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Is It Possible for an Autistic Child to Have Reactive Attachment Disorder?

You know what’s interesting? In the most recent edition of the “Diagnostic and Statistical Manual” (the DSM 5), which is the book that sets the standard for what psychology professionals are and are not allowed to diagnose, it’s stated that Autism and Reactive Attachment Disorder (RAD) cannot be diagnosed at the same time in the same child.

Why is that?

Ironically, I was just talking on the phone with a friend who has a RAD child yesterday, and I actually spoke the words, “Reactive Attachment kids are basically the opposite of Autism kids. One is socially inept while the other is so socially adept that they’ve mastered manipulation.”

Think about that. Kids who have RAD are almost always skilled manipulators.

And how are they able to manipulate so skillfully? Because it is truly a skill. Don’t mistake it for anything else.

They’re skilled manipulators because they’re very socially adept, very perceptive, very quick to connect the dots. They’re observers who read through the lines faster than anyone in the room.

The trauma that happened to them when they were small doesn’t ENHANCE their brain functioning, but it does teach them from a very early age how to survive. It teaches them that they have to fight to get what they want/need, even if that means lying/cheating/stealing/or whatever else.

Many of them also watch the adults in their lives manipulate those around them so they pick up the habits.

While other kids their age were playing with their siblings (forming bonds), being disciplined by their parents (learning boundaries), snuggling with their parents (forming attachments), being comforted when they’re hurt/sick/scared (building trust), these kids were instead being pitted against their siblings (preventing bonds), being abused/neglected by their parents (learning that boundaries don’t exist), sometimes being sexually abused by their parents (forming either unhealthy attachments or destroying their ability to form attachments at all), and being ignored when they were hurt/sick/scared (damaging their ability to trust).

Other kids spent their brain power learning how to form relationships, but RAD kids spent their early brain power learning how to mistreat and manipulate.

They really do become masters of it.

That’s why, in my opinion, it seems so unlikely that a child with Autism would also be diagnosed with RAD. The DSM 5 agrees, but there have been many studies trying to prove why it IS possible for a child to have both.

After all, just because a child has Autism, that doesn’t mean they’ve been protected from severe trauma their entire lives.

The difference is that RAD kids were originally born with the ability to form typical emotional attachments. The trauma they endured changed their brain patterns and taught them that if they wanted comfort, they would have to do it themselves. Autistic children, however, are naturally born with less ability to form “typical” emotional attachments, even to caregivers.

This isn’t to say they don’t love their parents (or caregivers); not at all! It’s just to say that they’re born right off the bat with subdued emotions, social barriers, and inability to understand social constructs. They might also comfort themselves as a RAD child would, but it’s not because of abuse. They were just born that way.

So, although kids with RAD and kids with Autism might both ignore you and get lost in their own worlds, it’s usually for entirely different reasons.

Kids who have Reactive Attachment Disorder have the ability to act as if they’ve attached to you. They have the ability to pretend to be something they’re not. They can identify “cool kids” in school, they can change their own behavior to become more socially admired, and they can (often) keep their emotions perfectly in control until they choose to unleash them.

Kids who have Autism are mostly unable to feign attachment because they can’t identify what attachment looks like versus what it doesn’t. They don’t really have the ability to pretend to be something they’re not because the idea of having an “image” doesn’t compute to them. They can’t identify cool kids (they might be able to recognize that someone has a lot of friends, but wouldn’t know why), they can’t change their own behavior to become cooler, and they can’t keep their emotions in control when they’re feeling overwhelmed.

To outsiders looking in, these two disorders could look similar because of their manifestations, but to the parents who live amongst these kiddos, the two are drastically different.

Although studies are happening to disprove the theory that these two disorders cannot co-occur, I’m of the mindset that they really can’t.

If a child with Autism were to go through severe trauma as a young child, I think their reaction to it would be quite different. They would suffer and show difficulties in trusting people again, but I don’t think they would gain the same ability to socially manipulate that “typical” kids do.

That social manipulation is one of the biggest identifiers for RAD.

What are your thoughts on this?

I understand that this topic is a controversial one and that some of my words might cause frustration, but I still want to open the topic up for conversation. Do you think these two disorders can co-occur? Has your child been diagnosed with one or the other (or both), and how do you feel like the diagnosis is accurate?

Thank you, as always, for reading and giving me your input.

Happy parenting, friends.

Is It Possible for an Autistic Child to Have Reactive Attachment Disorder?

W. R. Cummings

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APA Reference
Cummings, W. (2018). Is It Possible for an Autistic Child to Have Reactive Attachment Disorder?. Psych Central. Retrieved on August 5, 2020, from


Last updated: 14 Sep 2018
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