The Facts About Reactive Attachment Disorder

What prospective adoptive parents need to know about reactive attachment disorder, and how to recognize the symptoms.

Reactive Attachment Disorder

What is attachment disorder, and how can I tell if a child is at risk?

Child psychiatrists believe that children lay down emotional patterns, beginning in infancy. A child who does not experience consistent affection may never learn to feel or express affection for others. This syndrome is called “attachment disorder” or “reactive attachment disorder” (RAD).

Psychiatrists generally say that reactive attachment disorders cannot be caused by anything that happens before a child is five months old; if your baby is younger, he or she won’t be at risk. Many psychiatrists also believe that a child who has been loved by a parent or caregiver in its first three years builds up “immunity” to attachment disorder; as a result, children who have lost parents after age three may be traumatized and grief-stricken, but they will generally be able to heal.

It’s commonly assumed that only older children or internationally adopted children are at risk for RAD, but this is untrue. Any child who lacked individual attention between about six months and two years is at risk. If your child was in an orphanage with a high number of children to caregivers, or in a series of short-term foster placements, you should assume that RAD is a possibility.

True attachment disorder is extremely rare, and must be carefully diagnosed by a therapist. A child who consistently displays many of the following symptoms should be evaluated—but bear in mind that ALL children, including healthy children raised in their biological families, exhibit some of these symptoms some of the time.

Symptoms of RAD

  • Superficially engaging and charming
  • Lack of eye contact
  • Indiscriminately affectionate with strangers
  • Lack of ability to give and receive affection on parents’ terms – not cuddly
  • Inappropriately demanding and clingy
  • Persistent nonsense questions and incessant chatter
  • Poor peer relationships
  • Low self-esteem
  • Extreme control problems—may attempt to control openly or in sneaky ways
  • Difficulty learning from mistakes
  • Learning problems—disabilities, delays
  • Poor impulse control
  • Abnormal speech patterns
  • Abnormal eating patterns
  • Chronic “crazy” lying
  • Stealing
  • Destructive to self, others, property
  • Cruel to animals
  • Preoccupied with fire, blood, and gore

Obviously, most of these are symptoms that appear over time, and may not be immediately apparent from a video or a first meeting. Adoptive parents should investigate their child’s early history and learn as much as they can about the child’s living situation. If the child is from an orphanage, talk to adoptive parents who visited previously: Were the children cuddled and loved? Were they held for feedings, or were bottles propped on their chests? Were the caregivers attached? Did they know individual children’s names and personalities? There are good orphanages and bad ones; factor this into your decision.

What happens if I discover a health problem after the child is home?

While almost all adoptees—even those coming from the most dire situations—turn out to be perfectly healthy, every once in a while families discover serious and unexpected health problems in their child. Most react exactly as they would had they given birth to such a child, that is, with love and commitment. When you are interviewing adoption agencies, ask about post-placement support, particularly for families faced with disability and illness. A good agency will have social workers on staff to help you navigate the medical and mental-health system for your child.

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Adoption Agencies

Adoption by Shepherd Care
Hollywood, FL
U.S. Newborn, International
Children’s Home Society & Lutheran Social Service of Minnesota
Saint Paul, MN
U.S. Newborn, U.S. Foster, International, Special Needs/Waiting Child
Building Blocks Adoption Service
Medina, OH
U.S. Newborn, Special Needs/Waiting Child
Family Life Services Adoption Agency
Lynchburg, VA
U.S. Newborn
Caring for Kids, Inc.
Cuyahoga Falls, OH
U.S. Newborn, U.S. Foster
Houston, TX
U.S. Newborn, U.S. Foster, Special Needs/Waiting Child
Cradle of Hope Adoption Center
Silver Spring, MD
U.S. Newborn, International
Miriam’s Promise
Nashville, TN
U.S. Newborn, International
Morton, IL
U.S. Newborn
Forever Families Through Adoption
Rye Brook, NY
U.S. Newborn, U.S. Foster, International
The Barker Adoption Foundation
Bethesda, MD
U.S. Newborn, U.S. Foster, International, Special Needs/Waiting Child
Children’s House International
Lynden, WA
International, Special Needs/Waiting Child
Adoptions of Indiana
Carmel, IN
U.S. Newborn

See all adoption agencies >

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