What is reactive attachment disorder?

Reactive attachment disorder is a disorder in which a young child doesn't establish a healthy attachment to parents or caregivers. This disorder may develop as a result of the child not receiving adequate nurturing and affection, being neglected and most commonly, children who have inconsistent caregivers.

How do I know my child has reactive attachment disorder?

There are two types of reactive attachment disorder: inhibited and disinhibited.

Reactive attachment disorder begins in infancy and from 9 months to 5 years of age, the following symptoms of the inhibited type can be noticed:

  • Unexplained withdrawal, fear, sadness or irritability
  • Sad and unresponsive attitude
  • Shows no response when comfort is given
  • Does not seek comfort
  • Lack of smiling
  • Watching others closely however not engaging in social interaction
  • Doesn't ask for assistance or help
  • Doesn't reach out when being picked up
  • No interest in interactive games with others such as peekaboo

Symptoms of the disinhibited type may include:

  • Indiscriminate sociability
  • Inappropriately over familiar with strangers and wont seek affirmation from regular caregiver before going to strangers
  • Shows no distress if caregiver is out of sight


How can Dr Tsepiso Mhlane help?

Emotional bonds and attachment between parents and child are created in the early years of childhood through soothing, comforting and nurturing. This disorder is found in children who have a severe lack of emotional attachment to parents or caregivers, due to extreme neglect and lack of a nurturing, caring and supportive environment. Without adequate emotional support and nurturing, children may fail to develop healthy relationships, love and trust in the future, develop aggressive behaviour, depression or learning difficulties and lack a positive self-image.

Often children who suffer from this disorder have been in foster homes and are adopted, therefore when treating reactive attachment disorder, Dr Mhlane aims to firstly ensure that such children are in a safe environment and that no abuse and neglect is continuing to take place in the current household. Thereafter, the relationship and bond between parents or caregivers and child must be addressed. Treatment may be aimed at the parents or caregivers regarding learning positive child and caregiver interactions and creating a stable, nurturing environment to address their behaviour towards the child and enhance the child's attachment with them. In many cases, parents or caregivers undergo therapy with their children with the help of Dr Mhlane or by a specialised psychologist in play therapy. In this way, both parents or caregiver and child are given the space to express thoughts, ideas, needs and fears in a safe environment.