Reactive Attachment Disorder In Children And Adolescents
- Michael Minnella
- Jan 3
- 3 min read
Reactive Attachment Disorder (RAD)
Reactive Attachment Disorder is a mental health condition that can develop in early childhood according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association. It arises when a child’s basic needs for comfort, affection, and security are not consistently met by their caregivers. This disruption in early caregiving can have lasting effects, impacting a child’s ability to form healthy emotional bonds throughout their life.
The DSM-5 criteria for diagnosing RAD in children include:
A consistent pattern of emotionally withdrawn behavior toward caregivers: This is manifested by the child rarely seeking or not responding to comfort when distressed.
Persistent social and emotional problems: This can include minimal responsiveness to others, no positive response to interactions, or unexplained irritability, sadness or fearfulness during interactions with caregivers.
Persistent lack of having emotional needs met by caregivers: This could be due to repeated changes in caregivers or care in a setting that limits opportunities to form attachments.
No diagnosis of autism spectrum disorder.
It’s important to note that diagnosis is not usually made before 9 months of age, and signs and symptoms typically appear before the age of 5 [1].
What to Look For
While RAD can manifest differently in each child, some common signs include:
Difficulty trusting or forming close relationships
Withdrawn behavior or seeming indifference to comfort
Inappropriate emotional responses, like intense outbursts or a lack of emotions
Preoccupation with gaining attention, often in negative ways
These symptoms can also be present in other conditions, so a mental health professional is crucial for accurate diagnosis.
Diagnosis
Diagnosing RAD can be complex and requires a thorough evaluation by a qualified mental health professional. Since RAD is relatively rare, a mental health professional will consider a child’s developmental history, symptoms, and any other diagnoses to make an accurate assessment. Often, RAD is a secondary diagnosis, meaning it can co-occur with other mental health conditions.
Treatment
Early intervention is crucial for children with RAD. Treatment approaches typically involve therapy techniques that help the child build trust with a therapist and learn healthy ways to connect with others. It’s important to remember that physical touch can be dangerous due to possible past trauma, so individual and family therapy services are essential [2].
Goals Of Treatment For RAD:
Provide a safe and stable living situation for the child
Develop positive interactions and strengthen attachments with caregivers
Address the child’s medical, safety and housing needs
Treatment Strategies May Include:
Encouraging the child’s development through nurturing, responsive care
Providing consistent caregivers to form a stable attachment
Creating a positive, stimulating, and interactive environment
Other Services That May Benefit The Child And The Family Include:
Individual and family therapy
Education of parents and caregivers about RAD
Parenting skills classes
If you suspect your child may be struggling with RAD, remember you’re not alone. Early intervention is key, and with the right support, children with RAD can develop healthy attachments and build fulfilling relationships. Consider scheduling a consultationwith a qualified mental health professional today. They can help you understand your child’s unique needs and develop a treatment plan to promote healing and growth.
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