1. Attachment Disorders & Education Outcomes
By: Ashley Day

2. Attachment Arousal Cycle
Child feels a need (discomfort, hunger, lack of attention)
Child expresses a need (arousal/protest cries escalate)
Needs are regularly met (child begins to calm)
Child feels comforted (in a calm regulated state)
Trust + Security = Attachment
(Ainsworth, 1978)
(Main, 1985)

3. The Child Who Missed Out
Child feels a need (discomfort, hunger, lack of attention)
Child expresses a need (arousal/protest cries escalate, child waits… and waits)
Needs are not met regularly (Help only comes sometimes or not at all)
Child gives up or self-soothes ( no trust develops, cannot regulate, gives up… who cares?)
No trust+ No Security= No Attachment
(Ainsworth, 1978)
(Main, 1985)

4. Reactive Attachment Disorder (RAD)
Bonding disorder
Unhealthy bonding
*Characterized by difficulties in forming loving, lasting relationships
(Chapman, 2002)

5. Causes of RAD
According to the Brown University Child and Adolescent Behavior Letter (2013), Reactive attachment disorder is cause by abuse or neglect of an infant’s need for:
Emotional bonds
Food
Physical safety
Touching

6. Symptoms of RAD Avoids caregiver Avoids physical contact
Difficult to comfort
Resists social interaction
Wants to be alone
Does not make distinctions when socializing with strangers
(Brown University Child and Adolescent Behavior Letter, 2013)

7. Why are we concerned as social workers?
Children form attachments with a caregiver
Learn about themselves through interactions with mother
Crucial in early development
Determines function later in life
(Taft et al., 2015)

8. Continued… Recognition & diagnosis is difficult
Treatment strategies are difficult to implement
school social workers are in an excellent position to provide multisystem interventions focusing on family, school, and community collaboration
(Shaw, 2007)

9. Comprehensive psychiatric assessment Individualized treatment plan
How is it assessed?
Comprehensive psychiatric assessment
Individualized treatment plan
(Brown University Child and Adolescent Behavior Letter, 2013)

10. Impact on school Speech/ language difficulties Processing problems
Lack of conscience (appropriate for development)
(Ainsworth, 1978)
(Main, 1985)

11. Impact on family system…
Shows aspect of parenting is lacking
Behaviors of the child with RAD;
such as superficial charm
severe tantrums
low intelligence
intentional destruction of property
age-inappropriate sexual acting out
physical aggression toward adults
profanity
difficulty adjusting to change
running away
Sociopathic tendencies
toileting accidents
(Shaw, 2007)

12. References
Attachment disorders. (2014). American Academy of Child and Adolescent Psychiatry,85. Retrieved from
Ainsworth, M. D., Blehar, M. C., & Waters, E. (1978). Patterns of attachment: A psychological study of the strange situation.
Chapman, S. (2002). Reactive attachment disorder. British Journal Of Special Education, 29(2), 91.
Comprehensive psychiatric evaluation. (2005). American Academy of Child and Adolescent Psychiatry, 52. Retrieved from
Main, M., Kaplan, N., & Cassidy, J. (1985). SECURITY IN INFANCY, CHILDHOOD, AND ADULTHOOD: A MOVE TO THE LEVEL OF REPRESENTATION. Monographs Of The Society For Research In Child Development, 50(1/2), doi: / ep
Reactive Attachment Disorder: What Parents and Caregivers Should Know. (2013). Brown University Child & Adolescent Behavior Letter,
Shaw, S. R., & Páez, D. (2007). Reactive Attachment Disorder: Recognition, Action, and Considerations for School Social Workers. Children & Schools, 29(2),
Taft, R. J., Ramsay, C. M., & Schlein, C. (2015). HOME AND SCHOOL EXPERIENCES OF CARING FOR CHILDREN WITH REACTIVE ATTACHMENT DISORDER. Journal Of Ethnographic & Qualitative Research, 9(3),