Attachment disorder

There are two distinct goals of attachment disorder treatment in children. These are:

• Making sure that the child and the rest of the family unit are operating safely, particularly if the child’s attachment issues have been caused by abuse or neglect
• Ensuring that treatment has encouraged the child to make a natural and loving connection with their parents, or with the appropriate caregiver.

Therapy sessions at Priory are tailored to the specific needs and experiences of children with attachment disorder. Our dedicated attachment disorder services are led by specialised therapists, who possess a wealth of experience in dealing with young people’s mental health. We are able to provide day and outpatient care, offering flexible treatment that fits in around school hours and other commitments. 

Play therapy and family therapy are often used when treating children with attachment disorder, with both approaches aiming to strengthen the bond between the child and their parents. Therapy is also designed to help children to cope with the symptoms of attachment disorder by providing a familiar and comfortable setting, primed to help them to overcome their attachment difficulties.    

Play therapy - this is a useful and engaging form of therapy for children, particularly in young children and in those who are often withdrawn. Our dedicated therapists ensure that therapy, and emotional/social skills teaching, is fun and accessible, helping to hold childrens’ attention spans for longer.   

Family therapy – while much depends on the specific circumstances and reasons behind a child’s attachment disorder, family therapy will often include parents or caregivers and the child, and works by reinforcing positive interaction through games and activities to help to form a more significant bond.

Attachment disorder is a mental and emotional condition which is mostly diagnosed in young children before the age of five and sometimes in school children.

While the deep connection and lasting bond between a child and their parents or caregivers is usually established within the first six to nine months after birth, instances of neglect, abuse or abandonment can lead to young children failing to develop these close connections.

If a child does not receive the expected love and care that would be usual in a typical family unit, then continued problems with behaviour, dealing with emotions, and trusting people can lead to the development of attachment disorder which can negatively impact their childhood and even later life.

Symptoms of attachment disorder in children

It is still possible to recognise the signs and symptoms of attachment disorder, even if the child is still a baby. For example attachment disorder may be present if the baby repeatedly cries inconsolably, or the primary caregiver isn’t responding to the baby’s needs in the correct manner.

There are two types of childhood attachment disorder:

Reactive attachment disorder (RAD) - if a child is diagnosed with reactive attachment disorder, they will tend to be more withdrawn in social situations, even during interactions with their caregiver.

Crucially, if something makes them upset, they won’t respond or calm their emotions if you try to comfort them, and can visibly display aggression and feelings of anxiety. This can stop the child from developing as they might otherwise do if they didn’t have RAD.

Disinhibited attachment disorder or disinhibited social engagement disorder (DSED) - in this type of attachment disorder, the child will appear excessively and sometimes even inappropriately friendly towards strangers that they don’t know, which stems from them believing that they must ‘over-compensate’ their positive behaviour in order to receive the emotional or verbal responses that they desire.

Some of the signs and symptoms that a child with attachment disorder may demonstrate include:

• Difficulty expressing anger – attachment disorder can cause appropriate social cues to be distorted, with children struggling to control or express feelings of anger. This may involve the child throwing tantrums or otherwise ‘acting out’
• Lack of eye contact - if a child struggles to look you in the eye, it can indicate problems with attachment, although you would need to match this with other symptoms of attachment disorder to rule out any other possible reasons
• Seeks affection from strangers - one of the more vital signs of a child developing attachment disorder is their need to seek sometimes inappropriate levels of affection from strangers outside of the family unit, indicating that they might not be getting the appropriate affection to develop attachment with their caregivers
• Problems checking their behaviour - when a child has difficultly monitoring their own behaviour, such as not rectifying their behaviour when they have been told to, this can be sign of attachment disorder and that they are not regulating their emotions as normal
• Lack of affection towards parents or caregivers – another important sign that a child may be developing attachment disorder is an inability to show affection to their parents or caregivers, highlighting that the bond may either be insecure or not there at all

In the majority of cases, attachment disorder usually develops by the age of five, and is typically caused by some form of neglect or abuse from a primary caregiver. Any situation where a child has been unable to form a bond, or has been separated from their parents, can lead to attachment issues.

Examples of children that are most at risk of attachment disorder include:

• Children who have been neglected or abused
• Children who have been placed in care institutions
• Children who have moved between a series of different carers or adoptive parents
• Children who have been separated from their parents
• Children whose parents abuse drugs or alcohol

A child inherently desires love and affection, as well as being able to build a trust and reliance on their caregivers to provide them with their basic needs. The negative impact of ignoring or neglecting a baby or child’s cries of hunger or nappy changing can leave them feeling abandoned. This may lead to fear that the world is an insecure place for them, without developing the understanding of attachment they need to forge strong relationships in the future.