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Overview

What is reactive attachment disorder (RAD)?

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Reactive attachment disorder (RAD) is a condition in which an infant or young child does not form a secure, healthy emotional bond with his or her primary caretakers (parental figures).

Children with RAD often have trouble managing their emotions. They struggle to form meaningful connections with other people. Children with RAD rarely seek or show signs of comfort and may seem almost fearful of their caretakers, even in situations where the current parent figures seem quite loving and caring. These children are often irritable or sad, and may report feeling unsafe and/or alone.

Who is likely to have reactive attachment disorder (RAD)?

Reactive attachment disorder is most common among children between 9 months and 5 years who have experienced physical or emotional neglect or abuse. While not as common, older children can also have RAD since RAD sometimes can be misdiagnosed as other behavioral or emotional difficulties. Children may be more likely to develop RAD if they:

• Have had many different foster care providers or spent time in an orphanage
• Were taken away from primary caretakers after forming a healthy bond
• Have had multiple traumatic losses early in life

Symptoms and Causes

What causes reactive attachment disorder (RAD)?

Although there is no exact cause, researchers believe that lack of an appropriate level of loving and consistent caretaking contributes to development of RAD. Inadequate caregiving can make a child feel abandoned, alone and uncared for – all of which can prevent that child from developing a healthy and secure emotional bond with his or her primary caretakers.

Young children form healthy relationships when their basic needs are consistently attended to – this builds a sense of trust between the young child and caretakers. Examples of inappropriate, ongoing caretaking situations that place a child at greater risk of developing RAD include:

• A baby whose diaper is soiled and not changed for many hours.
• A baby who is hungry and not fed for many hours.
• A baby who is crying and not attended to and who is not comforted when they are in distress.
• A baby who is not held, touched, talked to, or interacted with for many hours at a time.
• An infant whose needs are met only some of the time (the caregiving is not consistent).
• A young child who only gains the attention of caretakers by acting up/or being disruptive.
• A baby or young child who has had multiple primary caretakers (especially if the care provided is inconsistent and/or from unfamiliar people).
• Any situation in which the child has been physically or emotionally neglected or abused by primary caretakers or other adults.

What are the symptoms of reactive attachment disorder (RAD)?

Symptoms of reactive attachment disorder vary from child to child. Infants and young children who may have RAD show common signs such as:

• Failure to show an expected range of emotions when interacting with others; failure to show “emotions of conscience” such as remorse, guilt, or regret
• Avoiding eye contact and physical touch, especially with caregivers
• Expressing anger; having tantrums; being irritable, unhappy and sad; disobedience and arguing (beyond what would be “usual” for the child’s age and situation)
• Displaying inappropriate affection toward strangers while demonstrating a lack of affection for and/or fear of their primary caretakers.

When children with RAD grow older, their symptoms usually fall into one of two general patterns:

• Inhibited RAD symptoms. Children are aware of what happens around them, but they do not respond typically to outside stimuli. Children showing inhibited RAD symptoms are withdrawn and emotionally unresponsive. They may not show or seek affection from caregivers or others, keeping largely to themselves.
• Disinhibited RAD symptoms. Children may be overly friendly toward strangers. Children with disinhibited RAD symptoms do not prefer their primary caretakers over other people. In most cases, these children act younger than their age and may seek out affection from others in an unsafe way.

Diagnosis and Tests

How is reactive attachment disorder (RAD) diagnosed?

Your child’s doctor may assess for reactive attachment disorder by asking you about patterns in behavior suggesting withdrawal from primary caretakers. Your child’s personal history, including any history of neglect or abuse, is important for making an accurate diagnosis. Children must be between the ages of 9 months and 5 years (or at least have developed the specific patterns of behavior associated with this disorder during this age range) to be formally diagnosed with RAD. It is not uncommon, however, for the diagnosis to first be raised in a child who is somewhat older where it has never been identified.

Before diagnosing a child with RAD, doctors will want to rule out other causes for a child’s atypical functioning, including autism spectrum disorder (ASD). Autism spectrum disorder is a developmental condition that that affects behavior and communication and can, on the surface, present with some similar features as RAD. Although presenting in early childhood, abuse or neglect doesn’t cause autism spectrum disorder.

Management and Treatment

How is reactive attachment disorder (RAD) treated?

Treatment for reactive attachment disorder focuses on repairing and/or creating emotionally healthy family bonds. It aims to strengthen relationships between children and their caretakers in a way that can later help the child to develop other healthy relationships

Both children and parents benefit from tailored treatment plans. Treatment may incorporate:

• Psychotherapy/Counseling. A mental health provider works with the child and parents in a variety of ways, sometimes one-on-one with the child, sometimes with just caretakers, and sometimes in combination, to build skills and reduce problematic patterns of behavior.
• Family therapy. This therapy involves working together with the primary caretakers and child to develop ways to interact in healthy ways.
• Social Skills Intervention. This therapy teaches the child how to interact more appropriately with other similar–aged children in typical social settings. Parents are usually also involved to help the child to use the skills they learn.
• Special education. If a child qualifies, these are school-based programs that help children learn skills to succeed both academically and socially.
• Parenting skills classes. In these sessions parents may learn more effective ways of managing their child’s challenges. This can be particularly beneficial as managing discipline for children with RAD can be more difficult.

What complications are associated with reactive attachment disorder (RAD)?

Physical, emotional, and social neglect and abuse put children with RAD at higher risk for complications in later childhood and adolescence. These complications may include:

• Delays in developmental milestones
• Delays in physical growth (which can be linked to eating difficulties)
• Emotional problems, such as depression, anxiety, and anger management issues
• Drug and alcohol abuse and dependency
• Trouble in school (learning and/or behavioral)
• Problems in relationships (with peers or adults, and potentially later with partners)

Prevention

Can reactive attachment disorder (RAD) be prevented?

The best way to prevent reactive attachment disorder is by ensuring children form healthy bonds with their parents and/or other primary caretakers. Healthy bonds form when caretakers:

• Promote family bonding through secure and consistent relationships
• Help children feel secure and loved
• Support children through the phases of their development

Specific actions that can lead to the development of healthy bonds include:

• Setting limits. Because children with RAD have a need to have control and benefit from an environment in which there is a consistent pattern that can be counted on, setting limits is very important. By setting consistent and reasonable limits, children will know what is expected of them and what happens if rules are broken.
• Keeping your cool even when your child acts up. During times when your child is acting inappropriately, remain calm; do not respond if you are in an “emotionally heightened” state. Discipline the child according to the rules you have established and made known to your child. As soon as the child has settled down and is ready for positive contact, show love and care. This helps the child know that you will still be there for them, through even difficult times.
• Showing consistent love and attention. Spend one-on-one time with your child. Talk or sing with them. Play with them. Rock or hold them or show other signs of caregiver love and affection, acknowledging that some children are more open to this type of affection than others. Withholding love and affection should never be used as punishment.

Outlook / Prognosis

What is the prognosis (outlook) for people with reactive attachment disorder (RAD)?

Many children who receive treatment for reactive attachment disorder form stable, healthy bonds with primary caretakers and others, providing models for later important relationships.

Children who don’t receive treatment can face risks of ongoing emotional issues. Fortunately, it is never too late to seek treatment for developmental and mental health conditions, including RAD.

Key points to keep in mind

• Many children who are adopted from foster placements or orphanages develop into very healthy and well-adjusted children; not all such youth experience RAD. Children can be amazingly resilient!
• Children with significant trauma in their past may also have other risk factors for mental health and behavioral challenges, such as exposure to drugs or alcohol during prenatal development or a family history of emotional disorders, both of which may contribute to RAD and other difficulties.

Living With

When should I call my doctor?

https://torrentmatters.mystrikingly.com/blog/jixipix-vintage-scenee-2-76-oldsmobile. If you notice any symptoms of reactive attachment disorder in your child, contact your child’s doctor for an evaluation or referral. Early diagnosis and treatment leads to more successful outcomes for children with this condition.

If you’re the parent of a child with symptoms of an attachment disorder, these tools and treatments can help you bond with your child and shape their future development.

What is reactive attachment disorder (RAD)?

Attachment is the deep connection established between your child and you, their primary caregiver, that profoundly affects your child’s development and their ability to express emotions and build meaningful relationships later in life. Attachment issues fall on a spectrum, from mild problems that are easily addressed to the most serious form, known as reactive attachment disorder (RAD). Reactive attachment disorder is a condition in which your child is unable to establish healthy attachment with you, their parent or primary caretaker. This can lead to difficulty connecting with others and managing their emotions, resulting in a lack of trust and self-worth, a fear of getting close to anyone, anger, and a need to be in control. A child with an attachment disorder feels unsafe and alone.

Children with RAD have been so disrupted in early life that their future relationships are also impaired. They may experience difficulty relating to others and are often developmentally delayed. Reactive attachment disorder is common in children who have been abused, bounced around in foster care, lived in orphanages, or taken away from their primary caregiver after establishing a bond.

However, no matter how detached or insecure your child seems, or how frustrated or exhausted you feel from trying to connect, it is possible to repair an attachment disorder. With these tools—and a healthy dose of patience and love—you can bond with your child and help them develop healthy, meaningful, and loving relationships.

Attachment disorder causes

RAD and other attachment disorders occur when a child has been unable to consistently connect with a parent or primary caregiver. If a young child repeatedly feels abandoned, isolated, powerless, or uncared for—whatever the reason—they will learn that they can’t depend on others and that the world is a dangerous and frightening place.

This can happen for many reasons:

• A baby cries and no one responds or offers comfort.
• A baby is hungry or wet, and they aren’t attended to for hours.
• No one looks at, talks to, or smiles at the baby, so the baby feels alone.
• A young child gets attention only by acting out or displaying other extreme behaviors.
• A young child or baby is mistreated or abused.
• Sometimes a child’s needs are met and sometimes they aren’t. The child never knows what to expect.
• An infant or young child is hospitalized or separated from their parents.
• A baby or young child is moved from one caregiver to another (the result of adoption, foster care, or the loss of a parent, for example).
• The parent is emotionally unavailable because of depression, illness, or substance abuse.

Sometimes the circumstances that cause attachment problems are unavoidable, but the child is too young to understand what has happened and why. To a young child, it just feels like no one cares. They lose trust in others and the world becomes an unsafe place.

Early warning signs of an attachment disorder

Although it is never too late to treat and repair attachment issues, the earlier you spot the symptoms of insecure attachment and take steps to repair them, the better. Caught in infancy before they become more serious problems, attachment disorders are often easy to correct with the right help and support.

Your infant may have attachment issues if they:

• Avoid eye contact.
• Don’t smile.
• Don’t reach out to be picked up.
• Reject your efforts to calm, soothe, and connect with them.
• Don’t seem to notice or care when you leave them alone.

• Cry inconsolably.
• Don’t coo or make sounds.
• Don’t follow you with their eyes.
• Aren’t interested in playing interactive games or playing with toys.
• Spend a lot of time rocking or comforting themselves.

It’s important to note that the early symptoms of attachment disorders are similar to the early symptoms of other issues such as ADHD and autism. If you spot any of these warning signs, make an appointment with your pediatrician for a professional diagnosis of the problem.

Comforting a crying baby

It’s common to feel frustration, anxiety, and even anger when faced with a crying baby—especially if your baby wails for hours on end. In these situations, you need to remain calm and centered so you’ll be better able to figure out what’s going on with your child and how best to soothe their cries.

Signs and symptoms of reactive attachment disorder

Common signs and symptoms in young children include:

An aversion to touch and physical affection. Children with RAD often flinch, laugh, or even say “ouch” when touched. Rather than producing positive feelings, touch and affection are perceived as a threat.

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Control issues. Most children with reactive attachment disorder go to great lengths to remain in control and avoid feeling helpless. They are often disobedient, defiant, and argumentative.

Anger problems. Anger may be expressed directly, in tantrums or acting out, or through manipulative, passive-aggressive behavior. Children with RAD may hide their anger in socially acceptable actions, like giving a high five that hurts or hugging someone too hard.

Difficulty showing genuine care and affection. For example, children with reactive attachment disorder may act inappropriately affectionate with strangers while displaying little or no affection towards their parents.

An underdeveloped conscience. Children with reactive attachment disorder may act like they don’t have a conscience and fail to show guilt, regret, or remorse after behaving badly.

Inhibited reactive attachment disorder vs. disinhibited reactive attachment disorder

As children with reactive attachment disorder grow older, they often develop either an inhibited or a disinhibited pattern of symptoms:

Inhibited symptoms of RAD. The child is extremely withdrawn, emotionally detached, and resistant to comforting. The child is aware of what’s going on around them—hypervigilant even—but doesn’t react or respond. They may push others away, ignore them, or even act out in aggression when others try to get close.

Disinhibited symptoms of RAD. The child doesn’t seem to prefer their parents over other people, even strangers. The child seeks comfort and attention from virtually anyone, without distinction. They are extremely dependent, act much younger than their age, and may appear chronically anxious.

Parenting a child with attachment issues

Parenting a child with insecure attachment or an attachment disorder can be exhausting, frustrating, and emotionally trying. It is hard to put your best parenting foot forward without the reassurance of a loving connection with your child. Sometimes you may wonder if your efforts are worth it, but be assured that they are. With time, patience, and concerted effort, attachment disorders can be repaired. The key is to remain calm, yet firm as you interact with your child. This will teach your child that they are safe and can trust you.

A child with an attachment disorder is already experiencing a great deal of stress, so it is imperative that you evaluate and manage your own stress levels before trying to help your child with theirs. HelpGuide’s free Emotional Intelligence Toolkit can teach you valuable skills for managing stress and dealing with overwhelming emotions, leaving you to focus on your child’s needs.

To help a child with attachment issues, it’s also important to:

Have realistic expectations. Helping your child may be a long road. Focus on making small steps forward and celebrate every sign of success.

Stay patient. The process may not be as rapid as you’d like, and you can expect bumps along the way. But by remaining patient and focusing on small improvements, you create an atmosphere of safety for your child.

Foster a sense of humor.Joy and laughter go a long way toward repairing attachment problems and energizing you even in the midst of hard work. Find at least a couple of people or activities that help you laugh and feel good.

Take care of yourself. Reduce other demands on your time, make time for yourself, and manage stress. Rest, good nutrition, and parenting breaks help you relax and recharge your batteries so you can give your attention to your child.

Find support. Rely on friends, family, community resources, and respite care (if available). Try to ask for help before you really need it to avoid getting stressed to breaking point. You may also want to consider joining a support group for parents.

Stay positive and hopeful. Be sensitive to the fact that children pick up on feelings. If they sense that you’re discouraged, it will be discouraging to them. When you are feeling down, turn to others for reassurance.

Parents of adopted or foster care children with reactive attachment disorder

When you adopted a child, you may not have been aware of an attachment disorder. Anger or unresponsiveness from your new child can be heartbreaking and difficult to understand. Try to remember that your adopted child isn’t acting out because of lack of love for you. Their experience hasn’t prepared them to bond with you, and they can’t yet recognize you as a source of love and comfort. Your efforts to love them will have an impact—it just may take some time.

Making a child with an attachment disorder feel secure

Safety is the core issue for children with attachment problems. They are distant and distrustful because they feel unsafe in the world. They keep their guard up to protect themselves, but it also prevents them from accepting love and support. So, before anything else, it is essential to build up your child’s sense of security. You can accomplish this by establishing clear expectations and rules of behavior, and by responding consistently so your child knows what to expect when they act a certain way and—even more importantly—knows that no matter what happens, you can be counted on.

Set limits and boundaries. Consistent, loving boundaries make the world seem more predictable and less scary to children with attachment issues. It’s important that they understand what behavior is expected of them, what is and isn’t acceptable, and the consequences if they disregard the rules. This also teaches them that they have more control over what happens to them than they think.

Take charge, yet remain calm when your child is upset or misbehaving. Remember that “bad” behavior means that your child doesn’t know how to handle what they’re feeling and needs your help. By staying calm, you show your child that the feeling is manageable. If they are being purposefully defiant, follow through with the pre-established consequences in a cool, matter-of-fact manner. But never discipline a child with an attachment disorder when you’re in an emotionally-charged state. This makes the child feel more unsafe and may even reinforce the bad behavior, since it’s clear that it pushes your buttons.

Be immediately available to reconnect following a conflict. Conflict can be especially disturbing for children with attachment disorders. After a conflict or tantrum where you’ve had to discipline your child, be ready to reconnect as soon as they’re ready. This reinforces your consistency and love, and will help your child develop a trust that you’ll be there through thick and thin.

Own up to mistakes and initiate repair. When you let frustration or anger get the best of you or you do something you realize is insensitive, quickly address the mistake. Your willingness to take responsibility and make amends can strengthen the attachment bond. Children with attachment issues need to learn that although you may not be perfect, they will be loved, no matter what.

Try to maintain predictable routines and schedules. A child with an attachment disorder won’t instinctively rely on loved ones, and may feel threatened by transition and inconsistency—when traveling or during school vacations, for example. A familiar routine or schedule can provide comfort during times of change.

Repairing attachment disorders by helping your child feel loved

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A child who has not bonded early in life will have a hard time accepting love, especially physical expressions of love. But you can help them learn to accept your love with time, consistency, and repetition. Trust and security come from seeing loving actions, hearing reassuring words, and feeling comforted over and over again.

Identify actions that feel good to your child. If possible, show your child love through rocking, cuddling, and holding—attachment experiences they missed out on earlier. But always be respectful of what feels comfortable and good to your child. In cases of previous abuse, neglect, and trauma, you may have to go very slowly because your child may be very resistant to physical touch.

Respond to your child’s emotional age. Children with attachment disorders often act like younger children, both socially and emotionally. You may need to treat them as though they were much younger, using more non-verbal methods of soothing and comforting.

Help your child identify emotions and express their needs. Children with attachment problems may not know what they’re feeling or how to ask for what they need. Reinforce the idea that all feelings are okay and show them healthy ways to express their emotions.

Listen, talk, and play with your child. Carve out times when you’re able to give your child your full, focused attention in ways that feel comfortable to them. It may seem hard to drop everything, eliminate distractions, and just live in the moment, but spending quality time together provides a great opportunity for your child to open up to you and feel your focused attention and care.

Supporting the health of a child with attachment issues

Your child’s eating, sleep, and exercise habits are always important, but they’re even more so for kids with attachment problems. Healthy lifestyle habits can go a long way towards reducing your child’s stress levels and leveling out mood swings. When children with attachment issues are relaxed, well-rested, and feeling good, it will be much easier for them to handle life’s challenges.

Igt slots 100 pandas. Diet. Make sure your child eats a healthy diet full of whole grains, fruits, vegetables, and lean protein. Be sure to skip the sugar and add plenty of good fats—like fish, flax seed, avocados, and olive oil—for optimal brain health.

Sleep. If your child is tired during the day, it will be that much harder for them to focus on learning new things. Make their sleep schedule (bedtime and wake time) consistent.

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Exercise. Any type of physical activity provides a great antidote to stress, frustration, and pent-up emotion, triggering endorphins to make your child feel good. Physical activity is especially important for an angry child. If your child isn’t naturally active, try some different classes or sports to find something that is appealing.

Any one of these things—food, rest, and exercise—can make the difference between a good and a bad day for a child who has an attachment disorder. These basics will help ensure that your child’s brain is healthy and ready to connect.

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Professional treatment

If your child is suffering from a severe attachment problem, especially reactive attachment disorder, seek professional help. Extra support can make a dramatic and positive change in your child’s life, and the earlier you seek help, the better. Start by consulting with your pediatrician, a child development specialist, or an organization that specializes in child development or RAD.

Treatment for reactive attachment disorder usually involves a combination of therapy, counseling, and parenting education, designed to ensure that your child has a safe living environment, improves their peer relationships, and develops positive interactions with you, their parents or caregivers. While medication may be used to treat associated conditions, such as depression, anxiety, or hyperactivity, there is no quick fix.

Your pediatrician may recommend a treatment plan that includes:

Family therapy. Typical therapy for attachment problems includes both your child and you. Therapy often involves fun and rewarding activities that enhance the attachment bond as well as help parents and other children in the family understand the symptoms of the disorder and effective interventions.

Individual psychological counseling.Therapists may also meet with your child individually or while you observe. This is designed to help your child directly with monitoring emotions and behavior.

Play therapy. Helps your child learn appropriate skills for interacting with peers and handling other social situations.

Special education services. Specifically designed programs within your child’s school can help them learn skills required for academic and social success, while also addressing behavioral and emotional difficulties.

Parenting skills classes. Education for parents and caregivers centers on learning about attachment disorders as well as other necessary parenting skills.