A child with reactive attachment disorder is typically neglected, abused or orphaned. Reactive attachment disorder develops because the child’s basic needs for comfort, affection and nurturing aren’t met and loving, caring attachments with others are never established. This may permanently change the child’s growing brain, hurting the ability to establish future relationships.
Reactive attachment disorder begins before age 5. Signs and symptoms of the disorder may begin when the child is still an infant.
Signs and symptoms in babies may include:
Withdrawn, sad and listless appearance
Failure to smile
Lack of the normal tendency to follow others in the room with the eyes
Failure to reach out when picked up
No interest in playing peekaboo or other interactive games
No interest in playing with toys
Engaging in self-soothing behavior, such as rocking or self-stroking
Calm when left alone
Signs and symptoms in toddlers, older children and adolescents may include:
Withdrawing from others
Avoiding or dismissing comforting comments or gestures
Acting aggressively toward peers
Watching others closely but not engaging in social interaction
Failing to ask for support or assistance
Obvious and consistent awkwardness or discomfort
Masking feelings of anger or distress
Alcohol or drug abuse in adolescents
A child whose needs are ignored or met with emotionally or physically abusive responses from caregivers comes to expect rejection or hostility. The child then becomes distrustful and learns to avoid social contact. Emotional interactions between babies and caregivers may affect development in the brain, leading to attachment problems and affecting personality and relationships throughout life.
Complications of reactive attachment disorder can continue into adulthood and can include:
Delayed learning or physical growth
Delinquent or antisocial behavior
Temper or anger problems
Eating problems, which can lead to malnutrition in severe cases
Drug and alcohol addiction
Unemployment or frequent job changes
Inappropriate sexual behavior
There’s no standard treatment for reactive attachment disorder. However, it often includes:
Individual psychological counseling
Education of parents and caregivers about the condition
Parenting skills classes
Medication for other conditions that may be present, such as depression, anxiety or hyperactivity in a child or a parent
Special education services
Residential or inpatient treatment for children with more-serious problems or who put themselves or others at risk of harm
Other treatments for reactive attachment disorder that may be helpful include:
Development of attachment between the child and the child’s therapist
Close, comforting physical contact
Managing reactive attachment disorder is a long-term challenge and can be quite demanding for parents and caregivers. You may want to consider seeking psychological counseling yourself or taking other steps to learn how to cope with the stress of having a child with reactive attachment disorder.
Educate yourself about attachment issues if your baby or child has a background that includes orphanages or foster care. This can help you develop specific skills to help your child bond. Resources include books, pamphlets, Internet sites and support groups. You may want to check with an adoption agency to identify educational materials and other resources.
Take classes or volunteer with children if you lack experience or skill with babies or children. This will help you learn how to interact in a nurturing manner.
Be actively engaged with your child in your care by playing, talking to him or her, making eye contact, or smiling often, for example.
Learn to interpret your baby’s cues, such as different types of cries, so that you can meet his or her needs quickly and effectively.
Provide warm, nurturing interaction with your baby or child, such as during feeding, bathing or changing diapers.
Teach children how to express feelings and emotions with words rather than by acting out. Lead by example.
Offer both verbal and nonverbal responses to the child’s feelings through touch, facial expressions and tone of voice.
If you’re an adult with attachment problems, get help — it’s not too late. Seeing a mental health provider not only may help you, but also may prevent you from having attachment problems with your children.