Reactive Attachment Disorder

Reactive attachment disorder

The Mayo Clinic defines reactive attachment disorder—RAD—as a rare but serious condition in which an infant or young child does not establish healthy attachments with parents or caregivers. A child may develop the disorder if he is denied his basic needs—affection, nurturing, caring.


RAD begins in infancy. Symptoms include:

  • Withdrawal, fear, sadness or irritability with no apparent cause

  • Listlessness

  • Lack of response to caring or comfort

  • Never smiling

  • Observing but not participating in social interaction

  • No desire to be picked up or held

  • No interest in childhood games such as peek-a-boo


It is not clear why some infants develop the disorder. Children are exceptionally resilient beings; those raised in orphanages are able to form healthy attachments. A child whose needs are ignored learns not to expect comfort.


As a child ages, RAD manifests in two ways—inhibited and uninhibited. The former presents as a persistent failure to initiate or respond to social interactions in an appropriate way. The latter presents as indiscriminate sociability. The child expresses inappropriate familiarity with people he just meets.

With the fall of the Iron Curtain and the collapse of communism in Eastern Europe, researchers were permitted access to orphanages in Romania and other Eastern Bloc nations. They found numerous cases of RAD among the orphans. The research which resulted from the study of the orphans yielded information on the prevalence, causes, mechanism and assessment of the disorder. Since there are few cases of the disorder manifesting in children beyond the age of five, therapists have proposed expanding the range of conditions arising from attachment issues to be more inclusive.

Risk factors

RAD can arise when a child repeatedly experiences social and emotional neglect. The risk increases when he lives in an environment which prevents the opportunity to develop stable social attachments. These environments include:

  • Children’s home or similar institution

  • Repeated stints in foster case

  • Drug-addicted or alcoholic parents

  • Prolonged separation from nurturing parents

  • Birth mother with post-partum depression

  • Born into a unusually large family

Psychiatric evaluation

The Mayo Clinic notes a thorough examination by a child psychiatrist is required to diagnose RAD. The examination must determine the child’s behavior is not better explained by other conditions, such as an intellectual disability, an adjustment disorder, an autism spectrum disorder or a depressive disorder.


RAD occurs in children who are neglected. Infants instinctively respond to love and affection. The short answer for preventing RAD is simple: love and affection. Even a child suffering from symptoms of RAD will respond when treated as every child should be treated.


White River Academy is a residential treatment center for boys age 12 to 17. The boys who come to WRA have issues with substance abuse or mental/behavioral health—or both. Our school is located in Utah near the magnificent Great Basin. We offer an array of therapies and treatments. Our school curriculum exceeds the standard public school curriculum. For more information on our programs and how they relate to RAD, please call 866-520-0905 and speak to one of our intake coordinators.

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It is natural for parents to worry and have concerns when sending their son away to a residential treatment center. We hope this detailed description of the admission process at White River Academy will answer some of your questions.

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