Reactive Attachment Disorder is a rare disorder that was first recognized by John Bowlby in 1939 and has recently become a hot topic in the scientific community.
It's characterized by inappropriate (and sometimes severe) social contact and difficulty understanding and expressing emotion. These symptoms can manifest in complete withdrawal, outbursts of angry or even violent behavior or, bursts of indiscriminate affection and devotion.
What causes Reactive Attachment Disorder?
While the scientific community cautions that this disorder is not fully understood and could be the result of a genetic flaw or sensory disorder it's most commonly seen in foster children or adopted children where the child had suffered extreme neglect or abuse. Currently the most popular theory is that Reactive Attachment Disorder develops when an infant does not receive the contact and stimulation from a parent in the first formative year.
Science can't explain why some children develop the disorder and others do not when exposed to similar situations.
Symptoms of Reactive Attachment Disorder
Early symptoms may include:
Outbursts of anger, lack of eye contact, aversion to touch, difficulty expressing emotion, disinterest in play, rocking, poorly developed empathy, pre-occupation with blood and gore, impulsive behaviour, learning difficulties, lack of remorse, extreme "naughtiness", destructive or cruel behaviour, bossiness, overly rough play and overall slow social development.
As the child grows, Reactive Attachment Disorder develops two distinct classes of symptom; Inhibited or Disinhibited.
Inhibited children grow more withdrawn and detached while remaining hypervigilent and distrustful. The child resists attention, affection and may even react to such attempts with violence.
Disinhibited children become indiscriminately affectionate and will show strangers the same level of affection as a parent. They may be extremely needy, chronically anxious and be unable to cope with childhood milestones such as attending school.
Caring for a child with Reactive Attachment Disorder
There is no "cure" for Reactive Attachment Disorder. Experimental psychological reprogramming, rebirthing, neurofeedback and other controversial treatments have failed to give solid results. Like children suffering a severe Austism Spectrum Disorder, parents may struggle to "reach" their child. Teachers, social workers, medical professionals and family friends may also struggle with the child's unpredictable behaviour.
Besides a good dose of realistic thinking, patience and a positive outlook, there are additional steps that you can take to help your child repair:
- Like some autistic children, children with RAD may respond well to routine. As the child may not associate safety with a parent or guardian, she may find comfort in her environment. Keeping to a routine may help.
- Provide a loving and attentive environment. Talk, listen, play and help develop the child's interests. This may seem simple, but for a caregiver of an RAD child, it's anything but – be persistent and present.
- Understand the child's comfort zone. Observe actions and activities that the child enjoys and ones that cause anxiety or upset. You may need to provide more attention and affection to make up on what she's been missing, or, alternatively, wait for the child to initiate any physical touch.
- Help your child to understand emotions. While emotion may be instinctive to you, it may be complex and difficult for your RAD child to understand. Verbally remind a child of the emotions he witnesses in others, and help him to identify them as he feels them. His emotional age may not match his biological age and he may not understand how to appropriately express what he is feeling. He may confuse frustration or sadness with anger. In intense emotional situations, help him to identify exactly what he is feeling and offer him appropriate methods for expressing himself.
- Take control of outbursts. While a two year old tantrum may elicit frustration or anger in you, understanding that a child suffering RAD may not be " just being naughty". Ensure the child is safe, stay calm, enforce appropriate discipline, avoid isolation and provide a swift reconnection once the situation has been defused. When all is calm again, talk to your child about what is and is not appropriate and remind him of the alternative ways to express emotion.
- Consider if medication may help. The best possible treatment is believed to be a combination of medication, psychotherapy and family education.
- Stress management courses and therapy for caregivers is a must as it directly impacts on the child
- Seek out therapists, schools and counsellors with experience in Reactive Attachment Disorder as they will be able to better understand your child's needs and offer the right therapy and learning techniques. As there is still a lot to learn about this disorder, keep an open mind to different therapies and stay in contact with other caregivers for up-to-date information and ideas that may work for your child.
Most of all, stay calm and know that you're repairing a human being, it's going to take time and patience.
Janet Reid is passionate about helping all kids to reach their full potential. Her experience with children suffering Reactive Attachment Disorder has inspired her to become an educator on this rare but incredibly difficult disorder. She currently resides in Australia and sells boys clothes online.