Reactive Attachment Disorder Checklist

This list was compiled from the Infant Symptom Checklist developed by Walter Buenning, PhD, and the Evergreen Consultants symptom list. The items marked by an asterisk* are additional symptoms observed by Attach-China families.

Click on symptoms to read experiences of Attach-China families.

1. Reciprocal Relationships
   1. Disturbances in physical contact/connection with parents
      1. Resists or dislikes being held
      2. Stiffens or becomes rigid when held
      3. Prefers being held with back towards mother
      4. Does not hold on when held (no reciprocal holding)
      5. When held chest to chest, faces away
      6. Cries or rages when held beyond wishes
      7. Gets in and out of parents lap frequently (never settling in)
      8. Likes playpen or crib more than being held
      9. Does not return or reciprocate hugs (remains limp or stiffens up, turns away)
   2. Disturbances in emotional connection with parents
      1. Resists comforting or nurturance
      2. Poor eye contact or avoids eye contact
      3. Does not return smiles
      4. Shows very little imitative behavior
      5. Generally unresponsive to parent
      6. Reaches for others to hold her rather than parent
      7. Not affectionate on parent's terms (when parents ask for affection)
      8. Prefers dad to mom
      9. Unable to give and receive love
      10. Inappropriately demanding and clingy
      11. In infants, wants to hold the bottle as soon as possible
   3. Disturbances in relationships in general
      1. Lack of or unstable peer relationships
      2. Mistrustful of / lacks trust in others
      3. Exploitative, manipulative, controlling, bossy
      4. Inability to feel empathy towards others*
      5. Need to always be in control*
      6. Superficially engaging and charming
      7. Indiscriminately affectionate with strangers
2. Affect
   1. Flat, lifeless affect (too quiet) / inability to show emotions
   2. Frequently sad, depressed or helpless
   3. Intense displays of anger (rage)
   4. Inappropriate emotional responses -- e.g. laughing when people get shot on TV
   5. Extreme fright at unexpected or unusual triggers
   6. Marked mood changes
   7. "Abnormal" crying in infancy
      1. Cries/miserable all the time; chronically fussy
      2. Rarely cries (overly good baby)
      3. Child's cries sound the same regardless of cause, i.e., cries for food, discomfort, pain, anger, sadness, rage all sound the same
      4. Angry or rageful when cries
3. Behavior
   1. Difficulty with change or transitions
   2. Lack of impulse control
   3. Consistently irresponsible
   4. Hyperactive
   5. Persistent nonsense questions and incessant chatter
   6. Self destructive behavior
   7. Difficulty with saying good-byes*
   8. Autistic-like behaviors*
   9. Conceals knowledge/skills/abilities*
   10. Accident prone
   11. Poor hygiene
   12. Victimized by others -- i.e. sets self up
   13. Blames others for own mistakes and problems
   14. Enuresis and encopresis - e.g. refusing to use toilet, smearing poop, wetting or pooping in pants to express anger
   15. Inappropriate sexual conduct and attitudes
   16. "Antisocial" behaviors
       1. Aggression / violence toward others
       2. Steals
       3. Deceitful (lying, conning)
       4. Cruelty to animals
       5. Frequently defies rules (oppositional)
       6. Preoccupation with fire gore or evil
       7. Victimizes others (perpetrator, bully)
4. Development
   1. Little or reduced verbal responsiveness in infants
   2. Lack of cause and effect thinking
   3. Learning disorders
   4. Language disorders
5. Sleeping
   1. Physically restless when sleeping
   2. Difficulty falling asleep / fear of falling asleep* / extreme bed-avoidance behaviors*
   3. Talking in sleep
   4. Night wandering
   5. Frequent nightmares and/or night terrors*
   6. Clings to parent when asleep / can't be put down without waking*
6. Eating
   1. Hoards food
   2. Continuous eating / doesn't know when to stop eating*
   3. Refuses to eat*
   4. Abnormal eating habits -- e.g. eats slowly one day, gulps the next
   5. Uses eating/appetite to control parents (asks for tuna, then says "I hate tuna, or I'm not hungry"
7. Play
   1. Overly independent play in infants or toddlers / makes no demands
   2. Overly controlling play* Does not accept direction/suggestions from playmates
   3. Disorganized or repetitive play*
   4. Games with abandonment themes*
   5. Aggression towards toys*
   6. Inability to "bond" with any toy*
   7. Cannot play by themself, needs constant direction/supervision or demands constant interaction
8. Self-concept
   1. Perceives self as a victim (helpless)
   2. Grandiose sense of self-importance
   3. Perceives self as bad and not worthy of loving
9. Physiological
   1. Chronic body tension
   2. High pain tolerance/overreaction to minor injury
   3. Tactilely defensive -- can't tolerate light touch
   4. Seldom gets sick*
   5. Prone to "autoimmune" type conditions*

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