Wednesday, September 17, 2008

RAD Symptoms or Maybe Not.

The symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders -- DSM IV (code 313.89) for Reactive Attachment Disorder of Infancy or Early Childhood -- RAD, may seem to be pretty clear to any parent with a child who displays them.

But, for any parent of an Adopted Child these symptoms can be pointed at as proof THE problem the child has is RAD. After all the adoption in and of itself indicates there have been broken bonds and the very fact a child is adopted seems to be enough for the child to be labeled as a RAD Kid...

In a 1994 paper written by Dr. Margot Moser Richters and Dr Fred R Volkman, point out a few interesting facts about Reactive Attachment Disorder of Infancy or Early Childhood and remind us that since the addition of RAD was made to the DSM-Ill, reactive attachment disorder has stood apart from other diagnoses for two reasons:

  • Reactive Attachment Disorder is the only (mental health or illness) diagnosis designed for infants in the DSM III, and

  • In order to make the Diagnosis it requires the presence of a specific etiology.

NOTE: With the update of the DSM IV Reactive Attachment Disorder remains a Mental Health Issue diagnosed in infancy and childhood. While many issues are diagnosed for children there are few mental health issues doctors are willing to label babies and children with. Most Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence generally are not mental health diagnosis.

The doctors describe the pattern of disturbances demonstrated by some children who meet DSM criteria for reactive attachment disorder and make three suggestions:

  • (1) The sensitivity and specificity of the diagnostic concept may be enhanced by including criteria detailing the developmental problems exhibited by these children;

  • (2) The etiological requirement should be discarded given the difficulties inherent in obtaining complete histories for these children, as well as its inconsistency with ICD-10; and

  • (3) the diagnosis arguably is not a disorder of attachment but rather a syndrome of atypical development.

In other words because we have adopted children and there is a mental disorder that might define our child's behaviors they are often diagnosed with RAD... One of the few mental order diagnoses that can be made for children and infants.


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