Reactive Attachment Disorder

Reactive attachment disorder is a rare but serious condition. It is when an infant or young child can’t establish healthy attachments with parents or caregivers. It may develop if the child’s basics needs for comfort, affection and nurturing aren’t being met and loving, caring, stable attachments with others are not established. With treatment, children with reactive attachment disorder may develop more stable and healthy relationships with caregivers and others. Treatments include positive child and caregiver interactions, a stable nurturing environment, psychological counseling, and parent or caregiver education.

Reactive attachment disorder can start in infancy. Some signs and symptoms may include withdrawal, fear, sadness or irritability that is not readily explained; sad and listless appearance; not seeking comfort or showing no response when comfort is given; failure to smile; watching others closely but not engaging in social interaction; failing to ask for support or assistance; failure to reach out when picked up; and no interest in playing peekaboo or other interactive games.

Infants and young children need a stable, caring environment to feel safe and develop trust. All of their basic emotional and physical needs have to be constantly met. A child needs are ignored or met with a lack of emotional response from caregivers does not come to expect care of comfort or form a stable attachment to caregivers. Most children are naturally resilient, and even those who’ve been neglected, lived in orphanages, or had multiple caregivers can develop healthy relationships.

The risk of developing reactive attachment disorder from serious social and emotional neglect or the lack of opportunity to develop stable attachments may increase in children who: live in a children’s home or other institution, frequently change foster homes or caregivers, have inexperienced parents, have prolonged separation from parents or other caregivers, have a mother with postpartum depression, and are parent of an usually large family where such parental time is scarce or available unequally or rarely.

The best treatment for a child with reactive detachment disorder is a positive, loving, stable, caring environment and caregiver. There’s no standard treatment but it should involve both the child and parents or primary caregivers. Early intervention appears to improve outcomes. Goals of treatment are to help ensure that the child has a safe and stable living situation and develops positive interactions with parents and caregivers. Treatment strategies include: encouraging the child’s development by being nurturing, responsive and caring; providing consistent caregivers to encourage a stable attachment for the child; providing a positive, stimulating, and interactive environment for the child; addressing the child’s medical, safety and house needs as appropriate; individual and family psychological counseling; education of parents and caregivers about the condition; and parenting skills classes. Without treatment, reactive attachment disorder can continue for several years and may have lifelong consequences.

This was one of my assignments to do with my internship so that I could get some background on what some of the children are going through in their lives. Researching reactive detachment disorder has really opened up my eyes and has helped me understand more about some of the children. Very eye opening.


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