RAD occurs when attachment between a young child and his or her primary caregiver does not occur or is interrupted due to grossly negligent care. This can occur for many reasons, including:
- Persistent disregard of the child’s emotional needs for comfort, stimulation, and affection.
- Persistent disregard of the child’s basic physical needs.
- Repeated changes of primary caregivers that prevent formation of stable attachments (for example, frequent changes in foster care).
RAD can affect every aspect of a child’s life and development. There are two types of RAD: inhibited and disinhibited.
Common Symptoms of Inhibited RAD Include:
- Unresponsive or resistant to comforting
- Excessively inhibited (holding back emotions)
- Withdrawn or a mixture of approach and avoidance
Common Symptoms With Disinhibited RAD Include:
- Indiscriminate sociability
- Inappropriately familiar or selective in the choice of attachment figures
The first step is to ensure that the child is safe and living in a safe environment and secondly to help the child learn to develop a health relationship with an appropriate caregiver. Treatment often focuses on the caregiver. Counseling, parenting skills, play therapy, and neurofeedback are healthy methods to stabilize a child that has RAD. There is no medication to target RAD specifically and neurofeedback would be a more natural method to help in conjunction with other therapy modalities mentioned above.
In neurofeedback for attachment disorders, neurofeedback training is used to quiet fear networks in the brain. Early disruption of your child’s most basic need – to feel safe and protected in relationship with a dependable caregiver – resulted in fear networks becoming overly activated. Since these networks do not quiet, your child cannot come to feel safe through connection to you, even when you are ready to provide a sense of stable safety and security. When neurofeedback for attachment helps to quiet these fear centers, your child can begin to allow you to provide this fundamental sense of security. This is the beginning of attachment.
You may also want to read the articles about RAD and Neurofeedback by Sebern Fisher, M.A. LMH, BCN. Sebern is a brilliant psychotherapist who played a critical role in bringing neurofeedback to the field of attachment therapy. Her articles are insightful and very educational.