Dealing With R.A.D. (Reactive Attachment Disorder)

For many a child in foster care, a healthy and loving relationship with a biological parent was never created.   By the time the child is placed into a 
loving and stable foster home, the damage has been done, and the results can be both damaging and exhausting for all involved.    The trauma is too
deep, the lack of attachment has profoundly affected the child, and sadly the child may never fully recover.

Reactive Attachment Disorder (R.A.D.) is a condition in which children have great difficulty in forming healthy attachments with others.  Along with this,
these children also struggle mightily with connecting with others on any type of social level.    Children who are diagnosed with R.A.D. also find it very 
difficult to keep their emotions in control.   Though often undiagnosed, many children in foster care suffer from R.A.D.; a condition that their foster 
parents and caseworkers may not be familiar with.
Causes of Reactive Attachment Disorder

Every baby, indeed every child, needs to feel loved.  Young children need to develop a feeling of trust with a loving adult, as well as develop a healthy
loving bond between the caregiver and the child.  If these simple emotional and physical needs are ignored, or instead met with emotional or physical 
abuse from the adult, attachment issues arise.  Children who suffer from these conditions become distrustful of others, at the same time learning to 
avoid contact with others in a social setting, while at an early age.  Though Reactive Attachment Disorder is rare, scientists have discovered that R.A.
D. begins generally before a child reaches the age of five years old, and most often during a child’s infancy stage, or while a baby.

Children in foster care may develop R.A.D. for a number of reasons.  To begin with, as the disorder is one that results in children having a difficult 
time socially interacting with others, those children in foster care who experience multiple displacements are more likely to develop R.A.D.  Multiple 
displacement is the term used when a foster child moves from one foster home to another, and so forth, on a regular basis.  Each move, each 
displacement, is another traumatic experience for the child.  Indeed, each time a child is displaced, it is more difficult for the child to form a healthy, 
loving bond with another.

Sadly, a large number of children in foster care have suffered from extreme neglect from a biological family member or caregiver.  These children 
have not had the opportunity to form the healthy attachment they sorely need as an infant.  Other causes of Reactive Attachment Disorder stem from 
physical, emotional, or sexual abuse at an early age; living in a home that is stricken with high levels of poverty; parental inexperience or 
abandonment; household alcohol or drug abuse; separation from a birth parent; prolonged periods of hospitalization, emotional instability, 
depression, or prolonged illness from a parent, or simple lack of daily engagement.

Signs and Symptoms

As indicated earlier, R.A.D. can begin when a child is an infant.  Thus, signs of the disorder can sadly begin to show up in a child quite early in his 
life.  For those babies who suffer from Reactive Attachment Disorder, they may appear to be withdrawn or sad.   Not only do babies with Reactive 
Attachment Disorder often withdraw from others, they are often unable to engage in any activity where another adult is attempting to pacify or soothe 
the infant, such as with stroking the child’s head, or whispering to the baby in soothing words and calming voice. Many babies with R.A.D. seldom, if 
ever, smile, despite the most persistent attempt from another.  Along with this, lack of eye contact is another indication that the baby is suffering from 
the disorder, and the child will most likely not even have the inclination to follow others with his eyes as they walk across the room or pass in front of 
him.  Another trait to those who suffer with the disorder is the failure to respond to interactive games with others, such as Peek-a-boo and other 
games that engage the small child.  

As a child with Reactive Attachment Disorder grows older, his symptoms may grow more troublesome and difficult to manage.  Anger issues may 
begin to develop, as the child might lash out in tantrums and/or uncontrolled rage, or act in a passive aggressive manner.  While most with R.A.D. will 
endeavor to remain in control in an attempt to avoid a feeling of helplessness, many times, these children will instead act defiant and disobedient, and
will be quick to argue with another.  Indeed, those who have problems with anger and control issues may be more likely to act in an aggressive 
manner towards their peers.  Feelings of remorse or guilt for their negative actions and behavior are also often missing with those who are diagnosed
with R.A.D.

While some children with R.A.D. may exhibit anger problems, others with the same disorder may withdraw from others, like they had in infancy.  These 
children will seek to avoid interaction with others, including their peers, and act in an awkward and uncomfortable fashion while around others. Some 
children will strive to distance themselves from any type of physical contact with another, as they may perceive this interaction as a threat of some 
sort.  Furthermore, these children will be more likely to seek out an affectionate relationship that is inappropriate with another, even those they do not 
know, yet display little or no affection towards their parents or caretakers.

Children with Reactive Attachment Disorder may display two different signs and patterns of their malady.  Inhibited behavior is that in which the child 
will shun or discourage relationships and attachments with others.  As noted above, these are the children who are withdrawn or emotionally detached 
from others and from their surroundings.  Disinhibited behavior occurs in those children who attempt to seek out attention from any and all that may 
be near, including that of strangers.  This child will seek out comfort and attention from virtually anyone, yet at the same time, will try to act very 
dependent of others.   Along with this, he will very likely refuse to ask for help or support from his peers.  At times, the child with Disinhibited behavior 
will act much younger than his actual age, and appear to be filled with high levels of anxiety, as well.