BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuReactive attachment disorder of infancy or early childhoodReactive attachment disorder is a problem in which a child is not able to easily form a normal or loving relationship with others. It is considered to be a result of not forming an attachment to any specific caregiver when very young. Causes Reactive attachment disorder is caused by abuse or neglect of an infant's needs for:Emotional bonds with a primary or secondary caretaker Food Physical safety TouchingAn infant or child may be neglected when the:Caregiver is intellectually disabled Caregiver lacks parenting skills Parents are isolated Parents have a poorly controlled mental health condition Parents are teenagersA frequent change in caregivers (for example, in orphanages or foster care) is another cause of reactive attachment disorder. Symptoms In a child, symptoms may include:Avoiding caregiver Avoiding physical contact Difficulty being comforted Not making distinctions when socializing with strangers Wanting to be alone rather than interacting with othersThe caregiver will often neglect the child's:Needs for comfort, stimulation, and affection Needs like food, toileting, and play Exams and Tests This disorder is diagnosed with a:Complete history Physical examination Psychiatric evaluation Treatment Treatment has two parts. The first goal is to make sure the child is in a safe environment where emotional and physical needs are met.Once that has been established, the next step is to change the relationship between the caregiver and the child, if the caregiver is the problem. Parenting classes can help the caregiver meet the child's needs and bond with the child.Counseling may help the caregiver work on problems, such as drug abuse or family violence. Social Services should follow the family to make sure the child remains in a safe, stable environment.Drug abuseSubstance use disorder occurs when a person's use of alcohol or another substance (drug) leads to health issues or problems at work, school, or home....Read Article Now Book Mark Article Family violenceDomestic violence is when a person uses abusive behavior to control a partner or other family member. The abuse can be physical, emotional, economic...Read Article Now Book Mark Article Outlook (Prognosis) The right intervention can improve the outcome. Possible Complications If not treated, this condition can permanently affect the child's ability to interact with others. It can be connected with:Anxiety AnxietyGeneralized anxiety disorder (GAD) is a mental disorder in which a child is often worried or anxious about many things and finds it hard to control t...Read Article Now Book Mark Article Depression DepressionDepression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...Read Article Now Book Mark Article Other psychological problems Post-traumatic stress disorderPost-traumatic stress disorderPost-traumatic stress disorder (PTSD) is a type of anxiety disorder. It can occur after you have gone through an extreme emotional trauma that invol...Read Article Now Book Mark Article When to Contact a Medical Professional This disorder is usually identified when a parent (or prospective parent) is at high risk for neglecting their child or when an adoptive parent has difficulty coping with a newly adopted child.If you have recently adopted a child from a foreign orphanage or another situation where neglect may have occurred and your child shows these symptoms, contact your health care provider. Prevention Early recognition is very important for the child. Parents who are at high risk for neglect should be taught parenting skills. The family should be followed by either a social worker or provider to make sure the child's needs are being met.Open ReferencesReferencesAmerican Psychiatric Association website. Reactive attachment disorder. In: American Psychiatric Association, ed. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013:265-268.Milosavljevic N, Taylor JB, Brendel RW. Psychiatric correlates and consequences of abuse and neglect. In: Stern TA, Wilens TE, Fava M, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 3rd ed. Philadelphia, PA: Elsevier; 2025:chap 62.Zeanah CH, Chesher T, Boris NW; American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI). Practice parameter for the assessment and treatment of children and adolescents with reactive attachment disorder and disinhibited social engagement disorder. J Am Acad Adolesc Psychiatry. 2016;55(11):990-1003. PMID: 27806867 pubmed.ncbi.nlm.nih.gov/27806867/.AllVideoImagesTogRelated Information Review Date: 4/17/2024 Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. 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Reactive attachment disorder of infancy or early childhoodReactive attachment disorder is a problem in which a child is not able to easily form a normal or loving relationship with others. It is considered to be a result of not forming an attachment to any specific caregiver when very young. Causes Reactive attachment disorder is caused by abuse or neglect of an infant's needs for:Emotional bonds with a primary or secondary caretaker Food Physical safety TouchingAn infant or child may be neglected when the:Caregiver is intellectually disabled Caregiver lacks parenting skills Parents are isolated Parents have a poorly controlled mental health condition Parents are teenagersA frequent change in caregivers (for example, in orphanages or foster care) is another cause of reactive attachment disorder. Symptoms In a child, symptoms may include:Avoiding caregiver Avoiding physical contact Difficulty being comforted Not making distinctions when socializing with strangers Wanting to be alone rather than interacting with othersThe caregiver will often neglect the child's:Needs for comfort, stimulation, and affection Needs like food, toileting, and play Exams and Tests This disorder is diagnosed with a:Complete history Physical examination Psychiatric evaluation Treatment Treatment has two parts. The first goal is to make sure the child is in a safe environment where emotional and physical needs are met.Once that has been established, the next step is to change the relationship between the caregiver and the child, if the caregiver is the problem. Parenting classes can help the caregiver meet the child's needs and bond with the child.Counseling may help the caregiver work on problems, such as drug abuse or family violence. Social Services should follow the family to make sure the child remains in a safe, stable environment.Drug abuseSubstance use disorder occurs when a person's use of alcohol or another substance (drug) leads to health issues or problems at work, school, or home....Read Article Now Book Mark Article Family violenceDomestic violence is when a person uses abusive behavior to control a partner or other family member. The abuse can be physical, emotional, economic...Read Article Now Book Mark Article Outlook (Prognosis) The right intervention can improve the outcome. Possible Complications If not treated, this condition can permanently affect the child's ability to interact with others. It can be connected with:Anxiety AnxietyGeneralized anxiety disorder (GAD) is a mental disorder in which a child is often worried or anxious about many things and finds it hard to control t...Read Article Now Book Mark Article Depression DepressionDepression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...Read Article Now Book Mark Article Other psychological problems Post-traumatic stress disorderPost-traumatic stress disorderPost-traumatic stress disorder (PTSD) is a type of anxiety disorder. It can occur after you have gone through an extreme emotional trauma that invol...Read Article Now Book Mark Article When to Contact a Medical Professional This disorder is usually identified when a parent (or prospective parent) is at high risk for neglecting their child or when an adoptive parent has difficulty coping with a newly adopted child.If you have recently adopted a child from a foreign orphanage or another situation where neglect may have occurred and your child shows these symptoms, contact your health care provider. Prevention Early recognition is very important for the child. Parents who are at high risk for neglect should be taught parenting skills. The family should be followed by either a social worker or provider to make sure the child's needs are being met.Open ReferencesReferencesAmerican Psychiatric Association website. Reactive attachment disorder. In: American Psychiatric Association, ed. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013:265-268.Milosavljevic N, Taylor JB, Brendel RW. Psychiatric correlates and consequences of abuse and neglect. In: Stern TA, Wilens TE, Fava M, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 3rd ed. Philadelphia, PA: Elsevier; 2025:chap 62.Zeanah CH, Chesher T, Boris NW; American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI). Practice parameter for the assessment and treatment of children and adolescents with reactive attachment disorder and disinhibited social engagement disorder. J Am Acad Adolesc Psychiatry. 2016;55(11):990-1003. PMID: 27806867 pubmed.ncbi.nlm.nih.gov/27806867/.