July/August 2005Vol. 6, No. 6Study Casts Doubt on Attachment Disorder Screening Instrument

Reactive attachment disorder is the subject of considerable debate within the adoption field. Professionals disagree about what constitutes the disorder and whether or not it is overdiagnosed. A study published in the February 2005 issue of Child and Adolescent Social Work Journal (Vol. 22, No. 1) attempted to assess the attachment problems of children in child welfare custody and, at the same time, to validate the Randolph Attachment Disorder Questionnaire (RADQ)—an instrument professionals use with children's caregivers to diagnose attachment disorders. Instead, researchers concluded that the RADQ has not been adequately validated and may have limited usefulness as a clinical assessment tool.

The authors' conclusions are based on a double-blind study of 54 children in the custody of North Carolina's child protective services. Children in the sample varied with respect to placement setting, gender, age, length of time in placement, and number of placements. Adults who had lived with the children at least 3 months completed the questionnaires. Findings included:

• The group of children in this sample had significantly lower total scores on the RADQ than expected. Although the children in this study had experiences that would seem to contribute to the development of an attachment disorder (as defined by the instrument), only one child in the sample had a RADQ score that suggested the disorder.
• In contrast, the Achenbach Child Behavior Checklist (CBCL) more clearly identified problems as would have been expected, given the children's histories. Most of the children in the sample scored significantly higher on the CBCL than the normative sample, indicating they were having more difficulties. However, CBCL scores for the children in this sample were not outside the "typical" or average range.
• None of the placement variables were significantly related to any of the RADQ variables. However, several of these variables (e.g., number of placements, length of time in placement) were significantly related to scores on the CBCL.

From these findings, the authors concluded that the RADQ's ability to differentiate among different pathologies, including attachment disorder, may be limited. The authors note that future research should examine RADQ's usefulness in other samples and geographic locations. They also note that the sample for this study was taken from a suburban-rural area and may not represent the types of children in placement in an urban area.

The article, "Correlates of the Randolph Attachment Disorder Questionnaire (RADQ) in a Sample of Children in Foster Placement," by G.G. Cappelletty, M.M. Brown, and S.E. Shumate, can be found in the Child and Adolescent Social Work Journal 22(1). Find information about the journal online at www.springerlink.com/link.asp?id=104690