Imagine the feeling of being unable to connect with anyone and unable to feel the comfort of being loved. Reactive attachment disorder (RAD) is a rare but serious condition in which a child fails to establish healthy attachments with parents or caregivers. The absence of emotional warmth during the first few years of life can negatively affect a child’s entire future. Children who experience severe neglect, abuse, early separation, and an implicit lack of an identifiable, preferred attachment figure are susceptible to a condition referred to as reactive attachment disorder (RAD); characterized by an inability of the child to form normal, loving relationships. Children with RAD generally are at higher risk for depression; aggressive disruptive behavior; learning difficulties; behavior problems in school; an inability to form meaningful relationships; and low self-esteem. Without treatment, RAD can have a negative impact on a child’s physical, emotional, behavioral, social, and moral development and other lifelong consequences.
Adopted children are considerably more at risk of exhibiting emotional, behavioral, and educational problems related to RAD than children raised by their biological parents. A child who is lacking the experience of forming a strong, secure connection with the mother or primary caregiver during the crucial period of early brain development is at a higher risk of becoming emotionally scarred in infancy. The lack of opportunity for proper growth and development increases the risk of various forms of psychopathology, including reactive attachment disorder and post-traumatic stress disorder (PTSD); behaviors based on attachment theory. The lack of an identifiable attachment figure may result in grossly disturbed internal models for relating to others leading to indiscriminate sociability manifested by inhibited, hyper vigilant, ambivalent and contradictory responses; poor social interaction with peers; aggression toward self and others; a failure to thrive and atypical abnormal behaviors that persist for many years.
There is no universally accepted diagnostic protocol for RAD. Signs and symptoms may include withdrawal from others, fear, sadness and irritability; listlessness; a failure to smile; avoidance of social interaction; a failure to reach out to others; and a lack of interest in interactive games. Children with reactive attachment disorder are believed to have the capacity to form attachments, but this ability has been compromised by their experiences. The best treatment for a child with reactive detachment disorder is early intervention with a positive, loving, stable, caring environment and caregiver. Treatments for reactive attachment disorder include positive child and caregiver interactions, a stable, nurturing environment, psychological counseling, and parent or caregiver education. Modifying the behavior of the parents or primary caregivers provides most of the treatment.
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