I spend a fair amount of time with foster families.
Foster families are a unique population of caregivers who allow children who have been removed from their homes to stabilize, heal and stay connected to community with the ultimate goal of enabling them to safely and sustainably return to their biological families whenever possible.
Over 2,000 children are in foster care in Colorado. Colorado, like most states, does not have enough certified foster families available to meet the need for foster homes across the state.

I have a special place in my heart for a particular sub-set of foster (and adoptive) families who embrace children whose trauma is so severe that most would simply walk. Instead, these families walk in, at great personal cost and in great service to Colorado.
These foster parents are helping children with Reactive Attachment Disorder, or RAD, a condition that affects about 1.4% of our general population. A plethora of children in the foster care system have significant attachment issues because their early years were filled with trauma, but RAD is particularly challenging.
Children diagnosed with RAD generally suffered severe maltreatment and neglect as infants, and were not provided opportunities to form secure, healthy emotional bonds with their caregivers.
The first three years of a child’s life are essential for brain development and building the skills to manage emotions, self-soothe and positively attach to others.
During this crucial time period, infants need caregivers who meet their basic needs on a consistent basis: needs that include love and attention, a comforting touch and cradling when they cry, nutritious food when they’re hungry, eye contact and smiles when they smile or laugh.
Children with a RAD diagnosis did not have these basic needs met. These are children who were left alone for long periods of time, whose diapers were not changed, who were rarely cuddled to allow physical and emotional connection with their parent.
These are children whose caregiver showered them with positive attention in one moment, then unexpectedly yelled, hit or ignored them in the next. Emotional nourishment was as unpredictable as feeding.
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Because of this neglect, children with a RAD diagnosis develop their own survival skills, which are often neither healthy nor safe.
They have a harder time empathizing with others because empathy was rarely modeled for them. They may have violent outbursts, and often direct anger and hostile intentions toward caregivers. Children with RAD can also demonstrate a spectrum of more hidden, covert behaviors that again emerge as survival tactics.
These can include extreme lying and self-harming behaviors, making false accusations, manipulation and the ability to superficially adapt to their surroundings with a heightened need for control.
Sadly, these children often enter foster care before their diagnosis is clear, and families discover, as the child ages, that the violent outbursts and more covert behaviors they witness are not “regular tantrums,” but something deeper. Unfortunately, foster parents often see these behaviors long before professionals.
Foster homes with a child diagnosed with RAD are very different from those with children who form healthy attachments. Bedroom doors have professionally installed locks, video cameras are scattered all throughout, kitchen drawers are sealed shut, and homes have few decorations or furniture. Knives and sharp objects are nowhere to be seen. These homes are often filled with heaviness and loneliness.
The foster and adoptive parents who stand with children diagnosed with RAD always astound me. Their stories are sadly similar, and recount extreme aggression toward caregivers that throws entire family systems into chaos.
A profound sense of isolation is experienced by all as services for children with RAD are scarce, and parents seeking help for the children with extreme behaviors exhibited behind closed doors are almost never believed by friends, communities of faith, schools or even deeply caring people in the child welfare systems when relaying their experiences.
Tragic stories of RAD-diagnosed children abusing a family’s biological children add a further layer of hurt that permeates the home. Parents wonder how they could expose their own children to these situations while simultaneously, and remarkably, also considering the children diagnosed with RAD their own and in need of continued support.
These caregivers give their all and know that their child would “trade them for a box of LEGOs” if given the chance.
One mother weeps as she speaks of how her isolation, her “hysterical mom” reputation; her shame and her now-diagnosed PTSD manifest at home, in her marriage and at work. She is pushed to the brink, yet in the same breath — and with the same tears — she also says she will never abandon her child, whom she recalls as a 1-year-old who needed love and a chance.
That chance is being offered by Colorado’s RAD Advocates and the Institute for Attachment & Child Development. These are dynamic agencies giving neglected children a chance to flourish, against all odds, with cutting-edge services designed to overcome the harm caused in those crucial first years of life.
They work to become part of a family’s healing treatment team and make their journey a little less lonely.
Because RAD kids often present themselves as “normal” to therapists and child welfare workers when they first meet, families often don’t receive the critical Medicare funding or resources they need to help their RAD children.
We need to create more awareness and education about RAD within our communities so that RAD families can get the support they need. Professionals in child welfare, schools and churches need more training on what RAD looks like and how they can help these kids heal.
And we all need to stand with these families, who refuse to walk away from RAD kids, stabilize and thrive for the good of the children, families and Colorado.
Edward D. Breslin (Ned) is the president and CEO of the Tennyson Center for Children.