In this article, I want to give you an understanding of the characteristics of RAD in infants and in children. Parents are in the best position to see the true nature of their child. If they are educated about RAD, they can help detect the condition early. With this information, parents can seek help from a professional who can confirm the diagnosis and provide treatment.
The degree of Reactive Attachment Disorder (RAD) can range from mild to severe and is directly related to the extent and duration of the child’s early trauma. Abandonment is usually part of the history of RAD. If neglect and abuse are added the resulting condition is generally worse. Usually, the earlier the trauma begins and the longer it lasts, the more severe the RAD condition will be. Diagnosis is best made by assessing the current symptoms of the child and is confirmed by the child’s history. Information taken from the parents is usually more valid than a clinician’s perception of the child because the child with RAD has the capacity to manipulate and fake “looking good” especially in a short term relationship.
When I worked at Evergreen Consultants from 1990-1995, it was standard practice to use information from the parents in making a RAD diagnosis. Click here for the CHILD Checklist.
When more symptoms are present, your child has a greater chance of having RAD. Similarly, when more items are listed as severe versus mild, the condition is more serious. Children with RAD usually display their symptoms more intensely with their mother than their father. Consequently, the parents are asked to describe their child as he relates to them individually and their answers are scored separately. The following are general comments about RAD and its diagnosis and symptoms.
- All RAD children display difficulty in giving and receiving love. Many parents struggle with the question, “Does your child love you?” Even though a child may have lived in a family for several years, parents often are uncertain of their child’s genuine loving feelings for them. Children with milder forms of RAD usually can express genuine love for their parents. Parents of children with severe RAD will often describe their child as lacking genuine loving feelings for them.
- At all levels of severity, RAD children will have difficulty accepting or seeking out physical affection and touch. If you touch a child with RAD, often he will recoil or flinch and say, “Ouch,” even though your touch is gentle and should produce no pain. “What would life be like if all touch either tickled or hurt?” I believe this is how many unattached children experience physical closeness or touch.
- All children with RAD have control issues. The key question is, “How extreme or intense is their need to be in control?” These control issues are captured in a number of the 28 symptoms listed in the checklist. The child with RAD is oppositional, argumentative, disobedient or often defiant. They are exceedingly strong-willed and will go to great extremes to be in charge. Their need to control comes from their intense fear that further harm will occur if they are once again as helpless as they were as babies.
- Most children with RAD have problems with anger. Many will express their anger overtly, having frequent temper tantrums and a short frustration tolerance. A smaller percentage of children will be passive-aggressive and engage in annoying, frustrating, and aggravating behavior. Often this is disguised by a facade of innocence or hidden in socially acceptable behavior. For example, a child with RAD can hug a parent so hard it physically hurts. To a casual observer, it would seem the child’s hug was a loving act. In reality, the child inflicted pain, a hurtful act, within a hug, which is a loving act. This is the hallmark of passive-aggressive behavior or indirect anger.
- Children with RAD have problems developing a conscience. In the most severe children, their conscience is entirely absent. They have no remorse, regret, or guilt when they violate their parents’ or other people’s rights. In the milder condition of RAD, the conscience is underdeveloped. A number of the items on the checklist are related to the child having little or no conscience.
- All unattached children have trust issues. They do not trust their parents and the parents cannot trust their children. The severity of trust issues is directly related to the severity of the RAD condition. A number of the 28 symptoms assess the child’s desire and willingness to live outside their parent’s circle of control by being deceptive and disobedient. This failure to develop a bond of love, trust, and cooperation must be present in order for a child to be accurately diagnosed with RAD.