Reactive attachment disorder (RAD) is a condition in which an infant or young child does not form a secure, healthy emotional bond with his or her primary caretakers (parental figures).

Children with RAD often have trouble managing their emotions. They struggle to form meaningful connections with other people. Children with RAD rarely seek or show signs of comfort and may seem almost fearful of their caretakers, even in situations where the current parent figures seem quite loving and caring. These children are often irritable or sad, and may report feeling unsafe and/or alone.

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Symptoms of reactive attachment disorder vary from child to child. Infants and young children who may have RAD show common signs such as:

• Failure to show an expected range of emotions when interacting with others; failure to show “emotions of conscience” such as remorse, guilt, or regret
• Avoiding eye contact and physical touch, especially with caregivers
• Expressing anger; having tantrums; being irritable, unhappy and sad; disobedience and arguing (beyond what would be “usual” for the child’s age and situation)
• Displaying inappropriate affection toward strangers while demonstrating a lack of affection for and/or fear of their primary caretakers.

When children with RAD grow older, their symptoms usually fall into one of two general patterns:

• Inhibited RAD symptoms. Children are aware of what happens around them, but they do not respond typically to outside stimuli. Children showing inhibited RAD symptoms are withdrawn and emotionally unresponsive. They may not show or seek affection from caregivers or others, keeping largely to themselves.
• Disinhibited RAD symptoms. Children may be overly friendly toward strangers. Children with disinhibited RAD symptoms do not prefer their primary caretakers over other people. In most cases, these children act younger than their age and may seek out affection from others in an unsafe way.

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