Reactive Attachment Disorder in Children: Signs and Treatments

Medically reviewed by University of Illinois-Chicago, College of Medicine on June 10, 2016Written by Leah Campbell on June 10, 2016

Overview

When I first decided that adoption would be my path to parenthood, my heart was actually set on adopting an older child. This was perhaps mostly because it was in viewing the plight of older children in the foster care system that I began to come around to the idea of adoption at all.

But when I told friends and family that I was taking steps to adopt a preteen or teen girl from foster care, I was met with a lot of fear. Those who cared about me most went immediately to worst-case scenarios, convinced that no older child in care could ever possibly form a parent-child bond.

Their fears weren’t totally unfounded. Reactive attachment disorder is a real thing, a condition where, according to the Mayo Clinic, “an infant or young child doesn’t establish healthy attachments with parents or caregivers.” This is most often the result of a child not having their basic needs met early on in life. They aren’t given the comfort, affection, and stable attachments they need in order to establish that trust.

Which means that kids in foster care are, potentially, more at risk for developing this condition.

But the important thing to know is that it’s a fairly rare condition. Not every child in foster care, or every child who has their basic needs neglected, will get reactive attachment disorder.

And for those who do, there are treatments that can help.

Signs and symptoms

Indications of reactive attachment disorder in infants and children might include:

  • avoiding physical contact
  • withdrawal or sadness that has no discernable explanation
  • no attempts to reach to a caregiver for nurturing or support
  • difficulty being comforted
  • never smiling
  • no interest in interactive games
  • resisting social interaction
  • showing no response when comforted
  • failing to reach out when picked up

Most of these symptoms will appear early on, prior to the age of 5.

Diagnosis

It’s important to know that reactive attachment disorder really is quite rare. Not all children who experience neglect in early infancy will struggle with forming attachments, and for those who do, researchers don’t fully understand why yet. More research needs to be done in this area.

But when it comes to diagnosing reactive attachment disorder, many factors are evaluated. The symptoms associated with reactive attachment disorder can also be indicative of other conditions, like autism spectrum disorder. So a doctor takes a full history to assess what contributing factors may be at play. They also perform a physical and psychiatric evaluation.

Treatment

Caring for a child with reactive attachment disorder can be emotionally difficult. It’s frustrating to want to comfort a child who won’t allow you to, and to find yourself loving a child who can’t seem to love you back.

The good news is, there are treatment options available for children experiencing reactive attachment disorder. It’s believed that by first providing a loving, warm, and stable environment, these children can learn to form attachments. But doing so obviously takes time and commitment.

Beyond that, treatment options may vary based on the expert you talk to. Early intervention does seem to lead to better outcomes. That means providing a loving and stable home environment as early as possible. Individual and family counseling can provide the family with tools to better provide that environment, and education resources exist to help parents better understand their roles.

Be aware that there are some controversial treatment options out there that have been criticized and denounced by several professional medical associations. These include any treatments that involve intentionally breaking down a child first in the hopes of them being able to forge a bond. There is no actual research to suggest that this works, and it can be dangerous in implementation.

Next steps

If you suspect that your child may be experiencing reactive attachment disorder, the best place to start looking for answers is with a pediatrician or psychologist you trust. Know that it can be a long road to recovery, but that there is hope for your child to form lasting connections. In the meantime, be kind to yourself and consider joining an online support group to draw support from other parents in similar situations.

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