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Preparing for your appointment
By Mayo Clinic staffIf you suspect your child may have reactive attachment disorder, you may start by first taking your child to see your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, your child may be referred to a psychiatrist for a complete evaluation.
Because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready, and what to expect from your doctor.
What you can do
- Write down any behavior problems or emotional issues you've noticed, and include any signs or symptoms that may seem unrelated to the reason for which you scheduled your child's appointment.
- Write down key personal information, including any major stresses or life changes your child has been through.
- Make a list of all medications, as well as any vitamins or supplements, that your child is taking.
- Write down questions to ask your child's doctor ahead of time.
Your time with your doctor is limited, so preparing a list of questions ahead of time will help you make the most of your time together. List your questions from most important to least important in case time runs out. For signs and symptoms that could be caused by attachment problems, some basic questions to ask your doctor include:
- What is likely causing my child's behavior problems or emotional issues?
- Are there other possible causes for my behavior problems or emotional issues?
- What kinds of tests does my child need?
- What is the best course of action?
- What are the alternatives to the primary approach that you're suggesting?
- My child has these other mental or physical health conditions. How can I best manage them together?
- Are there any restrictions that my child needs to follow?
- Should I take my child to see a specialist? What will that cost, and will my insurance cover seeing a specialist?
- Is there a generic alternative to the medicine you're prescribing my child?
- Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend visiting?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
The doctor will do a physical examination and is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Some questions the doctor may ask include:
- When did you first begin noticing your child's behavior problems or emotional issues?
- Have your child's behavior problems or emotional issues been continuous or occasional?
- How severe are your child's behavior problems or emotional issues?
- What, if anything, seems to improve your child's behavior problems or emotional issues?
- What, if anything, appears to worsen your child's behavior problems or emotional issues?
- Reactive attachment disorder of infancy or early childhood. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed June 23, 2009.
- Reactive attachment disorder. In: Moore DP, et al.: Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa.: Mosby; 2004. http://www.mdconsult.com/das/book/body/145545363-3/0/1243/32.html?tocnode=52436085&fromURL=32.html#4-u1.0-B0-323-02911-6..50032-4_311. Accessed June 23, 2009.
- Newman L, et al. Recent advances in the theories of and interventions with attachment disorders. Current Opinion in Psychiatry. 2007;20:343.
- Haugaard JJ, et al. Recognizing and treating uncommon emotional disorders in children and adolescents who have been severely maltreated: Reactive attachment disorder. Child Maltreatment. 2004;9:154.
- Cornell T, et al. Clinical interventions for children with attachment problems. Journal of Child and Adolescent Psychiatric Nursing. 2008;21:35.
- Hanson RF, et al. Reactive attachment disorder: What we know about the disorder and implications for treatment. Child Maltreatment. 2000;5:137.
- Report of the American Professional Society on the Abuse of Children Task Force on Attachment Therapy, RAD and Attachment Problems. American Psychiatric Association. http://www.apa.org/divisions/div37/RADTaskForceManuscript.pdf. Accessed July 1, 2009.
- Coercive interventions for reactive attachment disorder. Association for Treatment and Training in the Attachment of Children. http://www.attach.org/apsac.htm. Accessed July 1, 2009.
- Child Abuse and Neglect Committee. American Academy of Child & Adolescent Psychiatry. http://www.aacap.org/cs/root/policy_statements/coercive_interventions_for_reactive_attachment_disorder. Accessed June 29, 2009.
