‘Prepared, not scared.’ I love this phrase which was repeated last weekend by Debbie Burt throughout the discussion on adoption and older children at the Arise Cape Town conference. During this session, a question arose, a commonly asked question about RAD – Reactive Attachment Disorder and its prevalence. People who google ‘pros and cons of adoption’ or google ‘adopting an older child’ or read print stories of attachment are bound to encounter this term. It’s often used to dissuade people from adopting, or simply used to tell dramatic stories of ‘children gone bad’.

Attachment: A dance that develops between a primary caregiver and a child

Attachment refers to, according to a former supervisor of mine, Dr Christelle Blunden, the “dance that develops between a primary caregiver and a child”. This primary relationship is one in which needs are met within the context of relationship – physical and emotional (think hunger, warmth, affection, stimulation, response to another). This ‘dance’ develops over time and forms a secure base from which a child can grow and explore the world. It’s an important part of child development and has implications for the physical, social, cognitive and emotional development of children. All of us have our own attachment dance and it influences our friendships and romantic partnerships.

What is RAD?

Reactive Attachment Disorder occurs when this primary attachment is not formed for whatever reason. In this case, the dance, needed to learn the important steps towards emotional, cognitive, social and behavioural well-being, is disturbed or not initiated.

Child development theory suggests that it is in the first year of our lives that we learn to either trust or mistrust the world and we can understand that if my (one dance partner) emotional and physical needs aren’t being met by the person who is responsible for me (the other dance partner), that the world will feel very unsafe. Practically this might be a baby who initially cries a lot to voice distress, but stops when they learn that this strategy doesn’t work – or perhaps it has worked, but it’s a different person every time who responds! What I learn from this is: people can’t be trusted, or if I am open enough, someone, anyone, might respond to me.

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When the optimal child development dance is disturbed, we might see a child who doesn’t know with whom to engage appropriately – they may be open and affectionate to anyone who will initiate or respond to their attention, or alternatively, regardless of how hard one initially tries to engage with a child, the child doesn’t reciprocate the desire to emotionally connect in return – which is intensely disappointing for people who are excited about growing their family through adoption! The dance being disturbed may also result in behavioural, learning and cognitive challenges.

It’s important to recognise that the parts of the dance that were disturbed need to be re-learnt – and while we can’t always specifically pinpoint which steps are messy or missing, there are ways to relearn.

  • Prepare yourself so that when the dance gets messy you know who to ask for help or how to change the music.
  • Be proactive in practical attachment exercises. (See Alexa’s next post for some advice on this!)
  • Speak to other adoptive families about what worked for them, but also what didn’t, in developing attachment with their children.
  • Ensure that the professionals you consult have an understanding of the needs of adopted children, as well as different strategies in their toolkit for exploring attachment in families.
  • When you think you might need help, ask for it sooner rather than later.

RAD exists and there are very real challenges that come with it

I have heard it said that children with attachment challenges have predetermined outcomes and yet I have witnessed, as well as listened to far more experienced and researched professionals engage with strategies to overcome these challenges. It’s not all doom and gloom!

I think that the key to experiencing strong attachment with your adoptive child is through developing a primary relationship as soon as possible, not being afraid to seek help and being prepared. Being prepared helps us to be less scared. Being less scared makes it easier to dance.

About the Author: Alexa Russell Matthews is a Social Worker with a Master’s Degree in Social Work alexa(Play Therapy) from the University of Pretoria. She’s also a future adoptive mom and one of her most passionate work spaces has been engaging with children who are still in children’s homes or with children and families post adoption.

If you’d like to follow more of Alexa’s story, you can check out her blog over here: The Outrageous