Child-caregiver relationships play a pivotal role in every child’s life, shaping how children perceive themselves and others, express emotions, and build social connections. Unfortunately, many children in the United States lack a stable and nurturing environment in their formative years and struggle to bond with their parents or guardians.

When infants and young children fail to establish healthy relationships with their caregivers, they may develop reactive attachment disorder—a chronic mental health condition with long-lasting negative consequences. Learn what reactive attachment disorder is, what symptoms it may cause, and what treatment options are available to support children diagnosed with this disorder.

Table of Contents

• What Is Reactive Attachment Disorder
• Symptoms of Reactive Attachment Disorder
• Causes of Reactive Attachment Disorder
• Diagnosis of Reactive Attachment Disorder
• Treatment of Reactive Attachment Disorder
• Preventing Reactive Attachment Disorder

What Is Reactive Attachment Disorder

Reactive attachment disorder (RAD) is a mental health disorder first recognized in the 1980s and included in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). RAD is a rare but serious condition that develops when a child does not form secure and stable bonds with their primary caregivers.

Children with RAD struggle to manage their emotions and build relationships with others. This disorder negatively affects a child’s physical and mental development. If RAD is not addressed, children may deal with its adverse consequences—from low self-esteem to difficulty trusting others—long into their adult years.

Symptoms of Reactive Attachment Disorder

How can you tell that a child has RAD? Here are the common signs of reactive attachment disorder to look out for:

• Emotional Withdrawal: Children with RAD may appear sad, listless, and unresponsive. If a child rarely shows their emotions and does not react when their caregiver tries to engage them, this may be a reason for concern.
• Anger Issues: On the other hand, a child with RAD may seem constantly agitated and frustrated. Pay attention to a child’s reaction to seemingly minor issues and their behavior around other children—kids with RAD may resolve their disputes with peers by yelling at them or even hitting them.
• Avoidance of Physical Touch: While some children are not naturally affectionate and do not like being hugged, a lack of physical touch combined with other symptoms on this list may mean the child is suffering from RAD. A child who flinches or freezes when they are being touched—even when they are being patted on the back or held by the hand—may have attachment issues.
• Poor Sleeping and Eating Habits: It is not unusual for a child’s mental troubles to affect their physical well-being. RAD may lead to insomnia, lack of appetite, or, on the contrary, binge eating. In many cases, children start to complain about headaches, muscle pain, and stomachaches when they have RAD.

Causes of Reactive Attachment Disorder

The main reason why RAD develops is the deprivation of a loving and supportive environment in the first months of a child’s life. Here are a few specific causes of RAD:

• Neglect: When a baby’s basic needs are not met—for instance, the caregiver does not feed the baby often enough, leaves the baby alone for long periods of time, and ignores the baby when it is crying—the child may fail to see their caregiver as a reliable and trustworthy figure in their life.
• Abuse: Sadly, many children are mistreated by the adults who are supposed to take care of them. Physical violence, verbal insults, and sexual exploitation will certainly have a long-lasting negative impact on the child’s psyche.
• Frequent Changes of Caregivers: Stability is crucial for the child’s proper development. Sometimes, children are unable to stay with their biological parents—they are sent to foster families, move from one adoptive family to another, or grow up in an orphanage. In these scenarios, RAD becomes a major concern—a child who does not have a permanent caregiver may struggle to form attachments.

Diagnosis of Reactive Attachment Disorder

If you suspect your child has RAD, it is important to reach out to a healthcare provider who will be able to determine whether the child has this disorder. A qualified mental health professional—for instance, a psychologist or a psychiatrist—will be able to diagnose RAD.

The doctor will talk to the child and their caregiver to learn more about the child’s history, observe the behavior of the child, and perhaps run a few tests to figure out whether the symptoms the child displays are caused by RAD or another mental health disorder.

Treatment of Reactive Attachment Disorder

Fortunately, RAD is a treatable disorder—here are a few therapy methods you can try to help the child:

• Therapy for the Child: There are different types of therapy that may be beneficial for a child with RAD. Bring the child to a therapist so that a mental health provider can talk to the child, teach them how to express and control their emotions, and equip them with coping mechanisms that the child can use in their daily life.
• Therapy for the Caregiver: It may be useful for the parent or guardian of the child to attend therapy sessions as well—either together with the child or on their own. A therapist will be able to advise the caregiver, show them the best practices to communicate with the child, and accelerate the healing process.
• Build a Support System for the Child: The efforts to help the child should not be limited to therapy only. Talk to your friends and relatives—let them know the child is struggling so that they can adjust their behavior in the presence of the child and avoid saying or doing anything that may upset the kid.

Preventing Reactive Attachment Disorder

Is it possible to avoid RAD? Follow these tips to prevent reactive attachment disorder:

• Do Not Ignore the Child’s Needs: Whether your child is still an infant or they are already in school, make sure you pay attention to their needs. Talk to your child, ask them how they are feeling, and spend enough time in their company to understand their likes and dislikes.
• Provide a Nurturing Environment: Your child needs to feel safe both at home and outside of it. While you may not be able to control what happens when the child is not around you, you can make your house a safe haven for the kid—avoid shouting, listen to the child’s complaints, and be there for them when they are struggling.
• Bring the Child to a Therapist: Therapy can be beneficial both for the child and their caregiver. A professional therapist will be able to spot the signs of RAD early on, talk to the child and the parent to learn more about their unique relationship, and offer advice tailored to the specific needs of the child.

If you or someone you care about is struggling and needs reliable, compassionate support, Los Angeles Mental Health is here to help. Our team is dedicated to providing safe, effective mental health treatment tailored to each individual’s needs. Contact us today to learn more about your options, ask questions, or schedule an appointment. You don’t have to navigate this alone—expert guidance is only a click away.

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