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What You Need to Know about Reactive Attachment Disorder

If you’re a prospective adoptive parent, you’ve probably come across something called “reactive attachment disorder” as you’ve been researching adoption. Because it’s uncommon, and not many families seek help for the disorder, it may seem scary to you — and make you worry even more about the challenges of adoption.
While RAD is rare, it’s important to understand the realities of the disorder to not only prevent it but know what to do if your adopted child starts to exhibit symptoms. To help all prospective adoptive parents, we’ve answered some of the most common questions about the disorder.

What is Reactive Attachment Disorder (RAD)?

Reactive attachment disorder is a condition that develops in children when they are unable to form a healthy emotional attachment with their primary caregivers before the age of 5, according to PsychCentral. It’s rare, occurring in only 10 percent of cases involving severely neglected children.
RAD can occur for many reasons, and each case is different. Commonly, a child develops this disorder because of a primary caregiver’s continual disregard for their needs (whether emotional or physical) and inconsistency in primary caregivers, such as is experienced in the foster care system.

What are the symptoms of RAD?

When a child develops RAD, they start becoming detached and withdrawn from their primary caregivers. They may hold back emotions and be resistant to comforting, becoming unresponsive to the attention that they’re given. Usually, if a child is exhibiting attachment problems, parents can tell that something is wrong.
If a parent thinks that their child is exhibiting any of these symptoms in excess of the normal adjustment for an adopted child, they should contact a physician or a child and adolescent psychologist, who can more thoroughly test if the child has RAD.

How is RAD treated?

There is no medication to treat RAD, as treating the condition focuses mainly on the emotional and physical wellbeing of the child and their relationship to their primary caregiver. If a child is diagnosed with RAD, the most important thing to determine is whether they are in a safe and stable environment. If they are, the focus moves to the primary caregiver — providing them appropriate advice and parenting skills to develop a healthy, trusting relationship with their child. With time and patience, most children can learn to trust others and live a happy and healthy life.

Why is RAD associated with adoption?

Children who are adopted are often associated with RAD because of their seemingly heightened potential for developing the condition. While there is no research supporting a connection between adoption and RAD, children who are adopted may be more at risk because of their early childhood experiences.
For example, children who are adopted from the foster care system may have only known a life where they were persistently moved from foster home to foster home — and, subsequently, were unable to develop a strong relationship with a primary caregiver. Unable to have positive examples of relationships, they may have difficulty trusting an adult once they are finally adopted. Likewise, internationally adopted children who lived in orphanages may not have received the one-on-one emotional care they needed to develop a secure trust in caregivers. RAD can also affect children who were adopted as infants.

When should I seek help about an adopted child who is having attachment problems?

First, it’s important to recognize that an adjustment period is normal when you welcome an adopted child into your home, no matter their age. It will take time to adjust to your and your child’s new life together, and that may come with challenges bonding at first. However, most adoptive parents and their children create a loving, trusting relationship within the first few weeks and months of placement.
If more time passes and attachment problems continue, it may be beneficial to seek professional help. For example, if a baby continues to refuse to make eye contact or interact with their parents or doesn’t seem to like being cuddled or held, they may be exhibiting the first signs of an attachment disorder. It’s important to address these issues sooner rather than later, as leaving these symptoms unchecked can lead to more severe problems as a child grows up.
A child with attachment difficulties does not mean that you’re a bad parent. With the proper care and lots of patience, a child can learn to trust and love their parents. It’s rare that attachment difficulties develop into full-blown RAD, but it’s important to recognize the warning signs so you can ensure a healthy relationship with your adopted child from as early on in their life as possible.
To learn more about RAD, contact an experienced child and adolescent psychologist or psychiatrist.