Last month we saw the tragedy of a little boy, flying alone on an airplane to Russia returned by his adoptive mother to a place he barely recalled. This sad event became an international news story, if not an international incident. As with many tragedies, this one could have been prevented.

Intermountain, a 100-year-old children's agency, in Helena has worked for the past 28 years with families just like the one in the new story - families who are trying to raise children whose early years were spent alone in a crib lined up against the wall, or in chaos and trauma. We know that many of these children come into relationships unable to respond to the soothing or nurturing that parents offer. Instead, normal frustration turns into rage, and most of the rage is focused on the mother who is trying to soothe the child.

So, what's a mother to do? Mothers and fathers of these children must provide more than the average amount of structure that would normally help a child feel safe. They must, in a patterned, repetitive way, override their own propensities towards anger and frustration and soothe and contain the child often in ways that are appropriate for much younger children. They can rock the child in a rocking chair and play sensory-motor games even if the child is 10. These parents must regulate themselves as they feel the frustration and fear grow, and they must seek support and help to be the therapeutic parent that will help this child emerge from the isolation of fear into relationship.

Most parents cannot do this alone. They need the support and direction of therapists, case workers, teachers, psychiatrists, case managers, bureaucrats and insurance agencies who understand what early neglect and trauma does to a child's brain; who understand that parents need to learn specifically how to attune to a child who screams in rage when he really feels lonely or afraid. They need to learn how to take the child's relentless assaults less personally. And they need rest and respite, support and structure, because this is one of the most demanding jobs there is - to raise the unwanted children of the world.

In Helena and in Montana we have the expertise and the resources for this work. Intermountain trains parents and professionals all around the state, and has influenced the work and understanding of these children and families as far away as Scotland and Australia. In residential treatment, community-based services, and through public education, Intermountain works with children and families just like the family of the little Russian boy.

There are centers of excellence around the state, like the Partnership for Children in Missoula and community clinicians in Bozeman, Helena, Missoula and Kalispell who have specific training and expertise in working with attachment disturbances. The funding can be difficult to obtain and the children present as confusing constellations of disturbance that don't neatly fit into fundable categories. But there are answers and there is help.

Without that help even the most loving of parents can become so exhausted and defeated that they do the unthinkable - they abandon the very child they had hoped to save. It doesn't have to happen, especially in Montana.

About the Author:
Elizabeth Kohlstaedt, Ph.D., has been the clinical director of Intermountain for 20 years. For information about Intermountain, contact Sami Butler, RN, Professional Relations Manager at 406-457-4744 or samib@intermountain.org, or visit www.intermountain.org.