Quick Start: Understanding RAD & Attachment Challenges

Raising a child with Reactive Attachment Disorder (RAD) can feel confusing and overwhelming, especially in the early stages. This quick start guide explains what RAD is, the signs to watch for, how to get an evaluation, and what to expect after a diagnosis. You’ll also find tips on where to start looking for the right help.

Your child might have RAD if…

One challenge for parents is knowing if the behaviors they are seeing are just a kid being defiant. Here’s a few clues that you might be dealing with RAD.

1. They experienced early childhood trauma before the age of 5

• They struggle to form relationships and attachments with caregivers

• Their behaviors are extreme compared to those of other children

• Traditional and therapeutic parenting methods simply don’t work

• As their mom, you feel like you might be losing your mind 

If any of this is sounding familiar, keep reading.

What is RAD

Reactive Attachment Disorder (RAD) is a little known, stressor-related mental health disorder caused when a child suffers chronic trauma when their brain is vulnerable and developing. 

Many traumas can cause RAD, but some common ones are abuse, neglect, and abandonment. RAD is extremely rare in the general population but far more common among children who have spent time in foster care or who are adopted.

RAD is a spectrum disorder and some children are severely impacted, others less so. Children with RAD do not know how to form healthy attachments with adults and may either be indiscriminately fawning or deliberately thwart attachment and push others away. 

Other common symptoms of RAD include:

• Food issues, including hoarding

• Weaponizing bodily functions

• Crazy lying and being superficially charming

• Physical aggression towards property, pets, and/or others

• Violent outbursts and rages

Typically, these behaviors are directed towards the child’s mother figure. Children with RAD often triangulate adults against their mom because this gives them a comforting sense of control in a world that feels subconsciously scary and out of control due to the early childhood trauma they suffered.Many children with RAD have underdeveloped cause-and-effect thinking and impulse control and are dysregulated. Their fight-flight response is heightened and may engage during even minimally threatening situations. All this exacerbates the condition and attachment issues. 

How to get an evaluation

It’s important to get a formal evaluation for your child if you think they have RAD. This is a complex diagnosis and many other diagnoses have overlapping symptoms. Also, many children with RAD have co-existing diagnoses such as ADHD, conduct disorder, learning disabilities, and developmental delays.

A formal diagnosis will be necessary in order to receive appropriate treatment and medication, and insurance coverage. The diagnosis can also be used to obtain a 504 or IEP for your child.

Be forewarned that many children with RAD are first misdiagnosed with ADHD. This prevents them from receiving early treatment for RAD and the stimulant medications for ADHD can exacerbate their condition. 

To get an accurate diagnosis, schedule a psychological evaluation with a mental health clinician, psychologist, or psychiatrist. 

Didn’t find what you are looking for? Check out: Adoption-Competent Organizations & Professionals

What to expect

A RAD diagnosis for your child may be an “aha” moment because suddenly all the incongruous behaviors will make sense—and you’ll feel a little less crazy. However, it’s important that you proceed eyes-wide-open. Unfortunately, there are no quick and easy solutions for RAD.

RAD is a complex, little known disorder. There are few service providers with the experience needed to provide comprehensive treatment for kids with RAD and to support their families. The few treatment options that have shown positive outcomes for kids on the more severe side of the spectrum are expensive and often not covered by insurance.

Parenting a child with RAD is a difficult, often very lonely journey. Your friends, family, and community are unlikely to “get it” and often their comments and suggestions will be hurtful and counterproductive. Therapists and other service providers may blame your child’s behaviors on you and your parenting rather than focusing on the underlying disorder.

My blog post, Parents of Kids with RAD: 10 Unfortunately Truths You Must Know, is the most popular post on my website. This is also the most popular chapter in my book Reactive Attachment Disorder (RAD): The Essential Guide for Parents. (This post contains Amazon affiliate links. As an Amazon Associate I earn from qualifying purchases — but I only share products I’ve tried or truly believe will help you.)

There’s a reason these are so popular.

Few people are willing to talk honestly and transparently about the struggle of raising a child with RAD. I am one of the people doing so, and there are others. This resource list is curated to point you towards books, blogs, organizations, and other resources who “get it” and can offer you actual support on this journey. 

Where to find help

When you’re raising a child with RAD it is challenging—if not impossible—to find help, whether it be from the child welfare system, mental health system, school system, your community, family, or friends. A good starting place is always to seek out providers and people who have experience working with children who have been spent time in foster care or have been adopted. While other children can and do develop RAD, these kids are disproportionately impacted.

All the sections and resources in this book may be helpful to you, but here are my top 3 recommendations to get you started:

1. Join an online Facebook support group. This is an excellent way to get support, advice, and recommendations for local providers and services.

• Educate yourself on the disorder. There are some great websites, blogs and online articles as well as books to get you started learning the basics.

• Educate your community and support system. Most people in your life will not know anything about RAD. Educating them is key to building a strong support system for yourself and your child.