Sometimes parents need to ask the tough questions … and hang in there to hear truthful answers. Here you will find a handful of just such tough questions from families of infants and children with attachment disorder, whether DSED or RAD.
DSED is a new diagnosis in the DSM-5: Disinhibited Social Engagement Disorder
RAD is the pre-existing DSM diagnosis: Reactive Attachment Disorder
Children with an attachment disorder may qualify for DSED or RAD, but it is unlikely that a child will qualify for both. Both DSED and RAD are based on Bowlby’s Attachment Theory. Attachment Parenting is a mainstream parenting orientation that offers some support for children with DSED or RAD; infant and children with these disorders require much more intensive therapeutic parenting and intervention.
Follow are some questions and answers to help current and future parents prepare to handle these developmental disorders.
Do some children of adoption or foster placement always have a disorder of attachment? That is a difficult question to answer. An older infant or child who is available for placement has, by definition, experienced an interruption in initial bonding with a caregiver or has been separated from a parent or caregiver. This can happen a variety of way. Common causes include medical crisis or hospitalization that separates child from parent, trauma or abuse of the child, neglect by parents or caregivers, and death or incarceration among others.
Can disorders of attachment occur with a family with parents who raise their own children? The sad truth is that this does happen. Premature birth that places newborns in neonatal intensive care units can interfere with proper parent-child bonding and attachment. Maternal depression, including postpartum depression, is also implicated in frustration of attachment. Parents who are mentally ill, working excessive hours, addicted, inattentive of their children, or neglectful may cause an interruption of their child’s attachment formation.
What happens when a child’s diagnosis is changed from RAD, or Reactive Attachment Disorder, to DSED, or Disinhibited Social Engagement Disorder? From a practical perspective, the change in diagnosis may not have much of an impact on parent or child. Naturally, a more focused diagnosis may lead to more focused and accurate treatment and intervention. RAD and DSED have one critical distinction in terms of the child’s social tendencies. Consequently, treatment and intervention for social behaviors and capacities will be different for DSED versus RAD.
Can an infant really have serious attachment problems? The answer to this question, unfortunately, is yes. Infants who were neglected tend to have more intense attachment delays than children of abuse. Essentially, children need attention. They can still develop and thrive, even when receiving the negative attention of abuse. Infants and children who are ignored, however, seem to have the most intensive problems. While each case is unique, parents and educators must be aware that an early history of neglect or lack of nurturing can have devastating and potentially lifelong implications for infants.
What is the most important thing a parent needs to know about raising a child with DSED? Whether DSED or RAD, parents must understand that Attachment is a developmental capacity that involves brain development and a wide spectrum of social and emotional capacities of the child. As a result, DSED and RAD both require intensive therapy but also a focused and definitive curriculum of emotional, social, and self-regulatory knowledge and skills.
Where can a parent find this “curriculum for DSED or RAD”? Unfortunately, a firm curriculum is difficult to find. Follow along as we continue to share information and release a comprehensive curriculum of social, emotional, and self-regulatory capacities, knowledge, and skills that work along with therapeutic strategies. Parents will be empowered to take charge of their children’s DSED and RAD problems through evidence-based developmentally appropriate parenting and childcare practices that will help children establish healthy attachment.
How will a healthy attachment formation help my child? This is the most important question of all! Healthy attachment formation helps a child be happy in their own skin. Attachment helps children have compassion for others. Attachment allows children to be in relationship with others, including family and friends. Attachment also allows children to learn to be lawful and appropriate citizens who contribute to family, community, and society in a meaningful way. In short, attachment formation is the key to children having a happy life.
Darleen Claire is a Parenting Expert with a background in Clinical Mental Health, Exceptional Student Education, and Brain-Based strategies to promote healthy growth and development – including capacities for healthy attachment. She is available for individual consultation to support parents, teachers, and mental health professionals in creating integrated and focused solutions to address unique needs of infants and children with disordered attachment.