RAD (Reactive Attachment Disorder) is one disorder on the spectrum of disorders associated with lack of attachment built with a primary caregiver as an infant. When babies are born, they naturally and instinctively cry when they need something. If he or she needs their diaper changed, if they’re hungry, or if they’re tired, they cry to receive the attention of a trusted adult in their life. When the trusted adult comes to change their diaper, feed them, or rock them back to sleep, the baby learns to trust their caregiver. They start to believe, through repeated, consistent care from their parents, that their parents will meet their needs and that there is no need to fear the possibility that their needs will not be met. This results in attachment, which is the foundation upon which children develop the ability to process emotions and form relationships. When the contrary occurs, and a child does not receive the necessary care and attention needed to build trust, the opposite happens. Children learn that they cannot trust the adults in their lives. They cry for help with a certain need, and their need is not met. This, therefore, results in a lack of attachment, preventing children from being able to create secure attachment and develop stable relationships with caregivers in their lives. Children who have experienced multiple foster care placements, have lived in an orphanage, or whose parents could not adequately care for them due to mental illness or substance abuse most likely have some kind of attachment issues. The most serious attachment disorder is Reactive Attachment Disorder. RAD is a diagnosis that is no fault of the child’s, but will require much work from both the child and the caregivers to overcome. But it is possible!

Children with RAD may resist affection with their primary caregivers, or they may show inappropriate affection indiscriminately to other adults in their lives. Their disorder may manifest as defiance, resistance to touch, lack of care in relationships, or anger, leaving families feeling hopeless and lost. If you are parenting a child with RAD or are wondering if they should be diagnosed with it, the diagnosis can certainly be overwhelming and discouraging. It can feel like there is no end in sight, like the behaviors associated with RAD will never end, and that there is no hope for healing. But there is hope for children who have experienced the overwhelming loss of their parents and the lack of attachment in early stages of their lives. Parents can provide what is necessary for healing, but it certainly will take time, patience, and consistency.

5 Things to Know about Parenting a Child with RAD

1. You will need to shift your expectations when parenting a child with RAD.

Children who did not receive the necessary care as infants and toddlers may find it difficult to attach to their new adoptive parents. Through no fault of their own, he or she will struggle to meet their parents’ eyes, take social cues, and receive physical touch and affection. It may be necessary to shift your expectations about what you thought your family might look like before this particular child joined your family. This can be difficult, and you may need to grieve the family you thought you wanted so that you can fully embrace the family that you have. It is then that you will be able to see your child and your family life with new eyes and begin creating a pathway to healing for your child, for you, and for your entire family.

Although you won’t be able to un-feel the hurt you may experience when your child pulls away from a hug or runs up to a stranger and tries to go home with them, you can reframe the way you think about it. Knowing why your child is acting this way can help tremendously in your journey to becoming a parent who promotes healing. This can also help you to not take your child’s actions personally and respond in a way that promotes connection and togetherness.

Imagine you are on the playground with your 6-year-old son, and he scrapes his knee. He lies there for a minute, and instead of coming to you for nurture, a band-aid, and a kiss, he runs up to a stranger. Before changing your mindset and expectations, you may have the urge to run up to your son, pull him away from the stranger, and reprimand him publicly. This would have undoubtedly resulted in shame and anger, with little to no connection or trust built as an end result.

However, if you are able to change your expectations and mindset when parenting your child with RAD, you may be able to gently guide your son away and remind him that you are the mom and you meet his needs. You can sweetly look into his eyes, even if just for a moment, and remind him that you will be there for him and will meet his needs, including helping with injuries (though you might call them boo-boos).

Changing your expectations has tremendous benefits and can bring you back to compassion, reminding you why you decided to adopt or foster a child in the first place. It can restabilize you and make you an immovable force of healing in your child’s life.

2. RAD could be a misdiagnosis.

RAD is a serious (but rare) condition that requires parents to intentionally move towards healing by going above and beyond in meeting their child’s needs. On the spectrum of attachment disorders, it is the most severe disorder. Children with RAD have a difficult time with eye contact. They struggle with lying, stealing, and having a conscience. They may not feel guilty or sorry for a wrong action. They may show cruelty to animals or use manipulation to have their needs met. They struggle with sharing power and with impulse control, among other difficulties. Children with RAD are either overly affectionate toward adults who are not their parents (even strangers), or are withdrawn and resist attachment from adults who are caring for them.

For children who have experienced abuse, neglect, or abandonment, there is a spectrum of attachment issues, with RAD being the most severe. It is a rare condition, meaning it affects less than 200,000 people in the United States. RAD can be difficult to diagnose because many of the symptoms noted above can be found in other disorders, such as conduct disorder, attention deficit hyperactivity disorder (ADHD), opposition deficit disorder (ODD), or post-traumatic stress disorder (PTSD). It might be tempting to look at a list of symptoms and diagnose children with RAD because naming the attachment issues can feel empowering. Sometimes, it feels like if you name the problem, you can address it. However, labeling a child with RAD without complete assurance from a licensed professional can be detrimental if they have a different disorder that can be treated. Other disorders have more treatment methods, and it is important that the child is correctly diagnosed so that he or she can receive appropriate treatment.

3. Parenting a child with RAD requires creative parenting.

Although parenting a child with RAD is overwhelming and discouraging at times, it can encourage intentional, creative parenting. As with all children from hard places, it will be necessary to approach parenting from a different angle. When a child has experienced separation from biological parents, abuse, and neglect, their brains will not develop in the ways that they’re supposed to develop. As babies, they did not receive the physical and emotional care that is needed for a baby to develop attachment. Their basic needs were not met, and so they learned to not trust adults. This is why many children with RAD resort to manipulation and control in order to get their needs met, instead of asking for what they want or need.

As the parent, though, you can help rewire their brains to know that their needs now are being met. Many times, when a child has experienced the trauma of separation, abuse, or neglect, they are emotionally functioning at half their chronological age. For example, an 11-year-old child who experienced extreme neglect as a baby may behave more like a 5 or 6-year-old. Therefore, you can consistently (over time) meet their needs in order to rewire their brains to believe that you, the parent, can be trusted.

Children who have experienced trauma need to feel like they have a voice and some kind of control over their lives. While still remaining in full authority, you can share power with your child by giving them realistic choices, such as “We are having peanut butter and jelly for lunch. Would you like an apple or a banana for your fruit?” You can also help them to feel in control by allowing them to ask for a compromise to your request. For instance, if a child needs to get ready for dinner but is in the middle of playing a video game, he could ask, “May I have a compromise?” Then, you have the authority to come up with a reasonable compromise that will work for both of you and avoid a power struggle.

Additionally, you can provide structure for your children through consistent routines and predictable schedules. You can provide nurture for your children by engaging in meaningful play with them, rocking them, and being silly with them. All of these parenting strategies will positively contribute to your child’s healing. You can read more about parenting strategies for children from hard places in The Connected Child by Karyn Purvis, or The Connected Parent by Karyn Purvis and Lisa Qualls. You can find additional educators in this article as well.

It is incredibly important that you have the training and education necessary to be the best parent that you can be. This will provide you with the necessary tools to parent your child in the way that they need to be parented. In addition, it is essential that you find a counselor or therapist for both you and your child. They can help you work through the day-to-day struggles and walk your child through their trauma in a way that will eventually promote healing.

4. You will need to do your own attachment healing.

Generally, when parenting a child who has experienced trauma, your own shortcomings and trauma from your own past may re-emerge. It is important that you become aware of your own attachment style and how that will impact your parenting, especially when parenting a child with RAD. It is especially helpful to walk through these difficult memories with a trusted counselor, who can help you see the connections between your own past and your present parenting style. He or she can help you manage and slowly start to change some of your parenting strategies to be more helpful and life-giving for you and your child.

5. It is wise and normal to seek professional help, support, and respite when parenting a child with RAD.

As with all parenting of children who have experienced trauma, it is important for parents of a child with RAD to find a trusted therapist who is trained in attachment disorders, specifically RAD. They can help educate and inform the parents on best practices and parenting strategies that work, and they can also help your child navigate their difficulties and behaviors. Additionally, it may be helpful to seek out a support group. There are support groups for parents of children with RAD, but you can also look for connected parenting support groups, support groups for adoptive parents, or even trauma-informed parenting support groups. Equine therapy can also be especially calming for children with RAD. It can also be very helpful to find people who will provide respite for you, whether this is grandparents or licensed babysitters who are trained to work with children who have attachment disorders. This will give you the necessary space to be able to be the best parent that you can be.

Parenting a child with RAD can be trying, discouraging, and difficult, but please remember that you are not alone in this journey. There are other parents who have gone before you, and parents who can walk alongside you as you embark on or continue the journey. Though your child may have more difficulties, she also has her own unique strengths and talents to offer. Always remember that there is hope for healing and that there is immense value in the work that you are doing in helping your child heal.