FASD and RAD — “Cannot vs. Will Not”
by: Craig Peterson
The two often go hand in hand as parents and professionals will attest. Although they create enormous challenges for families, receiving an accurate mental health diagnosis for a child can be another challenge altogether.
Connecting the dots isn’t always easy.
When adopting my three first children – all under the age of five, I was lucky. I knew each had Fetal Alcohol Syndrome – which is more prevalent that most people realize. Since their birthmother’s drinking during pregnancy wasn’t a secret, their case manager did right. She took them to be diagnosed. No question, no mystery.
Their case manager also had common sense. She wanted prospective families to have complete information prior to an adoptive placement.
The opposite is often the reality for new parents.
One of the first phrases I learned about FASD was “cannot” versus “will not.” Is the child’s inability to comply or execute a task related to their permanent brain damage from alcohol exposure in the womb? Is it a learned behavior in response to early trauma and the subsequent need to survive?
Maybe a little bit of both.
Understanding the difference made my children’s transition into my home much easier. High structure created routine. That led to the predictability that enabled the formation of good habits. With reasonable expectations and minimal change, “can do” rather than “can’t do” was the result.
Without question, I had to be highly intentional to build a connection with them. At the same time, I served as their external brain – providing cues, sequencing thoughts and anticipating the next step.
I had to be highly intentional to build connections. I had to be their external brain.
At school a core of seasoned teachers understood the impact of early trauma better than me – because they obviously had experienced it. To them, qualifying for special education – and the extra services it would provide – was a no-brainer. They all understood the ups and downs of transitioning into a new home and attaching to a primary caregiver.
Clearly, they wanted my sons to succeed.
Three years later I learned about a different type of trauma from my three older children, all over the age of nine. They had experienced severe neglect and abuse – both physical and sexual – that my first three children thankfully missed. As often is the case, the intensity and frequency of their complex behaviors grew over time in my home. After professionals observed family dynamics and used common sense, they connected the dots. All three were diagnosed with Reactive Attachment Disorder and Borderline Personality Traits on top of the previously diagnosed PTSD.
“Cannot” versus “will not” would soon take on a new meaning.
No doubt, the same structure that made the day predictable for my younger children made my older children feel safe. And they needed to feel safe to heal.
But they sometimes tired of the routine like many tweens and teens with attachment challenges. They wanted to be in control, as they had learned to do – both consciously and subconsciously over the years. It’s how they survived.
How could I break their bad habits? How could I reduce their “fight or flight” mentality? Unlike my three younger sons, their behavior didn’t come primarily from a lack of ability. It came from a lack of nurturing early in life, combined with a lack of life experience and lack of self-worth.
Were my children’s behaviors impulsive (cannot) from a lack of understanding? Or were they manipulative (will not) out of defiance?
Although no two children are the same – and many have co-occurring disorders, I found “impulsive” more closely related to the FASD behaviors in my three youngest sons. They often live in the moment and respond to the stimuli around them.
For example, a younger son took a teaching assistant’s phone one afternoon. The assistant left it unattended and then left the room. Without thinking, my son saw and took. But did he plan to steal a phone that day? Of course not!
In his case prevention and supervision were essential to controlling his impulsive behaviors. Teachers who kept the classroom free of “distraction” maintained a predictable environment while reducing his anxiety. In turn, they had less mess to clean up.
And so did I.
Likewise, an older son acted on impulse one morning and told the “lunch lady” that he wasn’t being fed at home. She fed him. Without confirming his story with anyone, she immediately planted a dangerous seed – from which manipulation took root. For nearly a month under her watchful eye, my son was late for first period while eating two to three “complimentary” breakfasts. When confronted ever-so-gently at home once the facts came to light, my son felt incredible shame.
Periods of going hungry or doing without will leave a lasting imprint within our kids.
Frozen in the thought of being severely punished – which frequently happened prior to his adoption, my son grew desperate. He had to maintain control at all costs. First he lied. Then he initiated a one-sided debate – before turning aggressive. His “fight” reaction had kicked into high gear.
Although the untrained observer would label the incident as “will not,” it too was a situation of “cannot.”
The following day, the wise assistant principal took the right approach after I called with an update. “I don’t ever want you going hungry and feeling people don’t care. Come to me first. We will call your father and figure something out together.”
“Cannot” versus “will not.” Impulsivity or manipulation.
Which one are you confronting? My understanding of the two helped me sort the pieces of the puzzle nearly every time. And complete the picture with greater accuracy.
It can do the same for you.
Lesson learned – wishing I had another chance.