Symptoms in Infants and Toddlers

  1. Cries; miserable all the time, chronically fussy
  2. Resists comforting or nurturance
  3. Resists or dislikes being held
  4. Poor eye contact or avoids eye contact
  5. Flat, lifeless affect (too quiet)
  6. Likes playpen or crib more than being held
  7. Rarely cries (overly good baby)
  8. Angry or rageful when cries
  9. Exceedingly demanding
  10. Looks sad or empty-eyed
  11. Delayed milestones (creeping, crawling, etc.)
  12. Stiffens or becomes rigid when held
  13. Likes to be in control
  14. Does not hold on when held (no reciprocal holding)
  15. When held chest to chest, faces away
  16. Doesn't like head touched (combed, washed)
  17. Generally unresponsive to parent
  18. Cries or rages when held beyond his wishes
  19. Overly independent play or makes no demands
  20. Reaches for others to hold him rather than parent
  21. Little or reduced verbal responsiveness
  22. Does not return smiles
  23. Shows very little imitative behavior
  24. Prefers Dad to Mom
  25. Gets in and out of parents lap frequently
  26. Physically restless when sleeping
  27. Does not react to pain (high pain tolerance)

The following is an excerpt from Dr. Buenning's Attachment and Bonding article:

In the last eight years, I have worked with the parents of babies and toddlers who had problems bonding. Through this work, I developed a 27 item Infant Attachment Checklist. A diagnosis of RAD can be made in an infant with only several items checked in a positive direction.

There are two major groups of unattached babies. The first group consists of babies who are fussy and unhappy. They are visibly disconnected and cry extensively. They are often inconsolable and reject nurturance and comforting from their parents. The parents are unable to appease or alter the infant’s unhappy condition.

The second group consists of babies who are overly good. They are calm, quiet, and appear independent. Usually, they have a flat affect and calm appearance. They make few demands upon their parents. For example, if the parents place them on the floor, they can happily entertain themselves for an hour or more. They rarely cry or are fussy. In one instance, I gave a three-hour talk to a group of adoptive parents. One of the mothers present was holding a six or seven month-old infant. The infant sat on the mother’s lap with her back to the mother. She did not make eye contact, smile, or make a sound. The baby did not fuss or make a single demand of the mother during the entire three-hour lecture. The mother saw her baby as a “well-behaved” baby because she sat so quietly and cooperatively for three hours.

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Credits: Used with permission from:

Walter D. Buenning, Ph.D.
1773 S. 8th Street, Ste. 202
Colorado Springs, CO 80906
(719) 477-9033

Dr. Buenning has a private practice in Colorado Springs. Prior to working with adoptive families, he worked for twenty years in mental health centers in several Western states.