Reactive attachment disorder is a childhood mental health disorder where the child does not develop healthy, stable attachments to their parent/caregiver due to physical and/or emotional neglect early on. When caregivers are unstable or unresponsive during the first few years of the child’s life then the child is at risk for developing an attachment disorder.


What causes RAD?

A young child may be at risk for developing reactive attachment disorder when they have received insufficient care and little to no emotional response from their caregivers. Researchers have found that there is a link between the duration of deprivation and the severity of symptoms. The primary cause is neglect; however, there are many ways where a caregiver can neglect a child.

  • Not receiving comfort, affection, and appropriate stimulation from caregivers: A child needs constant physical affection as well as emotional affection and mental stimulation. A child requires physical touch, food, baths, and social interactions and when any one of these factors is reduced or eliminated it could create an attachment issue in the child. Leaving a child in the crib or playpen constantly, skipping late-night feedings, or not speaking to the child are also forms of neglect.
  • Lack of stable attachments due to repeated changing of primary caregiver: Parenting can be extremely difficult especially if you are managing a full-time job or have the role of a single parent. Babysitters and daycare are necessary however constantly changing childcare providers can be harmful. A frequent change in babysitters, daycares, or nannies can cause emotional distress in the child due to the constant change. Children need stable environments where they can interact with the same person over a long period of time in order to feel safe and trust their caregivers.
  • Receiving care in settings that offer a limited possibility for attachment: If a parent is incarcerated or in and out of the hospital, the child may need to live in another setting such as a foster home. Often times when a child enters a foster home they may move between families which prevent the child from being able to form an attachment to their caregiver.

Risk Factors for RAD

  • Being socially neglected
  • Growing up in an institutional setting such as an orphanage
  • Moving amongst multiple foster homes
  • Being forcefully removed from an abusive or neglectful home
  • Having a mother who suffers from severe postpartum depression
  • Going through other kinds of traumatic losses or significant changes with a primary caregiver

Preventing RAD

RAD may not be avoidable in cases where parents adopted or fostered their children but RAD is preventable. Biological parents and/or caretakers play the biggest role in preventing RAD by giving their child enough emotional engagement, physical affection, and mental stimulation. Some parents are unable to do this because they are struggling with their own mental health or maybe have a substance abuse problem. In this case, these parents must seek professional help immediately since they are at risk of gravely affecting their child. Caregivers who emotionally engage with their infants can prevent the development of reactive attachment disorder. Emotional engagement can look like:

  • Making eye contact
  • Reflecting the baby’s emotions in facial expressions and words
  • Limiting distractions such as technology
  • Interacting with the child when changing a diaper or bathing him
  • Singing to the baby
  • Smiling at the baby
  • Playing with the baby

Get help for yourself

As a parent, raising a child with RAD can seem nearly impossible at sometimes and therefore it is important that you are taking care of yourself. Joining community groups, self-help groups and support groups can help you bond with other parents who have children with RAD. Make sure you are exercising, getting enough sleep, and enjoying yourself so you are able to properly take care of your child in a healthy manner.

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.

Other relevant Articles:

Treatment for Reactive Attachment Disorder

Reactive Attachment Disorder: What Next?