Evaluating, Understanding & Treatment of Reactive Attachment Disorder

Yocheved Golani
July 7, 2018

A heart-breaking problem for the affected child as well as anyone trying to help them, Reactive Attachment Disorder (RAD) prevents any level of trust or interest in other people. Children with RAD don’t bond with anyone because they never had the opportunity to do so or were severely rejected after making such efforts. Neglect and other abuse by the adults in their lives is the cause of the problem. The children have been repeatedly traumatized and left without opportunities to learn coping skills.

RAD child


Diagnosing the problem has few but very effective guidelines: The child is between 9 months and 5 years of age, not on the autism spectrum and unresponsive to their environment. They’ve learned that it won’t matter. Or, they respond inappropriately. A complete history of the child’s circumstances, plus physical and psychological exams are taken.

The person interviewed for this article once agreed to foster such a child, who’d been abandoned in a shed to be minimally clothed and fed by his biological father for all of his three years of life. His baby sister had eventually been dumped with him, and treated in similar fashion. When he was discovered by social workers and legal authorities, the toddler’s only response to human interaction was to bite, grunt, kick, or withdraw in silence. His 3-month old sister couldn’t lift her head nor respond to cooing and touch. She made no noises herself. Mental health experts deemed the boy unfit to live with a foster family despite the interviewee’s extensive rehab training. The child was placed in a psychiatric institution where he was rehabilitated within a year, able to be adopted. However, the interviewee was able to help the infant sister placed in her care. Within nine months the baby achieved milestones that placed her mentally, socially, and physically ahead of infants her age. But what of RAD victims who cannot recover so quickly or easily?

Children with reactive attachment disorder, and there aren’t many of them, tend to seem listless and frightened. They’re depressed and literally don’t know how to respond to normal human interactions; they’ve never experienced them. RAD children might not be familiar with what the medical and psychological industry call Activities of Daily Living (ADLs). The children need help to understand how to play, how to soothe themselves, how to dress and to undress, and how to use every day utensils such as bathrooms, tubs, cutlery, and toys. Worse, the lack of normal human interaction, especially the tickling, cuddling and nurturing that loving adults usually lavish on little ones, can damage the development of the brains of RAD children. Their left primary visual cortex lacks sufficient gray matter. RAD children thus cannot correctly process stressful responses to the sort of images that arouse emotions in the rest of us. Without the basic biological tool for dealing with emotions, RAD children can’t adjust their moods or thought processes, let alone their behaviors, as they age. They can become destructive.

The only remedy for the devastating problem is unlimited affection and patience. Pro-active interaction initiated by trained, compassionate adults is necessary.

If necessary, children with reactive attachment disorder can be medicated to prevent violent outbursts and to reduce anxiety. Mental health professionals use attachment-based family therapy (ABFT) in severe cases.

RAD can affect older children and adults, too. The scope of the issue is too broad for this one article. Readers are advised to speak with competent mental health professionals about the matter, and to follow their guidelines. The futures of anyone with RAD will be influenced by that.

Yocheved Golani

Yocheved Golani is a popular writer whose byline has appeared worldwide in print and online. A certified Health Information Management professional, she is a member of Get Help Israel. Certified in Spiritual Chaplaincy (End of Life issues) and in counseling skills, her life coaching for ill people puts a healthy perspective into a clients’ success plan for achieving desired goals.

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