Reactive attachment disorder can develop when a child fails to receive adequate comfort and nurturing from caregivers. It is grouped under “Trauma-and-Stressor-Related Disorders” in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. However, even in populations of severely neglected children, the disorder is uncommon, occurring in less than 10 percent of such cases.

Children with reactive attachment disorder are believed to have the capacity to form selective attachments; that is, there is nothing neurobiological or medically wrong that can explain a child’s failure to form a secure relationship with parents or other caregivers. However, because of limited healthy physical contact and nurturance during early development (e.g, neglect), they fail to show the behavioural manifestations of selective attachments.

Manifestations of Reactive Attachment:

• They handle their emotions independently.
• Do not look for or reach for caregivers for support, nurturance, or protection.
• Lack a preferred attachment figure.
• Lack an interest in playing interactive games.
• Will not ask questions.
• When caregivers do sporadically make the effort to comfort the child, the child with this disorder will not respond reciprocally. For example, if a parent were to go to comfort their child when he/she is distressed, the child may appear confused, aloof, or fail to hug the adult back. The child may fail to reach out when picked up.