# What are the types or levels of Attachment Difficulties?

Canonical: https://pinnacleblooms.org/ask/what-are-the-types-or-levels-of-attachment-difficulties
Publisher: Pinnacle Blooms Network / Bharath Healthcare Laboratories Private Limited

Attachment difficulties are described by patterns rather than fixed levels: a secure pattern and three insecure ones — avoidant, ambivalent (resistant) and disorganised. When more marked, ICD-11 recognises two conditions — Reactive Attachment Disorder and Disinhibited Social Engagement Disorder. These describe relationship patterns, not a verdict, and can shift with responsive care.

*When a child struggles to feel safe and connected, it shows in how they reach for comfort — and understanding the pattern is the first step to helping.*

## In short
Attachment difficulties are usually described by the *patterns* a child shows when seeking comfort and safety from a caregiver, rather than by neat numbered "levels". Researchers commonly describe four attachment patterns: one secure pattern and three insecure ones — avoidant, ambivalent (resistant) and disorganised. In more significant cases, clinicians may recognise two formally named conditions: Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED). These are descriptions of relationship patterns, not a verdict on your child or your parenting.

## The patterns, explained simply
**The four attachment patterns** (from the way a child responds to separation and reunion):
- **Secure** — the child seeks comfort when upset, settles, and returns to play. This is the healthy goal.
- **Insecure–avoidant** — the child appears to manage alone and seems not to seek comfort, even when distressed.
- **Insecure–ambivalent (resistant)** — the child is clingy and hard to soothe, struggling to settle even with the caregiver.
- **Disorganised** — the child shows confused or contradictory responses, wanting closeness yet seeming fearful of it; often linked to frightening or very inconsistent early experiences.

**The two recognised clinical conditions** (described in ICD-11 and used when difficulties are marked and persistent):
- **Reactive Attachment Disorder (RAD)** — the child rarely turns to caregivers for comfort and shows little warmth or response, even when they have a caregiver available.
- **Disinhibited Social Engagement Disorder (DSED)** — the child is overly familiar with unfamiliar adults, with little of the usual wariness of strangers.

Importantly, attachment patterns are not fixed for life. Warm, predictable, responsive caregiving — and the right support — can help a child move towards security over time.

## When to seek support
Many toddlers are clingy, shy or take time to warm up — that alone is not a disorder. Consider a developmental check if your child consistently avoids comfort when hurt or frightened, shows little joy in connection across settings, or is strikingly over-familiar with strangers — especially after early disruption such as multiple changes of carer.

## The Pinnacle way
AbilityScore® is part of Pinnacle’s developmental assessment. Diagnosis, where needed, requires an appropriately qualified healthcare professional — never from an article or an online form. Our teams look at the whole relationship and the child's emotional development, then build a plan you can follow. Learn more about [attachment difficulties](/attachment-difficulties), explore how [behaviour and emotional therapy](/behaviour-therapy) supports connection, and see [how the AbilityScore® is established](/ask/what-is-the-abilityscore-and-how-is-it-calculated).

## Trusted sources
WHO ICD-11 descriptions of Reactive Attachment Disorder and Disinhibited Social Engagement Disorder; AAP and HealthyChildren guidance on early relationships and emotional development.

**Next step —** Worried about how your child seeks comfort or connects? [Book a developmental check with a Pinnacle clinician](/book-screening).

This is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.

## Sources
- WHO ICD-11: attachment-related disorders (RAD, DSED): https://icd.who.int/
- AAP HealthyChildren: early relationships and emotional development: https://www.healthychildren.org/

## Connected topics and perspectives
- Conditions: https://pinnacleblooms.org/ask/conditions
- Parent: https://pinnacleblooms.org/ask/lens/stakeholder/parent
- Emotional: https://pinnacleblooms.org/ask/lens/domain/emotional
- Definition: https://pinnacleblooms.org/ask/lens/intent/definition
- Screen: https://pinnacleblooms.org/ask/lens/lifecycle/screen
- Book Assessment: https://pinnacleblooms.org/ask/lens/route/book-assessment
- Early Clarity: https://pinnacleblooms.org/ask/lens/empowerment/early_clarity

## Related question paths

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### At home & in everyday life
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