Understanding Reactive Attachment Disorder

Reactive Attachment Disorder (RAD) is not very prevalent, but its impact on a child’s overall emotional functioning is huge. Young children need love, support, nurturing care, security, and trust with their caregivers in order to understand and develop healthy relationships. Some children, unfortunately, do not receive this level of care. Children who are neglected, abused, placed in too many different environments or have their primary caregiver (like a mother or father) taken away suddenly, can struggle to form secure relationships. These unfortunate circumstances usually happen in the first five years of life and impact a child dramatically.

If a child is experiencing RAD symptoms, they may act withdrawn, disengaged, or unresponsive to caregivers and others. The most common example of this would be when a child is removed from an abusive household where he was neglected and left alone for most of the day. He is placed in a foster home but struggles to engage, communicate or relate to his new caregivers. He may not seek any comfort from adults when distressed, injured, in need or scared. Another common symptom associated with RAD is emotional disruptions without any obvious cause. These can include irritability, fearfulness, sadness, and aggression.

Signs of Reactive Attachment Disorder


Disinterest with other

No reaction to attempts to comfort

Weary of others

Lack of trust

Disinterest in play with others

Emotional outbursts

There is no “cure” for RAD, but therapy can dramatically improve the child’s overall lifestyle and future outcome. Being in a safe and stable environment is the first step to helping the child build healthy relationships with caregivers and other adults. The child must feel safe and comfortable for a long enough period of time to be able to view his caregivers as positive and safe supporters. Although RAD symptoms will usually dissipate after being placed in a secure environment, therapy primarily focuses on communication skills, behavior, and relationships. Communication of needs, fears, and interests with “safe” adults will be critical to building trust. Behavior therapies are effective for the management of how emotions are expressed and increasing coping skills. Relationship therapies can assist the family unit in trust building, and maintenance of a positive environment for the child. The process can be slow, as it is based on repeating positive interactions until trust is built, but over time this level of patience and consistency can help a child with RAD develop healthy relationships with others.

RAD can mimic or co-exist with many other disorders found in children, so be sure to consult a trained and experienced professional in order to receive the correct diagnosis and treatment plan.

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