Using Following Instructions to help your RAD child

If your child has been diagnosed with Reactive Attachment Disorder (RAD), you have probably noticed that they have trouble bonding with others and maintaining relationships. As infants or young children, inconsistency of caregivers caused them to develop defense mechanisms such as avoiding or resisting emotional attachment. Children with RAD also struggle understanding cause and effect. Because of this, they have difficulty taking responsibility for their behaviors, not recognizing how their actions lead to negative consequences or how it might affect long-term relationships. Feeling safe becomes more important to your child than giving and receiving love. The first step on the road to bonding with your RAD child is providing clear boundaries with choices and consequences because clarity (?) helps them feel safe.

For more information about Reactive Attachment Disorder, see our 5-part series

This is why using the Smarter Parenting skills is so effective with these children. Teaching and expecting consistent skills with the same steps each time provides the predictability that helps them feel in control. The skill of Following Instructions is a simple skill that can be easily learned and applied to many situations throughout the day.

While using the skill of Preventive Teaching, teach the steps of Following Instructions
Ensure that you have your child’s full attention before giving an instruction. One way to make sure you have their full attention is requiring eye contact. Eye contact is a key requirement to help RAD children practice emotional recognition in others and you know your child heard what you said when they are looking directly at you. Since children with RAD are often uncomfortable making eye contact, make it a positive experience by having calm facial features and not using it in a negative context such as, “Look at me when I talk to you.”

1. Get your child’s attention
2. Give a simple, clear, descriptive instruction

Break down tasks into small pieces that can be done without confusion. Then give only one instruction at a time. When your child is finished with that instruction you can give them another small one. This helps your child to avoid becoming overwhelmed with tasks, which can lead to high emotions and tantrums. Giving simple, clear, and descriptive instructions also helps them remember all that you have told them.

3. Child says “Okay” and immediately follows instruction

Continue to require eye contact as your child says “Okay”. Also practice having them say this in a calm voice. When I would teaching Following Instructions to children I would tell them that they don’t have to be excited and animated that they’re receiving an instruction, but they should be able to accept an instruction without becoming irritated or angry.

4. Child returns and reports when finished

The last step is beneficial so you know that the task was completed. It is also beneficial for the child because they get credit for what they have done. Reporting back is when they can receive a reward for completing their instruction. Your child will not receive a reward for every instruction they complete, but when first introducing a skill establish rewards to encourage use of the skill and to reinforce it. Visual reward charts and a list of the steps around the house will provide reminders for what your child is working on.

After teaching the steps of Following Instructions practice how to use the skill through role-play. Show them first how to complete all the steps and then have them role-play at least 3 times, or until they can use all the steps correctly. Children with RAD learn best through repetition. Continual role-play provides the repetition to reinforce the skill.

FOLLOWING INSTRUCTIONS LESSON

Extra tips

  • Children who have been diagnosed with RAD struggle coping with change and will often push against boundaries that have been set. Don’t become discouraged if your child doesn’t want to use the skill at first. Keep your expectations consistent and find a reward they want to work towards and they will eventually begin using the skill.
  • Your RAD child may be uncomfortable when receiving praise at first. Continue to praise each time your child uses Following Instructions, even if your child shows discomfort. Everyone likes to receive praise and it will reinforce positive behaviors even if it seems that your child doesn’t like it.
  • Rejecting physical contact is also a common symptom of RAD. You will have to gauge how comfortable your child is receiving positive physical touch. Do not force hugs or high fives if they are uncomfortable. As they start to feel secure with you and learn proper ways to express emotion they will become more and more comfortable with physical touch. When possible, positive physical touch is a great addition to praise.
  • Most importantly, Reactive Attachment Disorder is “curable”. Unlike most other mental health disorders, many children with RAD have completely recovered from their feelings of inadequacy, lack of trust, and insecurity, and have gone on to develop deep, long-lasting attachments to their family and friends. Continue to love your RAD child, don’t take their resistance personally, and enforce boundaries through teaching them appropriate social skills and giving positive and negative consequences.

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