Reactive Attachment Disorder in Internationally Adopted Children
Therapists Explain Reactive Attachment Disorder
“Attachment” refers to the loving and dependent relationship that an infant develops with his or her caregivers. Attachment is typically established during the first year of life – and requires the intense, responsive, dependable presence of the infant’s caregiver or caregivers.
On the basis of this positive attachment the child then learns to trust and depend upon people to meet their needs. The attachment formed in earliest childhood lays the foundation for the health of our adult relationships.
The timing of a child’s attachment processes are fairly universal. Children seem to attach according to biologically pre-determined timeframes and sequences that are pretty predictable. Generally, children seem to develop a deep attachment to a caregiver by age six months or so.
Any interference with attachment at this early age may put children at risk of having difficulties trusting another person, or learning to separate and feel comfortably autonomous. If the interference with attachment is extensive enough, a child is described as having a Reactive Attachment Disorder (RAD).
Reactive Attachment Disorder in Internationally Adopted Children
Adoptions before the age of six months generally do not lead to attachment problems, because the child’s “attachment window” is still open. After six months of age children’s ability to form attachments may begin to slowly close down – and they may start to build up internal walls against relationships.
Because of the lengthy adoption process involved in most international adoptions, the vast majority of children adopted from foreign countries are older than 6 months old when they are finally united with their adoptive family. For this reason, Reactive Attachment Disorder (RAD) can be a challenge for some internationally adopted children.
The good news is that – for reasons that are still not completely understood – many children have the capacity to “catch up” successfully with the attachment that they missed in infancy, when offered a loving and supportive environment. However, some children cannot catch up and develop symptoms of Reactive Attachment Disorder (RAD).
Patterns of Reactive Attachment Disorder in Internationally Adopted Children
There are two types of attachment disorder commonly seen in internationally adopted children: “inhibited” RAD and “disinhibited” RAD.
Children demonstrating “inhibited” RAD tend not to initiate or respond to social interactions, either with other children or adults. Often these children are mistakenly thought to be “shy”. With internationally adopted children this perceived shyness is often explained away as simply being the result of their unfamiliarity with a new culture or new surroundings – when in fact it is something much deeper.
Children demonstrating “disinhibited” RAD exhibit almost over-the-top sociability, but with a lack of selectivity in their choice of attachment figures. These children are mistakenly thought to be “friendly” as they are anxious to climb into any and every adult’s lap. Although these “outgoing” children seem to be comfortable with people, in reality they only have a shallow attachment without forming any deep connections. With internationally adopted children this perceived “friendliness” is often explained as happiness to finally be around people – when in fact it is indicative of something more serious.
Symptoms of Reactive Attachment Disorder in Internationally Adopted Children
Because attachment is the fundamental basis of emotional development, children with Reactive Attachment Disorder can have a wide variety of differing symptoms.
Inhibited RAD behaviors may include being clingy, demanding or controlling. The child may also exhibit a reduced frustration tolerance, or be reclusive or a “loner”. Disinhibited RAD behaviors may include chattering incessantly, being overly friendly or superficially “charming,” or being overactive and distractible.
In more severe situations the child with RAD may lie, be aggressive or destructive, physically hurt themselves or their possessions, show a lack of remorse, exhibit anxiety, have an excessive concern about injury and/or have poor judgment about danger.
Additionally – since internationally adopted children with RAD may have been in situations that included prenatal nutritional deficiency & substance abuse, or lack of post-natal nutrition & physical care – they may also exhibit speech, language, or other physical developmental delays.
Treating Reactive Attachment Disorder in Internationally Adopted Children
If you are a parent who is concerned that your adopted child may have attachment problems, it is important to know that your son or daughter can be helped.
As a Child & Adolescent Psychoanalyst and Psychoanalytic Psychotherapist specializing in adoption, I am familiar with the unique challenges that internationally adoptive families face. I have assisted many internationally adopted children overcome the attachment issues resulting from their pre-adoption situation.
Keep in mind that Reactive Attachment Disorder describes a general psychological condition – but that each child’s particular temperament, age, abilities, pre-adoption history & adoptive family situation is unique to them. So the most appropriate kind of help for a child with attachment problems must be tailored to your child’s individual situation & needs, by an experienced adoption therapist.
An experienced adoption therapist can assist your child with any problematic behaviors, while simultaneously focusing upon their basic problem with attachment. A good therapist will help you as the parent find the delicate balance between expecting age-appropriate behavior from your child, while allowing certain attachment behaviors that would be appropriate for a much younger child.
Raising a child with RAD can require a great deal of parental time and sacrifice. Children with RAD have the usual demanding needs of young children, PLUS they need extra time, empathy, and assistance to make up for what they did not get early in life. Generally parents should also refrain from placing a child in daycare, who was adopted after six months – because “attaching” to new parents is made more difficult by spending large portions of the day away from them.
Evaluation by a qualified adoption therapist can determine if the basis of your child’s problem is RAD, or may be another condition with similar symptoms and behaviors. Obtaining professional therapy for an adopted child with RAD can often be the key to reaching the heart of your child, resolving their attachment issues, and helping them learn to respond in a positive way to those who reach out lovingly.
Timely intervention by a therapist skilled in international adoption & attachment issues can prevent concerns from becoming more serious problems – and help you and your child live your best lives together, as loving individuals and as a happy family!