Quick Guide to Reactive Attachment Disorder

Children with reactive attachment disorder (RAD) are not able to form the important bond that usually develops between a child and their caregivers. Children with reactive attachment disorder seem sad, fearful, or irritable, and they have a hard time interacting with others. Reactive attachment disorder can happen to young children whose basic needs for comfort, nurturing, and affection have not been consistently met.  

Reactive attachment disorder is rare. It is only diagnosed in children between the ages of nine months and five years.  

Signs that a child might have reactive attachment disorder include: 

• Not smiling 
• Being irritable for no reason 
• Seeming sad and fearful, especially around caregivers 
• Not feeling better when an adult tries to comfort them 
• Calming down more easily when left alone 
• Not showing interest in or looking at other people around them 
• Not reacting when picked up by an adult 
• Not laughing or playing interactive games like peek-a-boo 

Children are only diagnosed with reactive attachment disorder between the ages of nine months and five years. A doctor will make sure that the child does not have autism before diagnosing reactive attachment disorder, since the two disorders have some of the same symptoms. 
 
To be diagnosed, the child must be seem sad or fearful and not respond when their caregiver tries to make them feel better. The child must also have experienced serious abuse or neglect, or multiple changes in caregivers at a young age. 

It’s important to note that not all children who experience abuse or neglect develop reactive attachment disorder. 

Because kids with RAD are so young, therapy involves both the child and the parents or main caregivers. Parents learn how to create a consistent, responsive, and safe environment with positive child and caregiver interactions. It usually combines a few different therapies, including: 

• Individual psychotherapy for the child and sometimes for the parents too 
• Family therapy for the child, siblings and parents  
• Parenting training to teach parents how to help their child bond with them 

Special education services can also help kids with RAD. 

Young children who have been neglected or abused may also have developmental delays and delays in their physical growth. Older children may be at risk for disorders including eating disorders, anger issues, depression, anxiety, problems in school and drug and alcohol abuse.