• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.2
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• pp.132-142
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• 2004

Most articles of Reactive Attachment Disorder reported Disinhibited Type children adopted from other countries. Reports from only Turkey and Korea focused on Inhibited Type of Reactive Attachment Disorder children whom raised by their own parents and whose symptoms are very similar to Autistic Disorder. Since articles of treatment of Reactive Attachment Disorder, especially for Inhibited Type are very rare, this article informed the author's experiences of treatment for Korean Reactive Attachment Disorder children since 1987. To treat Reactive Attachment Disorder patients and their parents, three important areas must be included : 1) to make a therapeutic environment for a Reactive Attachment Disorder child, 2) to make an attachment between Reactive Attachment Disorder child and his/her mother through individual play therapy, filial therapy, and group therapy with sibling or peer, 3) to catch up developmental delay by speech therapy, cognitive therapy and therapeutic education. This treatment methods can be more easily and more effectively applied to Korean patients than other methods from western countries including USA or England.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.3 no.1
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• pp.3-13
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• 1992

For the purpose of better understanding of RAD children, comparisons were performed about the developmental and psychopathological characteristics between RAD and PDD children. Study subjects were the children between the ages 2 and 6. who visitied SNUCH Child and Adolescent Psychiatry OPD or treated in Day Treatment Center during May, 1989 and Sep., 1991, diagnosed by the child psychiatrist as RAD or PDD according to DSM-III-R diagnostic criteria. A total of 40 children were included in the study. 20 were RAD(18 boys, 2 girls). 20 were PDD(20 boys). PEP was performed to all study subjects, by the raters blind to psychiatric diagnosis of each. And analysis was done about the level of developmental functioning score and psychopathological scores between RAD and PDD children. The results are as follows 'There were retardation on the general developmental functioning in RAD children, and the severity of retardation were lined up as perceptual ability>imitation>gross motor>cogitive language>eye-hand coordination>fine motor. Characteristics of psychopathology in RAD children were lined up by severity as language>play>relationship>affection >sensory. Group differences of the two shows on PDD group rejection score was significantly higher on the perception item. while RAD was superior on the perception emerging response. Differences of the psychopathology between two groups were on such areas as ; Affection, which was significantly higher on 'Absent' in RAD, while significantly higher on 'severe' in PDD children. On the interest for the play and materials. sensory and language areas, RAD children were significantly higher ratings on 'Absent' than PDD children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.118-132
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• 1994

The purpose of this study was to compare communication and mother-child interactions of reactive attachment disordered children with normal children. The subjects were 24 children and their mothers participated in this study'12 reactive attachment disordered children and mothers, 12 normal children and mothers. The mother and her child were brought into a p]lay room and the mother was instructed to play with her child as she normally would at home. The play situations were videotaped. Tapes were transcribed and transcribed data was analyzed with 13 mutually exclusive categories encompassing pragmatic functions represented in communication form the early stage of multiword speech in childhood. The tapes were analyzed with 10 behavioral mother-child interaction patterns. As the statistical method, t-test and correlation was calculated. The results of this study were as follows : 1) Reactive attachment disordered children used significantly fewer 'filler', 'information', 'requests', 'describes' and 'disscus self'. 2) Reactive attachment disordered children's mother used significantly fewer 'filler' and 'names'. 3) Reactive attachment disordered children used significantly more 'independent play', fewer 'intiates interaction', 'responsiveness' and 'answer' Reactive attachment disordered children's mother used more 'control play', 'observe' and fewer 'initiates interaction'. 4) Children's communication patterns were related lo mother·'s communication and mother-child interaction types. Children's 'filler', 'information requests', 'describes' and 'disscus self' were consistantly related to mother's 'filler' and 'names', (Children's 'filler', 'information requests', 'describes'. 'disscus self' and mother-child's intiates interaction 'responsivness' were significantly positively correlationed and 'independant play', 'control play', 'observation' were significantly negatively correlationed. The results of reveal that communication and mother-child interaction pattern of reactive attachment disordered group was different from normal group and children's communication pattern were influenced by mother's communication and interaction patterns.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.2
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• pp.123-131
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• 2004

We reviewed four types of Attachment intervention, 1) programs that seek to enhance sensitivity, 2) programs designed to alter parents' representations, 3) programs that provide and enhance social support, and 4) programs designed to enhance maternal mental health and well-being, and Project STEEP(Steps Toward Effective and Enjoyable Parenting). We have learned from the these studies that the emotional sensitivity and responsivity are very important factors for the development and treatment of Attachment relationships and the needs of the parents should also be addressed. Our recommendation for future attachment intervention is to design programs 1) that have the flexibility to meet participants' needs, 2) that involve other important people in the participants' lives, 3) that focus on fostering individual strengths, 4) that begin early, and 5) that are intensive and sufficiently long.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.2
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• pp.207-216
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• 1997

This study was conducted to investigate the communicative intent between Reactive Attachment Disorder(RAD) and Developmental Language Disorder(DLD). The subject of this study were 20 27-51 monthold children(10 RAD Children, 10 DLD children) functioning at similar stage of language development. The communicative intent was investigated vertical and horizontal dimension. Rating of vertical communicative intent was based on the assessment scales devised by Wetherby and Prutting(1984). Horizontal dimension was measured by the assessment guidelines of Wetherby and Prizant(1989). All the data were rated by two rators independantly. 1) In communicative intent, vertical development level of DLD children was more sophiscated than that of RAD children. 2) DLD children expressed more horizontal communicative intent than RAD children. The percentage of the three major categories(behavioral regulation, social interaction, and joint attention) of communicative intent in DLD children was lined up social interaction>joint attention>behavioral regulation. On the contrary, RAD children displayed in order of behavioral regulation>social interaction>joint attention. In addition, DLD children showed diversely as compared with RAD children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.22-33
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• 1997

The objective of this study is to understand disordered parent-child relationships of Reactive Attachment Disorder(RAD) systematically through the mother’ internal working model of child. In this study, RAD mothers’internal representations of the child were compared with mothers’of control group and association between mothers’ representation classifications and children’ attachment classifications was examined. Also individual differences in mother-child interaction by mothers’representation classifications was observed. The subjects of this study were 40 2-5 year-old children and their mothers, 20 attachment disordered dyads and 20 normal dyads of control group. Mothers were interviewed using the Working Model of the Child(Zeanah, Benoit & Barton 1986) to classify internal representations of child. Children’ attachment patterns were assessed by the Strange Situation Procedure. For observation of motherchild interaction, Each dyad was seen in DPICS devised by Eyberg and Robinson(1983). The results of the study were as follows：1) Among RAD group, 55% of mothers were classified as disengaged and 45% classified as distorted, while all mothers of control group were classified as balanced. In rating scales, there were significant differences in all 3 representation classifications in Intensity of involvement and Coherence. In Intensity of involvement disengaged representations had the lowest score and distorted representations had the lowest score in Coherence. 2) Mothers’representation classifications were related to children’ attachment classifications. All mothers of control group whose children were classified as secure were classified as balanced. Among RAD’ mothers, by contrast, 82% of mothers classified as disengaged had children classified as anxious-avoidant, 56% of mothers classified as distorted had children classified as disorganized / disoriented and 33% of mothers classified as distorted had children classified as anxious-resistant. 3) There were individual differences in mother-child interactions by mothers’representation classifications. In the child-centered play, mothers classified as disengaged used discriptive statement, reflective statement and discriptive-reflective question less than balanced mothers. Mothers classified as distorted used direct command and indirect command more than balanced mothers. In the clean-up task, mothers classified as disengaged and distorted used direct command and indirect command more than balanced mothers. The results of this study suggest that parents’working model of the child is an important factor to understand parent-child attachment relationships and their interactions. The understanding of parents’ working model of the child is thought to enrich our understanding of disordered parent-child relationships and to provide useful informations for specific and successful treatments.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.7 no.1
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• pp.14-22
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• 1996

This study aims to look at main problems of visiting the clinic, diagnoses and other related factors of outpatients in a private psychiatric clinic f3r children and adolescents located in Seoul. The analyses were based on the reports of 2,785 patients who were 18 years old and less, and visited the clinic during last 4 years. The results showed that the ratio of boys to girls was 2.7 to 1, and about 64% of the whole sample were 6 years old and less. Especially the percentage of patients aged 3 and less was the highest and that of schoolage and more was gradually reduced. The average number of siblings was 195 and the percentage of the first child in a family was the highest. Particularly, there were more boys in rase of one child families and more girls in case of families with 3 children and more. The chief problems were mainly language-deficit, hyperactivity, autistic behaviour, tic, aggressive behavior and academic problem. The higher frequency of diagnoses was in the order of parent-child problem, mental retardation, developmental language disorder, reactive attachment disorder, other emotional disorder, and pervasive developmental disorder. The more frequently used method fir treatments was in the sequence of psychotherapy, play therapy, parental counseling, occupational therapy and speech therapy. The results from this study were compared with those from other studies and discussed.