Extreme Problem Behaviors in Reactive Attachment Disorder

Children with RAD (Reactive Attachment Disorder) often exhibit extreme behavior problems. Below is a list of the behaviors that are associated with this diagnosis.

What is RAD?

Reactive Attachment Disorder (RAD) is defined as a problematic pattern of developmentally inappropriate moods, social behaviors, and relationships due to a failure in forming normal healthy attachments with primary care givers in early childhood. Click here for a RAD symptoms checklist to learn more about attachment problems, and click here for helpful resources if you are parenting a child with RAD.

RAD is a serious diagnosis. Because the initial trust in people was broken, children and teens with attachment problems often exhibit incredibly challenging behaviors. Below is a list of some of them.

If you are considering adopting a child with has a diagnosis of RAD, especially if you are adopting a child from foster care, an international adoption, or adopting an older child, read the list below carefully. Are you prepared to manage these life-changing behaviors?

If you are currently parenting a child with RAD, read this list to know you aren’t alone (and you aren’t crazy).

Attachment Issues: On a Continuum

While all attachment issues are serious, they appear on a continuum of severity.

• Some children have attachment insecurities but are able to connect and form meaningful relationships. They have behavior issues but they are manageable with advanced parenting techniques.
• Other children struggle to form meaningful connection but are able to have some relationships. Their behaviors are challenging but moderate. They are able to function within a home or community, although continual relationship difficulties are to be expected.
• The most serious cases are children who lack a conscience or remorse when they hurt someone. Their behaviors are severe and difficult (or impossible) to manage in a home situation. Residential treatment may be required.

Problem Behaviors in Children with RAD

Here is a list of difficult behaviors often seen in children with disordered attachment.

Fear

A child with RAD lives in a state of constant fear.

On the outside, their behaviors might look like aggression, manipulation, or destruction, but at the heart of it all is deep fear. While this doesn’t make parenting these behaviors easier, it’s important to understand that the root of it all is trauma, loss and a PTSD response.

Manipulation

Of all RAD behaviors, the one that perhaps drives parents the most crazy is manipulation.

Children with RAD are superficially charming and engaging. They make friends quickly (although the relationships don’t last) and somehow seem to earn favors, treats, and rewards everywhere they go.

Adults outside of the family are often conned by the RAD child. This drives parents nuts because they know that each time a child is able to manipulate an adult, it drives the child deeper into their unhealthy thinking patterns.

Children with attachment problems are masters at triangulation because they create relationship issues, disagreements and misunderstandings between adults in their lives. This can happen between teachers and parents, between spouses, between grandparents and parents, and between therapist and parents.

Parents often say they feel like they are going crazy because the child with RAD tells half-truths and spins situations to look different from reality. While this term isn’t typically used with children, many parents feel like it’s gaslighting to live with a child with RAD.

Lack of Eye Contact

Young people with RAD often refuse to make eye contact unless forced. Eye contact feels too intimate and relational. Some children will make eye contact when lying or when trying to get something from adults. This is not a true connection but rather a form of manipulation.

Keep in mind that poor eye contact can also be a sign of other diagnosis, such as autism.

Poor Boundaries

Because children with RAD do not have a clear sense of self, they do not understand proper boundaries between people.

Improper boundaries shows up in many ways, including:

• Physical boundaries. Children with attachment problems may cling to strangers and ask to hold their hand or climb on their lap. They may act sexually inappropriate.
• Verbal boundaries. Kids with RAD interrupt conversations, attempt to work their way into adult discussions, swear, insult others, or are verbally aggressive.
• Mental and emotional boundaries. Children with attachment issues break relationship boundaries continually by triangulation and manipulative behaviors.

Limited Understanding of Time and Money

These children with attachment issues often have poor executive functioning skills which includes lack of organization.

They lack of awareness of time. While they understand the future in a conceptual way, they aren’t able to translate that into improving their behavior. They live in the moment. They do not comprehend future consequences.

Children and teens with RAD have a poor concept of money and will spend, borrow or steal money without regard for its worth. They may give away or break items of value without seeming to understand the significance. For example, a child with RAD may steal her mother’s antique ring and give it away to a friend at school or sell it for $1 to someone on the bus.

Unusual Speech Patterns

You may notice unusual speech patterns such as:

• Talking very softly so that adults say, “What?” or “What did you say?” over and over.
• Talking non-stop so that others cannot speak.
• Talking very loudly or quickly.
• Talking about things in a sing-song voice that seems almost pretend.
• Using made-up words or phrases.
• Asking non-stop questions.

Many of these speech patterns are done as a form of manipulation.

Lack of Empathy or Remorse

Because attachment problems lead to problems developing a conscience, these children lack empathy. They are not able to put themselves into someone else’s shoes. They will play the victim, only seeing how they have been wronged yet ignoring how they have wronged the other person.

They may destroy someone else’s property, hurt their feelings or verbally or physically attack them with no remorse for their actions.

Because relationships represents the ultimate threat, children with RAD have a deep sense of rage against their primary caregivers, often directed at the mother most intensely.

Bladder and Bowel Problems

Some of the most challenging RAD behaviors are bathroom issues. These may include:

• Peeing in unusual places, such as in a bucket in their room, down heating registers, or on toys.
• Attempting to pee on others.
• Poop smearing, such as in the bathrooms or in their rooms.
• Peeing or pooping in their pants, seemingly deliberately.
• Encopresis.
• Withholding pee or poop.
• Bladder and bowel issues far beyond the age that is typical.
• Bedwetting.

Some children also smear blood and other bodily fluids similarly.

Sexualized Behavior

Many children with RAD act out in sexually inappropriate ways. Children with attachment problems may act out sexually even if they have not been abused in this way themselves.

Click here for more information about parenting a child who sexually acts inappropriate and click here for treatment programs for sexualized behavior.

Sexualized behaviors include:

• Flashing people, undressing at inappropriate times or coming out of the bathroom not fully clothed.
• Attempting to “come on” to adults with sexually provocative behavior.
• Speaking, writing, or drawing sexual content.
• Having knowledge of sexual information that is beyond what is typical for their age.
• Masturbation in front of others.
• Attempting to engage (or engaging, if unsupervised) in sexual activity with other children or pets.
• Seeking out and watching pornography if unsupervised.
• Attempting to dress provocatively in order to receive sexual attention.
• Falsely accusing others of sexual abuse.
• Teens may engage in risky sexual behaviors and relationships.

Food and Eating Problems

Most children with attachment problems have food issues to some degree because food is a primitive need. Food is also an area where children fight for control. Some children have food issues because they were neglected and went without food, but kids with attachment disorder can have food issues even if they never went without.

Food issues seen with RAD:

• Extremely picky eater.
• Overeating to the point of being sick or throwing up.
• Seemingly limitless appetite.
• Constantly asking for food.
• Hiding and hoarding food, such as in their room, backpacks or a secret hiding place.
• Stealing food.
• Eating foods specifically meant for others.
• Obsession with sugar or junk food.
• Refusal to eat what is provided by parents.
• Telling others outside of the family that they are being starved or not fed.
• Manipulating adults into buying or giving them food, even if they are fed at home.

Stealing and Hoarding

Children with RAD steal items in ways that seem non-sensical. They may steal items with little to no monetary value or are of no worth to themselves, such as their mother’s toothbrush or their sibling’s homework notebook.

They may hoard items of no value. Parents may find a huge pile of bent paperclips, used facial tissues, or staples in their bedroom.

Other children steal money and other valuable items and keep, lose, or give the items away.

They also misuse items like dumping out all the shampoo while taking a shower or taking file folders from a teacher’s desk and throwing them into the dumpster.

Violence, Aggression, and Destruction of Property

Some children with attachment problems are violent. They rage, destroy property, and attempt to attack and hurt others.

Rages of a child with attachment problems can be quite serious, to the point that family members have to call 911, contact the police, or lock themselves in their rooms for safety during a rage. The family may feel like they are walking on eggshells, never sure what will set off the next rage. (This leads to PTSD in family members of a child with RAD.)

Children with disordered attachment may be preoccupied with gore and violence by drawing it, talking about it, and seeking out violent movies, video games, and TV shows.

They may engage in fire starting or be obsessed with matches and lighters.

These children often have no sense of the value of property. They may destroy all their birthday or Christmas gifts within a few days or ruin all the toys in a sibling’s room with no remorse. They lose items continually, like backpacks, school assignments, gloves, coats, and shoes, and seem to have no concern for the consequences.

In addition, some children with RAD run away from home frequently, often starting at an early age.

Hyperawareness

As part of their trauma response, children with attachment issues are hyperalert. From infancy, they learned that they must be “on” in order to feel safe and take care of themselves.

Some children rarely sleep more than a couple hours a time. Door alarms and video cameras may be necessary for a child who attempts to wander at night.

Many children with RAD are highly intelligent (although they do poorly in school). They know directions for how to get to places even when very young. They keep close tabs on where family members and other important people are at all times. They have an almost obsessive need to know what is happening, what the schedule is, and what comes next. They demand information and control at all times.

Lack of Maturity

Although a child with RAD may seem knowledgeable on certain topics far beyond their years, their overall maturity is lagging behind their peers.

Because they lack a sense of self, they will go along with whatever works in the moment or is being done around them. Their behavior is highly inconsistent. They struggle to keep and maintain friendships.

They are completely self-centered in an almost infantile way. They play the victim, seeing themselves as wronged yet failing to see how they contribute to the problem.

Teens may use drugs and alcohol with little understanding of the long-term consequences. They may go to live with a friend or someone they recently met, with no concern for the family they leave behind.

Many children with RAD do quite well in residential treatment because there isn’t the need for bonding and relationships.

Note that some of these behaviors can be due to other diagnosis such as Fetal Alcohol Syndrome or lower intellectual function (low IQ) and are not the same as RAD.

False Accusations

Parents, teachers, and social workers must protect themselves when working with children with RAD because false accusations are common and even expected.

Inform people who work with the child of the diagnosis and what to expect. Keep careful records and if needed, take pictures such as if the child falls and gets a cut or bruise.

Maintain appropriate boundaries and be overly cautious if necessary.

Parents should have therapists, doctors, and others who can defend them if false accusations are made.

A Word for Parents

If you are currently parenting a child with attachment problems, this list is a way of letting you know you aren’t alone. Many of these behaviors are incredibly difficult to manage in a home setting and there are no quick fixes.

You aren’t crazy. You are doing some of the toughest parenting on the planet.

Here are some of things parents say to describe what life is like with RAD:

• His behavior is bizarre.
• I feel like we are living in a war zone.
• She’s out to get me.
• The behavior makes no sense.
• If I wasn’t living it, I wouldn’t believe it.
• No one believes me when I tell them what we are going through.
• I hate my child with RAD.
• I wish we had never adopted.
• I heard about RAD before we adopted, but I was sure we would be the exception.
• I came into this with excellent parenting skills. I was sure we could handle it.
• I feel like I’m losing my mind.
• My mental health is in crisis, my health is suffering, and my marriage is strained.
• My other kids are suffering.
• My system offers me no support.
• No one believes me whey I say what her behavior is like at home. She acts so sweet in public.

When a child has RAD, their behaviors seem strange and pointless to you, but that’s because you have healthy attachment. For the RAD child, these behaviors are a survival mechanism.

The child with RAD is not out to get you. They are living in a constant state of fear. You are the target because you represent healthy connection and relationship, which is what they fear the most. The child with RAD believes their survival rests in NOT trusting you.

As a parent, it’s one thing to understand this on a logical level and another to live it out day to day when a child is attacking you, destroying your property, attempting to hurt your pets, or making false accusations against you.

Remember that you are not alone. While RAD is rare, it’s not so rare. There are other parents walking this journey, too. I’ve walked this road as a parent and foster parent. I get it, and you have my support.

A Word for Social Workers, Therapists, Judges, and Teachers

Support parents who are parenting children with RAD. Believe them. They are doing some of the toughest parenting that exists.

Get these parents help in the way of respite, funding, and attachment therapy. If necessary, help them secure and fund residential treatment.

Make sure the family has a realistic safety plan in place. Are they getting time for self-care, rest, and their own therapy for the PTSD they surely have from living with a child with attachment problems? Help them find these resources.

Don’t give parents more to do or make them feel guilty. They are doing the best they can just to survive each day. Tell them what a great job they are doing and how important their work is to society.

Children with RAD exhibit extreme behavior problems that are rooted in fear. Their behavior may seem strange to us, but to them it’s for their survival.

Are you parenting a child with attachment problems? Which of these behaviors do you deal with? Share about it in the comments below.

Click here for a free PDF printable checklist of the 7 steps to take when your child needs residential treatment.

More Related Posts:

RAD in Teenagers: Available Treatments and Support Options

How Do I Know If My Adopted Child Has Reactive Attachment Disorder (RAD)?

Can Reactive Attachment Disorder (RAD) Occur in Adults?