Reactive Attachment Disorder: The World Might Be a Better Place If We Supported These Parents
Updated: Jan 12
This is the second half of a 2-part series. Read part I, "How a Stranger's Early Childhood Experiences Can Impact Your Life (and what you can do about it)" here.
Imagine you're at the doctor's office with a very sick child. Without the right care, their illness will fester and greatly decrease their quality of life. Although you've tried everything you can to help your child, the illness only gets worse. You're exhausted and scared.
And then the clinician hands you a parenting book and prescribes more love. Like everyone else in your life, they suggest you try patience and sympathy. They send you on your way.
This is the reality for many people raising traumatized children.
Just like a parent can't love away cancer, they can't erase the impacts of early trauma with "good parenting". Yet, that is often the unrealistic expectation placed upon their weary and very human shoulders.
This is a problem, not just for children and families, but for all of us. We know that as trauma grows up, it leaves a mess behind. So the world is left with the grown-up symptoms of trauma—everything from homelessness to domestic violence.
What Happens to Traumatized Children
When a child suffers through early trauma, their neural-pathways develop accordingly. For some, trauma impacts the brain so severely that they develop a serious affliction called reactive attachment disorder (RAD).
Children with reactive attachment disorder, and the families who raise them, come from various places. Some children experience early trauma in the form of abuse or neglect. Others may struggle through early medical complications, violence in their community or other traumatic circumstances. They live with various people, from biological parents or grandparents to stepparents and foster and adoptive parents.
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But no matter where children with RAD go after the trauma ends, the disorder remains. So even if the child finds safety after a mother flees an abusive relationship or moves into a relative's home, for example, the disorder follows. Thus, so does the chaos.
What Helps Children with Reactive Attachment Disorder
The best chance to give a child potential healing from early trauma is through permanency. But that doesn't just happen on its own. Permanency requires support.
"The whole family needs support, not just the child with RAD,” says licensed clinical social worker Forrest Lien. In his over 40 years of working with children with RAD, Lien has seen families and children begin to heal when provided the following interventions:
Support for children with RAD to:
Have a calmer and more organized brain to feel better and optimally receive treatment and healthy parenting via neurofeedback and/or proper medication for co-morbid mental disorders
Learn to trust their safe primary caregivers, understand their trauma and its impacts on themselves and in relationships, recognize and practice healthy ways to react to their trauma triggers, function in a family and express their feelings rather than act out
Support for primary caregivers to:
Process their own feelings and triggers in relationship with their child
Understand their child’s trauma and emotional delays and learn effective parenting strategies for them, without feeling blamed and shamed
Receive support and collaboration with their community, from schools, local police, social services, etc.
Where We Go Wrong for Kids and Families
To put a child in a safe and loving home is not the only step; it is the very first step. Yet, the first step is often the only one a child is given. “Parents come to us after the system has failed them,” says RAD Advocates President Amy VanTine. “Their families are falling apart. It is harmful for everyone, including the child with RAD." Many families are on the brink of disruption.
RAD Advocates recognizes the following as barriers to health and healing for children and families:
1. The disorder itself is complex. Reactive attachment disorder is a tricky disorder that is created out of fear and survival. A child with reactive attachment disorder will go to great lengths to rely only upon themselves and repel the very interventions that may help them. They create conflict and confusion in their homes and within the teams of adults attempting to help them via a keen ability to control, manipulate and triangulate others.
It is human nature to rush to the aid of traumatized children. But reactive attachment disorder typically paints a false picture of a traumatized, yet charming, child with unreasonable adults with poor parenting skills. And when focus is mistakenly diverted from the disorder to the parents, the disorder prevails.
2. Professionals lack training. While many professionals have the best intentions, they lack the knowledge required to help families of children with reactive attachment disorder. It is a result of many factors, including the following:
University curriculums do not include sufficient information about the disorder. While some clinicians, teachers or other professionals have heard of the disorder, many did not learn about reactive attachment disorder in school. Or they breezed through a section about it in one class. Those who truly understand learned about the disorder through first-hand experience or a personal interest, will and commitment to learn more on their own accord.
Reactive attachment disorder is difficult to diagnose. Reactive attachment disorder is often missed due to co-morbidity or confused with other diagnoses that share similar symptoms.
Get support & advocacy while raising a child with RAD. Become a RAD Advocates member.
Many clinicians believe that reactive attachment disorder is rare and, thus, dismiss its possibility. Reactive attachment disorder is considered a rare disorder. While this may be true in terms of the general population, it is common within the population of children who have been abused, neglected and transferred to and from various living environments. Yet it is often overlooked, no matter a person’s past circumstances.
The Diagnostic and Statistical Manual of Mental Disorders: DSM-5 does not contain a thorough definition that helps clinicians identify the complex impacts of early trauma. Renowned trauma expert Dr. Bessel van der Kolk has submitted proposals to remedy this issue with his better-defined term, developmental trauma disorder. It is yet to be accepted, unfortunately.
Clinicians apply traditional therapy and parenting strategies that do not work for children with RAD. Interventions that work for neurotypical children do not work for children with reactive attachment disorder. In fact, they make matters worse. Without effective intervention, a parent’s love and “good parenting” is like oil to water. And time, institutionalized care (residential treatment centers, psychiatric hospitals, incarceration), traditional therapy and behavior modification techniques do not work. Children often cycle in and out of these programs, institutions and multiple homes.
Apathy. Sadly, some professionals simply give up. "I've had several different professionals tell me that they ignore the diagnosis of RAD because they believe there is no cure," says VanTine. "While this is not the case for all professionals, it's extremely disheartening to work with professionals who lack the will to learn and do more on behalf of kids and families. We can't do this alone."
3. Parents of children with reactive attachment disorder lack resources and support.
Because friends, family and professionals don’t understand reactive attachment disorder, they rely upon what they know in their own lives—neurotypical brains and families. They incorrectly believe that love, stability and time will heal early trauma.
To push attachment between the child and family without effective intervention actually makes matters worse. The more the parent tries to connect with the child, the further the child will push them away, a maladaptive fear-based response. For example, they may create physically or emotionally unsafe environments in their homes and falsely accuse primary caregivers of abuse and neglect.
Families often struggle and fall apart from the overwhelming stress and chaos of RAD, leaving traumatized children without their greatest chance of success—stability and nurturing. And the disorder festers.
4. Parents can't afford effective treatments for RAD on their own.
Even if parents find effective interventions for reactive attachment disorder, they often lack the financial means to secure such services. Insurance companies and adoption subsidies, for example, do not provide sufficient coverage to provide the specialized care children with reactive attachment disorder require.
How to Advocate for Children with Reactive Attachment Disorder
Just as children deserve stable and healthy families, parents deserve authentic support—not blame and shame—to protect safety and permanency. When we start with that basic understanding, we can unite to get families all that they need.
We can all make a difference in our own way. Only you know the unique strengths and connections you can contribute. Here are some ideas:
Raise awareness of reactive attachment disorder
Advocate for the inclusion of developmental trauma disorder in the Diagnostic and Statistical Manual of Mental Disorders: DSM-5
Join the RAD Advocates movement—our mission is to educate and advocate to equip families, communities and professionals to effectively support children with reactive attachment disorder
Perhaps it all starts with a simple call to a parent you know. Tell them you’re there to listen and support them, not judge. Maybe that's how you can begin to help one child—and the many lives that child encounters throughout their lifetime.
You'll never know if you don't try.
Anyone can be a RAD advocate. Learn what you can do.
About the author:
With a background in the nonprofit, education and mental health sectors, Nichole Noonan writes to raise awareness and funds for important causes. She earned a Bachelor of Arts in Journalism and a Master of Education. Nichole founded Pen & Stick Communications to help noble organizations and people further their reach in the world.