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Reactive Attachment Disorder and Puberty

Puberty can be a very hard and scary time to navigate for caregivers of children with Reactive Attachment Disorder.

Due to hormone changes, growth spurts and brain development, the brain and body revert back to what they were like as a newborn and infant, needing to relearn basic skills all over again.

With that reset comes the need for the brain to work through past trauma all over again. 

The longer it took for the trauma to end, the longer this difficult time period can last.

Behaviors can become quite scary. 

What a caregiver thought the child had worked through and moved past, may come back in full force or worse.

Reactive Attachment Disorder and Puberty

This has occurred with Princess and was scariest earlier this year when she wanted to take her own life.

It has also occurred with Sunshine as she goes through precocious puberty. She became homicidal with a significant increase in aggressions and assaults towards others

This is why she is currently in residential treatment.

How do you navigate Reactive Attachment Disorder during puberty?

Navigating Physical Health during Puberty with Kids Who Have Reactive Attachment Disorder

Physical Health

Whether a child has Reactive Attachment Disorder or not, puberty is extremely hard on the body. There are so many changes that take place. So much growth occurs at an extremely fast pace.

We often hear the word “awkward” as a description of the body during puberty, and it’s true! The body is literally learning how to work all over again.

With all of our children who have diverse needs, we’ve observed that during puberty, all of the same struggles they had as infants and toddlers have returned.

When Princess came to our home she did not know how to use her body correctly. She spent a long time in physical therapy.

Over the last year we’ve seen her gross motor skills deteriorate in significant ways. Princess is no longer able to do so many things that she was able to do correctly before.

The biggest red flag was when we gave her rollerblades for Christmas and she couldn’t stand up straight in them.

She has also developed Sever’s disease which complicates things further.

Due to Reactive Attachment Disorder, Princess was not communicating that she was pushing through pain and making accommodations with her body to compensate for lost skills. These accommodations caused more harm than good.

She has been in physical therapy for a few months now and will continue until her body is working correctly again. Progress is slow but steady.

If you notice regression of skills and especially if your preteen/teen with Reactive Attachment Disorder complains of unexplained pain, make an appointment with her pediatrician immediately.

Don’t hesitate to request physical therapy or at least an evaluation done by a physical therapist to determine what’s going on.

If your child worked with a physical therapist as an infant or toddler, there’s a good chance they’ll need to do it again.

Please also know that injuries like broken bones are completely normal during puberty. As the body changes rapidly, the bones have a part to play too, which makes them extremely vulnerable.

Diet during Puberty with Reactive Attachment Disorder


When Princess came to us as an infant, she had some significant issues related to food. These issues resulted in her needing an endoscopy and allergy testing. Eosinophils were discovered during the endoscopy. Further blood work and allergy testing confirmed allergies and intolerances.

Over time Princess’ gut healed and she grew out of her food sensitivities and allergies.

Fast forward to now, during puberty, and gut issues have returned. We are thankful to say that allergies have not reared their ugly head again, but intolerances and sensitivities have definitely made themselves known.

Princess has now returned to a gluten free diet which has made a tremendous difference with her body functions and her moods.

She tried gluten again over this past weekend, just to see what would happen. Sure enough she became ill AND crashed emotionally.

If you notice significant irritability, mood swings, and rapid, unexpected changes in eating habits, do not hesitate to consult your child’s pediatrician or discuss dietary changes with your child in an effort to help.

If your child is resistant to recommendations, let the pediatrician take the lead and document, document, document!

Amen Clinic identified a part of Sunshine’s brain that was being affected by her diet during her brain scans last summer.

The psychiatrist prescribed her a gluten free, corn free, soy free, dairy free, sugar free diet, because the impact of her diet was so significant.

We could not believe the changes in behaviors when we implemented their recommendations. It didn’t change everything, but helped significantly with her overall health and wellness, which led to an improvement in behaviors.

We often think about diet as one of the last reasons for changes in behavior, but during puberty, it’s definitely one of the first things you want to consider.

Mental Health during Puberty with Reactive Attachment Disorder

Mental Health

It would be absolutely wonderful to see consistent progress with attachment and behaviors through puberty with children who have Reactive Attachment Disorder.

Unfortunately, no matter how much progress has been made, there will be regression during this time.

If a family hasn’t experienced a mental health crisis before puberty, it’s very common for the first one to occur around that time.

If things have been consistently rough, be prepared for things to get worse.

For how long you ask?

That depends on how long your child endured trauma during those early years. 

It may also depend on how long it takes to find the correct medication regime if required.

When the brain resets at puberty, it has to work through past trauma in an entirely new way that matches how the newly developed brain works.

If you’re struggling to understand this, just think about the end of the movie Inside Out when the old control panel is replaced with the new one. There are so many new buttons for the emotions to learn how to use. Not to mention, Riley’s whole view on life has changed.

How do you navigate this time of regression?

Expect it.

Plan on it.

Have resources in place and ready to go!

At home, make sure you have all of the necessary safety protocols in place and working efficiently. You will need them.

If you don’t have a mental health therapist already, do your research and find one that can help.

In areas where that may not be possible, or isn’t the right fit (mental health therapy equals trauma for Princess), now may be the perfect time for the caregiver to start therapy. I can’t tell you how beneficial it has been for both my husband and me during this time.

In our home, Sunshine had in-home emergency mental health services leading up to her residential stay.

When Princess became suicidal, we contacted her pediatrician who met regularly with her to determine a need for medications and/or other services.

We attempted to obtain in-home emergency mental health services but it took forever due to insurance complications and COVID-19. Instead we found a program through our church that we did as a family that helped significantly.

When things hit the fan during puberty with your child who has Reactive Attachment Disorder, please remember nothing is your fault. You are not going crazy. This is tough stuff!

As abnormal as it feels, it’s completely normal.

It’s to be expected.

Even if you’ve done everything right up to this point, things are going to fall apart.


Have faith and confidence. You will make it through this.

At the same time be realistic. This is not something that you can do by yourself.

The best case scenario is that your child with Reactive Attachment Disorder and you will need some great therapy.

Worst case scenario, your child may become so unsafe that she is unable to live in the home for a while for safety reasons.

I’ve experienced both scenarios and have lived to tell the tale. You can too!

For those who want to learn more and receive support related to Reactive Attachment Disorder, be sure to subscribe to our FREE newsletter.

If you enjoyed this post, you may also enjoy the posts below.

What Is Reactive Attachment Disorder Our Pediatric Mental Health Crisis What NOT to Do with a RAD Child How to Discipline a Child with Reactive Attachment Disorder A Safety Plan for Mental Health 4 Steps to Managing Aggressive Behaviors One Sure Way to Help Your Child Work Through Emotions

Reactive Attachment Disorder and Puberty

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