What is Reactive Attachment Disorder (RAD)?
RAD is a very serious disorder that must be identified before the age of 5 in children. According to the DSM 5, a tool mental health professionals use to diagnose disorders, RAD can be classified as a severe, but rare disorder. RAD occurs when the bond between the infant and the main caregiver is broken, or if the infant does not properly “attach” or “bond” with a single caregiver during infancy. Usually a child who suffers from RAD will either have issues forming new bonds or relationships with others, or they will be know no boundaries when interacting with strangers.
It is important to note that there are evaluations that can be conducted to assess for RAD in children, as well as the extent to which they suffer from the disorder. This may be beneficial in order to rule out other disorders such as Autism Spectrum Disorder or Depression.
How does it affect children?
Here are some things to expect from a child who suffers from RAD:
• A consistent pattern of emotionally withdrawn behavior toward caregivers, shown by rarely seeking or not responding to comfort when distressed
• Persistent social and emotional problems that include minimal responsiveness to others, no positive response to interactions, or unexplained irritability, sadness or fearfulness during interactions with caregivers
• Persistent lack of having emotional needs for comfort, stimulation and affection met by caregivers, or repeated changes of primary caregivers that limit opportunities to form stable attachments, or care in a setting that severely limits opportunities to form attachments (such as an institution)
• In cases that involved sexual abuse, children could become openly sexual by masterbating in public or lacking sexual boundaries with strangers.
What “causes” RAD?
Many of the children who develop RAD as infants are typically victims of child abuse, neglect or sexual abuse by their primary caregiver. These are all situations in which a child’s bond would be broken as a result of the abuse. In other cases, RAD in infants may occur in foster homes or orphanages, where infants are unable to properly attach to a single caregiver. For example, many orphanages or group homes will have staff who interact with the children on a daily basis, but they change shifts so frequently that the child aren’t able to form an attachment to a single caregiver.
Why does it happen to children in our dependency courts?
Unfortunately, our foster care system doesn’t do the best job (mostly due to funding) in caring for the emotional needs for the children involved in our dependency court system. This means that foster parents are getting usually getting 5-6 children at a time or group homes are at capacity with children. A child who was removed from their parent’s care due to abuse or neglect, won’t really benefit from being housed with other children, who may suffer from other mental health issues.
Fortunately, our very own 15th Judicial Circuit is currently working with mental health professionals to develop a therapeutic court for children who suffer from severe mental health issues. Hopefully, this will better serve children who are involved in the dependency court. In addition, Palm Beach County recently began forming “therapeutic” group homes for children who suffer from severe mental illnesses, such as RAD.
Is RAD something that can be treated?
RAD is a ver severe disorder that with intensive inpatient treatment, the symptoms can be managed and the child, can sometimes, be rehabilitated to function normally. It is important to note that every case differs in severity, therefore, treatment options will vary from case to case.