Reactive Attachment Disorder

By: Nicole Gaffney

Chapter 6: Attachment and Personality

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Attachment is a deep and enduring affectionate bond that connects one person to another across time and space (Bergin & Bergin, 2012). There are many different types of attachment. Secure Attachment is when children feel secure, have open communication and feelings of delight (Bergin & Bergin, 2012).  It also promotes a life-long attitude that comes from the consistent trust that parents will be available for comfort and security. There are also insecure attachments, which result from unresponsive and insensitive parents. These types of attachments affect the development in a child’s social and emotional well-being, which later influences adulthood.

 What happens when a child goes without a primary caregiver and does not develop an attachment early in life? What if a child is severely abused in their early years?  The lack of warmth and positive emotional relationships can lead to Reactive Attachment Disorder. “Attachment Disorder is a condition in which individuals have difficulty forming lasting relationships” (Thomas, 2013). Reactive attachment disorder (RAD) is one possible psychological consequence of a child’s emotional or physical abuse or neglect for very young children. RAD is usually apparent in children by the time they reach the age of five.

 Fortunately, RAD is uncommon. It is hard to know how many children are affected by the disorder because many families do not get treated. A child can be at risk for the disorder if they experience negligence in the first 36 years of life (Thomas, 2013).

  • Disregard of the child’s emotional needs for comfort, stimulation, and affection
  • Neglect of the child’s basic physical needs
  • Inconsistent caregivers that prevent formation of stable attachments (foster cares, failed adoptions)

 Children with Reactive Attachment Disorder have very distinct characteristics. These children are often very focused on keeping themselves safe (Smilth, 2000).  They have been abandoned, hurt and/or neglected. They feel threatened, anxious or scared and act on these emotions.  These students can act like bullies when they feel threatened.  When another child is simply looking in their direction, they might say, “Stop looking at me ugly” as a way to protect themselves. They can also exhibit some cognitive disabilities. According to Shirley Crenshaw (2011), some issues at school might include:

  • Need to control others
  • Transitional trauma (changes in class, schedule, substitutes)
  • Easily distracted, impulsive
  • Immature behaviors caused by feelings of threat
  • Extreme need for attention
  • Triangulation (victim-student, perpetrator-parent, and rescuer-teacher)
  • Anxiety, defiance, aggression, stealing, lying
  • Concentration, information processing and ability to organize

 Each child is different.  If there is a child in your classroom with RAD, there are many resources to help support him/her.  Many times, triangulation can be the most damaging hazard and should be broken first (Smith 2000).  This can be broken with frequent parent contact so that the child understands communication is open with home and school.  Children with RAD also are more successful when they can avoid large groups where they might feel threatened or intimidated. 

 Although there is no known “cure” for RAD, there are many treatment plans to help the child grow. A parent has to be willing to support the child’s disorder at home along with his/her teachers (Smith, 2013).

 References:

 Bergin, C.C. & Bergin, D.A. (2012).  Child and Adolescent Development in Your Classroom.  Belmont, CA:  Wadsworth/Cengage Learning.

 Crenshaw, Shirley. (2011) Children with Trauma and Attachment Disturbances: In the Classroom [PDF document]. Retrieved from Slide Show: http://www.attachmenttrauma.com

 Smith, Lawerence B.  (February 1, 2008). Oil and Water: The Attachment Disordered Child in School. Retrieved from http://www.attachmentnewengland.com/oil_water.pdf

Thomas, Nancy (2013). Reactive Attachment Disorder. Retrieved from http://www.attachment.org/parents/reactive-attachment-disorder

 Discussion Questions:

  1. Have you had a child who has been diagnosed with RAD in your classroom?  If so, how did this particular child show signs of the disorder and how did you support him/her?
  2. If a child in your classroom was getting ready to leave you and move onto a different grade/teacher, they might feel threatened or abandoned. What steps could you take to make sure that child feels secure with this move?
  3. How does Maslow’s Hierarchy of Needs (pg. 42 in the textbook) relate to a child with RAD and development? 
  4. If a child with RAD feels threatened in large groups, explain how you can modify your classroom so they would feel safe and undistracted.

 

 

 

 

 

 

 

 

 

 

 

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7 Responses to

  1. Amanda Morris says:

    Have you had a child who has been diagnosed with RAD in your classroom? If so, how did this particular child show signs of the disorder and how did you support him/her?

    To my knowledge, I have not had a student diagnosed with RAD in my classroom. I would say if I had students with this disorder, the parents wouldn’t have the money or resources to get tested. After reading this, I realized I didn’t fully understand the process for RAD students. I found some useful information on the Mayo Clinic’s web-site.
    At first I started picturing one of my student’s as possibly having this disorder, but as I read on, it stated that it has similar characteristics as:
    “Post-traumatic stress disorder (PTSD)
    Anxiety disorders
    Adjustment disorder
    Autism spectrum disorders
    Social phobia
    Conduct disorder
    Attention-deficit/hyperactivity disorder (ADHD)” (Mayo Clinic 2011)

    This student is currently being tested for autism, which makes you wonder if he should be getting tested for something else as well! The web-site also discusses differences in opinions by different doctors and educators on what effectively tests for this disorder.

    While “my student in mind” doesn’t have a diagnoses, I still do things to build a relationship with this child. The first is modeling friendship with the other teacher in the room. The student may say mean things and I care for the student as well as the teacher. At first, this didn’t do much, but the student has started caring about the feelings of the teachers and even classmates when before he had a “so-what” attitude. I have also been consistent with our schedule, activities, and what I expect of him. I am always kind and caring, calm and firm. Whether the student is diagnosed or not, when you see some of the associated characteristics, extra care and precautions need to be taken.

    • Amanda Morris says:

      And of course, here’s my citation:
      Mayo Clinic Staff. (2011, 07 06). Reactive attachment disorder. Retrieved from http://www.mayoclinic.com/health/reactive-attachment-disorder/DS00988/DSECTION=tests-and-diagnosis

      • Nicole Gaffney says:

        Thanks Amanda! What a great piece of information to add. It DOES look a lot like PTSD. There was so much information that I could include in my post, but didn’t have the time or space. I agree with you, most children are not diagnosed and we need to be able to recognize signs to support them by taking extra precautions. The child I worked with was not diagnosed. However, I researched the disorder and which helped me understand her behaviors and ended up helping her tremendously. Thank you for the extra information!

  2. Drew Ibendahl says:

    If a child in your classroom was getting ready to leave you and move onto a different grade/teacher, they might feel threatened or abandoned. What steps could you take to make sure that child feels secure with this move?

    Having taught fifth grade for the past four years in districts where the students move on to sixth grade in a separate building, every school I have taught in has a sixth grade visitation day. During this time, students tour the middle school building, meet their future teachers, learn about their schedule, and, usually, the greater independence they are allowed in the middle school. Students receive advice from “professional” sixth graders about how to survive a new school, new grade level, and new teachers and be successful in the next stage of their education. This transition is quite a step in many students’ lives, and often is a struggle, but the simple transition from one grade to another within the same building or even from one class to another within the same grade level can be just as much of a struggle for many students. Because of this, a similar visitation day, or even week, is necessary. Students need the opportunity to familiarize themselves with their new teacher, the new classroom routines and procedures, new/different classmates, and they need time to practice these new routines and procedures. Teachers within grade levels need to collaborate, not only with regards to curriculum, but also to make each other aware of what is going on each classroom to help prepare students as they switch throughout the day for classes. In addition, teachers need to work together to make classrooms as consistent as possible, especially at the younger grades. This is not saying that classrooms should be like factories, whereby the day runs exactly the same, but routines help students feel secure in knowing what to expect. In addition to teachers within grade levels, teachers from one grade to the next should communicate to provide as much consistency as possible in terms of helping students know what to expect as they enter the next grade level. Often times, teachers don’t have enough time to plan within their grade level teams, let alone with teachers from other buildings. However, most students, like most adults have a natural fear of the unknown. It is our job as educators to alleviate some of that fear by making some of the unknown known.

  3. Mary Decker says:

    Have you had a child who has been diagnosed with RAD in your classroom? If so, how did this particular child show signs of the disorder and how did you support him/her?

    I have had two experiences with RAD in my teaching career. About eight years ago, my husband was starting his first year as an eighth grade teacher at a private middle school. He had a student in his class who had been adopted from Russia when he was six. This boy had been adopted into a very loving family, but the effects of his time in an orphanage were definitely apparent. He was very hesitant to form relations with others – children and adults. He would often want to be alone and would get surprisingly aggressive without any seeming provocation. He also exhibited signs of depression. My husband worked with the parents and the counselor to try to foster relationships. They tried to give him his space, but also make sure that he felt safe and secure. Unfortunately, things did not end well. This boy tragically took his own life before he graduated 8th grade. It was a horrible shock to the community and to my husband, as you can imagine.

    In my own classroom, I had another boy that I suspected had RAD about three years ago. He was also an adoptee. His family adopted him from the Ukraine when he was three. He exhibited very odd behaviors. He would often refuse to speak to anyone. This would happen for hours at a time. He would also refuse to do any sort of creative writing. I could have him copy other text, but he would not generate his own. He was also very paranoid. Several times a week, he would say that students were talking about him behind his back in a negative way. I was very worried about this child and got help from many resources. Weekly, I checked in with his parents to let them know about our progress and check with his behaviors at home. I arranged weekly meetings with the counselor and him as well, just so that he could have another relationship with a trusted adult in the school. I also tried to pair him with any student towards whom he exhibited positive behaviors. Now, he is in 5th grade and seems to be doing well! He is not the highest achiever, but he seems happy at school, which is the most important thing to me.

  4. Leslie says:

    If a child with RAD feels threatened in large groups, explain how you can modify your classroom so they would feel safe and undistracted.

    If a child with RAD feels uncomfortable in large group settings, it might be a good idea to give them a special place in the room that is only theirs. I have had to do this in the past and it worked pretty well. I got a small carpet and placed it off to the side of the room. I put the child’s desk on it. I had a talk with my class about how that carpet was only for little Johnny and nobody else could even step foot on it. It helped the student feel comfortable because he had his own space. Another thing that you could do is get a desk with a divider. We have them in our focus room at my school. It is a desk that has walls on 3 sides. A student sitting there might feel safe and away from everyone else because while sitting in that desk, you can not see anyone else. It is kind of like you are in your own little tent. Some other things that you could modify would be to let the student stay at their seat when the rest of the kids come to sit on the carpet. They could have a special place to sit in the lunch room away from the other kids. They could have a special place to sit at assemblies and any other place where there are large groups of people.

  5. Sinclair says:

    3. How does Maslow’s Hierarchy of Needs (pg. 42 in the textbook) relate to a child with RAD and development?

    Now that I can look back at my CPS time from a distance, I see RAD in many of the delinquent children we had. I did not know about RAD at the time. Occasionally we would have someone just show up at the office and wish to turn their adopted child over to the state because of their behavior. It makes perfect sense now why these children acted as they did, even though the new parents had done everything possible to make life perfect for them. Their basic needs as Maslow stated them had not been met in the early, formative years and they could not accept the new life they had been given. This is a cruel trick with adoption/fostering that keeps the new parents up, wondering what they are doing wrong when in reality, they are probably doing most things right. Since studying about RAD at the master’s level, when I do a home study now for a private adoption I always inform the parents to be about the possibility of RAD. Regretfully, I always advise them to seek a child they can take straight home from the hospital after birth if possible. It has been my experience that adopting a toddler usually does not have nearly as good an outcome and takes the patience of Job, which parents may not have with a non-biological child.

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