What is it? We cover what it is and how to treat it. Access additional resources like support information and testimonials.
Reactive attachment disorder (RAD) is a serious disorder that occurs when an infant or child is unable to form attachments to parents or caregivers. This usually occurs when a baby’s emotional and physical needs are neglected. Children most often at risk for developing RAD may have experienced the following situations: live in a children’s home or facility, frequently changes foster homes or caregivers, have inexperienced parents, have prolonged separation from parents or other caregivers due to hospitalization, have a mother with postpartum depression where she is not actively caring for the child or are a part of an large family where time with the parent or caregiver is rare. It should be stated that not all children in these situations develop RAD. Every child is different and respond differently to these situations.The literature states that RAD is rare and uncommon.
Reactive attachment disorder (RAD) requires the following criteria from the DSM-5 (Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition).
A. A consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, manifested by both of the following:
B. A persistent social or emotional disturbance characterized by at least two of the following:
E. The criteria are not met for autism spectrum disorder.
F. The disturbance is evident before age 5 years.
G. The child has a developmental age of at least nine months.
Specify if Persistent: The disorder has been present for more than 12 months.
Specify current severity: Reactive Attachment Disorder is specified as severe when a child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels.
Remain calm. Learn as much about parenting, relationships, behavioral skills and reinforcement. Parents will be working on building a trusting relationship. Trust will be based on the perception of the child and not the parent. It’s easier to understand it from the point of view of the child. Children who have been hurt will often find other ways to protect their emotions. It will take time to break down those barriers and establish new ways of relating to caregivers. This will take time. It is important for parents to be patient and consistent.
Inconsistency may reinforce the idea that caregivers or parents are not to be trusted. It is important to be consistent and remain consistent in your child’s life. It doesn’t mean you have to be perfect. You should just be consistent and acknowledge when mistakes are made and go back to the established rules.
There are two main approaches to treatment
First, ensure the child is in a safe environment where their emotional and physical needs can be met.
Second, focus on changing the relationship between the child and the caregiver. If the caregiver is the cause of the problem it is recommended that they learn parenting skills to improve the relationship.
If not treated a client may also develop additional problems including: anxiety, depression, post traumatic stress disorder, substance abuse or other psychological problems.
Your child should have a complete physical from a physician to determine if there are other issues going on in relation to any behavior problems. If he recommends mental health counseling he may be able to provide some referrals. He may also refer your child for a psychiatric evaluation to determine if your child suffers from RAD. This evaluation will rule out other issues including: intellectual disabilities, adjustment disorders, autism and depressive disorders which may look like RAD but have different treatment protocol.
Once the diagnosis is confirmed an addition referral may be made for mental health counseling for the child and family.
Consider the following if you are seeking out a competent mental health professional:
These criteria help establish trust in the relationship and consistency with the child which helps address the issues of abandonment and mistrust.
Working together with a mental health therapist, parents can learn skills to implement at home that help expedite treatment and increase the probability of success.
Children and parents can benefit greatly from using basic skills. The recommended Parenting Skills for RAD are found in the lessons Effective Communication. Effective Praise, Preventive Teaching. These parenting skills address negative behaviors and in many ways seeks to prevent them. All the lessons on Smarter Parenting will be beneficial in building and strengthening trust and improved relationships.
This lesson provides a key element that will help improve treatment and your relationships. When it is effectively used it will build trust.
Children with RAD have difficulty establishing healthy relationships and receiving any sort of feedback or correcting. Effective Praise allows your RAD child to trust you and that trust helps them receive correction without blowing up.
All the skills on Smarter Parenting will provide you with additional tools to improve your power as a parent and help you raise happy, responsible children. Check them out and watch the videos.
The Mayo Clinic has additional information on treatment options.
WebMD breaks down the RAD diagnosis into easy to understand sections.
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