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Reactive Attachment Disorder


Reactive attachment disorder (RAD)

means your child has trouble forming bonds with people who take care of him. A child may become frightened and frustrated if no one responds to his needs, or if response is inconsistent. He may not be able to trust that he is safe and will be given what he needs. Your child may not form bonds with his parents or other caregivers he sees regularly. He may instead be openly affectionate or cling to strangers but not respond to known people.

Common signs of RAD:

Signs of RAD develop fully by the time a child is 5 years old. You may start to notice signs when your child is about 1 year of age. As he gets older, you may notice the following:

  • Not responding to someone who tries to talk to or play with him
  • Not being easy to comfort, or not seeking comfort from a caregiver
  • Being open with or seeking attention or comfort from strangers, or not being afraid of strangers
  • Trouble understanding emotions of others
  • Listlessness, or looking sad
  • Acting frightened or watchful
  • Lack of fear when separated from a regular caregiver
  • Taking risks or doing dangerous things such as running into traffic
  • Being destructive or lying often

Seek care immediately if:

  • Your child tries to harm himself or another person, or he threatens harm.

Contact your child's healthcare provider if:

  • You have questions or concerns about your child's condition or care.


Healthcare providers will first make sure that your child is living in a safe environment and that he is not being abused. A therapist can help your child's parents and caregivers learn to respond to his needs and bond with him. The therapist can teach you ways to manage your child's behavior problems in a positive and productive way. Therapy may include helping parents or caregivers talk about their own childhoods and relationships with caregivers. This may help develop a responsive relationship with your child. Parenting classes are also available. Ask your healthcare provider for more information on classes in your area.

Help support your child:

  • Respond to your child's needs. Respond the same way each time. Children learn to trust when they receive consistent care and attention. Do not force attention on your child or force him to hug you. Offer attention and be willing to accept if he offers attention to you. You may have to build trust before you can hug him.
  • Do not try to discipline your child if he will not respond. An attempt to force your child to respond may make the behavior worse. Therapists can help you learn when discipline is appropriate and how to be strict without making your child feel unsafe.
  • Be interactive with your child. Give your child eye contact and smile when you speak with him. Give him your full attention when he speaks to you. Talk to your younger child while you are giving him a bath, changing his diaper, or feeding him. Ask your older child about his day at school. Eat meals together, and encourage him to talk with you. Remember that he is learning to understand body language. He may misinterpret if you seem hurried or tense. Be patient as he learns to pick up cues and body language. It might be helpful to tell him why you are stressed. This will help him understand that it is not because of him.
  • Limit the number of people who take care of your child. He will have a more difficult time bonding if several people take care of him regularly. It may be helpful to find someone you trust to care for your child for short periods of time. This will allow you time to rest and come back to your child feeling calm and positive.
  • Talk to your child's teachers and school officials. Your child may have trouble making friends. He may act out in class. His teachers or classmates may not want to include him in activities. It is important for your child to feel accepted and supported at school and at home. Your child's teachers may be able to help him in the classroom. His school may have programs to help him.

Follow up with your child's healthcare provider as directed:

Write down your question so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Reactive Attachment Disorder (Ambulatory Care)

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Further information

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