The New A.D.D?

Reactive Attachment Disorder is increasingly being recognized as a trauma-based diagnosis in children who have insecure
or disrupted early bonding relationships with their biological mother.  In the 1980’s RAD as it is commonly known became
a formal diagnosis based on the recognition that deviant forms of attachment led to marked behavioral and emotional
difficulties in children (1) and are caused primarily by maternal deprivation and severe abuse and/neglect.  

So why do children develop RAD, can it be prevented, or is it as one caller asked me over the radio – CAUSED by foster
care placement?  Very thought provoking!

RAD develops from the primary loss of the mother-infant/child bond.  The key deficits lie in two areas.  These are in terms
of capacities to socialize effectively, and to form stable relationships over time.  

Characteristics of RAD Children:
-        Severe neglect and/or abuse by biological mother prior to the age of five years
-        Difficulties in developing meaningful social relationships with others
-        Easily attaches to complete strangers who become caregivers and treats every caregiver as if they share a
very close and intimate bond or will be detached from any caregiver and move from one to another without any
distress.

Effects of RAD in Teenagers:

In teenagers, the ongoing symptoms of detachment remain.  What is different is the presentation.  The hormonal mood changes along with the feelings
that they are not loved enough, not wanted, and feeling abandoned and rejected worsen their fragile self-confidence and they can become very
affectionate one moment and violent and aggressive the next.  Foster/adoptive teens can express these emotional and behavioral changes with
symptoms of running away, impulsively breaking things, punching, kicking, fighting, crying, and screaming and cursing.  These behaviors are often
misdiagnosed as Bipolar Disorder and the young teen is placed on mood stabilizers that work as temporary Band-Aids.  

Meanwhile, parents are bewildered, fearful of getting hurt or seeing the child hurt, and in efforts to get help use behavioral methods to enforce
discipline.  Most of these techniques fail hopelessly and in severe cases, the teen’s condition worsens to the point that residential treatment and
hospitalization become the new homes for these teens.  Later, untreated severely RAD teens experience homelessness as young adults, engage in
substance abuse, crime, and unstable, high risk relationships.  

All of these factors lead these teens into severe depression, suicide attempts, abusive relationships, and hospitalizations.