It's time to have a serious talk about residential treatment centers.

Seven months have passed since Sunshine was admitted to her second residential treatment center (RTC) after homocidal thoughts and behaviors at home.

To experience the trauma of a residential placement a second time has been a horror worst than the first.

There are two songs that I shared with Sunshine when she was in residential the first time to help her remember I'm fighting for her and that I will not forget her. I play them often.

The first is Don't Give Up On Me by Andy Grammer. 

The second song is What About Us from Pink.

These songs helped me have the courage to write this post tonight.

Please be warned it may be very triggering for some.

It's Time to Have a Serious Talk about Residential Treatment Centers

Our First Residential Treatment Experience

During Sunshine's first time in an RTC, I fought HARD to make sure her needs were being met.  

And by HARD I mean HARD.

It was a constant uphill battle.

I was consulting a lawyer.

I was constantly in communication with the RTC caseworker and administration, as well as our community caseworker demanding Sunshine's needs be met.

There were many times I was in direct contact with the insurance company, working with them to ensure that the RTC was providing Sunshine all that she was entitled to.  

I spent many days studying contracts the insurance company had with the RTC.

This was all on top of being very involved with Sunshine's treatment on a daily basis with her therapist and others that worked with her.

Sunshine deserves the BEST treatment, just like every other child who is trapped in this broken system.

I was determined to make that happen for her until she could return home to us.

The Results of My Fight

The representative from the insurance company called me after Sunshine's case was closed (after the first RTC) to let me know that because of my work to help Sunshine, I had caused systemic change throughout the entire state of Virginia that was already helping other families.

Today when speaking with our community caseworker about the first RTC experience (she was by my side the entire way), she called me a Trail Blazer for systemic change in a broken system.

But the truth of the matter is, fighting HARD is HARD work. 

It's exhausting. 

It comes with a huge price.

So many sacrifices were made.  You may remember I didn't blog for about a year!

And so, this time, during Sunshine's second RTC placement, I decided not to be as fierce.  

The reputation that comes with creating systemic change is not one I enjoyed. 

I was so worried it was hurting Sunshine.

I couldn't keep fighting at the intensity I was before, and still provide for my family. 

Advocating for Sunshine took all that I had.

A Mother's Grief

When Sushine returned home after that first placement and things went downhill, there was a big part of me that felt like a failure because after all I'd done, nothing worked. 

Sunshine couldn't remain at home.

Perhaps if I had just let people do their jobs in the first RTC the way they wanted to, things would have turned out better?

Perhaps I don't know Sunshine's needs as much as I thought I did, and only caused more damage?

Perhaps I'm not a good parent, and this is all my fault?

I was broken when Sunshine entered her second RTC.

Unless you've experienced what I have, you can't begin to understand what something like this does to a mother. 

Doing Things Differently

For six months while Sunshine was at the second RTC, I played nice. 

I tried not to ruffle feathers.

I worked hard to go along with whatever the therapist and treatment team thought was right.

I trusted that they knew better than I did.

I gave everyone at the RTC the benefit of the doubt. 

After all, I knew how hard Sunshine is sometimes. 

I know what she's capable of. 

I know how dangerous she can become. 

(This is not her fault, it's just how her brain works right now, which is the whole reason she needs help!)

And you know what?

There has been no improvement.

Behaviors have worsened.

Sunshine isn't receiving the supports she needs.

Her IEP has not been followed.

Our local school district hasn't received a single progress report about Sunshine from the school at the RTC, nor have we, which is against the law.

Even the funding source of her treatment has not received the paperwork they've requested from the second RTC.

Heck! We don't even know if Sunshine has the proper medical insurance right now, or that her medical needs are being met, because no one will call us or our community case worker back.

WE ARE DEVASTATED.

It Gets Worse!

At Sunshine's six month treatment team meeting administration initiated the topic of how they felt Sunshine was close to receiving maximum benefits of treatment, and that the RTC she is in, may no longer be the best fit for her.

Basically it was a fancy way of saying they're sick of her and ready to kick her out.

And yes, residential treatment centers can do this. 

They do so all the time.

Administration has given us no time line as to when this is happening, but Sunshine's therapist told us that if it will take longer than thirty days to find Sunshine another placement, we need to start now.

So many RTCs will only permit a three to six months stay now, and so those who need a longer course of treatment are only getting worse bouncing from place to place.

Despite our community based team offering funding for more supports, the second RTC has declined providing any further individualized help and support for Sunshine.

This is an absolute nightmare.

Our community based team has stated that under no circumstance can Sunshine return home as she has not improved and is still a danger to family members. 

In the event that we would go against this advice and bring Sunshine home, (which we won't), we could be charged with endangering the welfare of our other children. 

So realistically speaking, it is against the law for us to bring Sunshine home right now.

To further complicate things, Sunshine is not ready for a step down to a group home, so she needs to be transferred to another RTC.

No RTC in the state of Virginia will accept her because of the severity of her case. 

We've exhausted so many options already. There have been so many RTCs that have said no throughout the entire U.S. because of the severity of her case.

There are two exceptions with wait lists, but the waitlists are months long.  

Sunshine has been on one waitlist for seven months already. 

The other wait is a minimum of two months.

So literally, there is no place for Sunshine to go. 

And even if she goes to one of these places, who's to say it's not worse than where she is now?!

We've tried arranging a meeting with the RTC two times in the last month and they've not even responded to our requests. 

Our community based team has tried to arrange a meeting about Sunshine with the RTC, and they are having no luck.

Sunshine's Suffering

Meanwhile Sunshine continues to suffer.

The one time I did step in and fight hard during this second RTC stay was when Sunshine continued to show up to therapy sessions and ZOOM visits with new bruises EVERY. SINGLE. TIME. 

And I'm not talking small bruises. 

There have been black eyes.

There have been black and blue finger prints on her arms. 

Her lower arms are constantly covered with large bruises.

There have been bruises on her head.

Administration never got back to me about findings over some of these big bruises early on in her stay, despite my constant requests for more information.

They did promise daily body checks with calls to report what's going on and followed through for a little while.

Many bruises were from peers. Some were from staff.

But then there was silence again.

Silence didn't equal less bruises though.

The only calls we receive now are when Sunshine has been restrained or injuries are severe.

It's been a nightmare speaking with nursing staff several times over the past week and a half as Sunshine has been put in holds by staff eight times in ten days. 

One incident came with a report that staff had left bruises on Sunshine.

Yesterday I broke down with the nurse on the phone. 

I've decided I can't stay silent any longer.

Since when is it okay for a child to be physically abused in any way? 

If the continued bruising we're seeing on Sunshine occurred while she was at home, you better bet you Child Protective Services would be involved immediately.

Why is it not okay for things like this to happen at home, but totally fine that these things happen to a child in a residential treatment center?

(We did launch an investigation during Sunshine's first RTC stay because of these issues as well.)

Nothing that's happening to Sunshine is even close to being okay!

Children Deserve Better!

ALL children deserve to be treated with dignity and respect, having their individual needs being met in every setting.

ALL autistic children should be receiving supports they need to be successful each day, NOT just behavioral training to teach them not to be autistic.  

ALL children with Reactive Attachment Disorder deserve the very best treatment that promotes attachment to family, without further neglect and abuse.

Did I mention we're not even allowed to call Sunshine at this RTC? 

It's her responsibility when permitted (about two times a week), no matter what she's in the middle of, to stop everything and call us. 

For a child who's documented to have issues with transitions, this is a fail almost every time.

ALL children who suffer with severe mental health illness deserve early intervention and the best pediatric treatment to help them reach stability and success, no matter how severe their symptoms. 

If mental health issues of the brain were treated as a physical illness like cancer, denial of treatment is illegal.

Severe mental health issues in children are real and they deserve people's attention.

Just because Sunshine is in a residential setting does not mean she is any less of a person or child than anyone else.

Our system is so so so broken.

For children like Sunshine with autism, Reactive Attachment Disorder and a mood disorder, there is nothing. 

Watching Sunshine suffer like she is has been the most painful experience I've ever had to endure.

And Sunshine is not the only one this is happening to.

If you've read this far, please help us! 

Help spread the word that this is real and happening to children in the U.S. and everywhere else.

Change will not occur until enough people decide it's necessary.

In order for that to happen, people have to know that it is happening and want to do something about it.

And if this hasn't touched your heart, consider the path that Sunshine is on right now.

Where does it lead?

If no one is willing to help her...

If no one does help her...

Where does she end up?

I should not have to prepare myself to love a child who resides in juvenile detention or prison because no one will help her.

This isn't right!

This is part one of a serious of articles about residential. If you would like to continue reading about Sunshine's experience in this particular case, be sure to click the links below.

Part 2: How Do You Work with a Broken Mental Health System?

Part 3: The System Failed Us Horribly

Part 4: She Needs a Forensics Exam

For those who would like to continue to follow Sunshine's journey in residential treatment, be sure to subscribe to our FREE newsletter by clicking the link below.

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FREE How to Solve Addition Fraction Problems Visual

We continue our journey with fractions now that the three kiddos have memorized all of their math facts and feel comfortable utilizing those skills in multiple ways.

Princess and Dinomite are grasping fraction concepts quite easily, but Bulldozer is REALLY struggling with how to solve addition fraction problems.

The parts he has the most difficulties with are deciding how to make denominators equal and then what to do with the numerators. He often confuses which number to multiply them by.

I was hoping that with continued practice Bulldozer would learn the steps, but he hasn't.  Even the use of Montessori fraction materials isn't doing it for him.

A couple of weeks ago he asked for a control chart to help.  

This FREE visual printable is the result!

How to Solve Addition Fraction Problems

There are many ways to solve addition fraction problems.  

I want to make it clear that the techniques used in this printable are not the only ways to do so. 

The techniques in this printable best follow the Montessori approach presented in the elementary math albums and meet Bulldozer's need for simple, concise, step-by-step directions. 

If your student is struggling, we hope that you find it beneficial as well.

There are four simple steps for each and every addition fraction problem. 

In some cases, Bulldozer will only have to work through step one and he's done.

In other problems he'll need to work through step two. 

When steps one and two don't work, he moves on to steps three and four.

This printable is a Subscriber's Only Freebie. For your copy, follow the directions at the bottom of the post.

Fractions: Addition Clip Cards Printable Pack

The FREE How to Solve Addition Fractions Problem Visual is designed for use with the Fractions: Addition Clip Cards Printable Pack. 

The Fractions: Addition Clip Cards Printable Pack includes two hundred clip cards, fifty of each type of addition fraction problem to ensure that every child achieves mastery.

My kids are in LOVE with these clip cards. They love the challenge of each problem and that there are choices to help them know they have the right answer.

If you're studying fractions, you may also enjoy some of our other FREE visuals!

FREE How to Reduce Fractions Visual

This visual is such fantastic resource to guide kids through the process of reducing fractions. 

There are so many steps involved that can easily be missed or skipped. But with this visual, kids are sure to solve the problems correctly.

FREE How to Change an Improper Fraction to a Mixed Number Visual

If you're trying to teach a child how to change improper fractions to mixed numbers, this visual is a fantastic resource. Not only does it break down each step of the process, but the numbers are color coded to help with any confusion there may be as to where each number goes during the process.

Don't forget your FREE copy of the How to Solve Addition Fraction Problems Visual. Follow the directions below.

Directions on How to Obtain Subscriber Only Freebies

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2. Subscribe to our free newsletter.

3. Open the thank you message you receive in your e-mail, after subscribing. (Be sure to check your spam folder, as sometimes it ends up there.)

4. Click the confirmation link in the thank you message.

5. Once the confirmation is complete, you will receive another e-mail message with the Subscriber Only Freebies.

6. Click on link.

7. Find the printable pack you are looking for listed in alphabetical order, click on it, and voila!

We hope you enjoy your free printable.

Note: If you are already a newsletter subscriber, open your most recent newsletter. At the bottom you will find a link to the Subscriber Only Freebies page, along with the password in case you forgot it.

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Reactive Attachment Disorder and Puberty

Puberty can be a very hard and scary time to navigate for caregivers of children with Reactive Attachment Disorder.

Due to hormone changes, growth spurts and brain development, the brain and body revert back to what they were like as a newborn and infant, needing to relearn basic skills all over again.

With that reset comes the need for the brain to work through past trauma all over again. 

The longer it took for the trauma to end, the longer this difficult time period can last.

Behaviors can become quite scary. 

What a caregiver thought the child had worked through and moved past, may come back in full force or worse.

This has occurred with Princess and was scariest earlier this year when she wanted to take her own life.

It has also occurred with Sunshine as she goes through precocious puberty. She became homicidal with a significant increase in aggressions and assaults towards others. 

This is why she is currently in residential treatment.

How do you navigate Reactive Attachment Disorder during puberty?

Physical Health

Whether a child has Reactive Attachment Disorder or not, puberty is extremely hard on the body. There are so many changes that take place. So much growth occurs at an extremely fast pace.

We often hear the word “awkward” as a description of the body during puberty, and it’s true! The body is literally learning how to work all over again.

With all of our children who have diverse needs, we’ve observed that during puberty, all of the same struggles they had as infants and toddlers have returned.

When Princess came to our home she did not know how to use her body correctly. She spent a long time in physical therapy.

Over the last year we’ve seen her gross motor skills deteriorate in significant ways. Princess is no longer able to do so many things that she was able to do correctly before.

The biggest red flag was when we gave her rollerblades for Christmas and she couldn’t stand up straight in them.

She has also developed Sever’s disease which complicates things further.

Due to Reactive Attachment Disorder, Princess was not communicating that she was pushing through pain and making accommodations with her body to compensate for lost skills. These accommodations caused more harm than good.

She has been in physical therapy for a few months now and will continue until her body is working correctly again. Progress is slow but steady.

If you notice regression of skills and especially if your preteen/teen with Reactive Attachment Disorder complains of unexplained pain, make an appointment with her pediatrician immediately.

Don’t hesitate to request physical therapy or at least an evaluation done by a physical therapist to determine what’s going on.

If your child worked with a physical therapist as an infant or toddler, there’s a good chance they’ll need to do it again.

Please also know that injuries like broken bones are completely normal during puberty. As the body changes rapidly, the bones have a part to play too, which makes them extremely vulnerable.

Diet

When Princess came to us as an infant, she had some significant issues related to food. These issues resulted in her needing an endoscopy and allergy testing. Eosinophils were discovered during the endoscopy. Further blood work and allergy testing confirmed allergies and intolerances.

Over time Princess’ gut healed and she grew out of her food sensitivities and allergies.

Fast forward to now, during puberty, and gut issues have returned. We are thankful to say that allergies have not reared their ugly head again, but intolerances and sensitivities have definitely made themselves known.

Princess has now returned to a gluten free diet which has made a tremendous difference with her body functions and her moods.

She tried gluten again over this past weekend, just to see what would happen. Sure enough she became ill AND crashed emotionally.

If you notice significant irritability, mood swings, and rapid, unexpected changes in eating habits, do not hesitate to consult your child’s pediatrician or discuss dietary changes with your child in an effort to help.

If your child is resistant to recommendations, let the pediatrician take the lead and document, document, document!

Amen Clinic identified a part of Sunshine’s brain that was being affected by her diet during her brain scans last summer.

The psychiatrist prescribed her a gluten free, corn free, soy free, dairy free, sugar free diet, because the impact of her diet was so significant.

We could not believe the changes in behaviors when we implemented their recommendations. It didn’t change everything, but helped significantly with her overall health and wellness, which led to an improvement in behaviors.

We often think about diet as one of the last reasons for changes in behavior, but during puberty, it’s definitely one of the first things you want to consider.

Mental Health

It would be absolutely wonderful to see consistent progress with attachment and behaviors through puberty with children who have Reactive Attachment Disorder.

Unfortunately, no matter how much progress has been made, there will be regression during this time.

If a family hasn’t experienced a mental health crisis before puberty, it’s very common for the first one to occur around that time.

If things have been consistently rough, be prepared for things to get worse.

For how long you ask?

That depends on how long your child endured trauma during those early years. 

It may also depend on how long it takes to find the correct medication regime if required.

When the brain resets at puberty, it has to work through past trauma in an entirely new way that matches how the newly developed brain works.

If you’re struggling to understand this, just think about the end of the movie Inside Out when the old control panel is replaced with the new one. There are so many new buttons for the emotions to learn how to use. Not to mention, Riley’s whole view on life has changed.

How do you navigate this time of regression?

Expect it.

Plan on it.

Have resources in place and ready to go!

At home, make sure you have all of the necessary safety protocols in place and working efficiently. You will need them.

If you don’t have a mental health therapist already, do your research and find one that can help.

In areas where that may not be possible, or isn’t the right fit (mental health therapy equals trauma for Princess), now may be the perfect time for the caregiver to start therapy. I can’t tell you how beneficial it has been for both my husband and me during this time.

In our home, Sunshine had in-home emergency mental health services leading up to her residential stay.

When Princess became suicidal, we contacted her pediatrician who met regularly with her to determine a need for medications and/or other services.

We attempted to obtain in-home emergency mental health services but it took forever due to insurance complications and COVID-19. Instead we found a program through our church that we did as a family that helped significantly.

When things hit the fan during puberty with your child who has Reactive Attachment Disorder, please remember nothing is your fault. You are not going crazy. This is tough stuff!

As abnormal as it feels, it’s completely normal.

It’s to be expected.

Even if you’ve done everything right up to this point, things are going to fall apart.

DO NOT BLAME YOURSELF.

Have faith and confidence. You will make it through this.

At the same time be realistic. This is not something that you can do by yourself.

The best case scenario is that your child with Reactive Attachment Disorder and you will need some great therapy.

Worst case scenario, your child may become so unsafe that she is unable to live in the home for a while for safety reasons.

I’ve experienced both scenarios and have lived to tell the tale. You can too!

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