The child must have a developmental age of at least nine months in order to qualify for the diagnosis These early experiments became the foundation for Attachment Theory and outlined the constellation of symptoms of what the DSM, Third Edition (DSM–III) would later call reactive attachment disorder. As the deprivation continued, facial expressions became rigid and then flat motor development regressed, and by the fifth month, infants were “lethargic,” unable to “sit, stand, walk, or talk,” suffered from growth abnormalities, developed “atypical, bizarre finger movements,” and no longer sought or responded to social interaction 37.3% of the infants died within 2 years. ![]() In the film Psychogenic Diseases in Infancy (Spitz, 1952), infants deviated from the normal, expected course of development and became “unapproachable, weepy and screaming” within the first 2 months of maternal deprivation. Experiments completed in the 1940s and 1950s found that maternal deprivation had a profound effect on infant growth, motor development, social interaction, and behavior. Since WWII, physicians, psychologists, and attachment theorists have documented the impact of social neglect on physical and emotional development. ![]() During that same year, 48% of children entering the foster care system were also younger than age 5. 18 (Instability and Early Life Changes Among Children in the Child Welfare System) shows that 79% of children who died because of abuse or neglect in 2010 were younger than the age of 4. The National Survey of Child and Adolescent Well-Being, No. Neither gender nor ethnicity alone appears to be risk factors for developing the disorder however, African American and multi-racial children experience higher rates of child maltreatment than do their non-minority counterparts which likely translates to a higher incidence of reactive attachment disorder in minority populations. Research suggests that concordance rates among siblings raised in the same home to be between 67% and 75%. Additional research completed by Landsverk and Garland and cited in Mental Health Treatment of Child Abuse and Neglect: The Promise of Evidence-Based Practice (Shipman, Kimberly, and Taussig, Heather 2009) found that "between one-half and two-thirds of children entering foster care exhibit behavior or social competency problems warranting mental health services." A data analysis report published by the National Survey of Child and Adolescent Well-Being (NSCAW) indicated that 42% of children removed from their home and placed in an alternate setting met DSM–IV (1994) criteria for a behavioral health disorder. Īlthough difficult to accurately assess, recent data suggest a prevalence rate between 1-2%. As they approach adolescence and adulthood, socially neglected children are more likely than their neuro-typical peers to engage in high-risk sexual behavior, substance abuse, involvement with the legal system, and experience incarceration. ![]() In the classroom, these challenges inhibit the acquisition of core academic skills and lead to rejection from teachers and peers alike. Spontaneous changes in the child's routine, attempts to discipline the child, or even unsolicited invitations of comfort may elicit rage, violence, or self-injurious behavior. Most have a strong desire to control their environment and make their own decisions. Moods fluctuate erratically, and children may seem to live in a “flight, fight, or freeze” mode. Behaviorally, affected children are unpredictable, difficult to console, and difficult to discipline. Affected children have difficulty forming emotional attachments to others, show a decreased ability to experience positive emotion, cannot seek or accept physical or emotional closeness, and may react violently when held, cuddled, or comforted. The Diagnostic and Statistical Manual 5th Edition (DSM-5) classifies reactive attachment disorder as a trauma- and stressor-related condition of early childhood caused by social neglect or maltreatment.
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