Overview

Reactive attachment disorder is a serious condition in which an infant or young child fails to establish healthy attachments with parents or caregivers. This disorder may develop if the child's basic needs for comfort, affection, and nurturing are not met, and loving, stable attachments with others are not established.

With appropriate treatment, children with reactive attachment disorder may develop more stable and healthy relationships with caregivers and others. Treatments include creating a stable, nurturing environment and providing positive interactions between the child and caregiver. Parent or caregiver counseling and education can also be helpful.

Symptoms

Reactive attachment disorder usually starts in infancy, and symptoms may include unexplained withdrawal, fear, sadness, irritability, and a lack of interest in seeking comfort or responding to comfort given. Children with reactive attachment disorder may also display behavior problems and fail to seek support or assistance.

When to See a Doctor

If your child shows concerning signs that persist over time, consider getting an evaluation by a pediatric psychiatrist or psychologist. It's essential to determine whether the behaviors indicate reactive attachment disorder or another disorder, such as autism spectrum disorder.

Causes

The development of reactive attachment disorder is linked to a lack of a stable, caring environment and inconsistent meeting of the child's emotional and physical needs by caregivers. Infants and young children need to feel safe and develop trust through shared emotional exchanges with caregivers. The reasons why some children develop reactive attachment disorder are not entirely clear, and further research is needed to understand the causes better and improve diagnosis and treatment options.

Risk Factors

The risk of developing reactive attachment disorder may increase in children who experience severe social and emotional neglect, frequent changes in foster homes or caregivers, or have parents with severe mental health problems, criminal behavior, or substance abuse that impairs their parenting. However, most severely neglected children do not develop reactive attachment disorder.

Complications

Without proper treatment, reactive attachment disorder can have lifelong consequences, affecting relationships, social interactions, mental and physical health, behavior, intellectual development, and potentially leading to substance abuse. More research is needed to understand how experiences of reactive attachment disorder in early childhood may affect older children and adults.

Prevention

While it's uncertain if reactive attachment disorder can be entirely prevented, there are ways to reduce its risk. Infants and young children need a stable, caring environment, and their emotional and physical needs must be consistently met. Parenting suggestions to help reduce the risk of reactive attachment disorder include being actively engaged with your child, learning to interpret their cues, providing warm and nurturing interaction, offering both verbal and nonverbal responses to their feelings, and seeking experience or training if needed.