Reactive attachment disorder (RAD) is a condition that is often found in children. Individuals suffering from RAD have often suffered some sort of trauma or neglect in basic care. This type of neglect occurs when the individual does not form a healthy attachment to their caregiver or parent (typically their mother) before the age of five.
WebMD describes attachment from a caregiver as the child being “repeatedly soothed, comforted, and cared for,” and when the child’s needs are met. It is through this attachment that a child will learn to love and trust others. The child will also become aware of their own feeling and needs at this time. They will learn to regulate their own emotions and develop a healthy image of themselves and relationships with others.
Although reactive attachment disorder is rare, it is a serious condition that may affect the child throughout their entire life. According to the Mayo Clinic, RAD can continue for several years or lifelong for a child that does not seek treatment.
How Does a Teen Develop Reactive Attachment Disorder (RAD)?
According to WebMD, a child will develop reactive attachment disorder by the age of five. However, this disorder, when left untreated, may seriously affect the child through their teen years (or even their entire life).
A child may be at risk for developing reactive attachment disorder if they are in serious situations of neglect, either socially or emotionally. These children lack the opportunity to develop healthy attachment and relationship skills.
A child may be particularly at risk of RAD if they:
- Have lived in a children’s home or other institution
- Frequently changed foster homes or caregivers
- Have experienced prolonged separation from parents or other caregivers due to hospitalization
- Have a mother who experienced severe postpartum depression
- Are part of an unusually large family, where parental time is scarce, unavailable, unequally divided or rare
Although children are resilient, it is important for them to feel safe and learn to develop trust. Infants and young children require a stable and caring environment to grow and thrive. The basic needs of a child must be both recognized and met. For example; when a baby cries, the caregiver will need to recognize the infant’s need (perhaps a diaper change or a meal) and be able to meet that need. In addition to simply meeting the need of the child, the caregiver must also meet the child with an emotional exchange such as eye contact, a smile, or loving touch. When a child’s needs are not met, or when those needs are not met with an emotional connection, the child will learn not to expect it.
WebMD cites causes of reactive attachment disorder as:
- Persistent disregard of the child’s needs for comfort, stimulation, and affection
- Persistent disregard of the child’s basic physical needs
- Repeated changes of primary caregivers that prevent formation of stable attachments
Symptoms Found in Children with Reactive Attachment Disorder
Symptoms of reactive attachment disorder can fall into categories of inhibited and uninhibited. A child with inhibited RAD will be more self-conscious and show restraint. A child with uninhibited RAD will act out without consciousness or restraint.
Common symptoms of inhibited reactive attachment disorder include:
- Unresponsive or resistant to comforting
- Excessively inhibited (holding back emotions)
- Withdrawn, or a mixture of approach and avoidance
A child with uninhibited RAD may show signs of:
- Indiscriminate sociability
- Inappropriate selection in attachment figures
Does My Teen Have Reactive Attachment Disorder?
Signs and symptoms of reactive attachment disorder appear at a very young age. If you believe your teen may have reactive attachment disorder, collect an inventory of signs and possible causes from their childhood, as well as present circumstances.
Signs and symptoms often found in teens with reactive attachment disorder may include:
- Withdrawal, fear, sadness or irritability that cannot readily be explained
- Sad and listless appearance
- Not seeking comfort
- Showing no response to comfort
- Failure to smile
- Watching others closely but not engaging in social interaction
- Failing to ask for support or help
- Always seem angry
- Show extreme disrespect to parents or other people in authority
- Self-protect by keeping people at a distance
- Lie, manipulate and steal
There are many signs and symptoms of reactive attachment disorder that could be found in your teen. If your teen exhibits a number of these signs and symptoms, it is recommended that you seek professional help in order to assess if your teen may have RAD. If your teen does have reactive attachment disorder, treatment will be crucial to their future success.
Do These Symptoms Describe Your Teen?
- Intense control battles, very bossy and argumentative; defiance and anger
- Resists affection on parental terms
- Lack of eye contact, especially with parents – will look into your eyes when lying
- Manipulative – superficially charming and engaging
- Indiscriminately affectionate with strangers
- Poor peer relationships
- Lies about the obvious or tells crazy lies
- Lack of conscience – shows no remorse
- Destructive to property, self and/or others
- Lack of impulse control
- Hypervigilant or hyperactive
- Learning lags and/or delays
- Speech and language problems
- Incessant chatter and/or questions
- Inappropriately demanding and/or clingy
- Food issues – hordes, gorges, refuses to eat, eats strange things, or hides food
- Fascinated with fire, blood, gore, weapons, and/or evil
- Very concerned about tiny hurts, but brushes off big hurts
- Parents appear hostile and angry
- The child was neglected and/or physically abused in the first three years of life
Tips to Help Your Teen Affected by RAD to Feel Safe
Safety is the core issue for teens with reactive attachment disorder and other attachment problems. They are distant and distrustful because they feel unsafe in the world. They keep their guard up to protect themselves, but it also prevents them from accepting love and support. So before anything else, it is essential to build up your child’s sense of security. You can accomplish this by establishing clear expectations and rules of behavior. Also, by responding consistently so your child knows what to expect when he or she acts a certain way, and—even more importantly—knows that no matter what happens, you can be counted on.
Set limits and boundaries. Consistent, loving boundaries make the world seem more predictable and less scary for children with attachment problems such as reactive attachment disorder. It’s important that they understand what behavior is expected of them, what is and isn’t acceptable, and what the consequences will be if they disregard the rules. This also teaches them that they have more control over what happens to them than they think.
Take charge, yet remain calm when your child is upset or misbehaving. Remember that “bad” behavior means that your child doesn’t know how to handle what he or she is feeling and needs your help. By staying calm, you show your child that the feeling is manageable. If he or she is being purposefully defiant, follow through with the pre-established consequences in a cool, matter-of-fact manner. Never discipline a child with an attachment disorder when you’re in an emotionally-charged state. This makes them feel more unsafe and may even reinforce the bad behavior.
Be immediately available to reconnect following a conflict. For children with insecure attachment and attachment disorders, conflict can be especially disturbing. After a conflict or tantrum where you’ve had to discipline your child, be ready to reconnect as soon as he or she is ready. This reinforces your consistency and love and will help your teen develop a trust that you’ll be there through thick and thin.
Own up to mistakes and initiate repair. When you let frustration or anger get the best of you, or you do something you realize is insensitive, quickly address the mistake. Your willingness to take responsibility and make amends can strengthen the attachment bond. Teens with reactive attachment disorder or other attachment problems need to learn that although you may not be perfect, they will be loved, no matter what.
Try to maintain predictable routines and schedules.
An adolescent with an attachment disorder won’t instinctively rely on loved ones and may feel threatened by transition and inconsistency—for example, during times when traveling or during school vacations. A familiar routine or schedule can provide comfort during times of change.
If you believe your teen is suffering from Reactive Attachment Disorder, please give us a call today at (706) 703-4188 to find out if we can help, or direct you to someone who can.