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Re-Active Attachment Disorder (RAD)

Re-active attachment disorder is most often used to describe emotional and behavioural problems of children related to the inability to form healthy attachments to caregivers. Reactive Attachment Disorder (RAD) of Childhood is a very specific diagnosis that can only be made by a qualified psychiatrist, psychologist or physician, as with other formal diagnoses. RAD refers to the very limited set of circumstances in which a child is thought to not have the opportunity to develop any attachment to a caregiver. Diagnostic criteria have not yet been agreed on. RAD can be broken into two types – inhibited and disinhibited. Many children have both. Symptoms are listed below for the combined type.


  • Resists affection on parents’ terms
  • Affectionate with strangers – shows bad judgment
  • Continuous and intense control battles, bossy and argumentative; defiant and angry
  • Lack of eye contact, especially with parents but will look into your eyes when lying
  • Manipulative - superficially charming and engaging
  • Poor peer relationships
  • Steals
  • Lies about the obvious even when confronted
  • Shows no remorse – lack of conscience
  • Destructive to property, self and/or others
  • Lack of impulse control
  • Hyper-vigilant/Hyperactive
  • Learning delays
  • Speech and language problems
  • Incessant chatter and questions
  • Inappropriately demanding and/or clingy
  • Food issues – hordes, gorges, refuses to eat, eats strange things, hides food
  • Very concerned about tiny hurts but brushes off big hurts

Possible Causes

  • Neglect or abuse
  • Separation from the primary caregiver
  • Changes in the primary caregiver or frequent moves and/or placements
  • Environmental disruption (a “chaotic” home)
  • Traumatic experiences (exposure to domestic violence)
  • Caregiver mental health problems (depression, psychosis)
  • Maternal addiction – drugs or alcohol
  • Undiagnosed, painful illness such as colic, ear infections, etc.

RAD can be a lifetime disability. Seek help from a knowledgeable professional as soon as possible. Consider getting a second opinion if you have questions or concerns about the diagnosis or treatment plan.


Links or Useful Resources for RAD:
Attachment Disorder Site -
Child and Parent Resource Institute - - or call 1-519-858-2774
Institute for Attachment -
Mayo Clinic -