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Understanding Reactive Attachment Disorder

© Susan Ward

As adoptive parents, some of our children come to us with challenging issues tied to either their biological or environmental backgrounds. Reactive Attachment Disorder (RAD) is not uncommon among adopted children. The disorder is still misunderstood among many professionals, as well as the lay public. The following questions and answers provide a parent's perspective on a very challenging disorder to live with.

What is RAD?
RAD (Reactive Attachment Disorder) is a psychological and neurological (although the psychological diagnosis "bible" only calls it psychological) disorder that occurs during the first three years of life when a child does not attach and bond properly to her primary caregiver. Fundamental processes do not occur resulting in on-going rage, fear of attaching to anyone, lack of trust, an unusual effort to control everything in their lives, a lack of self worth, and an inability to fully comprehend cause and effect.

Give me some examples of how RAD develops
A baby cries and cries and no one comes. A baby has a wet diaper, and it isn't changed for hours. No one smiles at the baby. A baby is generally ignored and is only able to get attention through extreme misbehaviors or by being overly cute.

Because the primary parent mistreats the child, she assumes that all caregivers are inherently mean.

No one cares for the baby's basic needs. The baby doesn't trust anyone.

Sometimes when the baby cries she's ignored. Sometimes when she cries, someone yells at her. Sometimes when she cries, someone gives her a bottle. Sometimes when she cries, some one smiles and rocks her. She does not learn proper cause and effect.

Why don't I know about RAD?
The diagnosis hasn't been used until fairly recently. Even many psychiatrists, social workers, and psychologists don't know about it. So, it's not surprising that the general public isn't aware of it. Other psychological and neurological disorders are so common as to be written into movie and TV scripts. Think of Rain Man and autism. Other disorders such as Obsessive Compulsive Disorder, Attention Deficit Disorder, and others have become a common part of our general awareness. RAD will, but it's still new.

I think I've heard of RAD, but aren't they supposed to be kids who burn down houses, kill pets, and are unable to attach to their parents?
When RAD was first diagnosed, the cases that were identified and treated were the extreme ones. Now, there's a realization that RAD, like most illnesses and diagnoses, has varying degrees of severity.