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Attachment disorders comprise a spectrum. The most severe form is reactive attachment disorder (RAD). These children have severe, life-long problems if not treated. Wikipedia defines RAD as follows: "RAD arises from a failure to form normal attachments to primary care giving figures in early childhood. Such a failure would result from unusual early experiences of neglect, abuse, abrupt separation from caregivers after about age 6 months but before about age 3 years, frequent change of caregivers, or lack of caregiver responsiveness to child communicative efforts. It is characterized by markedly disturbed and developmentally inappropriate social relatedness in most contexts, beginning before the age of 5 years."

At the milder end of the spectrum are children with attachment issues who do not fulfill diagnostic criteria for RAD. This includes many international adoptees, who may have signs of disordered attachment, usually of the insecure or anxious type. This may also result in social, behavioral, cognitive, and emotional problems. Common findings are lack of awareness of social boundaries, social cues, and differentiation in responses to adults. Some children readily go off with a stranger, fail to check back with the parents, and develop distress without coming to the parent for comfort.


From THE HANDBOOK OF INTERNATIONAL ADOPTION MEDICINE by Laurie C. Miller. © 2004 by Oxford University Press, Inc. Used by Permission.


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