Dealing with Reactive Attachment Disorder (RAD) in the Classroom.

I remember my first year teaching. Armed with educational theory from the likes of Piaget, Skinner, and a basic understanding of Blooms I felt confident that I understood the basic premise of what motivated kids.

Armed with comfy corners, snacks and other tips and techniques from an amazing teacher who supervised my intern experience, I felt ready to be an effective educator, who was ready to meet my students where they were.

However, as you may have guess, the reality of teaching, and the needs of my students often felt overwhelming and sometimes impossible.

There was one young man, lets call him Johnny, who I just could not connect with. I would stand at the door every morning and greet him and try to find out what he was interested in. But no matter how I tried to show him I cared, it just seemed that there was a disconnect between the two of us.

I remember trying to reason with him after he had snatched another students book, and tore it to pieces. When I asked him to put himself into the other persons shoes and think about how they must have felt. He quickly responded, “Its not my job to care about their feelings.”

It was not until much later that I came to understand that this lack of ability to connect and empathy was part of a larger attachment disorder called Reactive Attachment Disorder or RAD.

Reactive Attachment Disorder (RAD) is a rare but serious condition that begins in early childhood. It makes it difficult for children to form healthy, loving relationships with others, especially parents and caregivers. This disorder typically stems from a lack of consistent nurturing and care in early development, leading to a disruption in the child’s ability to form secure attachments.

Here are some common symptoms of RAD as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [1]:

Emotional and Social Symptoms:

Withdrawal: The child may seem emotionally detached and unresponsive to comfort, even when distressed.
Lack of Social Engagement: They may show little interest in interacting with others, including caregivers, and may not respond to social cues.
Unexplained Fear or Irritability: The child may exhibit frequent and unexplained episodes of fear, sadness, or irritability, especially in social situations.
Difficulty with Emotional Regulation: They may struggle to manage their emotions and may exhibit outbursts or tantrums.

Behavioral Symptoms:

Avoidance of Physical Contact: The child may resist cuddling, hugging, or other forms of physical affection.
Lack of Eye Contact: They may avoid making eye contact with others.
Self-Soothing Behaviors: The child may engage in repetitive self-soothing behaviors, such as rocking or self-hugging.
Aggression: In some cases, children with RAD may display aggression towards peers or caregivers.⁶

Often students diagnosed with RAD will come to the classroom with a behavioral IEP. Many students who have RAD have also been adopted, are in foster care, or have had multiple family placements in their lifetime.

These transitions, often coupled with a history of trauma make them resistant to trust that someone has their best interest at heart, making it hard to form attachments.

So what does this mean for a teacher?

It’s important to remember that every child with Reactive Attachment Disorder (RAD) is unique, and strategies that work for one might not work for another. Flexibility, patience, and collaboration with parents and therapists are key. Here are some suggestions for teachers dealing with a student with RAD, based on expert advice:

1. Create a Safe and Predictable Environment:

Establish Clear Routines: Children with RAD thrive on consistency and predictability. A structured classroom with clear expectations and routines can help them feel safe and secure. [1, 2]
Minimize Changes: Transitions and unexpected events can be very stressful. Prepare the student in advance for any changes in schedule or activities. [2]
Offer a Safe Space: Provide a designated quiet area in the classroom where the student can go to de-escalate when feeling overwhelmed. [3]

2. Build a Trusting Relationship:

Be Patient and Understanding: Building trust takes time. Be patient, consistent, and avoid taking the child’s behaviors personally. [4]
Offer Consistent Support: Show the student that you are there for them by providing emotional support and encouragement. [1]
Maintain Healthy Boundaries: While offering support, it’s essential to maintain professional boundaries and avoid becoming overly involved in the child’s personal life. [3]

3. Focus on Positive Behavior:

Use Positive Reinforcement: Catch the child being good and provide specific praise for positive behaviors. [2]
Avoid Power Struggles: Power struggles can escalate challenging behaviors. Stay calm and redirect the student instead of engaging in arguments. [2]
Collaborate with Parents/Therapists: Work closely with the child’s parents or caregivers and therapists to develop a consistent approach and support the child’s overall treatment plan. [1, 4]

4. Adapt Teaching Strategies:

Provide Individualized Instruction: Children with RAD may have learning difficulties due to their emotional and behavioral challenges. Consider providing individualized instruction or modifications to assignments as needed. [5]
Teach Social Skills: Explicitly teach social skills, such as recognizing emotions, understanding social cues, and appropriate ways to interact with others. [2]
Use Visual Supports: Visual schedules, cues, and reminders can be helpful for children with RAD who may struggle with auditory processing or remembering instructions. [5]

For more specific strategies search on the RISE Community – Fostering Resilience for Empowered Educators (FREE) and the key word RAD.

Citations:

[1] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.¹

[2] Bath, H. (2008). Helping children with attachment difficulties in school. Jessica Kingsley Publishers.

[3] Blaustein, M. & Kinniburgh, K. (2010). Treating traumatic stress in children and adolescents: How to foster resilience through attachment, self-regulation,² and competency. Guilford Press.

[4] Hughes, D. A. (2007). Attachment-focused parenting: Effective strategies to care for children. W. W. Norton & Company.

[5] Purvis, K. B., Cross, D. R., & Sunshine, W. L. (2007). The connected child: Bring hope and healing to your adoptive family. McGraw-Hill.

[6] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Citations:

In addition to the DSM-5, you can find more information about RAD from reputable sources like:

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