Observations used to test for attachment behavior are based in having the infant or child interact with a stranger to see if the child is responsive to the stranger or caregiver, and in cases of older children, whether the child will willingly go off with a stranger. Great strides have been made in diagnosing attachment disorders in the last 20 years as clinicians use situational observation and interviews or questionnaires.

These attachment disorders fall on spectrum, meaning these disorders share multiple linked conditions with diverse symptoms and degrees of severity. Children with either RAD or DSED may exhibit symptoms of inattentiveness and hyperactivity which may affect academic achievement. In contrast, children with DSED experience similar forms of neglect, but instead exhibit signs of being extremely social, overly friendly, and fail to acknowledge normal social boundaries. This results in a failure to seek or respond to comfort, hypervigilance, becoming emotionally withdrawn and indifference to caregivers. RAD is observed as social inhibition and occurs when a child’s need for stimulation, comfort and soothing are not met. The delineation between social inhibition (RAD) and social disinhibition (DSED) is a fairly recent development, as before they were viewed under the umbrella of attachment disorders in the DSM-IV but were reclassified with these differences in mind upon the release of the DSM-V. Children diagnosed with either of these attachment disorders did not have their basic emotional needs met in early life, but the symptoms of the disorders are very different.

Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) are the result of this maltreatment and can prove to be a long-term detriment to the social, emotional, and intellectual development of affected children. While childhood trauma can consist of physical, sexual, and emotional abuse, one of the most common reports received by child protective services is neglect. Reactive Attachment Disorder and Disinhibited Social Engagement Disorder: Diverging Responses to Neglect

Inhibited rad disorder symptoms