Adopted Children with Reactive Attachment Disorder: A Qualitative Study on Family Processes

Children with histories of early childhood neglect can exhibit a multitude of problematic behaviors, along with the potential for numerous physical and cognitive deficits. In some cases, these children can exhibit behaviors reflective of a diagnosis of reactive attachment disorder (RAD). Families who adopt children with RAD may face unique issues when it comes to addressing problem behavior and providing the child adequate care. This article discusses the results of a study that examined the processes that occur in families who adopt children with RAD. Guided by the principles of grounded theory, this study employed a multi-stage semi-structured interview design. The sample consisted of five adoptive families from the Midwest, and included both adult and child participants. The findings revealed six prominent themes: Parents report difficulty educating others about RAD; obtaining the needed care and services was a constant fight; RAD behavior is socially isolating; and raising a child with RAD is continuously stressful. Older siblings felt compelled to intervene in the care of the child with RAD; and felt increased autonomy from their parents. Implications for social work and clinical practice are discussed.