recognizing attachment syndrome

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\"Baby\"Recognizing attachment syndrome in a child in your family is an important step in early intervention and preventing lifelong consequences.  The particular process is also called reactive attachment disorder (RAD) or reactive attachment syndrome.  This is a complex childhood psychiatric illness that begins early in infancy or in early childhood.

The condition occurs when individuals have difficulty forming loving, lasting intimate relationships.  The words attachment and bonding are usually used interchangeably.  The disorder will vary in severity but the term reactive attachment disorder is usually reserved for people who show a nearly complete lack of ability to be genuinely affectionate with others.  Unfortunately they usually typically fail to develop a conscience and don\’t learn how to trust others.

The exact cause for reactive attachment disorder is not known.  It is thought to stem from a disruption in the relationship between a child and his primary caregiver.  The DSM-IV defines this as a diagnosis which requires a history of gross deprivation of caregiver emotion or a succession of multiple caregivers.  Unfortunately these children have often been physically, emotionally or sexually abused or may have even received inadequate care and an institutional setting.

In 2005 the US Department of Health and Human Services reported the number of children entering the foster care system was fairly constant however these numbers are also consistently large and appear to be increasing however incrementally, every year.  The American Academy of Pediatrics also stated in 2000 that large numbers of young children with complicated physical health, mental health or developmental problems are entering the foster care system during the early years of their life when brain growth is at its most active.

Infants who have not thoroughly bonded with their caregivers may exhibit signs that lead caregivers to believe they have bonded.  They can appear happy and move easily from person to person or may be clinging and cry inconsolably when their caregiver leaves.  In the first case the infant has not bonded and has instead withdrawn into himself.  In the second case the child has an intense fear of being abandoned by their caregiver, especially in the case of children who have lived in multiple foster care homes or have been adopted.

Symptoms of reactive attachment disorder are more easily seen in toddlers and preschoolers.  These symptoms will include frequent, out-of-control temper tantrums and behavior that is usually defiant and disobedience.  These children will fly into a rage at the least little thing and can deliberately soil their pants and inappropriate places.  Normal methods of discipline are very ineffective.

Other children who have reactive attachment disorder will be unwilling to separate from mom for any length of time.  Even as a toddler or preschooler they may be afraid to go to sleep alone at night and will wake up in the night to check on whether or not mom is still there.

Other symptoms can include children who need to control mom at all times.  They may be abnormally active which is intended to keep mom constantly vigilant at his side.  This child may also be disruptive when mom is on the phone are talking to other adults because they are jealous of the attention being given to someone else.  They may refuse to cooperate or be excessively demanding with eating, going to the toilet or dressing.

Sometimes children who suffer from reactive attachment disorder are unable to play alone and insist that others in the family play with them.  They demand affection on their own terms and may repeatedly asked for hugs.

All of these behaviors will eventually result in parents who limit outings or social contact that involve the child because it is just too difficult.

Children who exhibit symptoms quite opposite of those who are clinging, are those who dislike being coddled and will refuse to give any eye contact.  Instead of affectionate with mom or dad they can be inappropriately affectionate and trusting with visitors and strangers.  They may be intensely hostile or jealous towards siblings and may show a lack of affect and appear to be remote and detached.

It is important to recognize the signs and symptoms of reactive attachment disorder or reactive attention syndrome because without early intervention and treatment these children grow up with the inability to form intimate relationships as an adult.  Their behaviors may in fact appear to be sociopathic because they are on able to form attachments with other individuals and have no compassion and or understanding of another person\’s emotions or feelings.

RESOURCES

Washington University: Report of the APSAC Task Force on Attachment Therapy, Reactive Attachment Disroder and Attachment Problems

MayoClinic: Reactive Attachment Disorder

Focus on the Family: Reactive Attachment

DSM5: Reactive Attachment Disorder

Lynchburg College: Reactive Attachment

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