Disorders common in childhood
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#2 disorders common in childhood are anxiety and attachment disorder.
Attachment Disorders
No. 85; January 2014
Attachment Disorders are psychiatric illnesses that can develop in young children who have problems in
emotional attachments to others. Parents, caregivers, or physicians may notice that a child has problems with emotional attachment as early as their first birthday. Often, a parent brings an infant or very young child to the doctor with one or more of the following concerns:
· severe colic and/or feeding difficulties
· failure to gain weight
· detached and unresponsive behavior
· difficulty being comforted
· preoccupied and/or defiant behavior
· inhibition or hesitancy in social interactions
· being too close with strangers
Most children with attachment disorders have had severe problems or difficulties in their early
relationships. They may have been physically or emotionally abused or neglected. Some have
experienced inadequate care in an institutional setting or other out-of-home placement. Examples of outof-home placements include residential programs, foster care or orphanage. Others have had multipletraumatic losses or changes in their primary caregiver. The exact cause of attachment disorders is not known, but research suggests that inadequate care-giving is a possible cause. The physical, emotional and social problems associated with attachment disorders may persist as the child grows older.
Children who have attachment issues can develop two possible types of disorders: Reactive Attachment
Disorder and Disinhibited Social Engagement Disorder.
Reactive Attachment Disorder (RAD)
Children with RAD are less likely to interact with other people because of negative experiences with
adults in their early years. They have difficulty calming down when stressed and do not look for comfort
from their caregivers when they are upset. These children may seem to have little to no emotions when
interacting with others. They may appear unhappy, irritable, sad, or scared while having normal activities with their caretaker. The diagnosis of RAD is made if symptoms become chronic.
Disinhibited Social Engagement Disorder (DSED)
Children with DSED do not appear fearful when meeting someone for the first time. They may be overly
friendly, walk up to strangers to talk or even hug them. Younger children may allow strangers to pick them up, feed them, or give them toys to play with. When these children are put in a stranger situation, they do not check with their parents or caregivers, and will often go with someone they do not know.
Treatment
Children who exhibit signs of RAD or DSED need a comprehensive psychiatric assessment and
individualized treatment plan. Treatment involves both the child and the family. Therapists focus on
understanding and strengthening the relationship between a child and his or her primary care givers.
Without treatment, these conditions can a¥ect a child’s social and emotional development. Treatments
such as “rebirthing” strategies are potentially dangerous and should be avoided.
Parents of a young child who shows signs or symptoms of RAD or DSED should:
seek a comprehensive psychiatric evaluation by a quali§ed mental health professional prior to the
initiation of any treatment make sure they understand the risks as well as the potential bene§ts of any intervention feel free to seek a second opinion if they have questions or concerns about the diagnosis and/or treatment plan Reactive Attachment Disorder and Disinhibited Social Engagement Disorder are serious clinical conditions. However, close and ongoing collaboration between the child’s family and the treatment team will increase the likelihood of a successful outcome.