A boy who could not be comforted

Reactive attachment disorder (RAD) is a rare disorder occurring in young children who have experienced extremely insufficient care and have been deprived of the opportunity to form a secure attachment with a reliable caregiver. Children with RAD exhibit inhibited, emotionally withdrawn behavior toward caregivers, rarely seeking and responding to comfort when distressed. They may also have minimal social and emotional responsiveness to others, limited positive affect, and episodes of unexplained irritability, sadness, or fearfulness. Symptoms must begin prior to the age of five years. There are no medication treatments for RAD; however, psychiatric comorbidities may benefit from psychopharmacology. The single effective treatment for RAD is placing the child in an environment where they have the opportunity to form a selective attachment to a caregiver. Symptoms of RAD may completely resolve if this occurs.