Diagnosis

A pediatric psychiatrist or psychologist can conduct a thorough, in-depth examination to diagnose reactive attachment disorder.

Your child's evaluation may include:

  • Direct observation of interaction with parents or caregivers
  • Details about the pattern of behavior over time
  • Examples of the behavior in a variety of situations
  • Information about interactions with parents or caregivers and others
  • Questions about the home and living situation since birth
  • An evaluation of parenting and caregiving styles and abilities

Your child's doctor will also want to rule out other psychiatric disorders and determine if any other mental health conditions co-exist, such as:

  • Intellectual disability
  • Other adjustment disorders
  • Autism spectrum disorder
  • Depressive disorders

Diagnostic and Statistical Manual of Mental Disorders (DMS-5)

Your doctor may use the diagnostic criteria for reactive attachment disorder in the DSM-5, published by the American Psychiatric Association. Diagnosis isn't usually made before 9 months of age. Signs and symptoms appear before the age of 5 years.

Criteria include:

  • A consistent pattern of emotionally withdrawn behavior toward caregivers, shown by rarely seeking or not responding to comfort when distressed
  • Persistent social and emotional problems that include minimal responsiveness to others, no positive response to interactions, or unexplained irritability, sadness or fearfulness during interactions with caregivers
  • Persistent lack of having emotional needs for comfort, stimulation and affection met by caregivers, or repeated changes of primary caregivers that limit opportunities to form stable attachments, or care in a setting that severely limits opportunities to form attachments (such as an institution)
  • No diagnosis of autism spectrum disorder