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The article goes on to explain that RAD tends to fall into two distinct types of behavior: inhibited and disinhibited. Children with inhibited RAD tend to not initiate or respond to social interactions at all, or in an appropriate way. They have a history of neglect, and little to no attention or affection. Children with disinhibited RAD may be excessively friendly with strangers. They have a history of having had numerous caregivers or repeatedly losing attachment figures. As a result of that history, they will accept virtually anyone as a caregiver The symptoms of both types of RAD often persist into adulthood and are equally concerning (Shaw, & Paez, 2007).
There are no laboratory tests for many psychiatric disorders. Diagnoses are usually based on reports of symptoms, observable behaviors, family history and the clinical course of the disorder. For children with RAD, diagnoses can be especially tricky. There may be several observers of the behavior (maybe with conflicting viewpoints), or a complete and/or accurate family history may be inaccessible (Shaw, & Paez, 2007). Also, many symptoms of RAD mirror and overlap multiple other childhood psychiatric disorders. Steven R. Shaw and Doris Paez found that "nearly all children with disordered attachment or RAD have been given the diagnosis of ADHD at some time," (Shaw, & Paez, 2007, page 71).
There are many different types of treatment for children and adolescents with RAD. There is also much debate on how effective treatments actually are. Reactive Attachment Disorder in Adolescence states, "children and adolescents with RAD may improve in cognitive functioning, language, and motor development, but changes in social relatedness may be more difficult to achieve," (Kemph, & Voeller, 2009, page 170). In the article by Shaw and Paez, it states that, "RAD, by definition is caused by the environment. As a result, there is little evidence that child-focused therapies, including psychotropic medications and counseling, have a major effect," (Shaw, & Paez, 2007, page 71).
