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Reactive attachment disorder

Reactive attachment disorder

Reactive attachment disorder is a rare but consequential condition in which an infant or young child doesn’t form a healthy attachment with parents or caregivers.


Reactive attachment disorder can evolve if the child's basic needs for comfort, affection and nurturing aren't met and loving, caring, stable attachments with others are not established.


Signs and symptoms may include:
  • Fear, sadness or irritability that can’t be explained
  • Sad and listless appearance
  • Not seeking comfort or showing no response when comfort is given
  • Failure to smile
  • Watching others closely but not engaging in social interaction
  • Failing to ask for support or assistance
  • Failure to reach out when picked up
  • No interest in playing interactive games
Reactive attachment disorder normally starts in infancy. There's very minute research on signs and symptoms of reactive attachment disorder beyond early childhood, it still remains uncertain whether it occurs in children older than 5 years.


To sense safeness and develop trust, infants and young children require a stable, caring environment. Their basic emotional and physical needs ought to be consistently met. For instance, when a baby cries, his or her need for a meal or a diaper change must be met with a shared emotional exchange that may include eye contact, smiling and caressing. A child whose requirements are ignored or met with a lack of emotional response from caregivers does not come to expect care or comfort or form a stable attachment to caregivers. Most children are naturally flexible, and even those who've been neglected, lived in orphanages or had multiple caregivers can develop healthy relationships. It's unclear why some babies and children tend to develop reactive attachment disorder and others don't.


There's no standard treatment for reactive attachment disorder, but it should demand both the child and parents or primary caregivers. Early intervention appears to improve outcomes. Goals of treatment are to help ensure that the child:

  • Has a safe and stable living situation
  • Develops positive interactions with parents and caregivers
Treatment strategies include:
  • Encouraging the child's development by being nurturing, responsive and caring
  • Providing consistent caregivers to encourage a stable attachment for the child
  • Providing a positive, stimulating and interactive environment for the child
  • Addressing the child's medical, safety and housing needs, as appropriate
Other services that may benefit the child and the family include:
  • Individual and family psychological counseling
  • Education of parents and caregivers about the condition
  • Parenting skills classes

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