Reactive Attachment Disorder
Having your child disobey you, throw temper tantrums, and completely ignore you at times can be difficult, however, it is important to remember that our children are growing and going through different developmental stages. With each stage and age there are behaviors that are appropriate, while frustrating, are not of clinical concern; for example: a toddler that does not want to share, a child who throws things, a tween who refuses to go to bed early, or a teenager who wishes to spend more time with friends rather than parents.
Many times, we might link these behavioral issues to a condition called Reactive Attachment Disorder (RAD), however, RAD is a difficulty connecting with others and managing emotions, resulting in a lack of trust and self-worth, a fear of getting close to anyone, anger, and a need to be in control. Reasons as to why this may occur can be due to persistent disregard of the child’s emotional needs for comfort, stimulation, and affection. A child with RAD feels unsafe, alone, and may push others away out of fear, anger, and a variety of other emotions.
Inhibited Reactive Attachment Disorder vs. Disinhibited Reactive Attachment Disorder
As children with Reactive Attachment Disorder grow older, they often develop either an inhibited or a disinhibited pattern of symptoms:
Inhibited symptoms of RAD. The child is extremely withdrawn, emotionally detached, and resistant to comforting. The child is aware of what is going on around them—hypervigilant even—but does not react or respond. They may push others away, ignore them, or even act out in aggression when others try to get close.
Disinhibited symptoms of RAD. The child does not seem to prefer their parents over other people, even strangers. The child seeks comfort and attention from virtually anyone, without distinction. They are extremely dependent, act much younger than their age, and may appear chronically anxious.
Reactive Attachment Disorder is commonly found in but not limited to the following:
- An infant who is repeatedly left unattended when in distress may begin to form detachment from their caregiver.
- Children who received grossly negligent care.
- Children who do not form a healthy emotional attachment with their primary caregivers.
- Children who have been adopted and or not residing with their primary caregiver.
- Children who reside in and or have been in/out of the foster care system.
- Repeated changes of primary caregivers that prevent formation of stable attachments such as frequent changes in foster care, may exacerbate avoidance and inhibition.
- Where significant trauma has occurred by a primary caregiver.
Parenting a child who has been diagnosed with Reactive Attachment Disorder (RAD)
Have realistic expectations. Helping your child may be a long road. Focus on making small steps forward and celebrate every sign of success.
Stay patient. The process may not be as rapid as you would like, and you can expect bumps along the way. By remaining patient and focusing on small improvements, you create an atmosphere of safety for your child.
Foster a sense of humor. Joy and laughter go a long way toward repairing attachment problems and energizing you even in the midst of hard work. Find at least a couple of people or activities that help you laugh and feel good.
Set limits and boundaries. Consistent, loving boundaries make the world seem more predictable and less scary to children with attachment issues. It is important that they understand what behavior is expected of them, what is and is not acceptable, and the consequences if they disregard the rules. This also teaches them that they have more control over what happens to them than they think.
Take charge yet remain calm when your child is upset or misbehaving. Remember that “bad” behavior means that your child does not know how to handle what they are feeling and needs your help. But never discipline a child with an attachment disorder when you are in an emotionally charged state. This makes the child feel more unsafe and may even reinforce the bad behavior, since it is clear that it pushes your buttons.
Be immediately available to reconnect following a conflict. Conflict can be especially disturbing for children with attachment disorders. After a conflict or tantrum where you have had to discipline your child, be ready to reconnect as soon as they are ready. This reinforces your consistency and love and will help your child develop a trust that you will be there through thick and thin.
Own up to mistakes and initiate repair. Your willingness to take responsibility and make amends can strengthen the attachment bond. Children with attachment issues need to learn that although you may not be perfect, they will be loved, no matter what.
Try to maintain predictable routines and schedules. A child with an attachment disorder will not instinctively rely on loved ones and may feel threatened by transition and inconsistency—when traveling or during school vacations, for example. A familiar routine or schedule can provide comfort during times of change.
Identify actions that feel good to your child. If possible, show your child love through rocking, cuddling, and holding—attachment experiences they missed out on earlier. But always be respectful of what feels comfortable and good to your child. In cases of previous abuse, neglect, and trauma, you may have to go very slowly because your child may be very resistant to physical touch.
Respond to your child’s emotional age. Children with attachment disorders often act like younger children, both socially and emotionally. You may need to treat them as though they were much younger, using more non-verbal methods of soothing and comforting.
Help your child identify emotions and express their needs. Children with attachment problems may not know what they are feeling or how to ask for what they need. Reinforce the idea that all feelings are okay and show them healthy ways to express their emotions.
Listen, talk, and play with your child. Carve out times when you are able to give your child your full, focused attention in ways that feel comfortable to them. It may seem hard to drop everything, eliminate distractions, and just live in the moment, but spending quality time together provides a great opportunity for your child to open up to you and feel your focused attention and care.
Everyday activities to help foster a closer bond with yourself and child:
- Eat dinner as a family and do your best to have it at the same time each day to create a sense of consistency for your child.
- Have set play times outdoors that will encourage your child to play with you as a team. This will remind your child that you as the parent are always on their side.
- Play show and tell. Have your child show you one thing they completed at school and share what you have done as well. This will allow your child to feel as if what they do on a daily basis is of importance.
- Hug your child when they go to school and come back from school. Be mindful that you will have to start slow because they may be hesitant to your touch.
- Invite your child to make their favorite food along with you. This can give you the opportunity to spend quality time together and to get to know them more in an easy going and playful manner.
- Remind your child that you love them regardless of any mistakes they make. Assure them that you make mistakes as well and that you are not perfect.
- Listen to music and/or sing along with your child. Finding out what their favorite genre of music can facilitate conversations about their interests. Music allows for a connection between individuals. Research has found that listening to music releases oxytocin, known as a “love hormone” that promotes feelings of love, bonding, and well-being.
- Go on dates. They can range from going to dinner, watching a movie, going to a concert, going shopping, etc. Again, be patient with your child and ease into these activities.