Reactive Attachment Disorder (RAD) involves severely disturbed social relatedness that starts before the age of five years. The child fails to respond to people in an appropriate way, either being excessively withdrawn (inhibited type) or indiscriminately overly affectionate with many people (disinhibited type), some of whom are strangers. This disorder most often occurs in children who lack the opportunity to bond to a parent or caretaker, such as children who live in multiple foster care situations or are raised by severely abusive and/or neglectful parents.
Asperger’s Disorder is not likely to be mistaken for the disinhibited type of RAD, as Asperger’s Disorder children are not inappropriately affectionate. However, Asperger’s Disorder and the inhibited type of RAD both share oddities in their level of interest in interacting with others. Determining if the social deficits of poor eye contact, lack of empathy, and limited ability to share in the interests and joy of others is due to Asperger’s Disorder or RAD can present a challenge.
The history of the emotional attachments the child has can be a distinguishing determinant, with Asperger’s Disorder children generally having bonds with supportive parents. The Asperger’s Disorder child also has problems with communication and restricted patterns of interest that are absent in RAD.