Reactive Attachment Disorder of Infancy or Early Childhood Symptoms and DSM-IV Diagnosis

Reactive Attachment Disorder of Infancy and Early Childhood symptoms and diagnostic criteria follow below. While some of these Reactive Attachment Disorder of Infancy and Early Childhood symptoms may be recognized by family, teachers, legal and medical professionals, and others, only properly trained mental health professionals (psychologists, psychiatrists, professional counselors etc.) can or should even attempt to make a mental health diagnosis. Many additional factors are considered in addition to the Reactive Attachment Disorder of Infancy and Early Childhood symptoms in making proper diagnosis, including frequently medical and psychological testing considerations. This information on Reactive Attachment Disorder of Infancy and Early Childhood symptoms and diagnostic criteria are for information purposes only and should never replace the judgement and comprehensive assessment of a trained mental health clinician.

Diagnostic criteria for 313.89 Reactive Attachment Disorder of Infancy or Early Childhood

A. Markedly disturbed and developmentally inappropriate social relatedness in most contexts, beginning before age 5 years, as evidenced by either (1) or (2):

(1) persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions, as manifest by excessively inhibited, hypervigilant, or highly ambivalent contradictory responses (e.g., the child may respond to care with a mixture of approach, avoidance, and resistance to comforting, or may exhibit frozen watchfulness)

(2) diffuse attachments as manifest by indiscriminate sociability with marked inability to exhibit appropriate selective attachments (e.g., excessive familiarity with relative strangers or lack of selectivity in choice of attachment figures)

B. The disturbance in Criterion A is not accounted for solely by developmental delay (as in Mental Retardation) and does not meet criteria for a Pervasive Developmental Disorder.

C. Pathogenic care as evidenced by at least one of the following:

(1) persistent disregard of the child's basic emotional needs for comfort, stimulation, and affection

(2) persistent disregard of the child's basic physical needs

(3) repeated changes of primary caregiver that prevent formation of stable attachments (e.g., frequent changes in foster care)

D. There is a presumption that the care in Criterion C is responsible for disturbed behavior in Criterion A (e.g., the disturbances in Criteria A began following the pathogenic care in Criterion C).

Specify type:

Inhibited Type: if Criterion A1 predominates in the clinical presentation

Disinhibited Type: if Criterion A2 predominates in the clinical presentation

Also, See: Other Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence

Other Mental Health Diagnostic Symptoms and Criteria