Navigating reactive attachment disorder in children

Our early childhood experiences often have a large impact on our relationships — both with our childhood caregivers and people we encounter throughout life. If our caregivers or parents were affectionate with us and met our needs, we’ll probably repeat this behavior with others, as that’s how we’ve learned how to form emotional attachments.  

Unfortunately, not everyone receives this kind of nurturing. When caregivers are physically and emotionally inconsistent or inflict trauma, the child in their care can develop reactive attachment disorder (RAD). RAD is characterized by an inability to form healthy attachments with people, including caregivers and parents. While rare, up to 2% of children experience it.

Signs of reactive attachment disorder in kids

Since reactive attachment disorder is relatively rare, it can be hard to recognize the condition. RAD has two distinct types: inhibited and disinhibited. 

Inhibited reactive disorder 

A child with inhibited reactive disorder is usually cautious and monitors what’s happening around them. But their response to people and situations isn’t emotional. Instead, they tend to remove themselves from social situations, avoid caregivers or parents, and resist comforting gestures like hugs (or even react violently). 

Disinhibited reactive disorder

Children with the disinhibited type act without conventional social inhibition. This means they may walk away with a stranger or seek physical comfort from them. They usually also don’t understand social boundaries. 

What causes reactive attachment disorder?

Typically, reactive attachment disorder occurs in early childhood, which is a key time for forming attachments. Consistent and caring caregivers are crucial in helping kids develop the ability to form healthy attachments with others. When children lack this or experience disruptions (like parents who repeatedly enter and disappear from a child’s life), they may be at more risk for RAD.  

Neglect and frequent disruptions of a caregiver in early childhood can lead to abandonment trauma later in life. This can cause people to fear that anyone close to them will disappear or reject them, which might lead to cutting off close emotional ties first or not forming them in the first place. 

Being mistreated — whether emotionally or physically — can also increase the likelihood that a child will develop reactive attachment disorder. In fact, around 30% to 40% of mistreated foster children develop RAD symptoms. However, experts don’t know definitively why some children develop the condition while others don’t. 

Does RAD make a child more likely to develop other mental health conditions later in life?

While RAD starts in early childhood, it can persist into adolescence and even adulthood. If it’s not addressed, RAD can lead to a number of mental health issues, including depression, anxiety, post-traumatic stress disorder, eating disorders, and substance use disorder.

What’s the connection between RAD and behavioral issues in kids?

Life can be difficult for children with RAD. Research shows that children with RAD are more likely to have behavioral issues than children without the condition. They can experience mood swings and may be stuck in fight-flight-or-freeze mode. 

Many children experiencing reactive attachment disorder may like having control over their environments due to often feeling helpless. This can look like being argumentative, not following directions, or using manipulation tactics (like guilt tripping) to get their way.

Kids with RAD often try to push away their primary caregiver(s) because they learned that they can’t trust those close to them. This can happen even if that person isn’t the one who triggered the trauma. This behavior can manifest in emotional outbursts, aggression, picking fights, and even ignoring a person in an effort to avoid intimacy. 

It’s a common misconception that only children in the foster care system or adopted children can develop RAD. That’s simply not true. Anyone who’s experienced trauma — whether it’s triggered by abuse, neglect, or a number of other causes — can develop RAD. 

How to support a child who has reactive attachment disorder

Supporting a child with RAD can be incredibly difficult. Mainstream parenting advice often repeats that consistently demonstrating love is the basis of all good parenting. That isn’t the case with reactive attachment disorder.

Love and care can actually push away a child experiencing this mental health condition. That’s because many children with this condition unconsciously feel threatened by love because they didn’t have stable and healthy attachments early in life. 

Some ways to support a child who has RAD include:

• Giving them space: It’s natural to want to soothe a child who’s been hurt. But for children with RAD, this isn’t usually the best approach. Instead of forcing a connection when it might feel unsafe for the child, give them time and space so they can learn to trust you. 
• Recording therapies and parenting approaches you’ve experimented with: Every child has a unique experience of RAD. By writing down what does and doesn’t work for your child, you can keep this for your own memory and for any professionals who care for your child. 
• Documenting any situations that trigger your child: This log will help you avoid situations that aren’t a good fit for them.
• Knowing that it’s OK to feel discouraged: It can feel really discouraging to parent a child with RAD because it can feel like anything you do is wrong. Hang in there, and remember that support is available.

Professional support for reactive attachment disorder

Children with reactive attachment disorder can learn how to form healthy attachments. Though, it’s not an overnight process. Therapy and other approaches can help a child with RAD feel safe and establish healthy bonds. 

Some types of therapy that can help include:

• Cognitive behavioral therapy (CBT): CBT helps people recognize the negative and unhelpful thoughts they hold and transform them into more positive ones. 
• Play therapy: Play therapy uses play as a therapeutic tool to encourage bonding between parents and children. It can also help kids express their emotions, which can be especially hard with RAD.
• Attachment-based therapies: Attachment-based therapy centers on helping children rebuild trust and teaching them to express their emotions.
• Behavior management training: In behavior management training, caregivers learn about RAD’s psychology and how to improve difficult behaviors of children with RAD.

Find care with Rula

Children with reactive attachment disorder often experienced trauma early in life that can make it difficult for them to form healthy bonds. Because of this, caring for a child with RAD can pose unique challenges. But creating a healthy bond with a child who has RAD is possible with the right support. 

This is where Rula can come in. With our extensive network of over 10,000 therapists you can find one that’s compatible with your child’s needs and takes your insurance. Schedule a live video appointment as soon as tomorrow.

Find a therapist with Rula