By Joel Warner
By Michael Roberts
By Alan Prendergast
By Michael Roberts
By Michael Roberts
By Amber Taufen
By Patricia Calhoun
By William Breathes
Between 1996 and 2002, David saw nineteen different therapists outside of school, who tried everything from thought-field therapy to eye-movement desensitization and reprocessing, to biofeedback, allergy elimination, talking therapy, homeopathy and hypnosis. Medications, including Clonidine, Zoloft, Ritalin, Dexedrine and the anti-schizophrenic drug Seroquel, had little effect on the boy. Some of the treatments were covered by the Jefferson Center for Mental Health (JCMH), the agency that provides mental-health services to Medicaid-eligible residents of Jefferson, Gilpin and Clear Creek counties. Other were paid for out of the Mallamos' pocket, cutting into a monthly adoption-subsidy stipend.
The family collected diagnoses like baseball cards: post-traumatic stress disorder, personality change due to in utero toxic exposure, attention deficit hyperactivity disorder, opposition defiance disorder. Although the diagnoses differed, therapists all agreed on one thing: Isolating the root of David's problems would be complicated, if not impossible. "This is a complex and interacting constellation of possible disorders and will be a challenge to sort out," wrote a doctor at the University of Colorado Health Sciences Center in 1999.
Instead of improving, David worsened. Police were called to Hutchinson numerous times after he threatened classmates, destroyed property and yelled at teachers. At home, David fought with his siblings and parents. Family meetings designed to address some of the domestic problems disintegrated into shouting matches.
In the summer of 2002, Liz Smith, a JCMH therapist who'd made regular visits to the Mallamo home, presented a new theory. She believed David had reactive attachment disorder, an odious emotional and biochemical mixture that severely limited his ability to trust, control impulses and rages, give and receive affection, and experience empathy or remorse.
After hearing that, Paul and Susan began thinking less about fixing their son and more about just learning how to live with him.
"We were looking for a magic bullet, but there is none," Susan say. "You're trying everything; nothing is making a single dent."
"Nothing works, so you keep looking and looking and looking," Paul says. "There are so many unknowns. Sometimes all that you're doing is making your best guess and hoping for the best."
As harrowing as David's history is, it's fairly typical of an older child in the welfare system. Seven out of ten are estimated to have suffered some type of prenatal exposure to toxic substances, usually drugs and alcohol; many have biological parents who are mentally ill themselves.
These high-risk kids often develop a wide strata of psychological, physical and behavioral problems and, increasingly, are diagnosed with reactive attachment disorder, which, among other things, infuses a child with an inherent distrust of family dynamics or bonds. Although still far less understood or accepted than some conditions linked to childhood abuse, reactive attachment disorder is now seen as a condition that's shared by children who suffer extreme trauma and parental neglect as infants and toddlers. Attachment disorder is exhausting for both a child and his caregivers: Kids with the disorder are known to lie constantly, fear their own and others' emotions, struggle to dominate parents and siblings and, sometimes, believe that they have special powers that negate responsibility for their actions.
Two high-profile Colorado cases brought reactive attachment disorder out of clinical obscurity and onto the front page. Renee Polreis is currently serving an eighteen-year sentence for the 1996 beating death of her two-year-old adopted son, David. As part of Polreis's defense, her lawyers argued that the boy beat himself to death with a wooden spoon, so powerful were his attachment disorder-fueled rages. In 2000, ten-year-old Candace Newmaker suffocated while undergoing rebirthing therapy for attachment disorder; her therapists, Connell Jane Watkins and Julie Ponder, were convicted of reckless child abuse resulting in death; each was sentenced to sixteen years in prison.
"A lot of times with a RAD child, you can know them before you adopt them and never see any sign of it," says Deborah Cave, who heads the Colorado Coalition of Adoptive Families. "All of a sudden, when that child gets in the home, it triggers those attachment issues. Suddenly there's a dynamic where they're supposed to be calling you Mommy and Daddy, and it terrifies them. You show them a little bit of love, and it can send them into rages. You don't even realize how disruptive it is for a marriage."
A child's problems intensify the longer he stays in the system, although even children adopted as infants are known to present a wide array of problems in later life.
"There's a strong correlation between the number of moves a child in social services makes and the types of problems he's likely to show later in life. After the age of eight, the chances of being adopted really start to drop," says Cave. "A child doesn't move into an adoptive home and become cured. But it's still better to see that child in a home, because every child deserves a home. And it's better for the state, in terms of expense -- and that doesn't even point to the costs to society when kids stay in the social-service system for long periods of time."
County social-service departments are required to move children out of the foster system and into permanent adoptive homes within twelve months of their removal from their original homes, thanks in part to Colorado's Expedited Permanency Planning policy, which was approved by the Colorado Legislature in 1994. But the demand for permanent homes far exceeds the supply -- and some parents wind up taking in high-risk children without a full understanding of the difficulties ahead.