We began our foster care journey in the early 80s, and in 1985, we adopted a six-month-old baby girl from foster care, with known exposure to alcohol in utero. She smiled from the moment I saw her. She liked almost everyone at first meeting, and brought them books to read and toys to play with. She climbed into every willing lap she saw. She wasn’t much on cuddling, but as my mother said, “some kids are, some kids aren’t”. Although I didn’t know it then, I had just adopted my first child with Reactive Attachment Disorder (RAD) and FASD (Fetal Alcohol Spectrum Disorder).

Types of Attachment

Attachment between a mother and her child is the bond formed between them, and the foundation of all future development. The ideal bond is a Secure Attachment.

An Insecure Attachment occurs when something interferes with the bonding between the mother and child, such as in utero alcohol or drug use, physical abuse, or extreme stress experienced by the mother. Early neglect, physical abuse, sexual abuse, prolonged separation, major illness, or multiple changes in caregivers in a child’s early years can also interfere with a healthy attachment.

Attachment disorders come in degrees of severity, with the most severe being Reactive Attachment Disorder. Very few children, even those with RAD, have all of the following symptoms. Since a number of the major psychiatric disorders have overlapping symptoms, you should take any child you are concerned about for a full evaluation by a competent psychiatrist.

Overlapping Behavioral Characteristics – Click on the image to see full chart

 Symptoms of Reactive Attachment Disorder

• Superficially engaging & charming • Lack of eye contact on parents terms • Indiscriminately affectionate with strangers • Not affectionate on Parents’ terms (not cuddly) • Destructive to self, others and material things (accident prone) • Cruelty to animals • Lying about the obvious (crazy lying) • Stealing • No impulse controls (frequently acts hyperactive) • Learning Lags • Lack of cause and effect thinking • Lack of conscience • Abnormal eating patterns • Poor peer relationships • Preoccupation with fire • Preoccupation with blood & gore • Persistent nonsense questions & chatter • Inappropriately demanding & clingy • Abnormal speech patterns • Triangulation of adults • False allegations of abuse • Presumptive entitlement issues

Treatment of RAD

Children with attachment disorders who do not receive appropriate interventions frequently develop personality disorders as adults. RAD is the most severe attachment disorder and has the poorest outcome, especially if left untreated.

The younger the child, the less symptoms you are likely to see. We adopted a 4 ¾ year old in August 2010, from a disruption. She is now 6 ½ and diagnosed with RAD. The only two symptoms she doesn’t currently display are preoccupation with fire and preoccupation with blood and gore.

She attends a day treatment program held in one of the local elementary schools. She has therapy three times a week, sees the psychiatrist every two weeks. We recently were approved for waiver services, which gives us 24/7 crisis support, skill-building programs, and respite care.

We encourage eye contact with chocolate, incorporate as much good touch into play as possible, and refuse to allow her to sabotage the big family holidays with her behavior. We are even taking her on a cruise this summer with us, although a friend who is trained in providing respite is coming with us. We are currently looking for an attachment therapist, preferably trained by Dan Hughes in Attachment-Focused Family Therapy.

A child with RAD needs intensive support to heal. We have recently began implementing the “Parenting in SPACE” through Safety, Support, Supervision, Structure, Playfulness, Acceptance, Curiosity and Empathy. We feel that this paradigm gives us the best chance to help our RAD daughter heal. Providing safety, support, supervision, and structure are mandatory. Playfulness, acceptance, curiosity, and empathy are the things that differentiate a family from an institution.

Raising a child with RAD isn’t easy; however, as we see progress in our daughter, we find the rewards.
You can read more about attachment parenting in these books:
Attachment-Focused Parenting: Effective Strategies to Care for Children ,
When Love Is Not Enough: A Guide to Parenting Children with RAD,
The Connected Child : Bring Hope and Healing to Your Adoptive Family, or
Easy to Love but Hard to Raise: Real Parents, Challenging Kids, True Stories.

GBsMom is 55 years old and working on a PhD in Educational Psychology. She has been an adoptive and foster mother for over 30 years. Most of her kids have been some combination of Bipolar, FASD, RAD, ADHD. She has been married for 35 years and is raising her second family, GB, 9, and Hope, 6. She blogs about her life at Adopting Special Needs.