Reactive Attachment Disorder

Consider an example of a child who is not mute but does not speak. He/she has zero communication with their parents irrespective of being talked to repeatedly. Is it simply a disinterest in social engagement or an inability to form an emotional bond with their parent? While it could be both or many other reasons, we would focus on the latter aspect.

Overview of Attachment Disorders

Young children who struggle to form a strong emotional tie with their parents or primary caregiver−an attachment bond connection−can develop attachment disorders. Since the strength of the emotional bond significantly impacts the child's development, having attachment problems might limit their capacity for emotional expression, the development of security and trust, and the ability to form lasting relationships in the future. Reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) are two different attachment disorders that are recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM−5).

Meaning of Reactive Attachment Disorder (RAD)

A rare but severe syndrome known as reactive attachment disorder occurs when a baby or young kid fails to form secure relationships with their parents or other caregivers. If a child's fundamental needs are not satisfied for love, care, and nurturing, and loving, caring, and solid bonds are not formed with others, reactive attachment disorder might emerge. When upset, an individual with RAD rarely looks for consolation and instead feels vulnerable and alone. They could be very reclusive, emotionally distant, and hard to comfort. The youngster is attentive to what is happening around them−perhaps even hypervigilant−but does not respond or react. When someone tries to come close, they could push them away, dismiss them, or even respond violently.

With the right care, children with reactive attachment disorder might establish more solid and wholesome bonds with their caregivers and other people. Reactive attachment disorder is treated by teaching caregivers how to provide a secure, caring environment and fostering positive interactions between children and caregivers. Education and therapy for parents or caregivers can be beneficial.


Infancy is usually when reactive attachment disorder first appears. Beyond early infancy, there has been little research on the indications and signs of reactive attachment disorder, and it is still unknown whether it affects kids older than five. Some warning signs and symptoms include −

  • Unfounded dread, sadness, irritation, or withdrawal

  • A dejected and listless demeanor

  • Refusing to accept or respond to a consolation when offered

  • Absence of a smile

  • Carefully observing others while avoiding social connection

  • Not making contact after being pulled up

  • No desire to engage in interactive games like peekaboo

  • Behavioral issues

  • Failing to ask for help or support


Babies and young children require a stable, loving environment to feel safe and build trust. Caregivers need to meet their fundamental emotional and physical requirements constantly. When does an infant cry, for instance, the desire for comfort, a feeding, or a diaper check must be fulfilled with a mutual exchange involving eye contact, a smile, and touching. A child who experiences emotional neglect or a low emotional reactivity from caretakers does not learn to expect comfort or care or develop a strong relationship with them. Why some infants and kids experience reactive attachment disorder while others do not is unclear. There are several hypotheses regarding reactive attachment disorder or its origins, and more study is required to enhance diagnostic and treatment choices.

Risk Factors

Children who experience significant social and emotional neglect or lack opportunities to form secure bonds may be more susceptible to developing reactive attachment disorder. Some examples include −

  • Reside in an institution, such as a children's home.

  • Switch foster homes or caretakers frequently.

  • Have parents that engage in criminal activity, abuse drugs, or possess significant mental health issues that affect how they parent

  • Have a prolonged separation from their parents or other carers as a result of being hospitalized, placed out of the house repeatedly, or having a major caregiver pass away

  • Reactive attachment disorder does not typically develop in severely neglected children.


Reactive attachment disorder can last for years without proper care and may have long−term effects. A few examples are relationship issues, social interaction issues, physical and mental health issues, behavior issues, intellectual development issues, and substance misuse issues.


Reactive attachment disorder may not be entirely preventable, but there may be measures to lower the likelihood that it will manifest. Infants and young children require a stable, loving environment in which their fundamental emotional and physical requirements are met. The following parenting advice could be useful.

  • Play with the youngster frequently, chat with them, smile, and maintain eye contact.

  • Learn to recognize the baby's signals, such as the various cries, so that appropriate responses to the requirements can be made as soon as possible.

  • As the baby is fed, bathed, or changed diapers, engage in warm, nurturing conversation.

  • Respond to the child's sentiments through touch and nonverbal cues like expressions of the face and tone of voice.

When to Seek Help

If the child exhibits worrying symptoms that continue over time, it is best to have them evaluated. Children with other disorders, such as autism spectrum disorder, or those without reactive attachment disorder may also show some symptoms. Young children may occasionally show certain transient signs and symptoms, although they usually pass quickly, are not serious, or do not impair development.

Risk of Other Disorders

Developmental and physical growth deficits are possible in early childhood who have been abused or maltreated. Eating disorders, challenges with rage, melancholy, anxiety, difficulty in the classroom, and drug and alcohol misuse are among the conditions that older children may be more susceptible to.


Reactive attachment disorder affects everyone differently. Understanding reactive attachment disorder's warning signs, symptoms, and negative impacts are essential for beginning the road to recovery.