RAD Intervention: Face-to-Face Time
Face-to-Face time is a powerful intervention for disorders of attachment, such as RAD or Reactive Attachment Disorder and DSED or Disinhibited Social Engagement Disorder. The brain-based learning and development that results from meaningful face-to-face time is essential for growing a happy, effective, and well-adjusted child. While gazing into the face of your child may seem perfectly natural to you, this interaction may feel quite strange and even dangerous to a child of extreme neglect, trauma, or abuse. Parents of children with disordered attachment must plan careful interventions that allow children to develop a sense of trust and safety that allows face-to-face learning.
Face-to-Face Time is an important intervention for children healing from disordered attachment such as RAD or DSED.
Face-to-Face Time allows infants and children to see the emotions of love, compassion, and caring on the face of their caregiver. As children cry, they get to see expressions of sadness or concern pass over the face of the parent. Exposure to the parent during various emotional states is what teaches the child about feelings … of self and others. Compassion, empathy, and even self-care stem from the important learning and brain development that result from quality Face-to-Face Time.
Parents of children who have typical attachment development may overlook the importance of Face-to-Face Time for the child with disordered attachment. Being nose to nose and looking into each other’s eyes is natural during nursing, feeding, cuddling, and changing time. Yet, children who suffered neglect, abuse, or trauma often have a difficult time with being so close with another person, and may work hard to avoid making eye contact. Parents of attachment disordered little ones must remain patient and hang in there to allow the intervention time to do its magic.
One trick to pull a child’s attention to the face is to place a sticker on the nose or between the eyes. Other tricks include shaking a rattle off to the side to get the baby’s attention, then keep shaking as it is moved in from of the parent’s face. Another strategy is to gently coo and sing to the infant or young child while rubbing noses. Children with attachment problems may be highly resistant, but this will change over time. Little by little, the infant or child will become familiar and more comfortable with this type of intimate encounter and recognize that it is a safe and even pleasant experience.
How long can it take for this type of close connection to take place? Generally, the younger the child, the more quickly the intervention begins to make changes. Naturally, older children may never fully accept close face to face interaction, but may learn to feel safe sitting closer and having some eye-to-eye contact during conversations. Infants and toddlers who are being cared for in a nurturing and committed way are likely to overcome resistance to eye gaze within a few months or years. The nature and extent of the neglect, trauma, or abuse that led to the disruption of attachment will also determine how long it takes for a child to respond to Face-to-Face time interventions.
Caregivers must remember that the primary focus is to help the child recognize safety to develop a sense of trust in others. The secondary focus is to stimulate a sense of nurturing and love. Additional benefits of Face-to-Face Time include emotional and social development, stimulation of mirror neurons in the brain, and ability to feel compassion for others.
Face-to-Face Time is just one of many valuable interventions that can bring about the healing and development of fragile children with disordered attachment. The Face-to-Face Time intervention is more complex than explained here, but this brief introduction will get parents and caregivers off to a good start! Follow our series of articles on intervention techniques to help children with disordered attachment including DSED and RAD.
Darleen Claire Wodzenski, MS ESE, MS CMHC, QPPE, PhD is a child development interventionist, parent coach and clinical mental health professional who specializes in developmental issues of early childhood including RAD. She is the Program Developer for Orchard Human Services, Inc. and can be reached by phone at (770) 686-0894 for individual coaching and consulting. Counseling and intervention services available in the Metropolitan Atlanta area.
