Reactive Attachment Disorder Signs & Symptoms

What is Reactive Attachment Disorder (RAD)?

Reactive attachment disorder refers to the physical, psychological, and even biological bond that occurs between a child and their primary caretaker, such as the mother and father. For the baby, attachment begins while in utero when nourishment is needed from the mother’s placenta. For the mother, attachment begins immediately after birth. The attachment bond can become stronger throughout infancy and childhood with more physical touch and comfort. Strong emotional and physical attachment to a parent is important for development during childhood, so that there can be secure relationships in adulthood.

For many adopted children, the attachment bond is broken—sometimes multiple times—if the child is passed around foster care before finally settling into a permanent adoptive family. This bond can be reformed over time with the proper physical and emotional care. However, adoptive children are at an increased risk for reactive attachment disorder, which 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.

Warning Signs & Risks

  • Aversion to touch and physical attention – the child does not like to be held or hugged and instead may squirm away
  • Being in control – the child often needs to be in control and will throw excessive temper tantrums, and will be disobedient, defiant and argumentative
  • Lack of emotion during punishment – then a child is asked to go on time out, they are often relieved they can be alone, and punishment shows them reinforcement that they are “unwanted”
  • Inappropriate affection – the child will often be inappropriately affectionate towards strangers but will show no signs of affection towards their primary caregiver

Warning Signs of Insecure Attachment

Insecure attachment is on the mild side of the spectrum for attachment disorders (whereas reactive attachment disorder is more serious). Recognizing early signs of attachment problems and seeking action to repair this behavior can prevent reactive attachment disorder. The following are warning signs of insecure attachment:

  • Failure to engage in play or games with others
  • Failure to reach out when being picked up by a caregiver
  • Failure to smile
  • Watching others closely but not engaging in social interaction
  • Failure to ask for help or support
  • Avoiding eye contact
  • Crying inconsolably
  • Spending excessive time rocking or comforting themselves or talking to themselves
  • Not reacting when left alone by a primary caregiver

Reactive Attachment Disorder Treatment

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.

The primary caregiver must practice love and sensitivity even when the child acts out. It is important to attend to the child’s needs in the most sensitive manner possible. This process may take a very long time—even years. However, keeping a solid foundation of these three therapeutic ingredients will lead to a transition in emotions and behavior in the child. Play therapy is the most proven approach used by therapists for children with RAD. This approach should take place in front of the primary caregivers to allow the child to express his/her needs, anxieties and fears through the context of play.

We’re Here For You

If you or someone you know is struggling, we’re here for you. Discovery Mood and Anxiety Program specializes in treatment for mental health, substance abuse, and dual diagnoses, by creating unique programs to help every individual find their way to recovery. For more information, resources, or to consult with one of our specialists, call 714.828.0808.

Take a free Teen Mental Health Assessment

This evaluation can help determine if you or a loved one may benefit from consulting with a mental health professional.

What is Reactive Attachment Disorder (RAD)?

Reactive attachment disorder refers to the physical, psychological, and even biological bond that occurs between a child and their primary caretaker, such as the mother and father. For the baby, attachment begins while in utero when nourishment is needed from the mother’s placenta. For the mother, attachment begins immediately after birth. The attachment bond can become stronger throughout infancy and childhood with more physical touch and comfort. Strong emotional and physical attachment to a parent is important for development during childhood, so that there can be secure relationships in adulthood.

For many adopted children, the attachment bond is broken—sometimes multiple times—if the child is passed around foster care before finally settling into a permanent adoptive family. This bond can be reformed over time with the proper physical and emotional care. However, adoptive children are at an increased risk for reactive attachment disorder, which 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.

Warning Signs & Risks

  • Aversion to touch and physical attention – the child does not like to be held or hugged and instead may squirm away
  • Being in control – the child often needs to be in control and will throw excessive temper tantrums, and will be disobedient, defiant and argumentative
  • Lack of emotion during punishment – then a child is asked to go on time out, they are often relieved they can be alone, and punishment shows them reinforcement that they are “unwanted”
  • Inappropriate affection – the child will often be inappropriately affectionate towards strangers but will show no signs of affection towards their primary caregiver

Warning Signs of Insecure Attachment

Insecure attachment is on the mild side of the spectrum for attachment disorders (whereas reactive attachment disorder is more serious). Recognizing early signs of attachment problems and seeking action to repair this behavior can prevent reactive attachment disorder. The following are warning signs of insecure attachment:

  • Failure to engage in play or games with others
  • Failure to reach out when being picked up by a caregiver
  • Failure to smile
  • Watching others closely but not engaging in social interaction
  • Failure to ask for help or support
  • Avoiding eye contact
  • Crying inconsolably
  • Spending excessive time rocking or comforting themselves or talking to themselves
  • Not reacting when left alone by a primary caregiver

Reactive Attachment Disorder Treatment

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.

The primary caregiver must practice love and sensitivity even when the child acts out. It is important to attend to the child’s needs in the most sensitive manner possible. This process may take a very long time—even years. However, keeping a solid foundation of these three therapeutic ingredients will lead to a transition in emotions and behavior in the child. Play therapy is the most proven approach used by therapists for children with RAD. This approach should take place in front of the primary caregivers to allow the child to express his/her needs, anxieties and fears through the context of play.

We’re Here For You

If you or someone you know is struggling, we’re here for you. Discovery Mood and Anxiety Program specializes in treatment for mental health, substance abuse, and dual diagnoses, by creating unique programs to help every individual find their way to recovery. For more information, resources, or to consult with one of our specialists, call 714.828.0808.

Take a free Teen Mental Health Assessment

This evaluation can help determine if you or a loved one may benefit from consulting with a mental health professional.

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Preferred In-Network Provider for All Major Health Insurance

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