Children with reactive attachment disorder, also known as RAD, fail to form the essential bond that usually develops between a child and her primary caregivers. It often occurs in children who have been subject to extreme neglect or abuse, or experienced repeated changes in caregivers that gave them limited opportunities to form selective attachments. Diagnosis is limited to children between the ages of 9 months and 5 years who do not meet the criteria for autism spectrum disorder, but it is a lifelong condition that causes significant difficulties interacting with both adults and peers.
- Limited positive affect or smiling
- Unexplained episodes of irritability
- Sad, fearful, inhibited, or withdrawn behavior towards caregivers
- Failure to respond to comfort when offered
- Attempts to nurture or soothe oneself during times of distress as opposed to seeking comfort from caregivers, often calming down more quickly without the presence of an adult
- Lack of reaction to caregivers’ attempts to interact or to others moving about a room
- Failure to engage in interactive activities or motions such as reaching out when picked up or responding to a game of peek-a-boo
Treatment for reactive attachment disorder usually involves both the child who has been diagnosed and his current caregivers. Psychotherapy for the child, family therapy, parenting training, and special education services have all been known to help.