What is Reactive Attachment Disorder?

Reactive attachment disorder (RAD) is a form of attachment disorder which manifests in young children, usually before age five. Children with this condition have not formed secure attachments to their primary caregivers, and as a result, they do not develop well socially. Children with reactive attachment may engage in a variety of antisocial behaviors and have difficulty getting along with other children. If untreated, this psychological condition can persist into adulthood and may create hardships as the person attempts to navigate in society.

Causes of reactive attachment disorder revolve around situations in which children have difficulty forming attachments to their caregivers. Children who have been abused or neglected commonly have this issue, as do children who have been institutionalized or deprived of a stable home life. The lack of healthy attachments to people like parents, grandparents, and so forth leads children to develop maladaptive social behaviors.

In the disinhibited form of reactive attachment disorder, the child lacks conventional social inhibitions. Children may approach complete strangers, be very frank and open with people they do not know well, and exhibit other forms of indiscriminate sociability. Children with the inhibited form, by contrast, are withdrawn, preferring their own company and avoiding social situations.

Some signs that a child might have reactive attachment disorder include general disinterest in the surrounding world, pulling away from caregivers, not eating well, and behaving unusually when compared to children of the same age. For a diagnosis, a complete psychological evaluation needs to be conducted, with both the child and the caregivers being evaluated. It is important to confirm that a child has reactive attachment disorder before pursuing treatment.

In some cases, evaluators may feel that it is in the best interests of the child to be placed in a different home, as when children are victims of abuse and neglect. In other instances, therapists work with the child and the caregivers to help form healthy attachments. Solo and group therapy are used along with exercises and a variety of other techniques. Every therapist has a slightly different approach, and sometimes it takes some trial and error to find the right approach for a given family.

People should be aware that some dangerous therapies have been proposed for reactive attachment disorder, such as wrapping children to confine them. It is important to work with a certified and licensed psychotherapy professional during treatment, and to check with a physician before engaging in alternative therapies to make sure that they will not harm the child physically or psychologically.