Reactive Attachment Disorder (RAD) is a relationship disorder. Children with RAD fail to develop secure attachments to caregivers and are unable to love and to be loved. They have experienced trauma and neglect in their first few years of life, and thus do not trust anyone. To ensure that they do not get hurt again, children with RAD manipulate each family member to maintain a sense of control. Often, these children are found in foster or adoptive homes.
Causes:RAD is a result of trauma within the first two years of life. The following are common causes of trauma in infancy:

• Sudden separation from primary caretaker (through death, illness of caretaker, or removal of child)
• Physical, emotional, or sexual abuse
• Illness or pain not alleviated by caretaker
• Neglect (in holding, talking, nurturing, and meeting basic physical needs)

Effects:Since children with RAD experience trauma, loss, and grief at such an early age, it effects their brain development. It is in the first years of infancy that neural systems develop through experiences. If babies are held, fed, rocked when crying, and talked to, their brains will develop normally with the ability to attach or form a bond with caregivers. On the other hand, if these basic needs are not met, huge areas of the brain fail to develop the skills for taking in information about the world around them, to process and comprehend, in order to plan an appropriate response to it. Instead, what happens with RAD children is the child decides that the world is a dangerous place and that the best response is to control everything that they can control and pretend to control everything that they cannot. This explains why they will not allow themselves to trust and why they us sneaky tactics to maintain control later in life. Another effect of early abuse or neglect is a rise in levels of stress hormones and endorphins. When babies live in a stressful environment, with yelling, hitting, and abuse, their tiny bodies are subjected to a great amount of stress hormones and endorphins. Their bodies learn to expect high levels of these chemicals that are not present naturally. As a result, later in life these children engage in behaviors that stimulate their bodies to produce the high levels that they are used to. Thus, they often do dangerous, risky, or confrontational activities.
CHARACTERISTICS:Children with RAD exhibit a variety of characteristics, mainly relating to the need to be in control of situations. Listed are common symptoms:

• Superficially charming (using cuteness to get his/her own way)
• Cruel to animals
• Manipulative of adults
• Difficulty with eye contact (unless lying)
• Overly affectionate with strangers
• Has no friends, or just for short while
• Enjoys being sneaky
• Crazy lying (lying when it would have been just as easy to tell the truth, or lying when they know the other person knows the truth)
• Incessant chattering and nonsense question asking
• Excessively bossy
• Fails to re-establish interaction after separation (poor reunion response in infancy)
• Lacks compassion and remorse
• Overall developmental delays

Treatment:Treatment for RAD is still unclear and very controversial at this point in time. However, psychologists have been able to draw some conclusions about what does and does not work with RAD children. First, traditional therapy has been found not to be a viable option. It is predicated on the idea that a child can build trust with someone. These children are unable to trust adults and relax enough to give adults any power over them. What psychologists have found is that alternatives to traditional therapies are needed to help these children. One prospect that has been used is "holding therapy." Advocates for this technique profess that holding therapy provides the ultimate corrective emotional experience because it repairs a child's disturbed development more fully than any other therapy. The process is designed to provoke youngster's infantile emotions, including rage, frustration, anger and the need for nurturing. The child lies across the laps of two adults, usually the therapist and a primary caregiver. This is designed to let the child relinquish control. Throughout the holding, the therapist looks softly into the child's eyes and holds the child gently but firmly. The
technique is meant to build a new foundation for a healthier attachment between parent and child. This therapy has received much criticism and stirred controversy due to its physical nature. One thing that most all parents, psychologist, therapists, and social workers agree on, however, is that new therapies must include a family model where issues of trust and care are addressed instead of working with the child alone.

Reactive Attachment Disorder Resources

• Attach
  P.O. Box 9438
  Newport Beach, CA 95658
  www.attach.org
• Attachment Center at Evergreen: Evergreen Consultants In Human Behavior, LLC
  28000 Meadow Dr. Suite 206
  Evergreen, CO 80439
  www.attachmentcenter.org
  *contact (303) 674-1910 to be added to Attacments newsletter (cost $5 per yr)
• American Psychological Association
  APA Monitor
  www.apa.org/monitor
• Adoptive Families of America
  The Bookstore
  2309 Como Ave.
  St. Paul, MN 55108
  Phone (800) 372-3300
  *contact for books for RAD children
• Foster Friends
  University of Kentucky
  Training Resource Center
  Foster Parent Training
  304A Mathews Building
  Lexington, KY 40506-0047
  (800) 232-5437
• Center for Family Development
  www.center4familyDevelop.com