Our Mission​​
RAD Advocates is passionate about raising awareness about the mental illness Reactive Attachment Disorder (RAD).  They advocate for families during crisis, as well as educate the community and professionals about the ongoing challenges families face and the resources that they need.  Our goal is to see a change in the way that communities and professionals support children and families affected by RAD.
About Us
​​What is RAD

Reactive Attachment Disorder is the result of early developmental maltreatment of a child that occurs at any point beginning in utero until about age 3 years.  Preverbal trauma is the basis of this disorder making it difficult (and almost impossible in some cases) for the child to express how or why he or she has difficulty attaching to family members and developing primary attachments to caregivers. RAD is not typically diagnosed until about the age of 4 or 5, likely in part to the behaviors not becoming extreme enough to warrant evaluation.  More recently, clinicians have begun to recognize that this is a spectrum disorder ranging from mild to severe.  Symptoms and behaviors can include avoidance or aggression to primary caregivers (reactivity) at times of distress or when the child is in need of comfort.  If a caregiver persists to provide bonding and comfort, the child becomes even more dysregulated resulting in the caregiver distancing herself/himself from the child.  Lying, stealing and manipulative patterns of behaviors are common and function to isolate the child from bonding and emotionally attaching to family.  It is likely that these behaviors will not present to those outside of the family system,unless others caring for the child are able to align with the child's primary caregivers.  It is important that those treating attachment disorder have specialized training, experience and education on the treatment of complex trauma.  PTSD is not the same as attachment disorder and cannot be treated in the same manner.  While research on effective treatment of RAD is sparse, RAD can heal.  However, it can take years and requires extensive emotional, social, educational and community resources to assist a child in developing primary attachments within a family.  If a child is treated by a clinician without appropriate services, the child is at higher risk for developing severe pathological patterns as it undermines the efforts to develop a bond with caregivers.  Caregivers who attempt to bond with a child with RAD need a high level of nurture and boundaries.  They will also need to complete their own attachment history work to understand the triggers that may elicit strong responses to the child.  Children with RAD have behaviors that stem from abuse, trauma and abandonment history, and clinicians treating RAD need to be skilled in reaching the underlying terror of abandonment that is triggered when a caregiver attempts to bond with the child.  While the general population does not have a large percentage qualifying for the DSM-5 criteria for RAD, there is a much higher rate of attachment disorders in children who have been placed in foster care, adoptions or have early medical trauma during the time-span including in utero- 3 years of age.  Children with attachment disorders are at higher risk for personality disorders, substance abuse, poor relationships, and abusing others who attempt to bond with them.  When seeking treatment for RAD, it is helpful for parents to interview clinicians to determine whether the treatment will be effective and meet the complex needs of the child and family as healing occurs.
​​DSM-5 Definition of RAD

The DSM-5 gives the following criteria for Reactive Attachment Disorder:
A. A Consistent Pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, manifested by both of the following:

·         The child rarely or minimally seeks comfort when distressed

·         The child rarely or minimally responds to comfort when distressed

B. A persistent social or emotional disturbance characterized by at least two of the following:

·         Minimal social or emotional responsiveness to others
·         Limited positive affect

·         Episodes of unexplained irritability, sadness, of fearfulness that are evident even during nonthreatening interactions with adult caregivers

C. The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following:

·         Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caring adults
·         Repeated changes of primary caregivers that limit opportunities to form stable attachments (eg: frequent changes in foster care)

·         Rearing in unusual settings that severely limit opportunities to form selective attachments (eg: institutions with high child to caregiver ratios)

D. The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A (eg: the disturbances in Criterion A began following the lack of adequate care in Criterion C)
E. The criteria are not met for Autism Spectrum Disorder
F. The disturbance is evident before age 5 years
G. he child has a developmental age of at least 9 months
Specify if Persistent: The disorder has been present for more than 12 months
Specify current severity: Reactive Attachment Disorder is specified as severe when a child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels