Children between the ages of 9 months and 5 years that were subjected to neglect or abuse as an infant or toddler may suffer from reactive attachment disorder, commonly abbreviated as RAD. This is most common in children that live in an orphanage, are constantly exposed to different foster homes, or live with parents that have severe mental health issues or criminal behavior.

Keep reading to learn the causes and symptoms of this uncommon but serious disorder.

What Is Reactive Attachment Disorder?

Children with RAD don’t create the proper bonds with their parents or caregivers. Typically, when a child’s basic needs aren’t met or the child is subjected to extreme abuse, they can develop this syndrome that causes them to be irritable, inconsolable, and fearful when in the care of their parents or caregivers. As childhood progresses, the child or teen will often be insecure and will not form attachments or cultivate healthy relationships.

Causes of RAD

Babies and toddlers need a warm, nurturing environment when they are first brought into the world. They rely on adults for their every need. Not only do they require physical care, such as clean diapers, feedings, and proper sleep, but they also need emotional care from their parents or caregivers.

If the parents or caregivers don’t meet the baby’s or toddler’s needs or they don’t provide a warm and loving emotional response, the child doesn’t learn to expect it from them. This makes it difficult for the child to create a bond with the parent or caregiver.

This can occur because the parent or caregiver simply isn’t able to give the care because of a mental health or substance abuse issue or because the child gets passed around between caregivers, never having enough time to properly connect to any one caregiver.

Signs and Symptoms of Reactive Attachment Disorder

RAD can present itself in many different ways, but the most common symptoms include:

• Excessive withdrawal and self-isolation
• Fear when with caregivers
• Very little or no smiling or laughing
• Does not make eye contact
• No fear or separation anxiety when the caregiver is not in the room
• Lack of interest in socializing with others
• Does not want the comfort of adults
• Consistent rocking back and forth when upset
• Resists being picked up or carried by an adult
• Doesn’t play with toys

These signs and symptoms most pertain to kids ages 5 and under. It can present itself in older children and teens as well, but they can mimic other issues, which can make it difficult to diagnose later in childhood.

Typically, older children that have RAD have behavior that resembles that of children much younger than their actual age. They often have high levels of anxiety. They might seem controlling and unwilling to let others help them with small or large problems. They may seem irrational or moody and they may even throw temper tantrums past early childhood. Older children with RAD may seem closer to complete strangers than they do their own parents or caregivers.

Treatment for RAD

Since reactive attachment disorder is a condition that affects the entire family, the treatment focuses on fixing the family bonds. As children and their parents or caregivers repair their relationship, children can learn to create healthy relationships with others moving forward.

Typically, treatment for RAD includes cognitive behavioral therapy for everyone in the household. This includes the affected child, parents, and caregivers. It can also include siblings. Therapy sessions may focus on the child alone, parents alone, and then everyone together in some family sessions.

Children may also undergo social skills treatment. This helps them learn proper ways to interact with others as well as what healthy relationships look like. Sometimes children also qualify for special education in the classroom. This can further help children learn how to behave socially as well as how to focus on their academics.

RAD treatment may also focus on parents, as they play an integral role in developing a healthy relationship with their child. Parents often take parenting skills courses that help them learn how to interact with their child with RAD as well as how to discipline them. Because of the fear and lack of attachment with a parent, discipline may look a lot different for a child with RAD and parents need to learn this skill.

The Complications of RAD

The complications of RAD can present themselves differently in each child, but the most common issues include:

• Delayed development
• Lack of physical growth
• Mental health issues including anxiety and depression
• Trouble with anger management
• Substance abuse issue
• School issues (poor grades, social issues)
• Difficulty developing relationships

Without proper treatment, reactive attachment disorder can cause issues for a lifetime. Problems with anger management and the inability to form and maintain healthy relationships can plague the individual for years or decades. Treatment can be sought at any time, but it is most effective during childhood.