RAD and Attachment

Almost all children will be able to form attachments, but the quality of those attachments will depend on a child’s caregivers. A child will still form a bond with neglectful or abusive caregivers, but that bond will become insecure as a child’s needs are repeatedly not met, and that child may struggle to form secure attachments to loving and receptive caregivers in the future as a result of that learned distrust.

Parents who have adopted a child through foster care may see some degree of attachment issues in their new child as a result of their child’s past experiences with caregivers. As his or her new, permanent parent, how can you better understand and meet your child’s emotional needs? 

Here are some common questions that parents have asked about attachment issues, and about nurturing attachments, supporting children who are fostered or adopted and meeting their needs.

What is “Attachment Theory?”

When a baby cries, if he or she is consistently and quickly picked up and comforted, the child will develop a secure bond to that responsive caretaker. If a baby cries and is not met with that immediate and consistent comfort, trust is broken, and their bond will become insecure. The repeated reinforcement of either positive or negative responses from caregivers as a child grows will determine how they interact with future caregivers.

Separation from loving caregivers or a series of inconsistent caregivers can also break that trust formed in infancy and in early childhood and can lead to insecure attachments. When a child is deprived of a secure attachment with a consistent and loving caretaker, they are at greater risk for developing emotional and behavioral problems as a result. 

That’s why attachment in fostering and adoption is a common topic. Fostered and adopted children have all been removed from their first caretaker, and some will have experienced a series of inconsistent caregivers or neglectful ones. 

The use of attachment theory in adoption and fostering becomes helpful for understanding a child’s emotional state, so that parents can then appropriately provide for their child’s emotional needs. For a child to regain trust, they’ll need to have a consistent and responsive caregiver who meets their emotional needs as well as their physical ones.

What is Reactive Attachment Disorder (RAD)? 

Reactive Attachment Disorder (RAD) is caused by highly traumatic events in early childhood. It is rare — only an estimated 10% of severely abused children will develop RAD. However, even without a RAD diagnosis, some children may exhibit milder versions of some of the RAD symptoms, and could be suffering from attachment issues to some degree.

Some symptoms of children with RAD may include:

• Avoidance of eye contact
• Indiscriminately affectionate with strangers
• Not affectionate on the parents’ terms
• Destructive to self, others or things
• Cruelty to animals
• Lying about the obvious 
• Stealing
• No impulse control
• Hyperactive or hyper-vigilant
• Learning delays
• Lack of conscience or shows no remorse
• Abnormal eating patterns, such as hoarding food or refusing to eat
• Poor peer relationships
• Preoccupation with fire, violence, weapons or the concept of evil
• Persistent nonsense questions & chatter
• Inappropriately demanding and clingy
• Abnormal speech patterns

Reactive Attachment Disorder in adopted and foster care children has been more commonly seen due to the early trauma of losing their first caretakers, but that does not mean all fostered or adopted children will develop attachment issues or RAD.

The term “attachment disorder” and the more acute diagnosis of Reactive Attachment Disorder are often used loosely, and many parents have assumed that when a child has behavioral difficulties it’s due to attachment issues of some kind. However, not all children who have experienced trauma or struggle with behavioral problems will have an attachment disorder.

How Can You Tell If Your Child Has Attachment Issues?

Children who have experienced early traumas tend to be at greater risk for developing some degree of attachment issues, but that doesn’t mean that all children who have experienced trauma will struggle with attachments. The removal from their original home and caregivers, and being in foster care with multiple loving, but temporary, caregivers is often an emotionally traumatic experience for children of any age, even infants.

Even so, children will almost always be able to form secure attachments with their permanent caregivers when given enough time, care and consistency, except in the most extreme situations.

If you’ve noticed your children exhibiting mild symptoms associated with RAD, they may be struggling with attachment issues. Although it’s unlikely they have full-blown RAD, it’s not uncommon for abused or neglected children to show some milder aspects of the disorder. In these circumstances, you should work to address issues immediately so you can consistently meet your child’s emotional needs before symptoms become worse.

If you’re worried that your child is struggling emotionally and is having a hard time forming strong attachments to you as their permanent caregiver, contact a competent specialist who is qualified to assess whether or not your child may have RAD or attachment issues, and to help you support your child.

A specialist will also be able to give you professional advice based on your individual situation.

How Can You Help Your Child Develop Healthy Attachments?

Providing support to a child who is struggling to form healthy bonds and attachments can take an emotional toll on parents who are eager to have their love reciprocated. It takes time, love and, above all else, consistency. 

Children who have repeatedly been neglected by past caregivers, or who have experienced multiple temporary caregivers, may not always express their needs to you, or they may not express them in a “typical” way. However, remaining sensitive and responsive to their needs consistently is the best way to assure your child that you won’t let them down as their permanent caretaker.

Here are some ways you can support your child and foster healthy attachments:

• Anticipate your child’s needs as much as possible (i.e. regular meal times, sleep and waking routines, etc.)
• Respond to your child’s needs attentively and as immediately as possible, every time
• Make eye contact with your child as often as possible and for as long as you can, but without forcing it
• Respond with comfort and care, even if your child doesn’t seek it out from you (i.e. when they fall, give a hug or bandage, even if they don’t seem upset)
• Find ways to encourage appropriate physical closeness (i.e. wearing a baby in a sling as often as possible, cuddling and hugging whenever accepted, combing and stroking hair, sleeping in the same room, etc.)
• Don’t send your child away when they misbehave — stay physically present and provide comfort through temper tantrums, hold them in your lap as a form of emotional “time out,” etc.
• Talk to your child often, and listen closely when they speak (i.e. ask them questions, sing songs together, repeat their responses to confirm that you heard them, read to them, explain the schedule for the day, etc.)
• Create physical reminders of your child’s permanency within the family (i.e. hang up their artwork, take family photos and display them, display their name in their room, let them have an area of the living room for their toys, etc.)

If your child is struggling with behavioral issues or potential attachment problems, it’s not your fault as a parent. It’s certainly never a child’s fault. Emotional or behavioral issues are a common response to trauma and neglect.

If you and your child continue to struggle, or you feel that issues are getting out of your control, contact your caseworker for a referral to a competent specialist to assess for Reactive Adoption Disorder. Foster care adoption-competent specialists will not see you as failing your child, but rather as a good parent who is actively working to meet their child’s needs — so don’t wait to reach out if you need help and support.