Rationalizing Reactive Attachment Disorder
Your adopted five-year-old son can get very aggressive at times. He spits on you when he doesn’t get his way. He doesn’t like to be hugged. He could have reactive attachment disorder.
Reactive attachment disorder (RAD) occurs when an infant fails to receive healthy interaction with caregivers over a prolonged period of time. RAD is not brought on by illness, nor is it inherited. It is due solely to the fact that a child’s caregivers have not allowed sufficient time for a child to create a secure attachment, resulting in a chemical imbalance in the brain.
Infants can be prevented from bonding with a caregiver for many reasons. First, from not receiving necessary infantile attention, such as feeding, changing and consistent physical and emotional care. When care turns negligent, children may be precluded from creating appropriate emotional and psychological attachments. When bonding is interrupted or absent, the child may feel insecure, unstable, abandoned, isolated, powerless or not valued. While all infants have to learn to trust their caregiver, children with RAD may have never had a dependable caregiver, making this impossible.
Children suffering from RAD will generally react following one of two patterns: withdrawn/inhibited or disinhibited/indiscriminate. The withdrawn/inhibited child will not respond to social cues appropriately and instead will be on guard at all times. They do not often smile and may be irritable. The disinhibited/indiscriminate lacks proper screening techniques, seeking comfort and support from anyone. They might seem overly friendly but are most likely only bonded superficially to anyone. They may go off with strangers without notifying anyone.
But there is good news. Children who have suffered a lack of bonding may have a tough road ahead of them, but research shows most will be able to make emotional attachments with caring people. Any cognitive deficits faced by the child should be overcome as well. They may act like younger children, not understanding social situations, and be emotionally stunted. They may need their feelings explained, undivided attention and to be held, but with care and patience most can overcome all deficits.
RAD symptoms are similar to other disorders, such as attention deficit hyperactivity disorder (ADHD) and autism. But unlike ADHD and autism, RAD results from specific environmental and emotional interactions. RAD is hard to diagnose as the child has to have been displaying signs before the age of 5.
Some symptoms of RAD include:
§ Not showing positive emotions, like love, joy or comfort when interacting with others.
§ Avoiding eye contact and physical touch.
§ Expressing fear or anger by throwing tantrums or frequently displaying unhappiness or sadness.
§ Trying to control things in their environment, which results in breaking the rules.
There is no exact cause for RAD. But abuse or neglect early in age and inconsistencies in terms of caregiving are some of the factors that might make it hard for a child to bond with a caregiver.
In terms of diagnosing RAD, your health care provider might ask questions about abuse and the child’s early history, for example, if your child had multiple caregivers at an early age. Your primary health provider may refer you to a pediatric specialist, psychologist or a psychiatrist.
RAD is treated through a variety of different methods such as psychotherapy/counseling, family therapy, social skills intervention, special education and parenting classes. The object of these different approaches is to teach your child about consistent loving relationships. And it may take a while to teach that to your child.
RAD is a lifelong condition. The goal is to improve your child’s social and emotional wellbeing. And not to mention, learning about healthy reciprocal relationships. Don’t hesitate to consult your provider if you suspect your child has RAD.
