Reactive Attachment Disorder (RAD)

( info taken from helpguide)

Reactive Attachment Disorder (RAD) is a clinically recognized form of extreme insecure attachment. Common causes of RAD include severe child abuse and neglect. Children may have been removed from the home and placed in the foster care system. RAD also frequently occurs in internationally adopted children who were living in orphanages.

Signs and Symptoms of RAD
Children with RAD are so neurologically disrupted that they have extreme difficulty attaching to a primary caregiver, attaining normal developmental milestones or establishing normal relationships with other people. They show strong symptoms of attachment disruption. These children may be difficult or impossible to soothe, accepting comfort from no one, even the primary caregiver, and preferring to play alone. On the other hand, they may seem superficially friendly to everyone, inappropriately approaching and interacting with strangers as if they were the primary caregiver. What can be especially hard to bear for those who care for these children is that the child might not seem to be bonded to them at all, despite their attempts to show love and affection. Many of these children may be incorrectly diagnosed with severe emotional and behavioral disturbances ranging from bipolar disorder to depression. Families caring for children with RAD will benefit from treatment and therapeutic parenting skills. In time and with patience, even severe attachment disorders can be repaired.

Adoptive and foster parents
Adoptive and foster parents open their hearts and homes to children who have sometimes been severely abused and neglected. These parents might not have expected the challenges that come with children with attachment difficulties. Even if these challenges are known, anger, lashing out and difficult behaviors can be frustrating and hard to handle. Remember that the child is not acting out because of lack of love for you. They are acting out because their brain development has actually progressed differently. Your stability in the child’s life is giving him or her a tremendous chance to repair insecure attachments and have a much better start in life. Be sure to seek support from organizations and support groups that specialize in your situation, and don’t be afraid to seek help for yourself if you are feeling overwhelmed and frustrated.

Interactions with others, self-esteem, self-control, learning, and optimum mental and physical health are affected. Symptoms of insecure attachment may be similar to common developmental and mental problems including ADHD, spectrum autism, depression, and anxiety disorders.

Symptoms of insecure attachment
Emotional Problems
low self-esteem, needy, clingy or pseudo-independent behavior, inability to deal with stress and adversity, depressed, unresponsive, resists comforting.
Physical problems
susceptibility to chronic illness, obsession with food – may hoard food, gorge, refuse to eat, eat strange things, may be developmentally delayed
Social Problems
lack of self-control, inability to develop and maintain friendships, alienation from parents, caregivers, and other authority figures, overly friendly and treating strangers like the primary caregiver, aggression and violence, difficulty with genuine trust, intimacy, and affection, lack of empathy, compassion and remorse, negative, hopeless, pessimistic view of self, family and society
Learning problems
behavioral problems at school; speech and language problems; incessant chatter and questions; difficulty learning- brain development has actually progressed differently.

Conflict, boundaries, and repair in secure attachment
No matter how much we love our children, there comes a point where we are not in agreement with them, a point when we have to set limits, and say “no.” This conflict temporally ruptures the relationship as the child angrily protests. Such protest is to be expected. The key to strengthening the attachment bond of trust is to be consistently available when the child is ready to reconnect. It is also important to initiate repair when we have done something to hurt, disrespect, or shame a child. Parents aren’t perfect. From time to time, we are the cause of the disconnection. Again, our willingness to initiate repair can strengthen the attachment bond.
For children with insecure attachments and attachment disorders, this conflict can be especially disturbing and scary—for both the children and the primary caregiver. The child may overreact, having a wild tantrum, or rapidly withdraw. They may temporarily show developmentally regressive behaviors, like rocking or trouble with toileting. Don’t be afraid to set limits and boundaries with insecurely attached children. Consistent, loving boundaries will help them develop the sense of trust they need that their caregiver will be with them through thick and thin. These children also need to learn that no matter what they do, they will be loved and respected. Repairing insecure attachments and attachment disorders
Sadly, insecure attachment can be a vicious cycle. Due to problems with social relationships, insecurely attached children may become even more isolated and withdrawn from their primary caregivers, family and friends. They may be seen as “bratty” or “bullies”, making it hard for them to form relationships that may mitigate the effects of insecure attachment. However, it is never too late to work on forming secure attachments. While the brain is most pliable in infancy and early childhood, it is responsive to changes all of our lives. Relationships with relatives, teachers and childcare providers can also supply an important source of connection and strength for a child’s developing mind.

Here are some tips on repairing an insecure attachment:
Learn what creates a secure attachment. Attachment is an interactive process that requires both verbal and nonverbal skills. Emotional intelligence is critical to building a secure attachment, since even verbal children are sensing our moods and watching everything we do. Every child is unique and will have different ways to be soothed.
Provide support for the primary caregiver. The primary caregiver needs to be emotionally healthy, have adequate time, and the right skills to be attuned and responsive to the child’s needs. In some cases, the caregiver may simply be overwhelmed, and help with household or work responsibilities allows them to focus. Other caregivers may need more help, such as parenting classes, alcohol or drug treatment, or therapy for mental disorders such as emotional trauma or depression.
Help the child express his or her needs. Children with attachment problems will need extra help in learning to express their needs. They may have learned not to cry if in pain or frightened, for example, or not associate touch with being soothed. They may revert to developmentally inappropriate behaviors if stressed or scared. It might take extra creativity and diligence on the caregiver’s part to help the child express needs safely and appropriately.
Time, consistency and predictability is key. Problems in attachment result from problems with trust. By this very definition, repairing an attachment disruption takes time, consistency and patience. It will take time for a child to realize that they can trust and rely on their primary caregiver and other important people in their lives. Children with attachment disruptions may be more sensitive to life changes and situations like travel, returning to school or holidays. Caregivers should be aware and as attuned to this as possible, helping to keep a normal schedule during unpredictable times.