Reactive attachment disorder, a disorder that is seen in young children, results from the disruption of the attachment process by neglect, physical abuse, sexual abuse, or frequent change in the primary caregivers in the first few years of the child’s life. The child will exhibit withdrawn behavior towards caregivers, irritability, sadness or emotional turmoil during nonthreatening interactions with caregivers and/or minimal social or emotional responsiveness to others. Children need emotional, mental and physical bonding from their caregiver and without this, they become at risk of developing RAD. Although RAD is not as common compared to other childhood disorders, it is rarely talked about and as a result, is surrounded by many false beliefs and stigma.
Myth: Problems with attachment rarely occur and are not serious
Fact: Although RAD is not as common as other childhood disorders, it is strongly linked to children who have a history of trauma and can have a huge effect on the child’s development.
While it may be true that attachment problems are rare among emotionally healthy children raised by biological parents where no abuse, neglect or other trauma has occurred, tens of thousands of children do not live in that situation. Among children who have been traumatized, having difficulties attaching to their primary caregiver (parent) is much more common.
- Among children who have experienced abuse, neglect or both, 87-95% show an insecure attachment.
- According to a 2006 CDC study 1 out of 50 infants under one-year-old in the U.S., based on reports of maltreatment submitted to Child Protective Services
- Researchers identified attachment disorders in nearly two-thirds of children in foster care and 20% of those living in homeless shelters.
- Of the 1 million children in the US adopted internationally or through foster care, 15% (150,000) have severe behavioral problems contributed to attachment and trauma issues; another 30 % (300,000) show “some” attachment and behavioral problems worthy of clinical treatment.
Myth: My child was too young to remember
Fact: Pre-verbal emotional trauma runs very deep and is lasting
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5) symptoms of Reactive Attachment Disorder (RAD) must be evident before five years of age and the child must have a developmental age of at least nine months. The earlier the trauma occurs the worse it can be carried out later into childhood. Even if your child is unable to walk or speak, they are still prone to the long-lasting effects of early trauma.
Myth: This child seems perfectly normal to me
Fact: Children with reactive attachment disorders or most likely to act out towards their parents or caretakers and act normal in the presence of strangers.
Children with attachment disorders (specifically with RAD) often do not act anywhere near the same with others as they do with their parents or caregivers. In fact, they can be very charming and polite with others. By its very nature, a disorder of attachment means that the child will have the hardest time feeling safe with the people trying to be the most intimate with him/her, such as the parents. If you know this child casually, you’re not a threat.
Myth: Reactive attachment disorder can be treated with medication
Fact: There is no medication for reactive attachment disorder
Specific parenting patterns in conjunction with professional psychological therapy are the first-line approach to helping a child cope with attachment disorders. The three therapeutic ingredients for a child to develop new patterns of emotional attachment are security, stability, and sensitivity. The primary caregiver must practice extreme patience and give ample time for the child to express his or her emotions. Boundaries must be set but in a loving and empathetic fashion. A stable and repetitive everyday routine must be practiced for the child to regain trust and normalcy in their life.
Kristen Fuller, M.D., is a clinical content writer and enjoys writing about evidence-based topics in the cutting-edge world of mental health and addiction medicine. She is a family medicine physician and author, who also teaches and contributes to medicine board education. Her passion lies within educating the public on preventable diseases including mental health disorders and the stigma associated with them. She is also an outdoor activist and spends most of her free time empowering other women to get outside into the backcountry.