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March 22, 2022 · 11 Comments

Can a Child Heal from RAD? Answers to Questions about Reactive Attachment Disorder

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If you are parenting or treating a child with RAD, you probably have many questions about Reactive Attachment Disorder. Can your child heal from RAD? Is there hope for your family and for your child to succeed in life?

Here are answers to commonly asked questions about Reactive Attachment Disorder diagnosis, treatment, and helping a child who suffers from insufficient attachment.

Answers to Frequently Asked Questions about RAD
Answers to FAQ about Attachment Disorder

What is RAD?

Reactive Attachment Disorder (RAD) is defined as a problematic pattern of developmentally inappropriate moods, social behaviors, and relationships due to a failure in forming normal healthy attachments with primary care givers in early childhood.

A child who experiences neglect, abuse, or separation during the critical stages of development during first three years of life is at risk of developing an attachment disorder.

Children especially at risk for RAD include:

  • children in orphanages (especially from overseas adoptions)
  • children in foster care
  • children who are abused and neglected during the first 3 years of life
  • children whose primary caregiver is depressed, addicted or suffers from mental health issues
  • children whose parents are addicted to drugs or alcohol
  • children who have serious medical issues and hospitalizations in infancy
Baby shoes in crib

How Serious is Reactive Attachment Disorder and Can It Be Cured?

RAD is a diagnosis with the potential for life-long implications. While there are effective treatments for attachment disorders, they require intensive interventions and not all children respond positively.

Can RAD be cured? While it’s possible for children with RAD to heal, most will continue to have some personality and relationship issues into adulthood. It’s important for parents and caregivers to adjust expectations accordingly. We now understand that early childhood trauma has life-long, often devastating impact. The results of this are seen in the lives of children with RAD.

While RAD is serious, recognize that there is much hope. Many children who were diagnosed with RAD have gone on to live productive lives, get married, have children, and establish relationships.

Yet it’s also necessary to discuss that many of these children are not able to maintain life in typical homes and communities and this is not the fault of the parents.

Attachment issues fall on a spectrum, from mild problems that can be addressed and treated with great success to the most serious form, which is children with RAD who do not have a conscious.

In the worst cases of attachment disorder, these children can be dangerous. They require constant supervision or placement in a locked residential facility where they can be monitored 24 hours a day, 7 days a week.

Children who do not heal from RAD may grow into adults who do not have a conscience and go on to have critical personality disorders in adulthood.

The earlier in a child’s life that attachment therapy is started, the more likely it is to be successful.

Answers to Commonly Asked Questions about RAD (Reactive Attachment Disorder)

While RAD is a relatively rare diagnosis, it is one that impacts the children who have it, parents, caregivers, and those in the community. Children with RAD are not able to form attachments with others and so develop problematic behaviors as a way of coping with what they perceive as the scary world around them.

What is the best treatment for Reactive Attachment Disorder?

Attachment therapy with a qualified therapist is the best treatment for attachment disorder. Traditional play therapy or Cognitive Behavior Therapy (CBT) is rarely effective and can be harmful because the child tends to triangulate the parents and therapist. Other treatment modalities such as medications, animal and music therapy, physical and occupational therapy can be helpful, but attachment therapy should be the primary focus. Click here for the top 10 treatments for attachment disorder.

Does RAD go away?

Is RAD permanent? Attachment disorder does not go away as children get older unless intensive therapy and intervention is used. RAD is a diagnosis for children, so a person with RAD who does not receive treatment will have a different mental health diagnosis as an adult, most commonly narcissistic personality disorder, borderline personality disorder, or antisocial personality disorder.

How do you discipline a child with Reactive Attachment Disorder?

Children with RAD need extremely tight and firm boundaries. These children are highly charming and manipulative. Even the most trained therapists and social workers are often fooled by the child’s behaviors. Because many children with RAD are self-seeking and do not have a healthy conscious, they will cause harm to other children and animals without remorse. Here are effective discipline strategies for a child with RAD.

Can people with RAD love?

No. Children with extreme forms of RAD cannot give and receive love in a true form because they are lacking the necessary attachment. As they heal from trauma, they begin to develop empathy and the ability to love and have relationships with other people.

Is Reactive Attachment Disorder a form of autism?

No. RAD is a result of insufficient attachment with a primary caregiver and autism is a developmental disability. The symptoms and behaviors of autism and RAD can at times overlap. Children can also have a dual diagnosis of both autism and RAD. Click here for more on Autism vs RAD.

How do you help a child with Reactive Attachment Disorder?

Children with attachment disorder are highly fearful. Even behaviors that do not seem to be fearful at first, such as lying, stealing, and aggression, are rooted in fear and lack of attachment. Most important is directing the child back to the primary caregiver as a trusted source of support and love. Providing firm boundaries and a high level of supervision are also necessary. Each time a child “gets away” with manipulating adults, he becomes more deeply entrenched in unhealthy behaviors.

Can a child with RAD be cured?

There is no cure for attachment disorder. With many years of intensive attachment therapy and parental intervention, many children (especially those with less severe attachment issues) go on to be productive adults.

How rare is RAD?

Reactive attachment disorder is rare, affecting about 1.4% of the population.

What are the signs of attachment disorder?

Some of the signs of attachment disorder in children include extreme hyperactivity, lying, stealing, lack of eye contact except when lying or manipulating, sexually inappropriate behavior, lack of remorse, failure to seek comfort when upset and aggressive behavior. Click here for a detailed RAD checklist with symptoms and warning signs.

What does Reactive Attachment Disorder turn into in adults?

Adults who were not treated for RAD as children are most commonly diagnosed with narcissistic personality disorder, borderline personality disorder, or antisocial personality disorder.

Is there residential treatment for RAD?

Yes, there are some residential treatment facilities that specialize in treatment for RAD. Click here for a full listing. Other group homes and treatment programs may have services appropriate for a child with attachment disorders.

What is it called when a mother doesn’t bond with her child?

When a mother doesn’t bond with her children, the child may develop an insecure attachment. The most severe form of this is Reactive Attachment Disorder (RAD).

What is the treatment for RAD?

Attachment therapy with a qualified therapist is the best treatment for attachment disorder. Also important are supporting the parents and primary caregivers and providing a secure, highly structured situation where the child is carefully supervised.

What if I’m an adult with RAD?

Do I have an attachment disorder? If you were a child who was abused, neglected or had a broken relationship with your primary caregiver, and today you struggle to form and maintain positive relationships, it’s possible you had Reactive Attachment Disorder as a child and now have a personality disorder as an adult.

Why is it called Reactive Attachment Disorder?

This attachment disorder is called “reactive” because instead of forming loving, healthy attachments that lead to positive relationships, the child acts out (“reacts”) in inappropriate ways in order to get his needs met.

Are RAD and DTD (Developmental Trauma Disorder) the same thing?

Yes. While the official DSM diagnosis is Reactive Attachment Disorder, many specialists in the field of attachment prefer the term Developmental Trauma Disorder because the focus is on the traumatic events that happened to the child and how that impacted development.

What are the two types of Reactive Attachment Disorder?

There are now two sub-types of attachment disorders – emotionally withdrawn/inhibited and indiscriminately disinhibited, defined separately in the DSM-V as distinct disorders. Some experts believe there are 4 types of attachment disorder: Anxious Attachment Disorder, Avoidant Attachment Disorder, Ambivalent Attachment Disorder, and Neurologically Disorganized Attachment Disorder.

How is reactive attachment disorder diagnosed?

A diagnosis of attachment disorder can only be made by a qualified therapist who has experience diagnosing attachment and personality disorders.

How do you parent a RAD child?

Parenting a child with attachment disorder is extremely difficult. Take care of yourself as a priority. Seek out appropriate treatment, especially attachment therapy. Provide firm boundaries and a highly structured environment to keep your child and others around him or her safe.

Are children with RAD psychopaths?

No. Children with RAD or other attachment disorders are not psychopaths. Attachment disorders are on a continuum from minor to very severe. A small minority of children with attachment issues go on to become psychopaths as adults.

What should a child with RAD not do?

Children with RAD should not be unsupervised with other children or pets. They also should not be in charge of the relationship or allowed to dominate conversations. They should not attend therapy alone. Adults should communicate and work as a team to provide the best care possible for the child.

How can I parent a child with RAD without losing my mind?

Parenting a child with RAD is extremely difficult because the children lack the means to form healthy attachments or reciprocate love. Many parents honestly admit, “I hate my RAD child” or wish to give the child away or give them back. Parents and family members (including siblings) of children with attachment issues need a high level of support from the community around them.

What if I love someone who has RAD?

If you love an adult who you suspect had RAD as a child, recognize that they may struggle to form a healthy connection with you. If you are a parent of a child with RAD, seek support for yourself and attachment therapy for your child.

How do I supervise a child with RAD?

Children with RAD need line of sight supervision when around other children or animals. They should be carefully supervised to prevent stealing, food hoarding, and property destruction. Most children with RAD need to be placed in a small classroom situation with teachers and aides to supervise and support appropriate behavior.

What are the signs of RAD in an adult?

Adults who had RAD that was untreated in childhood might struggle with relationships into adulthood, including control issues, inability to show affection, distrust, anger problems, and inability to understand emotions.

How can a teacher handle RAD in the classroom?

Managing children with attachment issues present challenges for teachers at school. Typical discipline strategies are often ineffective. Classroom management strategies specific to RAD are necessary.

What are famous cases of attachment disorder?

It has been said that Hitler, Saddam Hussein, Edgar Allan Poe, Charles Manson, Jeffrey Dahmer and Ted Bundy had attachment disorder because of their violent tendencies, plus trauma and loss early in life. These are assumptions since they didn’t have an actual diagnosis. Helen Keller is someone who had attachment issues but then learned to connect because of the work of her teacher, Anne Sullivan. Beth Thomas from the documentary Child of Rage was able to successfully heal and become a healthy adult.

Residential Treatment for RAD

The goal is always for children with attachment issues to remain in the home environment. Healing happens within families, and in order for a child to learn to attach, he needs to be with his or her family.

Still, there are times when for the safety of the child or family, residential treatment is necessary. Click here for a complete list of treatment centers that specialize in RAD and attachment disorders.

With the answers to frequently asked questions about RAD, you have a clear picture of how to find treatment, therapy and provide support to a child with attachment issues.

Do you have another question about RAD that wasn’t covered in this article? Share it in the comments below and we will add the information to a future post.

Infographic RAD checklist
Click here for a PDF printable of this RAD checklist.

About Alyssa Carter

Alyssa is a certified Family Advocate who has worked with hundreds of parents and children. She has extensive experience working with children with attachment issues, RAD, foster care, adoption, trauma, developmental delays, autism (ASD), medical issues and more. She is a parent by birth and special needs adoption and was a foster parent to many children. She has personal experience placing a child into residential treatment successfully.

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Reader Interactions

Comments

  1. Parental Strength says

    December 30, 2021 at 12:16 am

    Permission to use this article on my youtube channel Parental Strength?

    Parental Strength About:Single mother, diagnosed with Post-Traumatic Stress Disorder (PTSD), raising children who are diagnosed with PTSD, General Anxiety Disorder, Reactive Attachment Disorder, and Eating Disorders; including physical complications.

    The Community of Parental Strength is a group of parents raising a child/children with physical, mental, emotional or behavioral health issues. Parental Strength Shopify helps sponsor this community in allowing awareness to disabilities and mental illnesses among children. Raising mental health awareness can help you to understand symptoms, find professional treatment, and, perhaps most importantly, break the mental health stigma that leaves so many people suffering in secret.

    Parents, you do so much to take care of your children. Question is… Who is taking care of you? Pamper and spoil yourself. Treat yourself with love. You deserve it!

    Thank you in advance,
    Parental Strength

    Reply
    • Alyssa Carter says

      December 31, 2021 at 1:59 pm

      Yes, you have permission to use this article with proper acknowledgement and link to the article.

      Reply
  2. Wafa Mom says

    May 8, 2022 at 9:24 pm

    I have been reading your many useful articles.
    I’m still at going through this one, but I notice that “conscience” is confused with “conscious”.
    You use the second one, when I believe you mean to use the first one.
    You may wish to correct it in the article.

    Reply
    • Alyssa Carter says

      May 9, 2022 at 10:46 am

      Thank you for the feedback.

      Reply
    • Alyssa Carter says

      May 9, 2022 at 10:49 am

      Thanks for your feedback.

      Reply
  3. Matt Bennett says

    January 16, 2023 at 6:45 am

    What is it called when a mother doesn’t bond with her child?

    Your answer is incorrect. It is called ‘maternal rejection’, or ‘refrigerator mother syndrome’, among many other terms.

    Reply
  4. Matt Bennett says

    January 16, 2023 at 6:50 am

    What is the best treatment for Reactive Attachment Disorder?

    Attempting to remediate the [non]caregiver(s) is futile. Their disregard for the child cannot be altered. The child’s only hope is removal from the abusive environment. The adult survivor has virtually no prospect of recovery.

    Reply
  5. Matt Bennett says

    January 16, 2023 at 6:55 am

    Children with RAD need extremely tight and firm boundaries. These children are highly charming and manipulative. Even the most trained therapists and social workers are often fooled by the child’s behaviors. Because many children with RAD are self-seeking and do not have a healthy conscious, they will cause harm to other children and animals without remorse. Here are effective discipline strategies for a child with RAD.

    Incorrect in several respects. Not necessarily charming. Or manipulative. More likely to be highly reserved and guileless, in fact. RAD does not preclude developing a healthy conscience, nor does it predispose to behaviour devoid of conscience, such as violence or sadism.

    Reply
  6. Matt Bennett says

    January 16, 2023 at 6:59 am

    No. Children with extreme forms of RAD cannot give and receive love in a true form because they are lacking the necessary attachment. As they heal from trauma, they begin to develop empathy and the ability to love and have relationships with other people.

    Ridiculous. Of course they are capable of love. Notwithstanding love has been denied to them. They struggle with interpersonal relationships as a consequence of being denied the foundational human relationship, which is NOT an incapacity to experience love.

    Reply
  7. Matt Bennett says

    January 16, 2023 at 7:03 am

    How do you help a child with Reactive Attachment Disorder?
    Children with attachment disorder are highly fearful. Even behaviors that do not seem to be fearful at first, such as lying, stealing, and aggression, are rooted in fear and lack of attachment. Most important is directing the child back to the primary caregiver as a trusted source of support and love. Providing firm boundaries and a high level of supervision are also necessary. Each time a child “gets away” with manipulating adults, he becomes more deeply entrenched in unhealthy behaviors.

    Ridiculous. Patently the primary caregiver – if there is one – is not a trusted source of support or love.

    Reply
  8. Matt Bennett says

    January 16, 2023 at 7:06 am

    How can I parent a child with RAD without losing my mind?
    Parenting a child with RAD is extremely difficult because the children lack the means to form healthy attachments or reciprocate love. Many parents honestly admit, “I hate my RAD child” or wish to give the child away or give them back. Parents and family members (including siblings) of children with attachment issues need a high level of support from the community around them.

    No. The correct course of action is to find the honesty within yourself to admit you do not want, nor wish to care for, the child. Then relinquish the child for it’s sake.

    Reply

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