1. Disinhibited Social Engagement Disorder (DSED)

2. A. A pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits at least two of the following:

3. Reduced or absent reticence in approaching and interacting with unfamiliar adults.
Overly familiar verbal or physical behavior (that is not consistent with culturally sanctioned and with age-appropriate social boundaries).

4. Diminished or absent checking back with adult caregiver after venturing away, even in unfamiliar settings.
Willingness to go off with an unfamiliar adult with little or no hesitation.

5. B. The behaviors in Criterion A are not limited to impulsivity (as in Attention-Deficit/Hyperactivity Disorder) but include socially disinhibited behavior.

6. C. The child has exhibited a pattern of extremes of insufficient care as evidenced by at least one of the following:

7. Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation and affection met by caregiving adults.
Repeated changes of primary caregivers that limit ability to form stable attachments (e.g., frequent changes in foster care).

8. Rearing in unusual settings that severely limit opportunities to form selective attachments (e.g., institutions with high child to caregiver ratios).
D. The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A (e.g., the disturbances in Criterion A began following the pathogenic care in Criterion C).

9. E. The child has a developmental age of at least nine months.
Specify if Persistent: The disorder has been present for more than 12 months.
Specify current severity: Disinhibited Social Engagement Disorder is specified as severe when a child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels.

10. 5 Critical Facts You Must Know about RAD/DSED
All Five are important!!

11. 1. Educators need to take good care of themselves.

12. It is estimated that the average classroom has five children with some type of attachment disorder (Thomas, 2004).
Working with children with attachment issues can be a challenging and exhausting endeavor. Educators need to establish a network of allies who can serve as sounding boards for their daily encounter with these students (Thomas, 1999).

13. Teachers should not take the student’s behavior or statements personally (Smith, 2000). This will probably take some practice as these children typically are able to push “buttons” that most adults never knew they had.

14. 2. Can be a serious risk to your professional and personal life

15. -Exhibit severely poor boundaries
-Exhibit severely poor boundaries. They can:  -desire to be hugged, touched and reassured of your positive feelings for them. -may ask to see you after school, in a "private" place to discuss "private" feelings. -formulate "deep" attachments to you quickly and behave.

16. 3. Recognize the child’s subtle attempts to control by:

17. Frequent Interruptions, Mumbling or using unclear speech
Asking you to repeat something that was said. (“Huh”?)
Asking to use the bathroom, get up and get a drink or get out of their seat without a plan and many times throughout the class.
Tipping the chair.
Others?

18. 4. The mother is the primary target of the child’s rage

19. She needs a lot of support.
Open and understanding communication is vital between home and school, however exhausted Moms often have a hard time hearing every detail of the child’s bad behavior, keep it short.

20. 5. Traditional problem solving questions don’t work!

21. What happened. What was your part in it
What happened? What was your part in it? What could you have done differently?
AD children will learn to spin off the "desired answers", but they will be meaningless answers.
The time spent on this exercise will be wasted time

22. Behaviors in the Classroom…

23. 1. Superficially engaging and charming 2
1.Superficially engaging and charming 2. Lack of eye contact on teacher’s terms 3. Indiscriminately affectionate with other adults not well known (Subs, coaches---not their own) 4. Destructive to self, others, and material things (includes being accident prone) 5. Lying about obvious things

24. 8. Stealing 9. No impulse controls (frequently acts hyperactive) 10
8. Stealing 9. No impulse controls (frequently acts hyperactive) 10. Learning lags 11. Lack of cause and effect thinking 12. Lack of conscience 13. Abnormal eating patterns 14. Poor peer relationships

25. 15. Persistent nonsense questions and chatter 16
15. Persistent nonsense questions and chatter 16. Inappropriately demanding and clingy 17. Abnormal speech patterns 18. Triangulation of adults