Reactive attachment disorder (RAD) occurs when children are unable to form healthy attachments with caregivers. It results from a lack of response to a child's needs which prevents the development of trust. Symptoms include emotional withdrawal, lack of eye contact, and no interest in interaction. RAD is caused by neglect, frequent changes in caregivers, or abuse. Treatment involves counseling, parenting classes, and addressing any other conditions present. Forming secure attachments early in life through consistent care is important for healthy social and emotional development.

1. Reactive Attachment Disorder
Gina Dessources
Windsor University School Of Medicine
Psychiatric Presentation
Dr. Daniel Martinez

2. Child of Rage
http://psychodocs.wordpress.com/2013/03/26/the-failure-to-bond-with-mommy-can-trigger-
psychopathy/

3. Fury as U.S. woman adopts
Russian boy, 7, then sends him
back alone with note saying: 'I
don't want him anymore'

4. So, what is Reactive Attachment Disorders ?
“Reactive attachment disorder is a mental health
disorder in which infants and young children
(usually before the age of 5) are unable to form
healthy social relationships [attachments],
particularly with a primary caregiver”.

5. Attachment Theory
Attachment is a deep and enduring emotional
bond that connects one person to another
across time and space (Ainsworth, 1973;
Bowlby, 1969).

6. Importance of Attachment
Harlow’s Monkeys (1958)

7. Link between Attachment and RAD

To feel safe and develop trust, infants and young children need a
stable, caring environment. Their basic emotional and physical
needs must be consistently met.

A child whose needs are ignored or met with emotionally or
physically abusive responses from caregivers comes to expect
rejection or hostility. The child then becomes distrustful and learns
to avoid social contact.

This may in some cases affect the brain development which may
lead to to attachment problems and personality and relationships
problems throughout life

9. Causes of RAD

A baby cries and no one responds or offers comfort.

A baby is hungry or wet, and they aren’t attended to for hours.

No one looks at, talks to, or smiles at the baby, so the baby feels
alone.

A young child gets attention only by acting out or displaying other
extreme behaviors.

Sometimes the child’s needs are met and sometimes they aren’t.
The child never knows what to expect.

The infant or young child is hospitalized or separated from his or
her parents

10. Risk Factors for Reactive Attachment
Disorder

Living in an orphanage

Institutional care / Prolonged hospitalization

Frequent changes in foster care or caregivers

Inexperienced parents

Extreme neglect or poverty

Physical, sexual or emotional abuse

Postpartum depression in the baby's mother

Parents who have a mental illness, anger management
problems, or drug or alcohol abuse

11. Signs and Symptoms in Babies

Withdrawn, sad and listless appearance

Failure to smile

Lack of the normal tendency to follow others in the room
with the eyes

Failure to reach out when picked up

No interest in playing peekaboo or other interactive games

No interest in playing with toys

Engaging in self-soothing behavior, such as rocking or self-
stroking

Calm when left alone

12. Signs and Symptoms in Toddler or
Older Children

Withdrawing from others

Avoiding or dismissing comforting comments or gestures

Acting aggressively toward peers

Watching others closely but not engaging in social
interaction

Failing to ask for support or assistance

Obvious and consistent awkwardness or discomfort

Masking feelings of anger or distress

Alcohol or drug abuse in adolescents

13. Criteria That Must be Meet for Diagnosing
Reactive Attachment Disorder

14. Misdiagnosis of RAD

Bipolar disorder

Attention Deficit Disorder

Fetal Alcohol Syndrome

Anti-Social Personality Disorder

Conduct Disorder.

15. Treatment of RAD

Individual psychological counseling

Education of parents and caregivers about the condition

Parenting skills classes

Family therapy

Medication for other conditions that may be present, such as
depression, anxiety or hyperactivity in a child or a parent

Special education services

Residential or inpatient treatment for children with more-serious
problems or who put themselves or others at risk of harm

16. “If a child is not attached–does not form a loving bond with the
mother–he does not develop an attachment to the rest of
mankind. The unattached child literally does not have a stake
in humanity” (Magid & McKelvey 1988).

17. References

Reactive Attachment Disorder. Retrieved on 7/10/2013 from
http://www.mayoclinic.com/health/reactive-attachment-disorder/DS00988

Harry F. Harlow. Retrieved on 7/10/2013 from
http://muskingum.edu/~psych/psycweb/history/harlow.htm (Image on slide 5)

Scott, Jenesis. (2004).The Importance of Touch to Your Child's Mental Health.
Retrieved on 7/10/2013 from
http://lisajeannejenesis.pbworks.com/w/page/17803926/The%20Importance%2
(Image on slide 5)

McLeod, Saul. (2009). Attachment Theory. Retrieved on 7/10/2013 from
http://www.simplypsychology.org/attachment.html

Steward, Will.(2010). Fury as U.S. woman adopts Russian boy, 7, then sends
him back alone with note saying: 'I don't want him anymore'.Retrieved on
7/14/2013 from
http://www.dailymail.co.uk/news/article-1264744/American-sends-adopted-Rus

Attachment & Reactive Attachment Disorders. Retrieved on 7/17/2013 from
http://www.helpguide.org/mental/parenting_bonding_reactive_attachment_dis
order.htm

18. References

“ Diagnostic Criteria for Reactive Attachment Disorder of Infancy or Early
Childhood”. Retrieved on 7/14/2013 from
http://wps.prenhall.com/wps/media/objects/5097/5219346/tools/diag_crit_reac

Reactive Attachment Disorder. Retrieved on 7/14/2013 from
http://www.learnalberta.ca/content/inmdict/html/reactive_attachment_disorder

McGeown, Kate. (2005).Romanian Adoptees Struggle to Adapt. Retrieved
on 7/14/2013 from http://news.bbc.co.uk/2/hi/europe/4649383.stm (Image
on slide 1)

“Information aboutReactive Attachment Disorder”. Retrieved on 7/15/2013
from http://www.therapeuticparenting.com/Page_3.html

Knight, Wintery. (2013). Does science support mothers who leave their
young children to go to work? Retrieved on 7/17/2013 from
http://winteryknight.wordpress.com/2013/03/22/does-science-support-mothers
(Image of brain scan)

The Failure to Bond with Mommy can trigger Psychopathy. Retrieved on
7/17/2013 fromhttp://psychodocs.wordpress.com/2013/03/26/the-failure-
to-bond-with-mommy-can-trigger-psychopathy/ (Video Clip)

19. References

Reactive Attachment Disorder. Retrieved on 7/17/2013 from
http://www.attachment.org/parents/reactive-attachment-disorder/