Reactive attachment disorder is a rare but serious condition in which an infant or young child doesn’t establish healthy attachments with parents or caregivers. Reactive attachment disorder may develop if the child’s basic needs for comfort, affection and nurturing aren’t met and loving, caring, stable attachments with others are not established.

With appropriate treatment, children who have reactive attachment disorder may develop more stable and healthy relationships with caregivers and others. Treatments for reactive attachment disorder include learning how to create a stable, nurturing environment and providing positive child and caregiver interactions. Parent or caregiver counseling and education can help.

Reactive attachment disorder usually starts in infancy. There’s little research on signs and symptoms of reactive attachment disorder beyond early childhood, and it remains uncertain whether it occurs in children older than 5 years.

Signs and symptoms may include:

• Unexplained withdrawal, fear, sadness or irritability
• Sad and listless appearance
• Not seeking comfort or showing no response when comfort is given
• Failure to smile
• Watching others closely but not engaging in social interaction
• Failure to reach out when picked up
• No interest in playing peekaboo or other interactive games
• Behavior problems
• Failing to seek support or assistance

Consider getting an evaluation if your child shows any concerning signs that persist across time. Some signs can occur in children who don’t have reactive attachment disorder or who have another disorder, such as autism spectrum disorder. Sometimes young children may display some temporary signs and symptoms, but they tend to be brief, minor or don’t cause developmental problems. It’s important to have your child evaluated by a pediatric psychiatrist or psychologist who can determine whether behaviors indicate a more serious problem.