To some other anwerers: attachment issues are NOT the same as RAD. It is not as easy as someone who just has trouble trusting, it is a complete re-wiring of the brain that lead to an inability to understand social situations and therefore make appropriate choices about how to behave. RAD has many more elements, but it is important to know that it is not at all the same as having typical attachment issues (that I have as an abused child raised by family other than my bio parents for example).
Reactive Attachment is very real. Children with RAD cannot always understand facial expressions and body language. Some of the issues are similar to sociopathic issues. RAD comes from exceptionally extreme abuse or complete neglect--situations in which the brain literally does not make the social connections most of us learn as babies and children.
We have been dealing with RAD in an extreme form for the past several years. I know how terrifying it can seem. If you are dedicated it does get better! Get a therapist who has specific experience with RAD--it is unlike other attachment issues. Secondly, remember that every moment is a teaching moment. For example, when we look at pictures of our family or watch television, we talk about how people are feeling by how they act or appear. We also avoid over-stimulating situations, the kids need time to rest because constantly working to understand social situations is really exhausting for them. Another really important thing is complete consistency in behavior and discipline and no violence in any form--none. Of course this means no spanking, but in addition,avoid yelling or having moments of anger--very hard when raising children with RAD.
My oldest was an incredibly extreme case and is now a success story. He now often understands love, he plays with his siblings and with us (without violence), after being kicked out of several schools, he is finally settled into a wonderful place that is willing to work with his outbursts.
My other two children have RAD to a lesser degree, and all are doing very well. A true diagnosis of RAD is like any other special need. Our children qualified for the school for the developmentally disabled and it was such a wonderful place for them. But now, they are all at a private school with a focus on positive discipline. They have been consistently making great strides and are really happy most of the time. Remember that your children will have issues likely for many, many years, so don't get too frustrated. My oldest will likely have residual issues throughout his life.
Honestly, we are a truly happy family and I would be happy to share with you if you would like to email me. It is a roller coaster, but for us, it is worth the downs for the ups.
children with RAD, extensive research and a PhD