Introduction
Some children are primarily shy and cling to their parents, while others may be chatty and more independent. However, a child cannot be friendly with unfamiliar adults. The child may develop sociable tendencies with strangers when they have attachment disorders. This article describes disinhibited social engagement disorder among children.
What Is Disinhibited Social Engagement Disorder Among Children?
It is an attachment disorder where the child experiences difficulty in forming emotional bonds with caregivers and lacks inhibition with strangers. It can be associated with other disorders like cognitive or language delays and malnutrition. For example, ADHD (attention deficit hyperactivity disorder) and PTSD (post-traumatic stress disorder) are common conditions diagnosed with disinhibited social engagement disorder among children. It is caused by trauma or neglect.
The characteristics of children with this disorder include preferred attachment, where the child reaches out to the parent for comfort but lacks social restraint toward strangers. Some children do not show a preference for caregivers, have difficulty recognizing if an individual is trustworthy, and display familiar physical and verbal behavior toward unfamiliar adults.
Parents having children with disinhibited social engagement disorder are under constant stress as they lack social discretion. They may be worried about taking their children to public spaces as the children may befriend harmful strangers. Sometimes, the parents may worry that the child may cause discomfort to others by being extremely talkative, intrusive, or attention-seeking. Parents are also concerned that the child may develop relationship difficulty as the child grows.
What Types of Attachment Do Children Develop?
The child develops a particular attachment style based on their early experiences. If the child feels safe and understood by the caregiver, they form a secure attachment style. If the caregiver does not provide comfort or is unresponsive to the child’s requirements, the attachment can be the insecure type that includes ambivalent, disorganized, or avoidant-dismissive.
The attachment styles that the child develops can impact their relationships as adults. Children with the disorder tend to develop insecure attachments. However, children with secure attachments also can develop signs of the disorder. It could be because the attachment got disrupted later.
What Are the Causes of Developing Disinhibited Social Engagement Disorder in Children?
Children who face disruptions in developing early attachments are prone to generate disinhibited social engagement disorder. For example, disturbance in the connection formed between an infant and their primary caretaker.
Parents who are abusive, neglectful, absent, unwilling, or unable to provide emotional support can adversely affect their relationship with the child. Traumatic experiences like a parent’s death can affect the attachment as the child may get passed among multiple caregivers.
According to research, 20 percent of orphan children are more likely to develop the condition. In these institutions, the child has less opportunity to form stable connections. It is overcome by providing the child with a stable family environment at an early stage.
However, many children do not tend to develop the disorder, even with inadequate caregiving. Therefore, it is concluded that other factors like genetics may contribute to the development of the disorder.
What Symptoms Do Children With Disinhibited Social Engagement Disorder Display?
The signs of disinhibited social engagement disorder develop in the first two years of life.
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Children with disinhibited social engagement disorder display a lack of social boundaries and minimal inhibition with strangers, and children are willing to go with strangers with little or no hesitation. The children do not hesitate to talk with strangers or seek physical comfort, like hugs from strangers. The child displays this behavior even when the caregiver is present. Therefore, the child is unable to form a deep and meaningful connection.
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Children old enough to talk can ask strangers questions that are intrusive or cause embarrassment.
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The child may only stay in strange areas like malls or theme parks if they look for parents. The child may also go with strangers.
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Older children can develop shallow and short friendships. The child can describe a stranger they just met as best friends.
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A child can try their best to get attention from other adults and will even resort to aggressive behavior.
Signs of the disorder in children below 12 months:
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The child may stretch their arms towards strangers, suggesting they want to be held.
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The child tends to become fussy when the stranger returns the child to the caregiver's arm.
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The child can accept food or toys from strangers without hesitating.
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The child does not become concerned when the caregiver leaves the room.
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In addition to behavioral patterns, the child can exhibit difficulty gaining weight, severe colic pain, detached behavior, or resistance to being comforted by a caregiver.
How Is Disinhibited Social Engagement Disorder Diagnosed in Children?
The child must be at least nine months old to diagnose the condition. It is the age when the child tends to develop an attachment or emotional bond. The healthcare provider will perform a psychological assessment and observe the child’s behavior. They also do not know how the child interacts with a caregiver during their presence or absence. The doctor’s record details about the child’s upbringing.
What Are the Concerns Regarding Disinhibited Social Engagement Disorder Among Children?
Although the attachment disorder develops at a young age, the child can still develop healthy boundaries. The role of parents becomes vital to mend attachment issues and enable the child to lead a physically safe and emotionally secure childhood. If the condition is left untreated, it can become a serious safety concern. Therefore, children with this condition need to seek medical help.
How to Care for a Child With a Disinhibited Social Engagement Disorder?
Emotionally available parents can reduce symptoms of Disinhibited social engagement disorder in children. The child’s entire family is required for treatment. Talk therapy is given to the child individually or in groups. Psychotherapy for the child includes art therapy and play therapy.
The caregivers will be given tools to interact with the child to make them feel safe and secure. The primary caregivers must learn to make the child feel secure to form a healthy attachment with the child. The improvement in the child’s symptoms is observed based on the child’s age and circumstances. Although the child may show improvement, it is necessary to continue the implementation of treatment tools as they may have suppressed feelings.
Conclusion
Children with disinhibited social engagement disorder may develop symptoms that can be hurtful to the caregivers. It is possible to help the child overcome the disorder with professional treatment and care from parents or caregivers. Patience is the key to creating a positive impact for the child.
