“Dr. Ronald Federici Saved Our Family”

We saw Dr. Federici in October of last year. Our 11-year-old son, adopted at age 8, spent the day alone with Dr. Federici while a myriad of tests were run. The second day, the entire family (including 12-year-old bio son) learned some new techniques for living together with Dr. Federici.

Our son was diagnosed FAE by a pediatrician that specializes in developmental delays less than a year earlier. Because we have no expert in our area when it comes to International Adoption or FAS, we wanted a second opinion. Dr. Federici diagnosed him full FAS and severely delayed (No surprise to us).

The 30-page report we received from Dr. Federici Outlined the testing results and also recommendations for future life. He also recommended specific medication.

I truly believe Dr. Federici saved our family. If we had not Had the appointment already made, we surely would have been looking for some kind of alternative living arrangements for our son. Dr. Federici said our son is not a “conduct problem”, but that he has a “trauma problem. He surely learned some negative behaviors in the orphanage, but Those can all be unlearned. Dr. Fed suggested we work on the trauma before anything else, and then other more positive characteristics will have room to shine.

[name redacted]

P. S. Our son is now 11 years 7 months old. He is still in early second grade. Children with FAS can learn, it just comes excruciatingly slow. They can also be quite bright in some areas.

Ronald Federici Interview

An interview with Ron Federici can be found here.

An Adoptive Mother Writes…

I highly recommend Dr. Ronald Federici. He’s a neuropsychologist in Alexandria. He specializes in adopted kids, and is a father of 7 older adopted kids. His book “Help for the Hopeless Child” is great. I had him evaluate my daughter and traveled from Atlanta for that.

Proud Mom to Alesia, adopted from Russia in 2004, and her little brother Michael, adopted from Kazakhstan in 2007!

Adoption from Economically Deprived Countries

Neuropsychologist Dr. Ronald Federici specializes in evaluating post-institutionalized children from economically-deprived countries. Federoco blames noxious chemicals for interfering with brain growth. Pre- and post-natal exposure to alcohol, nicotine, heavy metals and pesticides damages the child’s central nervous system. The result: mental retardation, attention deficit disorder, learning disabilities, developmental delays or behaviour disorders.

Specialty: Difficult Cases

1. Cases previously unresponsive to treatment
2. Court involved cases and forensic neuropsychological evaluations
3. Social Services/Child Protective Services (cases involving abuse and neglect)
4. Neuropsychological evaluation of Post-Institutionalized Children (assessment of neurodevelopmental disorders and differential diagnosis of bonding and attachment disorders: psychological vs.  neuropsychological)

I Never Could Have Imagined

‘I Never Could Have Imagined’

Dignity Was Denied the Dead as Bodies Were Stored and Handled Using ‘Disturbing’ Methods, Area Funeral Home Workers Say By Josh White Washington Post Staff Writer

Sunday, April 5, 2009; A01 Ronald Federici’s father, a retired Army colonel, had just died, and Federici wanted to escort his body to Demaine Funeral Home in Alexandria. But the driver who came to pick up the remains at the hospital said he wasn’t going to Demaine, he was going to some other place. Upset and confused, Federici followed the van driver, who pulled up to National Funeral Home in Falls Church. When the white garage door opened at the edge of a cemetery just off Lee Highway, Federici said, the foul odor of decomposition smacked him in the face. A body lay on a gurney in the garage near a rack holding coffins, and the walk-in cooler where his father was to be left was filled with exposed bodies. “The stench was horrific,” Federici, 53, said about the cooler. “Bodies were laying buck naked all over the place. There was no dignity whatsoever. It was disgusting, degrading and humiliating.” What Federici witnessed Dec. 6 echoed what embalmer-turned-whistleblower Steven Napper had been complaining about for months, first to his supervisors, then to the state. Napper documented the atrocities he saw in notes and photographs and turned them over to authorities. Napper, a retired Maryland state trooper, had been hired in May by National Funeral Home, which also acts as a regional clearinghouse that embalms and stores bodies for four other Washington area funeral homes — Arlington Funeral Home, Danzansky-Goldberg Memorial Chapel in Rockville, and Demaine Funeral Home in Alexandria and Springfield. From May to February, when he quit, Napper said that the walk-in coolers could not hold all the bodies and that a manager told employees to store them in unrefrigerated areas.

During his time there, Napper said, as many as 200 corpses were left on makeshift gurneys in the garage, in hallways and in a back room, unrefrigerated and leaking fluids onto the floor. Some were stored on cardboard boxes or were balanced on biohazard containers. At least half a dozen veterans destined for the hallowed ground at Arlington National Cemetery were left in their coffins on a garage rack, Napper said. He began to take photographs in December and presented them to the Virginia Board of Funeral Directors and Embalmers. Federici and Napper’s observations — accounts supported by three others who have worked there — have led to a probe by the state board, although board officials said they were prohibited by law from disclosing such an inquiry. Several people said they were interviewed by a board investigator in recent weeks. What was supposed to be a dignified end to thousands of lives had instead deteriorated into a haphazard operation, Napper said, more about money than honoring the dead. Part of the largest funeral services conglomerate in the world — Houston-based Service Corporation International — the company did not want to spend money to address the issues, Napper said supervisors told him. “It was disturbing and disrespectful and unethical,” Napper, 34, said. “I never could have imagined what I saw there or the things we were asked to do. These are people’s loved ones, and they never should have been treated this way.”

Representatives from Arlington Funeral Home, Danzansky-Goldberg Memorial Chapel, Demaine Funeral Home in Alexandria and National Funeral Home referred calls to the SCI corporate offices in Houston. Robert Malinow, location manager at Demaine in Springfield, said he was not aware of anything other than the highest standards at the central facility. “Service Corporation International has always represented to me that we carry out the highest standards and professional behavior within our industry and that we do not tolerate exceptions to those rules,” Malinow said. “Behavior such as this would not occur at my location. We do not tolerate this behavior, and we only ascribe to the highest standards.” J. Scott Young, president of SCI Virginia Funeral Services, said the company is conducting a thorough investigation of the “disturbing allegations.” “I can assure you that our company takes these allegations very seriously,” Young said in a statement. “Thus far, we have not found any evidence that supports the allegations. We have inspected our preparation facilities and found them to be completely sanitary and in compliance with all applicable laws and regulations, including OSHA. Our company is committed to treating all human remains with the utmost dignity and respect at all times.”

Young also said that SCI officials place “great importance on the condition of our facilities and invest significant resources to ensure that they comply with the highest professional standards.”

Napper, who was one of two embalmers, said as many as 2,000 bodies from the five funeral homes affiliated with SCI move through the regional care facility, sometimes called “Central,” at National Funeral Home each year for embalming, cosmetics, dressing and storage, overwhelming its facilities. Some bodies waiting months for burial at Arlington are stored in the garage and are subject to external temperature changes, Napper said. When he was hired in May, Napper was not aware that National Funeral Home had just been placed on three years’ probation for unsanitary conditions. SCI, which owns more than 1,700 funeral homes in the United States, has been accused of problems before, such as in the Menorah Gardens case in Florida. Customers filed a class-action lawsuit against SCI alleging that funeral homes in the chain desecrated vaults, oversold cemetery plots, and removed bodies from grave sites and dumped them in the woods in 2001. SCI settled the case out of court for $100 million in 2003. Lisa Hahn, executive director of the Virginia Board of Funeral Directors and Embalmers, said she could not confirm a current investigation or discuss specific allegations. Hahn said, however, that pools of body fluids left on the floor of preparation and storage areas “would likely be a violation of the laws and regulations.”

The board oversees funeral operations in the state and can impose sanctions ranging from fines and probation to license revocation. Although Virginia law does not require funeral homes to have refrigeration equipment, “inappropriate handling of dead human bodies” would violate the law, Hahn said. Further sanctions against a funeral home on probation in Virginia could lead to license suspension or revocation, Hahn said. Melissa Williams, executive director of the American Society of Embalmers, said storing a body in a coffin in a garage over a long period almost certainly would cause the corpse to mold and decay, and she said such storage would “not be a funeral profession acceptable practice.” Williams said she believes most funeral homes operate with high standards. “I don’t see how anyone could see that kind of scenario as being treated how they’d want their loved ones treated,” Williams said.

After the body of his father, Army Col. Anthony Federici, 88, was dropped off at National Funeral Home, Ronald Federici called Demaine officials the next day and later spoke with SCI’s regional market manager. Federici said that both said there must have been a misunderstanding. “I told them I stood there, that I was right there, and that I saw it with my own eyes,” said Federici, a McLean child neuropsychologist. “I said that it was a disgrace and an abuse and that I had caught them red-handed.” Federici reported his concerns to the Virginia Occupational Safety and Health Administration in late December, and officials there sent a letter to National Funeral Home asking it to investigate. Because an employee did not make the complaint, the agency’s policy is to address the issue by correspondence, said Jennifer Wester, a spokeswoman for the Virginia Department of Labor and Industry. National Funeral Home’s general manager at the time, Kevin Hough, wrote in a letter to state officials dated Jan. 2 that the conditions never existed. “National investigated the allegation that our equipment and environmental surfaces were not cleaned and decontaminated after contact with blood or other potentially infectious materials,” Hough wrote in the letter. “Our investigation did not substantiate the allegation.”

Keith Stringfield, 36, the van driver Federici followed to Falls Church, is a licensed funeral director who has been in the business for more than 13 years. Stringfield said Federici’s insistence on following the van led him to see things customers would not normally see. Stringfield said conditions at the funeral home were often “very unfavorable.” Stringfield said he and other contracted van drivers were instructed to leave bodies in the garage if there was no room in the coolers, something Stringfield refused to do. He said he spoke to a board investigator about the situation last month. “You don’t leave a body uncovered. You don’t let a body leak. You don’t leave a body on a stretcher in the garage,” Stringfield said. “But who’s going to see it?” Another employee, who spoke on condition of anonymity because he feared being fired, said that managers told workers to put bodies on the racks in the garage and that there are bodies in those coffins “constantly.” He also said the condition in the coolers and the garage disgusted him. “A lot of the bodies that are there are there for a week or a month, and they’re just sitting there dripping on the floor,” the employee said. “The families don’t know anything about it because the families aren’t allowed at Central.”

Marian Savage had no idea where her grandfather’s body would be stored before burial at Arlington, but she assumed that Demaine Funeral Home in Springfield would keep it in a refrigerator, much like the spotless morgue at the hospital where she works as the director of quality. Instead, retired Army Col. Andrew DeGraff’s body was placed in his coffin and left on a storage rack in the garage, Napper said. Photographs show the coffin on the rack weeks before his burial, and Napper said he lifted the lid and saw DeGraff’s uniformed decomposing body inside. DeGraff, a career Army officer who was close to the family of Gen. Peter J. Schoomaker, a former Army chief of staff, gave everything to his country, his family said. He was especially close to his grandchildren because his only daughter died at a young age. When DeGraff died, Savage said, she was encouraged to do a viewing almost immediately because the funeral home told her that the body wouldn’t keep until burial. She thought that strange because her grandmother, who was buried at Arlington a year earlier, had an open casket at her service two months after she died. On Jan. 2, the day of DeGraff’s burial at Arlington, Savage’s 4-year-old daughter, Sophia, went up to the coffin and asked to see “Papa” one last time. Savage decided not to disturb the American flag and flowers adorning the cherry coffin. She had no idea then that her grandfather had significantly decomposed. Upon learning about how her grandfather’s body was stored, she was stunned. “Most people don’t want to think about it, but you expect it’s going to be taken care of the right way,” Savage, 35, said. “Of course, you have no idea what’s going on behind closed doors, but this just can’t be acceptable.” Savage’s younger sister, Grace Wozniak, said she remembers how moving it was to walk behind the caisson at her grandfather’s burial with tourists and strangers looking on. “They all stopped. They all showed respect,” Wozniak, 34, said.

“Everyone respectfully watched this soldier go off to his grave. If strangers had the wherewithal to show this respect, it hurts me that this funeral home couldn’t give him even that minimal level of respect.” A light oak coffin containing a body was placed next to DeGraff’s on the storage rack, and, according to records and family members, it belonged to another veteran Army officer who died last year and waited months before burial at Arlington. That retired officer’s family members asked that his name not be used in this report but reacted with outrage and dismay. They said a funeral home official at Demaine assured them that their father’s body would be refrigerated until he was buried. “I have been in tears since the minute I heard about it,” the officer’s son said.

Having to place the veterans’ bodies on the garage storage rack was about as much as Napper could stomach. The son of a veteran, Napper said he was saddened to see people in uniform treated that way. Even worse, he said, was what his supervisors instructed embalmers to do before the bodies were shipped to Arlington. Napper said he was told to put scoops of an industrial deodorant powder, Dodge Company’s D-12, all over the bodies to ensure that odors wouldn’t be detected by officials at the public cemetery. Arlington’s protocol is not to accept coffins that have bad odors or leaks, said Kaitlin Horst, an Arlington spokeswoman. “The concern is that if the odor is too offensive that the casket team can’t carry it, or if there are other concerns with leakage, they will send the remains back to the appropriate funeral home,” Horst said, adding that it is a “very, very rare” occurrence. Napper said he went into embalming and funeral directing after leaving the Maryland State Police because he wanted to help people at the end of their lives. His decision to report what he saw at SCI was difficult, but Napper said he believes he owed it to the clients he was serving. He and another embalmer, who declined to be identified, left SCI in recent months. Napper has landed another funeral directing job at a local firm. “I spoke out because what I was seeing just wasn’t right,” Napper said. “Someone needed to stand up for these people.” Wozniak said she wanted to thank him for coming forward with information she would not have learned otherwise. “It’s not something I wish I would have known, but this can’t remain hidden, and this can’t go on,” Wozniak said. “Other families can’t have this happen to them.” Staff researcher Julie Tate contributed to this report.

Interview with Ronald Federici

Haley is five years old, mildly autistic and out of control. She’s one of a growing number of children with severe aggressive behavioural disorders. One minute she is hugging her mother, but seconds later she is biting and punching her. Her aggression towards other children has put her on the verge of being withdrawn from school and her parents are desperate.

Sergei is 12 years old. He is withdrawn, depressed and violent. He was found wandering the streets of St Petersburg at the age of five. Nobody knows what happened to him in those first five years. He was put into a Russian orphanage until he was adopted three years later by an American family. But the only interaction he has with his new family is through rage and physical attacks on his adoptive mother. As with Haley, no treatment, doctor or psychologist has been able to help… until now.

Dr Ron Federici is an American neuro-psychologist who specialises in working with institutionalised children (he has spent a good deal of time in orphanages in Eastern Europe, and has fostered seven of the orphans himself). Federici believes that what disturbed children need most are rules, structure, and a sense of order imposed on confused emotions and he has devised a treatment plan for even the most extreme cases of conduct-disordered children. He claims it is suitable no matter whether their behaviour lies in neurological or psychological problems and that it guarantees two things: firstly, that there will be an 80% rate of improvement in most children; and secondly, that neither the parents nor the children will enjoy the process – quite the opposite, in fact.

For at least 30 days, the child must stay within three feet of its parents, 24 hours a day. They have to be totally compliant to whatever their parents want and if they refuse to obey they are forced down onto the floor and held there. Their bedrooms are stripped bare; they are never left alone, nor allowed to see friends. Then, through a gradual process of reward and punishment, the child will eventually be reintroduced to their toys, their peers and the outside world. The treatment can last for months.

Horizon follows the families as they start to implement the treatment programme under the supervision of Dr Federici himself. He claims this is the only way the child can progress to developing normal emotions. His critics believe this process may be damaging. Thousands of American families are already keen to begin the programme, but does it really work and should it be applied?

TRANSCRIPT

CHARLIE MORTON: When he comes into the room he wants what he wants now and if he doesn’t get it he’s liable to attack you. He’s 12 years old and the kids that did Columbine and shot those people in the school at 14 or 15 and I’m not saying that that’s where he’s going to end up, but if you ask me could it happen I’d have to say yes.

(HAYLEY KEW’S TANTRUM)

JULIE KEW: People have said to us it, it’s a phase, she’ll grow out of it, but she’s been like it since she was 4 months old. She’ll, she won’t grow out of it.

(TANTRUM CONT’D)

NARRATOR (ADEN GILLETT): Coping with children with severe behavioural disorders is becoming a widespread issue. These parents are now forced to live with their children’s increasing aggression and violence. It’s a complex problem with no easy answers. Now one man is offering an extreme solution, but it requires parents to go against their deepest instincts.

DR. RON FEDERICI: There is a solution. The solution lies within the family. It’s difficult for the parents to hear but parents have to be able to give up what they believe is the right way to parent their child.

GLORIA MORTON: There’s just a lot of anger, a lot of contempt for people, a lot of hate.

NARRATOR: Sergei was found at five years old on the streets of St. Petersburg. Very little is known about his childhood, but it was clearly traumatic. He was adopted by the Morton’s from a Russian orphanage four years ago when he was eight. The Morton’s have adopted two other Russian children, but they behave nothing like Sergei. His adoptive parents say that he is depressed, violent, that he hates being near them and isolates himself.

GLORIA MORTON: Can you calm down just a little SERGEI MORTON: Shut up.

CHARLIE MORTON: When we were coming home from a dinner one night he attacked both his brothers, tried to choke his younger brother and even attacked his big sister. Now how much more violent is he going to be than he is now, when he’s stronger and bigger and maybe find a gun some place. Are you done? You don’t want to sit and talk?

SERGEI MORTON: No.

NARRATOR: His mother is frightened of him. His father, not wanting to physically fight with Sergei, no longer confronts him. The parents assumed that his troubled childhood was the cause and sent him to psychotherapy for 4 years. However they feel it changed nothing. Sergei is getting more violent.

INTERVIEWER: Do you understand why your Mum and Dad get upset with you sometimes?

SERGEI MORTON: Yes.

INTERVIEWER: Why do you think that is?

SERGEI MORTON: ‘Cos I’m nasty to people.

(HAYLEY KEW’S TANTRUM)

IAN KEW: She’s a lovely little child, but has an explosive behavioural problem.

JULIE KEW: She comes up to you and, and she says I love you Mummy. She gets hold of you and she gives you a squeeze and then it’ll turn to a pinch or she’ll headbutt you.

IAN KEW: The progression, it’s just been steady.

NARRATOR: Hayley is nearly 6 years old. She rages half a dozen times a day without provocation. She regularly attacks her mother, punching and biting her for no reason. Because her aggression has extended to attacking other children, Hayley has now been excluded from the school playground.

JULIE KEW: I went in the first day and I was with her and while I was there she’d turned round and bitten the little girl next to her and poked her eye.

(HAYLEY KEW’S TANTRUM)

NARRATOR: Hayley has been diagnosed with learning disabilities and a mild form of autism. This tends to make her inflexible and hyperactive. Her parents have sought help from many doctors, but none has offered the hope that he behaviour could really change.

From his Washington practice Dr. Federici claims an 80% success rate in his treatment of thousands of children in America suffering from what he believes are attachment disorders. His treatment is totally surprising. Where conventional psychology would emphasise love and understanding he insists the answer is not love.

RON FEDERICI: So often families feel that the best intervention they can give is unconditional love, affection, patience, time and talking to their child and that turns out to be the incorrect mode of dealing with the child.

NARRATOR: Dr. Federici’s treatment means reversing the normal rules of parenting. He believes the starting point is not love, but control, that through the parents almost military control these children will grow to trust, feel secure and ultimately attach, but will it work? Hayley and Sergei have now been diagnosed by Dr. Federici as having attachment problems and are about to start this radical treatment.

NARRATOR: The first stage of the treatment plan starts at level 1.
Sergei will be confined with his parents for at least 4 weeks. He must stay within 3ft of them 24 hours a day. They will be his sole influence.

RON FEDERICI: Show me 3ft. 3ft means 3ft. If I cannot touch you then you’re too far away. Follow instructions right away. Serge, get up, the answer is?

SERGEI MORTON: Yeah.

RON FEDERICI: Yes sir, I will. Your Mom and Dad are in charge of everything, meaning that you have to ask for permission. Excuse me, may I go to the bathroom? Excuse me, may I read a book? The answer is no unless your father says Serge, you can read a book with me. You cannot do anything alone. He cannot do anything alone because he likes to run away and if he runs to his room, take the doors off.

NARRATOR: The next step is to take away Sergei’s world and replace it with that of his parents. From now on they will be his life, they will even sleep here in his room. Everything else will be removed.

RON FEDERICI: OK? Everything gets boxed up, taken, toys, everything off the wall and we just have bed, pillow, Mom’s bed, sorry, Dad’s bed.

CHARLIE MORTON: We’re going to start the programme off bad today? Do you have any homework?

SERGEI MORTON: Yeah, I do.

CHARLIE MORTON: Go get it.

SERGEI MORTON: No.

CHARLIE MORTON: You don’t tell me no. Now go get your assignment. That’s it, throw it, that’s one demerit.

SERGEI MORTON: I’m not doing it with you Dad.

CHARLIE MORTON: You are doing it with me.

SERGEI MORTON: No I’m not.

CHARLIE MORTON: That’s 2 demerits.

NARRATOR: Charlie is trying out the 3ft rule. He must continually monitor and instruct Sergei on how to behave well. Controversially for a child treatment programme there is no school, no peer activities, no privacy. Three acts of disobedience and an extra day is added to the programme.

NARRATOR: Dr. Federici believes that Sergei barely has an identity and that a new one must be imposed.

RON FEDERICI: Critics may say that to control a child’s every movement in time and space is taking away his identity. Well we’ve established very clearly that he doesn’t have an identity and he’s an empty slate and what we are providing is not a control really per say, but a management and a structural modification of his day-to-day, hour-to-hour routine so he does not deviate and it may be dictated by the parents, but it has to be because left to his own devices he’s random and confused. He needs to be dismantled and taken apart.

PROF PETER FONAGY: I’ve major worries about this notion of knocking things down in order to build them up. The normal approach to cheating behavioural disorder of this kind is to help the parents understand the child better. What is so vulnerable in these children is their sense of themselves, their sense of who they are. Now if you are systematically undermining that very fragile, that very vulnerable sense of who that child is you could end up in the situation where the child becomes really very much more depressed and hopeless and helpless.

NARRATOR: Dr. Federici has an international reputation for working with institutionalised children and it is through his work with these children that he developed his unusual treatment plan.

RON FEDERICI: Most of my experience has been working with very damaged children in institutional settings in Eastern Europe such as Romania and also within the United States, seeing many children abused, neglected and severely deprived.

NARRATOR: From what he has learnt in these orphanages Dr. Federici has come to believe that many child behavioural problems stem from a lack of attachment and he has now developed a theory about how to help all unattached children, no matter what the cause of their problem. He now applies his theory beyond the orphanage to children who have failed to attach, for whatever reason, even to those brought up in ordinary homes.

HAYLEY KEW: I want to make you well.

JULIE KEW: So what are you doing then?

NARRATOR: Desperate for a solution, the Kew’s have also turned to Dr. Federici. He’s aware of Hayley’s autistic traits and believes they have inhibited her attachment to her parents. To put the parents in control Dr. Federici believes Hayley must learn to obey every instruction. Her parents must no longer negotiate, but dictate to her.

RON FEDERICI: So if we talk about breaking Hayley down, which she will not like, you have to maintain a boundary with Hayley and that you have to take a break on hugging her and letting her sit on your lap. Be a bit detached and watch the I love yous, the pleasantries, the honeys. She uses that to reinforce her bad behaviours. OK, Dad, if you were to practice right now and say Hayley, you will sit on the couch now and if she does not you pick her up and sit her on the couch.

IAN KEW: I mean I’d tell her, but she wouldn’t do it.

RON FEDERICI: I understand that (TALKING TOGETHER)

IAN KEW: Hayley, you go and sit on the couch over there.

HAYLEY KEW: I don’t really.

RON FEDERICI: See we have a problem. If you would do that now.

IAN KEW: Hayley, go and sit on the couch.

HAYLEY KEW: No, no, I want Mummy, (REPEATS THIS MANY TIMES)

RON FEDERICI: Just the way she should be. (TANTRUM CONT’D) It’s very painful for you to watch. (TANTRUM CONT’D)

NARRATOR: Dr. Federici believes a child will only learn to comply when it realises its parents are dominant. Controversially, Hayley is to be placed face down in a hold every time she disobeys. When she is calm she is to be comforted.

RON FEDERICI: She will have to learn and Mom will have to have her hands on here, so Hayley has some control from both parents. She could not transition from sitting on your lap to a simple order of sit on the couch. Give her an order to sit up on the couch and she…

IAN KEW: Hayley, sit up on the couch darling.

RON FEDERICI: No, no darling. Just sit up on the couch.

IAN KEW: Hayley, sit up.

JULIE KEW: Hayley, sit up.

IAN KEW: Sit up.

DR. F: Sit up on the couch.

DR. STEPHEN SCOTT: I can see the attraction for a very frustrated parent with a child who’s being very aggressive, kicking and spitting, that you do indeed need to get control and certainly I would agree one needs to have firm boundaries but not an arbitrary set of boundaries, so just to say I want to see you to sit over there for no apparent reason and to have instant obedience to that it’s not something they usually do and the child can’t see a reason for it.

RON FEDERICI: Did Hayley go sit on the couch? Say yes. Say yes.

HAYLEY KEW: Yes.

RON FEDERICI: Are you tired? Say I am tired.

HAYLEY KEW: I’m tired.

RON FEDERICI: Yes you are tired. Very good girl, very good girl. You’re tired.

NARRATOR: A sequence one hold will be used with Sergei, as with Hayley, to put the parents in control.

RON FEDERICI: I just want to show you something. There’s no problem now because you’re not fighting or being angry, so I’m showing you I’m not going to hurt you. We would never ever, ever hurt you, never, but you can never hurt us because the most important thing is to go down. You can go down, go down.

SERGEI MORTON: I have to?

RON FEDERICI: Yes. Down.

SERGEI MORTON: OK OK

RON FEDERICI: Down, down, lay down. You do anything violent, Mom and Dad will take you down to get you in control. There will never be fights. If he tries he goes down. He goes down for hitting, kicking, spitting, cussing in your face, screaming, breaking property, slamming doors. Where he’s out of control he must go down immediately. Now how do you feel Serge? Do you like this?

SERGEI MORTON: No!

RON FEDERICI: Not bad huh.

SERGEI MORTON: I said no.

RON FEDERICI: No, OK.

SERGEI MORTON: Can you get off me now?

RON FEDERICI: No.

SERGEI MORTON: Guys.

RON FEDERICI: There’s not being hurt.

SERGEI MORTON: No my toe is twisted. It still hurts from a long time ago.

RON FEDERICI: He may choose to make up all kinds of stories.

SERGEI MORTON: It’s not, I’m not making it up.

RON FEDERICI: He’s very angry.

SERGEI MORTON: I’m not making it up.

RON FEDERICI: Once he was down I think he felt, it was the first time I’d seen the boy cry at that level. The parents said they’d never seen him cry those type of tears. He didn’t complain of being hurt aside from some ridiculous statement that his toe was hurt and there was no pressure, there was no force, there was nothing dangerous. I think he felt safe for the first time and also that his parents cared enough for him to be on top and in charge of him because he’s not in charge of himself.

SERGEI MORTON: Mom, you can let one arm…

NARRATOR: Most psychologists only accept the use of restraint in the most extreme circumstances. They would not accept that a child would find the hold reassuring.

RON FEDERICI:..and Serge, don’t move.

PETER FONAGY: I think there’s a real danger in assuming that we know what’s going on in the child’s mind. How do we know that that child is going to interpret two parents trying to physically restrain him as an act of affection.

NARRATOR: The Kews are 2 weeks into the programme.
Both parents have taken time off work. Hayley’s room has been stripped.

JULIE KEW: Let me show you
first. Let go.

NARRATOR: She’s been taken out of school. Her world is her parents and they must be emotionally distant.

JULIE KEW: We have to try and be aloof from her
which I’m finding very difficult.

JULIE KEW: She has no toys, she, she doesn’t see any friends, she does no activities. We have to control her singing and her talking because when she does these things she’s actually in her own world where she has to be in our world and she finds that very difficult.

HAYLEY KEW: (INAUDIBLE REMARK)

IAN KEW: Let go.

HAYLEY KEW: I want it, I want it, I want it.

NARRATOR: When Hayley disobeys her parents are instructed to put her in a sequence 1 hold. This is happening several times a day.

(HAYLEY KEW’S TANTRUM)

IAN KEW: I mean you know you’re taught to love your child, hold your child, kiss her, cuddle her, give her all the support possible and this totally throws that out the window.

JULIE KEW: Are we destroying her? I want a better behaved Hayley, I don’t want a different Hayley.

STEPHEN SCOTT: My worry about such a severe approach is that it is actually at risk of being quite punitive, of frightening the child and of just repressing their behaviour so the kind of child this is bringing about is one who is instantaneously obedient, who doesn’t start thinking for themselves and doesn’t start adapting to their environment.

NARRATOR: Dr. Federici is still at the Mortons. Today he will teach them a new technique, a sequence 2 hold.
This requires Sergei to sit on his parents lap to learn about closeness and attachment. Sergei will find it hard as he has not let his mother embrace him for over a year.

RON FEDERICI: Eyes, only eyes, only eyes. Stand up.

NARRATOR: Dr. Federici believes Sergei can be taught how to feel and understand emotion by looking at his parents facial expressions and feeling their embrace.

RON FEDERICI: Is he looking at you Mom, or looking around you?

GLORIA MORTON: He’s looking at me.

RON FEDERICI: OK, good. This is a lot better for him than being on his own. This, this is much more positive than fighting with you. Is he still looking?

GLORIA MORTON: Yes he’s wandering a little.

RON FEDERICI: What they’re learning basically is a new language called emotions. They may have learned English, they may have learned another language, but the new language of emotion is one of the ones that’s the most important they will learn by practice.

GLORIA MORTON: I’m very proud of you when you do that.

STEPHEN SCOTT: They’re not re-writeable like some computer disc. Nearly all children who are behaving anti-socially do have a full range of emotion, they do understand happiness and sadness, so the notion that they’re all scrabbled up inside and you’ve got to cut through all that, I think is a mistaken one. I think it’s about reshaping and re-directing their emotions.

NARRATOR: Dr. Federici would disagree. He has now left the Morton’s and the treatment is in their hands.

GLORIA MORTON: I was surprised at the look of fear on his face when he sat on our lap, that he didn’t know what we were going to do.

CHARLIE MORTON: I don’t think it’s going to be easy, but it’s step by step. I mean he’s even reverted already. He’s telling us what to do and, and the doctor hasn’t been gone, what, two hours, so we can expect that.

GLORIA MORTON: Cut that streak.

SERGEI MORTON: What? (INAUDIBLE) the ground and it slipped.

GLORIA MORTON: (INAUDIBLE REMARK)

NARRATOR: Gloria decides to attempt a sequence two hold.

GLORIA MORTON: (INAUDIBLE REMARK) Turn around.

SERGEI MORTON: No.

GLORIA MORTON: Yeah, you’re doing it.

SERGEI MORTON: No.

GLORIA MORTON: Turn around. (TALKING TOGETHER)

SERGEI MORTON: …you’re doing this to me.

GLORIA MORTON: I’m just having you turn around.

SERGEI MORTON: Mom, your nails.

GLORIA MORTON: Put the car down, there, on the table. That’s the floor isn’t it? Is that the floor? What is it?

SERGEI MORTON: (ANGRY REMARK)

GLORIA MORTON: Come here, turn around.

PROF PETER FONAGY: If you are imposing proximity in the hope that you will impose attachment then you will quickly realise that that’s a paradox. Attachment is perhaps one of the only things in life that one cannot impose.

NARRATOR: The Kews are six weeks into the treatment. Hayley’s non-compliance has added another three weeks to level one. Nevertheless, her parents now feel she is showing an improvement.

JULIE KEW: I think, I think genuinely she has improved. She’s doing as she’s asked and very happy doing what she’s been asked to do as well.

NARRATOR: After four weeks Sergei is struggling on level one, but his parents believe they see some changes in his behaviour.

GLORIA MORTON: I, I don’t feel the, the threat to myself that I felt before. He would get very aggressive with me, pushing or hitting or shoving and I, I don’t feel that way now.

STEPHEN SCOTT: My concern of a total adherence programme of the kind of Dr. Federici’s is that the child may behave that way while they’re in the context with the parents, but phew, the minute their parents back are turned they’re going to resort to their old behaviour. They haven’t really internalised a better way of behaving and being.

GLORIA MORTON: I can’t hear any can I go or go…

SERGEI MORTON: Can I go please…

CHARLIE MORTON: There was just you were leaving.

SERGEI MORTON: Sure.

CHARLIE MORTON: Sure.

SERGEI MORTON: Thank goodness.

NARRATOR: After 4 months Hayley has started back at school away from her parents watch. If level 1 has been effective she should be able to control her behaviour outside the home. It’s a big test for Dr. Federici’s treatment.

JULIE KEW: Since she’s been back at school we still get the reports back that she’s hit somebody, she’s pushed somebody and that she’s bitten a child. I thought that maybe that she’d learnt, but obviously she hasn’t.

RON FEDERICI: Failures happen all the time. People go back to level 1 all the time if they violate the major rules which are resurgence of aggression, violence, lying, cheating and manipulation, because that gives the parents the message that the child needs even more time with them to help break down further barriers which have been left untouched because that means the child still has some deeper layers of problems.

NARRATOR: After 3 months Sergei’s parents report that he seems to have deteriorated and that his behaviour is almost as bad as before. they are continuing with the treatment. However, what concerns critics is that there have been no control trials to measure independently the effect of the treatment.

PETER FONAGY: Because it’s such an unusual intervention I would really want to know in a properly conducted randomised control trial that the treatment is (a) safe and (b) effective in the long run.

NARRATOR: Dr. Federici eventually plans to have control trials. Meanwhile he continues to gain a wider following of parents desperate for help and believes he can treat successfully even the most difficult cases.

RON FEDERICI: Even in the most difficult of situations where the child has been written off as being totally unattached and irrecuperable I believe very strongly that any child, even that level of damage, by hard work and very unorthodox and aggressive and innovative techniques will often bring that damaged child to an 80% solution with the family.

Meet Ron Federici…

Since 1986, Dr. Ronald S. Federici has served as the Clinic Director and Supervisor of Neuropsychological and Family Therapy Associates. A fully licensed and board certified Developmental Neuropsychologist, Dr. Federici is recognized internationally as a skilled professional in his field. Dr. Ronald Federici’s innovative treatments and techniques have led him to become the top Developmental Neuropsychologist in the country, and he is sought after to diagnose and treat the most complex cases.

Specializing in the behavioral and emotional problems of children adopted both nationally and internationally, Dr. Federici’s groundbreaking techniques and personal experience (he is the father of seven internationally adopted children) in assisting children in overcoming developmental or behavioral disorders are detailed in his book, “Help for the Hopeless Child: A Guide for Families (With Special Discussion for Assessing and Treating the Post-Institutionalized Child).”

In addition to his book, Dr. Ronald Federici has written numerous articles that have appeared in top psychological journals and news publications like Time and The New York Post. Additionally, Dr. Federici has been a featured consultant on ABC, BBC, HBO, NBC, and CNN news programs. Dr. Ronald Federici’s revolutionary work with one family and their troubled adopted son was featured on the NBC Dateline segment “Saving Dane, Saving a Family,” which chronicled their six-month behavioral treatment process.

Dr. Ronald Federici earned dual Doctorate degrees from the University of Illinois School of Professional Psychology in 1985. Aside from his work with Neuropsychological and Family Therapy Associates, Dr. Federici serves as an Assistant Professor of Child Development at the Virginia Polytechnic Institute and State University. Furthermore, Dr. Federici is a staff Neuropsychologist for Mount Vernon Hospital and Dominion Hospital. Dr. Ronald Federici currently lives in Virginia.