reactive attachment

Reactive Attachment Disorder in Children and Teens

Reactive Attachment Disorder (RAD) is a sad and frustrating diagnosis. Unlike many other mental health disorders, this is one of the few that is completely preventable. RAD occurs when an infant or young child doesn’t establish healthy attachments with a parent or caregiver, creating neurological damage that tells them the world is not a safe place. Although known to develop in children five years old or younger, it most often occurs within the first 36 months of a child’s life.

Reactive Attachment Disorder Causes

RAD is often associated with adopted children. While adoption is one of the most common risk factors, there are other situations that can also cause the disorder, including:

  • Time spent living in a group home—orphanage or other institution.
  • Frequent change of homes/caregivers.
  • Having a mother with postpartum depression.
  • Having prolonged separation from parents because of hospitalization.
  • Being part of a large family where individual attention is rarer.


Understanding RAD

Due to the neurological damage that comes from a lack of attachment or safety during these first fragile years, the child is wired to have both higher levels of adrenaline and the inherent belief that they are alone in the world and must fend for themselves.  Children with reactive attachment disorder have a deep craving for love and approval but do not believe that any love given to them is genuine. Sometimes, these traits can be spotted in early childhood through symptoms such as the child watching but not engaging in human interaction, or a refusal/disinterest in being picked up. But often, symptoms do not start appearing until early adolescence.

Reactive Attachment Disorder Symptoms

Do you suspect that your teen may be suffering from reactive attachment disorder? Detachment and a desire for independence are normal during the teen years, but if your teen is exhibiting several or more of the symptoms below, it is probably a more serious issue.

  • Unexplained withdrawal from family and friends
  • No response to or seeming to desire for comfort
  • Refusal to ask for or accept help
  • Distrust of everyone around them, especially authority figures
  • Relationships based on manipulation and control, rather than intimacy and trust
  • Cruelty to animals and/or siblings
  • Consistent lying and deceit to accomplish goals
  • No remorse for actions
  • Lack of empathy or compassion for others
  • Difficulty sleeping


During the teen years, children with RAD may learn to imitate normal human reactions such as empathy and caring. However, this limitation is not progressing towards healing, as it will just become another tool they use to attempt to control situations around them and keep themselves isolated.  Only with intentional, long-term treatment can RAD truly be overcome. Studies have shown that this treatment is typically most successful during two times in a child’s life—early adolescence and in their thirties. This does not mean treatment is hopeless during other stages of life, but if you have the opportunity to act while they are in your care as an adolescent, it is crucial to seize it.

Reactive Attachment Disorder Treatment

The most important first step in treating RAD is putting the child or teen in a stable environment with a loving caregiver. The next step is psychological counseling with a trained therapist. Since children with RAD are inherently distrustful, expect this process to be slow going at first as they take longer than the average child to open up to a therapist. Celebrate even the smallest steps of improvement as you walk with your child through this process! Here are some parenting strategies to help you along the way:

  • Explain your feelings over and over again: Children with RAD have trouble feeling emotions such as empathy and compassion. When your child hurts you, tell them how what they did made you feel.
  • Help your child learn to read facial expressions: A lack of emotional understanding also means an inability to read facial expressions to determine their connection to emotions. Show your child what a sad, mad, happy, or frustrated face looks like.
  • Ask your friends and family for help:  The problem with RAD is that unlike many other disorders, it is often undetectable by others in your family’s life. You may feel judged on your parenting, or experience comments like, “He/she doesn’t seem that bad to me!”  Letting people in on your child’s diagnoses gives you a support system and a group of people to encourage you, rather than undermine you.

We hope that this content has been informative and helpful. It is our desire to help families and bring struggling teens back together. We encourage you to share this information with others who may be in need.


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