Vol. 4, No. 1 • Fall 1999

Children Who Don't Love: Reactive Attachment Disorder

Psychologists and researchers have confirmed what we have known for a long time: poor parenting in early childhood can have a significant negative impact on children. Without the foundation of a close psychological bond with one or more caregivers in their first five years of life, children can develop �attachment disorders� such as Reactive Attachment Disorder (RAD). Left untreated, children with RAD or other attachment disorders may never learn to form normal relationships with others.

How does it start?
It is believed that Reactive Attachment Disorder is most often caused by poor care by the parent or caregiver in the first five years of life. In the case of an infant, parenting poor enough to cause RAD can include failure to comfort, touch, make eye contact, and generally meet the needs of a child. In addition, researchers speculate that RAD may be induced by experiences such as adoption, the death of a parent, abuse, neglect, unresolved chronic pain (earaches or colic)�anything that causes a break in a child�s normal, healthy bonds with a caretaker (Reber, 1996).

Not surprisingly, kids in foster care are at greater risk for RAD than children in the general population. One study of maltreated infants found that 80 percent showed signs of insecure/ambivalent attachment (Cicchetti & Barnett, 1991).

How do you recognize it?
In Children at Risk for Reactive Attachment Disorder: Assessment, Diagnosis and Treatment, Keith Reber describes children with the insecure/avoidant attachment typical of RAD as showing �the most confusing, contradictory behaviors, marked by two conflicting drives: approach and avoidance. A burst of anger may be followed by a sudden frozen watchfulness (Main & Soloman, 1990; Fraiberg, 1980; Delaney, 1991). This child will turn away from the caregiver, refusing to make eye contact, or will arch her back, push away, or fight viciously to avoid closeness. When distressed, she will not seek out caregivers or allow comforting. On the other hand, this child will, without fear, ask to be taken home by a stranger.�

Beyond these conflicting drives, a wide range of symptoms have been associated with RAD. Children with RAD can be

• Superficially engaging and charming. Children with RAD may easily win adults over, hiding extreme misbehavior and avoiding blame by lying and projecting an image of innocence.
  
  
• Cruel to siblings or animals. Pets are often the victims of a child�s anger.
  
  
• Inappropriately demanding. These children are terrified of losing parents (many of them have lost parents in the past). They are also afraid of losing control. This can lead to illogical demands and threats at times of normal leave-taking, such as leaving the child with a baby-sitter (Reber, 1996).

Even if your child exhibits one or more of the characteristics listed above, he or she may not have a RAD. The truth is, RAD can be very difficult to diagnose.

If you suspect your foster child has serious trouble with attachment, your first step should be to talk with your social worker. He or she may know where to go to have the child evaluated. Unfortunately, this can be costly, and there are a limited number of individuals capable of conducting this kind of evaluation in North Carolina.

Copyright � 2000 Jordan Institute for Families