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What is Reactive Attachment Disorder?

When a child is unable to form healthy attachments with their caregivers, it can have profound and long-lasting consequences. Known as whats reactive attachment disorder, or RAD, these children are at risk for serious emotional and behavioral problems as they grow up. Early detection and treatment is critical to preventing these complications.

A child with RAD may exhibit several warning signs that he or she is struggling to form relationships. These symptoms include frequent anger outbursts and/or an inability to express emotions. A desire to be in control and avoid feeling helpless is also common. In many cases, these children have an aversion to touch and physical affection. They may flinch, laugh or say “ouch” when touched. A lack of internalized social rules and regulations is also a common problem in children with RAD. This often leads to a lack of respect for authority figures and other adults.

Children with RAD are at increased risk of suffering from a variety of mental health issues, including anxiety disorders, attention deficit hyperactivity disorder and depression. The cause of RAD is not fully understood, but it appears to be associated with some type of abuse or neglect in childhood. Children who have been in multiple foster homes or have lived in orphanages are at particular risk for developing RAD.

Although a variety of treatments exist for RAD, the most effective approaches involve both psychotherapy and family therapy. These treatments aim to ensure a safe living environment, positive interactions with caregivers and healthy peer relationships. Depending on the severity of a child’s RAD, medication may also be used to reduce stress levels and promote emotion regulation.

Symptoms of RAD usually begin in infancy or childhood and are most often the result of severe abuse and/or neglect. However, a lack of consistent caregiving can lead to the development of RAD as well. This could include a caregiver who is not able to meet a child’s emotional and physical needs, frequent changes in primary caretakers or even the death of a parent.

Regardless of the cause, a child with RAD must be placed in a stable and nurturing environment to develop a strong foundation for future relationships. This requires a commitment from the whole family and often involves the use of individual and group therapy, parenting skills classes and other support services. In addition, parents should be aware of some controversial therapies that have been used in the past. These include holding therapy, which entails a caregiver physically restraining a child while allowing them to experience a range of emotions. This method has been associated with a number of injuries and even death in some cases. The American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry strongly caution against these techniques. It is also important for parents to have clear boundaries and expectations, limit the amount of disciplinary actions they take, and offer lots of positive reinforcement. This will prevent a child from becoming more isolated, angry and defiant.

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