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Reactive Attachment Disorder

What is reactive attachment disorder?

Reactive attachment disorder (RAD) is a rare condition in which infants and children are unable to trust or develop a healthy bond with parents or caregivers. This creates frightening and sometimes violent behaviors. Any child who lives through loss of their primary caretaker, separation, neglect, or multiple caregivers in the first 2 years of their life can suffer from RAD.

What is the cause?

RAD is the result of abuse, neglect, or other parenting problems early in a child's life. The child’s basic needs for comfort, affection, and nurturing aren’t met. Instead of learning to trust, this baby learns that he cannot depend on adults. Instead of trust developing, rage develops. The child thinks life depends on being in control.

What are the symptoms?

Babies may:

  • Never smile or respond
  • Not look at people or reach out when picked up
  • Not want to play with toys or play peekaboo
  • Rock themselves when left alone

Toddlers and older children with reactive attachment disorder may:

  • Be angry and unable to control impulses or be unable to express feelings of anger or discomfort
  • Resist affection and withdraw from others
  • Act aggressively
  • Be on guard and on the go constantly
  • Try to control everything and never ask for help or support
  • Be very demanding or clingy
  • Refuse to eat, gorge, eat strange things, or hide food

How is it treated?

Treatment for attachment disorder may include:

  • Cognitive therapy: This involves helping the child to recognize errors in his or her thinking and to learn healthy ways of thinking about self and others.
  • Psychodrama: This technique takes the child through early life events that are acted out by others in the room. This allows the child to find better solutions for dealing with the trauma of those events.
  • Family therapy: This therapy treats all members of the family rather than just the child. It helps the whole family to make changes.
  • Medicines may be prescribed if your child is depressed, hyperactive, anxious, or violent.

When you are parenting a RAD child, it is easy to doubt yourself. Parenting a child who fights you every step of the way can be very discouraging. Learn all you can about RAD. Join a support group.

If you're a parent or caregiver of a child with RAD, you may feel frustrated and stressed. Take time for yourself. Find respite care and use it. It can help to see a professional therapist. You need to take care of yourself in order to take care of your child.

When your child is violent, seek immediate professional help.

Developed by RelayHealth.
Pediatric Advisor 2014.1 published by RelayHealth.
Last modified: 2012-07-25
Last reviewed: 2012-07-03
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©2014 McKesson Corporation and/or one of its subsidiaries. All rights reserved.
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