What Is Reactive Attachment Disorder?
Those who work with children may have heard the term reactive attachment or reactive attachment disorder to describe a child’s behavior. Reactive attachment disorder is unfortunately common and is becoming a problem for many children and families. Children who experience reactive attachment disorder tend to struggle with social relationships, anxiety, school performance, and overall mental […]
Those who work with children may have heard the term reactive attachment or reactive attachment disorder to describe a child’s behavior. Reactive attachment disorder is unfortunately common and is becoming a problem for many children and families. Children who experience reactive attachment disorder tend to struggle with social relationships, anxiety, school performance, and overall mental health. There is treatment available for reactive attachment disorder, and there is no shame in being diagnosed with this disorder yourself. Learning more about the condition may help you recognize patterns in your own life and overcome them.
How Does Reactive Attachment Disorder Form?
StatPearls identifies the Diagnostic and Statistical Manual 5th Edition’s (DSM-5) definition that reactive attachment disorder (RAD) is, “a trauma-and stressor-related condition of early childhood caused by social neglect and maltreatment.” Children who are neglected or abused in the early stages of development will develop reactive attachment disorder due to the lack of a close bond with a loving adult. For example, babies who are taken from their parents due to neglect or maltreatment may develop reactive attachment disorder because they did not form a close, loving bond with a caretaker in infancy. Their struggles with love and attachment will be with them during their toddler years and into early childhood. Unfortunately, behaviors stemming from reactive attachment disorder can even carry into adulthood, rippling into other mental health issues.Signs and Symptoms of Reactive Attachment Disorder in Children
Children with reactive attachment disorder have a hard time forming bonds and relationships with others. Children with reactive attachment disorder will show decreased ability to demonstrate positive emotion compared to their peers. They may react negatively, or even violently, to loving touches such as hugs, cuddles, or other emotional support. Children with reactive attachment disorder will be difficult to predict behaviorally, difficult to console when upset, and difficult to set boundaries with for disciplinary purposes. Their mood is typically difficult to regulate, and these children will often be operating in fight, flight, or freeze mode. They may have a strong need to control their environment. Changes in the environment or routine could spark significant negative reactions from the child. Children with reactive attachment disorder tend to have a hard time in the classroom, both socially and academically. They may not be able to make friends easily and could have issues trusting their teacher. Official symptoms leading to reactive attachment disorder diagnosis (StatPearls, DSM-5) include:- The child demonstrates a chronic pattern of being emotionally withdrawn and inhibited, demonstrated by rarely seeking comfort when distressed or being non-responsive to comfort.
- Social withdrawal, discomfort, and minimal responsiveness around others.
- Unfounded or unexplainable irritability, sadness, or fears that are out of the scope of “normal” stress.
- The child has a history of insufficient care, meaning one or any of the following were present in the child’s early life:
- Deprivation or social neglect based on the social need for stimulation
- Lack of comfort, love, affection, or caregiving from caregivers
- A constant flux of caregivers, meaning a child was passed from home to home
- An unstable environment that limits the capabilities of attachment with a caregiver
- The child cannot meet the diagnostic criteria for Autism Spectrum Disorder (ASD). ASD and reactive attachment disorder are different disorders but may have some social symptom similarities.
- Behavioral perturbation should manifest before the age of five, meaning that these behaviors will begin before the age of five.
- The child must be nine months of age to be formally diagnosed with reactive attachment disorder.


