Causes of Reactive Attachment Disorder:
Where is the Attachment Break in the First 3 Years of Life?

• Abuse and/or neglect
• Physical loss of a parent due to
  • adoption (even on day 1)
  • death
• Multiple caretakers
  • no opportunity to attach or attachment is disrupted
  • orphanage
  • foster care
• Emotional absence or unavailability of a parent due to
  • post-partum or chronic depression
  • chronic pain
  • intergenerational RAD
• Temporary separation due to hospitalization
  • pre-mature infants
  • medical problem of parent in first two years of child's life
• Invasive or painful medical procedures
• Chronic, unrelieved pain in child
  • colic, GERD, chronic ear infection
  • undiagnosed medical problem
• Mother's poor prenatal care or prenatal alcohol or drug exposure
• Mother's feelings of rejection for fetus
• Neurological problems