Orem schoolteacher Terri Sherrell loves her 13-year-old daughter desperately, but she just can’t have her in the home right now.

Having adopted her at 28 days old, Sherrell watched her daughter — who had already been in eight other homes — scream nonstop from the adoptive agency in Georgia to her new home in Utah. A year and a half ago, Sherrell placed her daughter in another home in Utah Valley to protect Sherrell’s four other children from their violent older sister.

“She will rage for just about any reason and the rages can last from six to eight hours,” Sherrell said. “She has tried to attack people with a shovel and pieces of furniture. … No matter what else is going on, if (she) isn’t the center of attention, she tries to sabotage it.”

Psychiatrists have diagnosed Sherrell’s daughter with reactive attachment disorder, a condition characterized by violent outbursts, complete withdrawal or unchecked affection toward strangers. And while parents and clinicians throughout the nation are divided on what type of therapy is most appropriate, they have all reached one conclusion: simply loving a RAD child isn’t enough.

Reactive attachment disorder is one of the newest mental diagnoses for children, and no statistics exist for how widespread the disorder is, said Douglas Goldsmith, executive director of the Children’s Center in Salt Lake City, a nonprofit organization created to help children with mental disorders. The RAD diagnosis first showed up in medical journals in the 1980s.

However, the problem goes back much further, Goldsmith said, with diagnoses of children “who can’t reach out” or are “not affectionate” showing up in medical reports in the early 1900s.

“One of the problems is that it is still not very well understood,” Goldsmith said, adding later, “There’s not an appreciation of how new this is.”

Some parents have chosen to take their children to holding therapists, who employ methods of lying on top of children, yelling into their faces and forcing children to come to their parents for comfort.

This unorthodox treatment has come under fire from both the medical community and lawmakers, prompting a bill last year in the Utah Legislature to ban certain holding therapy practices. The bill failed however, and the debate continues over which therapies are most effective.

For Malory Alderink’s son Jeremiah, finding the right therapy was to be a lifelong process. Having adopted Jeremiah at 16 months, Alderink believed that despite her son’s war-torn first year in Liberia, she would fill his life with love and he would slowly recover.

Instead, she watched as Jeremiah interpreted her love over the years as an attack on his carefully constructed world of self-preservation. Instead of loving back, she said he lashed out by kicking, biting, screaming and, when he was older, threatening to kill both his parents and brothers and sisters.

“I’ve been taken hostage by this little kid,” Alderink said of their first few years together.

Even now, six years and tens of thousands of dollars in therapy later, Jeremiah still struggles with many of the same issues.

“The earliest message they get is, ‘I’m in this world alone,’ ” Alderink said. “It’s the survival instinct that kicks in.”

The only description by the American Psychiatric Association of a RAD child is one who is either completely inhibited and refuses to form emotional attachments or has no inhibitions and tries to connect with anyone.

RAD appears in children before the age of 5 who have received severely abusive or negligent care, Goldsmith said. They have often been moved around and seen as many as 15 different foster homes by this age and have learned not to trust those who are responsible to give them care.

“There is no question these are hard kids,” said Vicki Cottrell, executive director of the National Alliance for the Mentally Ill in Utah.

Cottrell, whose organization provides support networks for parents and RAD children, said many children with RAD are adopted from foreign countries and were shuffled around from place to place in the first critical years of their lives, making attachment almost impossible. When they finally find a secure home, they reject the parents who try to give them love.

Showing no or very little trust, the children “basically act like they really can’t stand you or have any use for you,” Cottrell said.

Cottrell said when parents come to her, she first encourages them to make sure their child is properly diagnosed. Once the child is diagnosed, she helps parents find the best treatment from those available. She encourages parents to become involved in a support group as they struggle with their RAD child.

“It’s very important the parents get the support they need,” Cottrell said.

Jeremiah, who could be the most charming child to everyone outside the home, directed almost unchecked rage at the Alderinks. One form of showing his anger toward his new parents was defecating on the rug and smearing feces behind the couches. He would even do this within just a couple of feet of the toilet.

“This was his way of saying, ‘See I could have made it, but this is what I think of you,’ ” Alderink said.

With Jeremiah turning 8 next week, Alderink said he has made some real progress both as certain therapies have taken hold and she has managed to work through some of her own issues. By better understanding his behavior, Alderink says she doesn’t look at him so much as the perpetrator anymore, but rather as the victim he really is.

Still, she said his future could go either way.

“I have all hopes for him,” she said. “I think by high school he could be a kid that no one would know had any real problems.”

On the other hand, if Jeremiah is not given the right therapy, “there is a serious consideration that he could be out of control,” she said. “We haven’t gotten over the hump of losing him to residential care.”

Sherrell said she feels life will always be hard for her daughter, but she hopes she and her husband will continue to build a relationship with their daughter through the years.

Meanwhile, they will continue to give their time, money and love to a girl who has drained them of almost everything.

“You’re either rich or you sacrifice your life,” Sherrell said.

Jesse Coleman can be reached at 344-2549 or jcoleman@heraldextra.com.

This story appeared in The Daily Herald on page A5.