Category — 2.9 Children with Mental Health Disorders: Attachment Disorders

Description

Reactive attachment disorder (RAD)¹ is a complex and serious condition that impacts the lives of children and their families. It is believed that children develop RAD in response to traumatic events or situations lived between birth and 5 years of age.  Children with RAD usually grow up in homes where their needs may not have been met or with parents/caregivers who are unresponsive (see full Glossary) homes.Some of these children may have also experienced abuse, uncaring, or neglectful parenting. Growing up in such environments makes some children unable to form healthy relationships with others, including significant others, such as parents, relatives, and friends. Many children who have been in care and/or have survived abuse and neglect tend to develop RAD. This is especially true for foster children who are frequently moved from one home to the next, as this prevents them from forming healthy relationships with their foster parents.

Infants with RAD may show some of these symptoms:

• Severe colic;
• No energy or will to eat or drink even if not sick;
• Cannot sleep, or shows disruptive sleep patterns (see full Glossary);
• Difficulty eating, in general;
• Avoids being close to others.

Children with RAD usually:

• Do not to smile to others;
• Do not reach for others;
• Do not react when their primary caregiver leaves them, even if they are left with strangers;
• May try to soothe themselves by scratching, hitting, masturbating themselves in what is known as  self-stimulatory behaviors (see full Glossary);
• May be aggressive with others;
• Do not join their peers in play activities;
• Do not ask for help, when needed;
• May be quite withdrawn, or excessively shy;
• Prefer to be alone;

There are two main types of RAD:

• The outgoing or uninhibited type: These children may seem very friendly, even with strangers. This is because they are so desperate for attention they are willing to take it from everyone. They may seem quite compliant and may appear very charming. This usually lasts until they are told no, or prohibited from doing what they want. At this point they may show aggressive behaviors, to the point of destroying property and hurting people.
• The more reserved, or inhibited type: These children completely dismiss others. They show no interest in grown-ups or peers. They appear to not to want love or affection from anyone. This is because they feel a need to protect themselves from being hurt, yet again.

Recent research suggests that when a child does not get the attention and care he or she needs, the development of his or her brain is altered, perhaps forever, in a very adverse way. This is why RAD requires intervention as early as possible, during the preschool years. It is important to stress that this condition has been seen to affect children who have experienced severe and traumatic home living conditions. Children are not “born with RAD;” it is not related to a genetic or medical condition.

Intervention Options

There is a combination of medical, counseling and educational strategies available to treat RAD. Treatment and strategies involve a team of specialists of different disciplines (see full Glossary) who understand mental health disorders in infants and young children, including anxiety, mood and depression disorders as well as attachment disorders. Family therapy and educational counseling needs to be in place for parents and other primary caregivers. Specialized therapy will involve both the child and their parents. Medical treatment might be needed if severe anxiety and depression are diagnosed with RAD.

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