What is Reactive Attachment Disorder?

reactive attachment disorder infographic

It is one of the trauma related disorders in children; it is characterized by disturbances in attachment behaviors that normally occur between a child and caregiver (most often a parent). The attachment is either absent or underdeveloped. Because the disorder results from grossly inadequate parenting (parental neglect or abuse), it may be associated with signs of severe neglect (e.g., malnutrition, poor hygiene) and may be accompanied by delays in speaking and in cognitive development.

The disorder is relatively rare and usually affects children under the age 5 years.

Signs & Symptoms

  • Avoid physical contact with caregivers
  • Unable to express emotions
  • Limited or no eye contact
  • Rarely seeks comfort from others
  • Spends a lot of time comforting themselves
  • They appear unhappy
  • They have tantrums
  • They are often irritable
  • They are often disobedient
  • They have arguments with others that’s unusual for their age
  • Inability to smile
  • They cry inconsolably
  • Not interested in playing interactive games with the parents or other kids

What to do if you think your child may have Reactive Attachment Disorder?

Visit your primary care physician if you suspect your child may have this disorder; they will be assessed and referred to the Child Psychiatrist if necessary.

Once diagnosed, treatment for RAD often focuses on the caregiver.

Counseling may help address issues that are affecting the caregiver’s relationship and behavior toward the child. Teaching parenting skills also can help improve the relationship and develop attachment.

Treatment may also include play therapy. This technique allows the child and the caregiver to express their thoughts, fears, and needs in the safe context of play.

References

  1. Diagnostic and Statistical Manual of Mental Health Disorders. DSM 5 TR 2022
  2. Kaplan and Saddocks. Synopsis of Psychiatry. 12th edition. 2022
  3. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). About ADHD – Symptoms, Causes and Treatment – CHADD. https://chadd.org/about-adhd/overview/

Prepared by:

Dr. Annesa Harrypersaud
GPHC Psychiatry Department