Reactive attachment disorder (RAD) is an extreme form of insecure attachment and can lead to ongoing behavioral problems. It can occur when children don’t get the emotional or physical support they need to grow and develop normally. Often, RAD is associated with traumatic experiences in early childhood, like abuse or neglect. It can also be caused by a child’s lack of consistent caregivers, especially in the first few years of life.
Typically, young children can form healthy relationships with their caregivers as long as they are consistently cared for. For example, infants will begin to bond with their parents in the womb as they hear their voices and mother’s heartbeat. However, some babies and children are unable to bond with their primary caregivers as they experience severe or persistent maltreatment. This may include physical and sexual abuse, chronic or recurring neglect, a history of multiple placements in foster care, or frequent changes of primary caregivers. Children with RAD have trouble connecting to others, and they may be described as inhibited or disinhibited.
Research has shown that if a child does not receive adequate treatment for RAD, they are at greater risk for ongoing social, emotional, and behavioral issues. It is also possible for them to develop a variety of other mental health disorders, such as depression and anxiety, or other behavioral disorders, such as substance use disorder or bipolar disorder.
The Diagnostic and Statistical Manual of Mental reactive attachment disorders Disorders, 5th Edition (DSM-5) classifies RAD as a disorder that occurs when a child does not build secure attachments with others and cannot emotionally express positive or negative emotions. Affected children are unable to seek physical and emotional closeness, and their moods change erratically. In addition, they may be aggressive or violent.
If you’re a parent or caregiver with a child who has RAD, it can be comforting to know that you’re not alone. You can find support in a RAD parent group or ask your doctor for resources to connect with other families who have similar experiences. Your provider will also help you understand the condition and provide you with options for treatment.
While RAD is a serious and complicated condition, there are ways to treat it. One option is to work with a child psychiatrist or psychologist who can help you understand the root cause of the problem and develop a plan to address it. A therapist can also teach you parenting skills to help your child feel safe and loved. Medications can also be used to reduce symptoms of RAD, such as antidepressants or selective serotonin reuptake inhibitors (SSRIs). These medications are usually taken only under the supervision of a doctor, and they should not be used with children younger than 8.
If you suspect your child has RAD, it’s important to see a healthcare professional as soon as possible. Your provider can evaluate your child and offer tests to rule out other conditions, such as autism spectrum disorder, which has similar symptoms but is not caused by abuse or neglect. In addition, your provider will recommend other treatments that can help a child feel safe and build healthy connections with others.