Follow this link to read a story of how Dr. Ronald Federici “put the puzzle together” and solved a family’s problems.
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Follow this link to read a story of how Dr. Ronald Federici “put the puzzle together” and solved a family’s problems.
Ronald Federici's Blog 
Dr.Federici’s brillian insight into neuro-pscyh and adopted children helped saved our family. My son, adopted at 19 months, had been a sick child who was moved back and forth over his short life before adoption form the orphanage and the hospital repeatedly. The first 6 months home he was wild, but I chalked so much up to the transition. Then it got worse. He was kicked out of 2 mother’s day out programs, was banned from the nieghborhood community center, and was becoming so violent in his rocking to go to sleep and punching, biting, scratching, ect aimed at me (mom) that I as at a loss for how to help him. By age 4, I had been staying home with him because he looked very cute and was bright enough one-on-one to pass the special ed. intervention program testing. I took him to many specialist and finally got in to see a private pay attachement therapist for evaluation and treatment. This started the help with attachment, but my son was still out of control. He acted 1 or 2 and he was 4. Out of desperation, I’d heard of Dr. Federici’s work with children like mine, so I read his book Hope for the Helpless Child: A Guide for Families. I took 6 months and truly followed his program. When it didn’t work, I got mad and hopeless, so I called Dr. Federici up and ask what he suggests when his book doesn’t work. He said to come to see him immediately. I flew my wild child to VA and he spent 1 day evaluating to see what we were dealing with and the next day for a family intervention. He taught me what to do and how to do it. He recommended meds. He had the same diagnosis the 2 specialist at home had: Severe RAD due to PTSD. Over the next year I followed the family program by Federici, kept the attachment therapist on board, got coaching and counseling for myself by another attachment therapist who taught me more about parenting a special needs child. Within a year, our household was the opposite of what it had been. All the changes combined, several med trails, and CONSISTENCE AND PRAYER, and now ALL the traces of RAD are gone. My conclusion is that early intervention is key. Parent training is key. Professional help is objective and is key. RAD and PTSD can be resolved when addressed directly with correct treatment. If FAE or FAS is involved, it can also play a role in the overall functioning of the kid-permanenly and needs to factored in to daily living. My son was also diagnosed with FAS, but he is in a regular ed kindergarten and an average student, average behaviorally. He is 6, and he is exactly 5 developmentally. As long as he is treated like a normal developing 5 year old-he fits right in. RAD stole a year of his life forever. But for now my message is that early intervention has a postive prognosis with the proper professional help. I give alot of credit to Dr. Federici for his work in neuro-psych with adopted kids.
Lillian Bliss
Author: Jon Goodman, AdvocateForTherapy@blogspot.com
September 5, 2010
HEADLINE on GOOGLE: ACT, also known as Advocates for Children in Therapy, a for-profit organization, has recently made a rather large public statement saying they can prove that Attachment Therapy, Holding Therapy and Therapeutic restraints always hurt kids and always are lethal. Nothing could be further from the truth! I disagree with this statement on many levels, and find it incredulous that ACT is willing to make this statement and yet gives NO acceptable alternatives for adoptive parents and adoptees that has the power to replace the aspect of touch therapies and properly applied attachment therapies for severely affected victims of childhood abuse and neglect. In addition, ACT has no creditials for making such an assertion and has made a smear campaign against professionals who are aiding adoptive families in working with their severly unattachment children on bonding issues that are life-threatening if left untreated. Whomever authorized such statements within the ACT community has not done their homework and must have a personal vendetta against an individual in the attachment community. But why put out such statements that may prevent many victimized children a chance at a cure? I believe more attention needs to be paid to the false blanket statements of such organizations as ACT that proclaim to be reaching for an audience of adoptive parents who have children with attachment disordered children.
For children with severe reactive attachment disorder due to post traumatic stress disorder, the power of touch is the only modality of therapy that can reach these children’s psych where abuse and neglect is often stored in the preverbal mind, which is the deepest and hardest to reach place later on in life. Does ACT not know that Traditional talk-therapy does not begin to address in a 3-5 year old the level of hurt that the child has experienced? Does ACT propose that parents do nothing? or use therapies that are known NOT to be effective? ACT seems to be putting adoptive parents in a catch-22. And after reading the ACT website, I am serioulsy wondering if any of the author’s have ever actually seen attachment therapy in action or if any authors have even stopped to consider their actions on the children that will be denied help or treatment due to their negative and unthinkable words of ignorance.
There are no words to heal this predicament called attachment disorder. Only touch. There were no words for the 3 month old in a Romainian orphanage of understaffed and untrained poverty-ridden staff when no one came when he cried in hunger or pain. There were no words for the 6 month old girl a a Russian babyhouse for orphans who itched from scabies so deep in her skin that only unconsciousness was relief and even though it went on for months. There were also no words for the infant who was left in a dark closet full of nibbling rats while the birth parents were passed out drunk in the backyard of their summer shack in Ethiopia. Words don’t heal attachment disorders. The pain is stored deeply within the child’s most primitive bodily memories-which are 100 % sensory, and 100% unreachable without touch. Memories of the smell in that dark rat infested closet or the freezing temperature the child experienced are all stored in a cluster along with the misery. Once one preverbal memory is activated it lets loose the whole chain reaction-even though this happened long before the adoption into a new family. Muliply these traumatic episodes over any period of time, and you have the basis for a few early traumatic memories. Muliply these instances over periods of years-and you have severe post traumatic stress disorder that effects the mind of a child and causes reactive attachment disorder in full swing. It is no wonder.
Attachment therapy requires getting inside the hard shell of these kids’ outer attitudes and emotions, getting to a vulnerable space where new memories of safety and security can begin crowding out the old, traumatic ones. There is no complete cure, only increments of recovery and better quality of life. In most cases, families have seen at least five professionals to help their child with his/her strange behaviors and attachment problems before they find out about or stumble upon a reference for a psychologist, counselor or social worker who has any experience in working with adopted children exclusively or with any expertise. Through trial and error, and usually desperation, a family will be relieved to find out:
A: the right diagnosis
B: that they aren’t the only ones with this situation
C: there is documented evidence that shows the number of recoveries from RAD and PTSD
D: that their child has hope of not ending up in prison, dead or on drugs
It’s also worth noting that ACT does not exclusively state in their literature that RAD is a problem only for adopted children. Rather, it states no knowledge of the special needs of children that have lived in institutions and what the post orphanage behaviors have done to them. although they are the largest group of children with known attachment disorders. Therefore, by saying ACT advocates for children in therapy, they are actually doing the opposite. It condemns the very type of therapies that specifically has been known by adoptive parents and professional attachment therapists to do wonders in healing. It is as if ACT has picked a cause to advocate for just because deaths and sensationalism has occurred in the misuse of attachment therapies used by unqualified individuals. It is a case of “contempt prior to investigation.”
In all fields of medicine there are truly horrible situations that arise from extreme use of any method-including medications, surgeries, psychological therapies and even using “NO therapies.” By using the extreme negativism of a handful of fatal cases of so-called rebirthing therapies, ACT stands that ALL therapies that include attachment therapies and the professionals that work with them are bad. ACT is fine with NO therapies or therapies that don’t work, such as traditional talk-therapy.
Orphans who are adopted that were exposed to alcohol and/or drugs or other lethal toxins during pregnancy are more prone to be severely traumatized by orphanage living due to their lack of appropriate or available coping mechanisms. These children can develop a hard, aggressive stance toward anyone who might hurt them—even if that means love and protect them. The severe form of personality disorder that develop out of this state is called borderline or antisocial personality disorder. Once into later teens and adulthood, the prognosis for adoptees with this label, personality disorder, is practically bleak. Prisons and insane asylums are full of personality disordered adults. These people often lead extremely lonely and isolated existences (and even committ suicide) because of a lack of early intervention strong enough to change the course of the reactive attachment disorder. Yet some type of attachment therapy gives an extremely good prognosis when intervention happens early in life.
Do parents want to do nothing as ACT suggests? Or are they willing to try what has worked for many other RAD and PTSD adpted children? In our case, we opted for hope. My wife and I became attachment therapy adocates ourselves as we watched and learned while our children grew beyond their pasts. Not only did I, personally, sit in on every single session with the attachmenent therapist, I was always asked to hold my child in a loving, gentle and safe way at all times even when I was being punched in the face repeatedly by my 5 year old son. Did I have to be strong enough to watch my child struggle when his comfort level was getting busted? Of course. Was it easy to see my son cry out in rage that he hated me for no reason? Yes. Did I look him in the eye and tell him over and over that I loved him and needed to keep him safe no matter what? I had to. When my son spit in my face and told me he wanted to go back to Russia (even though they’d abused him) because I was worse, did it shock me? No. He would say anything to keep intimacy out of his heart and mind. Truly, it is fear that held my son captive, not the work of attachment therapy. Intense feelings of fear of loving, being loved, trusting, caring, and needing another human being were paramount and highly subconscious in my son. Once those feelings were activated by any number of triggers known and unknown he would run or fight even if it meant self-sabotaging himself over and over. It was a no-win situation that held him prisoner and us, as parents, the wardens. Neither my son nor I could have told you any of this before we went through a year of attachment therapy with a qualified attachment therapist. Fast forward seven years ahead and you will see a boy who DOES NOT have these issues! He is still overly sensitive and sometimes jealous if he thinks we love the cat more than him, but there is no overt symptoms of a child who we were once told had brain damage, RAD, PTSD, Conduct Disorder, ADHD, Pervasive Developmental Delay and Fetal Alcohol Syndrome. The attachment factor is key!
The good news I want adoptive parents and adoptees to know is this. Once the attachment issue was resolved, everything else got better. That’s the testimony of a parent who’s been in the trenches, but this was an area I knew nothing about when we adopted our son. What would we have done without a qualified attachment therapist, like Dr. Ronald Federici, to take our case? Who would we have turned to if it weren’t for the work of Dr. Bryan Post and the Post Institute, or Heather Forbes? What if Bowlby had never written about the controversial attachment theory due to fear of whether groups like ACT would end his career by ruining his reputation? Where would we be now? Would our son be in a group home or juivenile delinquint facility? Yes, left to his own devices, we believe he would have had to be locked up and supervised carefully around the clock to keep from hurting himself or others when he was “activated” with PTSD triggers, which was constant and growing when we started attachment therapy with him.
Without being taught and actively working with our son by using behavioral and attachment therapy and therapeutic restraints that were age appropriate to limit his aggression, would we have eventually just let him run away or beat us up? He was trying his utmost at the time to get away and torment us. Should we have just let nature take it’s course? Hell no! My son was worth saving, and so is every other kid out there who suffers. We must do whatever it takes, while thoroughly doing our homework, to make sure we are using the utmost safety and latest standards of proven therapy modalities and qualified experts to give our children what they never had-ADVOCACY. I would advocate to the very end for my children and so would Dr. Federici, Bowlby, Forbes and Post! I pray these professionals don’t take an ounce of flack from organizations that promote NOT curing our kids. I pray adoptive parents will not delay early intervention using attachament therapy by a qualified attachment or behavioral specialist to get into the solution NOW before it’s too late. As for ACT, I wish they could have walked a mile in our shoes for just one day before they made such liable comments about attachment and holding therapy and the pros who helped us. Its a personal insult.
So why any organization or group would advocate against the work of a type of therapy that changes so many lives for the better, that enables so many severely disturbed children to recover over time, or that lends itself to the quality of persons teaching and delivering the therapy, I don’t understand. Why throw out the baby with the bathwater, so to speak? Show me some other equally effective treatment for RAD and PTSD in adopted children that works and I will certainly eat my words. Until then I pray ACT will rethink their wrongful propositions about what kids need in attachment therapy—especially if you haven’t had a child with RAD, aka. the raddishes.
Jon Goodman, Adoptive Dad
Thank God for Dr. Ronald Federici
In 2008 my son turned 3. I kept thinking the terrible two’s would phase out. I even named our adoption playgroup The Terrific Two’s and Three’s in hopes of a future life without screaming meltdowns and temper tantrums with fists. I had learned to expect the unexpected with my son adopted in Russia 1.5 years prior. Yes, he’d been sick frequently, and yes, he took medications that had ugly side effects. But I would never have been able to admit then that he had a permanent problem, a disorder that might be jumbling up his mind.
After attending several FRUA conferences, that is Families for Russian and Ukrainian Adoptions, I had heard many other stories of adopted children from the far Eastern European orphanages that struggled with many of the symptoms my son had—only his seemed more severe. He could not make eye-contact with me, but he could with others. He wouldn’t be still long enough to let me rock or hold him much without becoming very agitated and throwing a fit to get away. He broke all his toys and played so rough that he hurt other kids. He locked onto other boys in a vise-like grip and couldn’t seem to let go even when they would wail. He had an hour long meltdown when told no. He flat refused to hold my hand even to cross the street.
Even though my boy was very much loved, he could not return any affection. I thought he had a very hard shell around him and likened him to a feral cat that could not be domesticated. I was so disappointed that I would probably never be able to have a normal relationship with my son because he might be autistic or beyond help.
At a little of 3 years old he was kicked out of the 2nd mother’s day out program. He’d bitten a bigger boy on the face and left a huge wound. I quit my job and decided to do whatever it would take to get my son professional help. My first call was to a professional child therapist and attachment specialist referred by several families in our FRUA group. My second call was to a well-known child psychologist in our city who worked with adopted children’s issues also. I had both doctors do independent evaluations on my son to determine what plagued him. Both doctors came back with the exact same diagnosis in their reports-Fetal Alchohol Effects or Syndrome, Post Traumatic Stress Disorder, Reactive Attachment disorder caused most likely by the PTSD and possibly ADHD.
One doctor was a man and one was a woman. The woman suggested that my son would need to be medicated to make it through a treatment program. Since my son had such great rapport with men and not women, mainly me, and since he’d been passed around in the orphanage mainly by women caretakers, he had a much more severe reaction the the woman therapist. So I decided to go with the man for therapy. We started attachment therapy to help him learn to self-soothe and work on the preverbal trauma first. Every week we went and sometimes twice a week. Things were always calmer for a day or two after the doctor had had a session of holding time with my son-with me right there next to him-to allow an entire cycle of rage to complete. JJ always had a full body shutter after a cycle, and that was one way to know he was done. This cycle would take an hour to go through with screaming, biting, flatulating, kicking and flailing all over the doctor. The screaming could be heard through the office walls for at least a floor.
After the cycle the doctor would ask JJ to go sit on my lap. He would do that, and he would look at me. He would make eye contact. We started to see shorter rage cycles and more mommy holding time with JJ. It was hopeful. Then the rage would come back within a few days and never for any main triggering reason. Nothing would make the child happy.
I read every book I could get my hands on regarding bonding and attachment disorders in adopted children, early childhood trauma and sensory integration disorders. I tried everything I could to try to help my son short of medication.
At some point my misery won out and I started asking to see a psychiatrist. I was then told JJ had conduct disorder and possibly Aspergers. I got a second opinion, and that time I got pervasive developmental disorder and severe ADHD diagnosis. Since his case was so complex and overlapping in so many symptoms, I really wanted the doctors to take into account the orphanange situation. JJ had rickets from malnutrition. His medicals from the orphanage said he was weened from the bottle at 6 months, toilet trained at 13 months out of necessity and that he’d been moved from hospitals to several orphanages in a short amount of time due to overcrowding and poverity in his village. He had been neglected, very possibly abused physically since he flinched and ducked when I’d first met him and came near him with my hands, and he rocked and head banged in his crib every single night at bedtime. He woke up early but never ever called out from his crib. He’d been adopted at 19 months old. His first year and 7 months were not a picture of health or nurture. He lived in a survial of the fittest environment.
I heard about a doctor, a neuro-pscyhologist who worked exclusively with adopted children and had 7 little JJ’s of his own. I called him, and was put through to him on my first call! He was in Virginia, and I was in Texas. I told him my situaion and asked if he was qualified to do an evaluation on my child. He said, “just get to my office as soon as you can.” I worked with his secretary to get an appointment for the following week. I had to fly my wildchild to Virginia to see Dr. Ronald Federici. I couldn’t afford it. I was scared to death of taking him on the plane-after he’d screamed bloody murder all the way home from Moscow for 10 hours on our last plane ride. But I was desperate for professional help by someone who was competent about adopted children’s issues.
Dr. Federici came out and said hello to me and JJ, and then promptly took JJ by the hand and went into his office to do some testing for everything from auditory processing to Asberger’s. They took breaks and came out, we went to lunch together, and walked around the office building. Dr. Federici wanted to see JJ in action. He wanted to see JJ’s attitude toward me. I’d been asked to bring all my Russian medical records and video to Dr. Federeici for a review. I had copies made and had sent them a few days before we arrived. That evening after an all day appointment, Dr. Federici asked JJ to wait in the play area so he could give me the rundown on what he thought.
Dr. Federici first brought out my medical records that were in Russia and had English translations. He asked if I knew that JJ had been a preemie baby? No. Did I know his record from the hospital say he was born in withdrawal from opiates? He had alcohol in his system. His birthmother had had also tested positive for drugs and alcohol. The combination of problems had caused JJ to have a stroke of some type in his first few days, and he’d been on a breathing machine. “No-this is not what the medical said,” I told Dr. Federici. So Dr. Federici read to me word for word what the medical statements said, and it was all in there. It just had never been translated. The orphanage nor judge, not my agency, not even the caregivers ever said a word about any of these things that had made JJ a very special needs baby. But there it was in black and white. Thank God, Dr. Federici could read the Russian chicken scratching. Later I would send those pages off to a Russian-American physician who would fully translate all of the record for me and tell me he was so sorry for my very sick child.
Dr. Federici gave me the bad news first-the medical record information and the results of the low low scores on all the testing. The only good news he said would come the next day as we made a plan for treatment for JJ. All the information I had gotten from the day made me very sad, but it also validated my deepest intuition that the severity of JJ’s rage and fear had not been coming from simply a behavioral problem. He truly was brain damaged by his birth mother’s in utero choices to drink and do drugs and the hospital and orphanange neglect and trauma after birth.
On day 2 of our intervention with JJ we had a session called intensive family therapy. Dr. Federici showed me how to make a safety plan for JJ, a daily visual schedule. At one point Dr. Federici was giving me some private information and asked JJ to wait right outside the door. I knew that was a shot in the dark and after two minutes of total quiet had gone on, I said I needed to check on JJ. He was no where to be found. We finally found him running into the street on the busy road in front of Dr. Federici’s office building! This was a perfect example of what I meant about me feeling that I couldn’t keep him safe for even a minute if I wasn’t watching him closely. We found out that through an auditory processing dysfunction, JJ had interpreted “stand outside the door for one minute” as GO STAND OUTSIDE THE DOOR-AS IN THE OUT-SIDE DOOR-OUT SIDE THE BUILDING. So he did what was asked of him except that there were so many interesting things going on in the streets that he wandered off that way.
Dr. Federici and I put our hearts back into our chests and proceeded with putting together an applied behavioral analysis system based JJ’s problems and my parenting style for us to take home and immediately put into action. He put the 7-8 part plan on large poster boards for me to tack up to my walls and follow to the letter. He wrote out every piece of the plan for me, and told me to call him when I got home after a week for a consultation.
I have done exactly as he told me to do. Retraining my son has taken bundles of patience, medication, occupational therapy, ABA therapy and work within our home to provide him the proper type of attention for attachment. JJ started sleeping on a futon in my room, earning all privilages and repeating with me daily-over and over our safety plan, our home rules, our good words list, our privilages list, doing chores….and slowly but dramatically over one year’s period of time, I truly met my son’s real personality for the first time. He was more smiley than pouty. He obeyed out of respect and felt proud of himself for earning his likes. The longer we are on this journey into the solution, the closer we have gotten in attachment.
Since attachment had not truly taken place by JJ when we met Dr. Federici, it started when the program started. It took on a life of its own. And the more attached, trusting and open JJ can be the happier he is. We continued with the local attachment doctor who worked with us on our treatment goals with Dr. Federici. The last time we were in the doctor’s office, my son got up on his lap with not even a frown and said he’d rather sit with mommy. At that point I saw a boy who’d come full circle with attachment. The RAD is gone, and my son was considered a severe case. The PTSD symptoms are gone-except for the insecurity of abandonment which may always be a part of JJ’s emotional baggage. He tried to fake a temper tantrum the other day-and we both laughed.
Dr. Federici has never not returned an email or phone call within 12 hours to me-ever. He has never not given me his honest opinion even when he knew it was going to hurt. He has offerred to fight for us with the school board to get JJ the special services we thought he’d need (and now doesn’t require). He’s offerred to see JJ for free. He’s kept in touch and put me in touch with many professioanls who are following our case and hoping for JJ’s continued success. Dr. Federici took pity on this single mom and gave me a discount on office fees. He changed the quality of our lives. He gave to me and to my son hope and tools to find the way out of the darkness out into the light. We both will always be so grateful to Dr. F for his dedication to his work and clients. He has been an excellent role model for both my son and me. In our last talk, he asked when I was going to get on my my own work as a pediatric counselor….I’d already done the time….and other kids need the kind of experience I now have lived through. So now it is me who is rising to the challange to meet the great expectations of a wise doctor, Dr. F.
Posted by Karasel Kid at 10:13 AM on the AdoptionHarmonyBlog@blogspot.com