movement, eye contact and smiles, in addition to the basic necessities -- food, shelter, and clothing.

8. If this process is disrupted, the child may not develop the secure base necessary to support all future healthy development. Factors which may impair healthy attachment include: multiple caretakers, invasive or painful medical procedures, hospitalization, abuse, poor prenatal care, prenatal alcohol or drug exposure, and neurological problems.

9. Children with attachment disturbance often project an image of self-sufficiency and charm while masking inner feelings of insecurity and self hate. Infantile fear, hurt and anger are expressed in disturbing behaviors that serve to keep caretakers at a distance and perpetuate the child's belief that s/he is unlovable.

10. These children have difficulty giving and receiving affection on their parents' terms, are overly demanding and clingy, and may annoy parents with endless chatter. They attempt to control attention in negative ways.

11. Additional behaviors may include: poor eye contact, abnormal eating patterns, poor impulse control, poor conscience development, chronic "crazy" lying, stealing, destructiveness to self, others, and property, cruelty to animals and preoccupation with fire, blood, and gore.

12. A child with insecure attachment or an attachment disorder lacks the skills for building meaningful relationships.

13. So why do some children develop attachment disorders while others don’t? The answer has to do with the attachment process, which relies on the interaction of both parent and child.

14. Attachment disorders are the result of negative experiences in this early relationship. If young children feel repeatedly abandoned, isolated, powerless, or uncared for—for whatever reason—they will learn that they can’t depend on others and the world is a dangerous and frightening place.

15. COMMON CAUSES OF ATTACHMENT PROBLEMS(Highest risk if these occur in first two years of life) • Sudden or traumatic separation from primary caretaker (through death, illness hospitalization of caretaker, or removal of child) • Physical, emotional, or sexual abuse • Neglect (of physical or emotional needs) • Illness or pain which cannot be alleviated by caretaker

16. Frequent moves and/or placements • Inconsistent or inadequate care at home or in day care (care must include holding, talking, nurturing, as well as meeting basic physical needs) • Chronic depression of primary caretaker • Neurological problem in child which interferes with perception of or ability to receive nurturing. (i.e. babies exposed to crack cocaine In-utero)

17. Reactive attachment disorder and other attachment problems occur when children have been unable to consistently connect with a parent or primary caregiver. This can happen for many reasons: • A baby cries and no one responds or offers comfort. • A baby is hungry or wet, and they aren’t attended to for hours. • No one looks at, talks to, or smiles at the baby, so the baby feels alone. • A young child gets attention only by acting out or displaying other extreme behaviors. • A young child or baby is mistreated or abused.

18. Sometimes the child’s needs are met and sometimes they aren’t. The child never knows what to expect. • The infant or young child is hospitalized or separated from his or her parents. • A baby or young child is moved from one caregiver to another (can be the result of adoption, foster care, or the loss of a parent). • The parent is emotionally unavailable because of depression, an illness, or a substance abuse problem.

19. BEHAVIORS ASSOCIATED WITH PROBLEMATIC ATTACHMENT • A. Unable to engage in satisfying reciprocal relationship:1. Superficially engaging, charming (not genuine) 2. Lack of eye contact3. clingy

20. 4. Lack of ability to give and receive affection on parents' terms (not cuddly) 5. Inappropriately demanding and clingy 6. Persistent nonsense questions and incessant chatter 7. Poor peer relationships 8. Low self esteem 9. Extreme control problems - may attempt to control overtly, or in sneaky ways

21. B. Poor cause and effect thinking: 10. Difficulty learning from mistakes 11. Learning problems - disabilities, delays 12. Poor impulse control C. Emotional development disturbed: child shows traits of young child in "oral stage"13. Abnormal speech patterns14. Abnormal eating patterns

22. D. Infantile fear and rage. Poor conscience development.15. Chronic "crazy" lying16. Stealing 17. Destructive to self, others, property18. Cruel to animals 19. Preoccupied with fire, blood, and gore

23. E. "Negative attachment cycle" in family 1. Child engages in negative behaviors which can't be ignored2. Parent reacts with strong emotion, creating intense but unsatisfying connection3. Both parent and child distance and connection is severed

24. Signs and symptoms of insecure attachment in infants: • Avoids eye contact • Doesn’t smile • Doesn’t reach out to be picked up • Rejects your efforts to calm, soothe, and connect • Doesn’t seem to notice or care when you leave them alone • Cries inconsolably • Doesn’t coo or make sounds • Doesn’t follow you with his or her eyes • Isn’t interested in playing interactive games or playing with toys • Spend a lot of time rocking or comforting themselves

25. Common signs and symptoms of reactive attachment disorder • An aversion to touch and physical affection. Children with reactive attachment disorder often flinch, laugh, or even say “Ouch” when touched. Rather than producing positive feelings, touch and affection are perceived as a threat. • Control issues. Most children with reactive attachment disorder go to great lengths to remain in control and avoid feeling helpless. They are often disobedient, defiant, and argumentative.

26. Anger problems. Anger may be expressed directly, in tantrums or acting out, or through manipulative, passive-aggressive behavior. Children with reactive attachment disorder may hide their anger in socially acceptable actions, like giving a high five that hurts or hugging someone too hard.

27. Difficulty showinggenuine care and affection. For example, children with reactive attachment disorder may act inappropriately affectionate with strangers while displaying little or no affection towards their parents.

28. An underdeveloped conscience. Children with reactive attachment disorder may act like they don’t have a conscience and fail to show guilt, regret, or remorse after behaving badly.

29. Tips for parenting a child with reactive attachment disorder or insecure attachment • Have realistic expectations. Helping your child with an attachment disorder may be a long road. Focus on making small steps forward and celebrate every sign of success.

30. Patience is essential. The process may not be as rapid as you'd like, and you can expect bumps along the way. But by remaining patient and focusing on small improvements, you create an atmosphere of safety for your child.

31. Foster a sense of humor and joy. Joy and humor go a long way toward repairing attachment problems and energizing you even in the midst of hard work. Find at least a couple of people or activities that help you laugh and feel good.

32. Take care of yourself and manage stress. Reduce other demands on your time and make time for yourself. Rest, good nutrition, and parenting breaks help you relax and recharge your batteries so you can give your attention to your child.

33. Find support and ask for help. Rely on friends, family, community resources, and respite care (if available). Try to ask for help before you really need it to avoid getting stressed to breaking point. You may also want to consider joining a support group for parents.

34. Stay positive and hopeful. Be sensitive to the fact that children pick up on feelings. If they sense you’re discouraged, it will be discouraging to them. When you are feeling down, turn to others for reassurance.

35. Repairing reactive attachment disorder: Tips for making your child feel safe and secure • Safety is the core issue for children with reactive attachment disorder and other attachment problems. They are distant and distrustful because they feel unsafe in the world. They keep their guard up to protect themselves, but it also prevents them from accepting love and support.

36. So before anything else, it is essential to build up your child’s sense of security. You can accomplish this by establishing clear expectations and rules of behavior, and by responding consistently so your child knows what to expect when he or she acts a certain way and—even more importantly—knows that no matter what happens, you can be counted on.

37. Set limits and boundaries. Consistent, loving boundaries make the world seem more predictable and less scary to children with attachment problems such as reactive attachment disorder. It’s important that they understand what behavior is expected of them, what is and isn’t acceptable, and what the consequences will be if they disregard the rules. This also teaches them that they have more control over what happens to them than they think.

38. Take charge, yet remain calm when your child is upset or misbehaving. Remember that “bad” behavior means that your child doesn’t know how to handle what he or she is feeling and needs your help. By staying calm, you show your child that the feeling is manageable. If he or she is being purposefully defiant, follow through with the pre-established consequences in a cool, matter-of-fact manner. But never discipline a child with an attachment disorder when you’re in an emotionally-charged state.

39. Be immediately available to reconnect following a conflict. After a conflict or tantrum where you’ve had to discipline your child, be ready to reconnect as soon as he or she is ready. This reinforces your consistency and love, and will help your child develop a trust that you’ll be there through thick and thin.

40. Own up to mistakes and initiate repair. When you let frustration or anger get the best of you or you do something you realize is insensitive, quickly address the mistake. Your willingness to take responsibility and make amends can strengthen the attachment bond. Children with reactive attachment disorder or other attachment problems need to • learn that although they may • not be perfect, they will be • loved, no matter what.

41. Try to maintain predictable routines and schedules. A child with an attachment disorder won’t instinctively rely on loved ones, and may feel threatened by transition and inconsistency—for example when traveling or during school vacations. A familiar routine or schedule can provide comfort during times of change.

42. School Interventions

43. INTERVENTIONS: WHAT DOESN'T WORK • Traditional problem solving questions such as: What happened? What was your part in it? What could you have done differently? Attachment Disorder children will learn to spin off the "desired answers", but they will be meaningless answers. The time spent on this exercise will be wasted time.

44. Vague praise, such as "you are handling things well today" is generally seen by the child as a manipulative control strategy on the adult's part. In addition, overt praise for expected basic behavior such as sitting in one's desk is likely to provoke an oppositional switch into the undesired behavior.

45. Conventional behavior management plans / level systems: Attachment Disorder children will see a behavior management plan, not as a way to change behavior, but as simply one more thing to learn "how to work" for their own purposes. AD children may even use behavior management systems as bait to draw the adults into useless discussions about how to sustain progress. The end result can be that it is the teacher's behavior, rather than the child's, that ends up getting "managed".

46. Consistent zero tolerance stances run a high risk of dragging the teacher into a cycle of escalating misbehavior followed by increasingly severe consequences. Zero tolerance also does not allow the teacher sufficient creative flexibility to approach the AD child in a useful way that the AD child could not predict.

47. Believing the child's tales about horrendous treatment at home by parents and offering support and sympathy in an effort to "compensate". In the case of an AD child, this is probably the worst possible thing an educational professional could do.

48. Challenging the Attachment Disorder child's perspective with "objective evidence" in order to persuade her that her thinking is somehow incorrect. This approach assumes that the teacher and child share a common view of "reality"- not true. The teacher's view will make little or no sense to the AD child. In fact, the AD child is apt to see this approach as a manipulative attempt on the teacher's part to set the child up in some way.

49. Setting the parents up to be the "heavies" by leaving it to parents and home to impose consequences for school infractions or work not done. • Teachers taking AD children's behavior or statements personally. This usually takes some practice as AD children are skilled at discovering adults' tender spots and going after them.

50. Reacting emotionally to AD children's behavior. This only reinforces the AD child's sense of being in control of the adult's emotions ( a goal they generally pursue). This really takes some practice as AD children's behavior can be relentless, day in-day out, as any parent can testify.