Reactive attachment disorder is a rare but serious condition in which infants or young children do not build healthy closeness (attachments) with parents or caregivers. Reactive attachment disorder can develop if the basic needs of children for comfort, compassion and parenting are not met and loving, caring, stable attachments with others not set.
Infants and young children need a stable environment and are concerned that they feel safe and trusting. Their basic emotional and physical needs should be met consistently. For example, when babies cry, the need for food or diaper changing must be filled with emotional exchanges such as eye contact, smiles, and caresses.
A child whose needs is ignored or lack of emotional response from a caregiver will not expect care, comfort, or form a steady attachment to a caregiver.
What is usually the main risk factor of RAD is the dormant social and emotional sense or lack of opportunity to develop a steady attachment of a stable relationship with the child, for example:
- Often move home child care or change caregivers
- Have had a prolonged separation from parents or caregivers because it was hospitalized.
However, not all children who have experienced the above will always suffer from RAD. It is still unclear why some children experienced RAD and some did not experience it.
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Reactive Attachment Disorder Symptoms
Reactive attachment disorder can start in infancy. There is little research on signs and symptoms of reactive attachment disorders beyond early childhood, and it is still unclear whether it occurs in children older than 5 years.
Signs and symptoms include:
- Withdrawal, fear, sadness or anger that is not easily explained
- Sad and lethargic appearance
- Do not seek comfort or show no response when comfort is given
- Failure to smile
- Seeing others up close but not engaging in social interactions
- Failing to request support or assistance
- Failure to reach out when invited
- Not cheerful when playing “peekaboo” or other interactive games.
Reactive Attachment Disorder Treatment
With the treatment, children with reactive attachment disorders can develop a more stable and healthy relationship with caregivers and others.
One of the most frequently used techniques is the type of psychological intervention known as holding therapy. It was designed to help reattachment with mother or foster parents.
Although popular, the holding therapy is also somewhat controversial because it is forced. The child is arrested and exposed to unwanted stimuli for a long time. These stimuli may include, but are not limited to:
The goal is to expose the child to stimulation until there is no resistance or attempt to avoid it. After this, the child is returned to the caregiver because the anger is suppressed against this action released which allows it to form new healthy bonds.
Studies show that those who received therapy showed substantial reductions in aggressive behavior compared to those who had never undergone treatment.
Play and Art Therapy
Other types of treatment of reactive attachment disorders such as play therapy and art therapy have demonstrated effectiveness in the treatment of other attachment disorders; However, not many clinical trials have been conducted to measure their effectiveness with RAD.
On the other hand, spending time outside therapy can be an addition to fixing the attachment between a caregiver and a child. Activities as mentioned earlier have benefits outside the therapeutic session as it encourages bonding.
Additional parenting strategies can include teaching them about emotions, consequences, and importantly, convincing the child that they are safe and loved.
Other treatments for reactive attachment disorders includes positive and stable interactions between children and caregivers, caring for the environment, psychological counseling, and education for parents or caregivers.