Attachment Disorders are psychiatric illnesses that can develop in young children who have problems in emotional attachments to others. Parents, caregivers, or physicians may notice that a child has problems with emotional attachment as early as their first birthday.
Most children with attachment disorders have had severe problems or difficulties in their early relationships. They may have been physically or emotionally abused or neglected.
Some have experienced inadequate care in their own home or other out-of-home placement ( for example: residential programs, foster care or orphanage). Others have had multiple traumatic losses or changes in their primary caregiver.
The physical, emotional and social problems associated with attachment disorders may persist as the child grows older.
The diagnosis of DSED is made before a child turns 5 years of age.
The diagnosis of RAD is made if symptoms become chronic. Children who have Disorganized Attachment may develop RAD.
The 4 main child/adult attachment styles have been identified as:
Reactive Attachment Disorder and Disinhibited Social Engagement Disorder are serious clinical conditions. Children who exhibit signs of RAD or DSED need a comprehensive psychiatric assessment and individualized treatment plan.
Treatment must involve both the child and the family. A close and ongoing collaboration between the child’s family and the treatment team will increase the likelihood of a successful outcome.
Attachment work has its roots in providing the nurturing responses that the client missed in early childhood and requires a very skilled therapist who is familiar with Attachment work. Attachment difficulties will get better, however it takes a long time.
The family will need to re-create an emotionally safe environment for the child; be consistent and see the behaviors from an Attachment perspective (for example: an argumentative/ defiant behavior is a reflection of their independence; running away is trying to escape from others and their own feelings; self-harm is to release their pain, mitigate their numbness, consolidate their feelings).