What is the characteristic behavior of children with Disinhibited Social Engagement Disorder?

Children with Disinhibited Social Engagement Disorder (DSED) are characterized by a lack of fear toward adults, which includes a tendency to engage openly with strangers. This behavior stems from a history of inadequate caregiving or neglect, often observed in children who have experienced disruptions in their attachment relationships, such as those who have been raised in orphanages or have undergone severe neglect.

In DSED, the child's unfiltered and overly familiar behavior towards unfamiliar adults is a prominent feature. They may approach and interact with strangers without hesitation, which can be concerning due to potential safety risks. The absence of wariness or appropriate social boundaries reflects their difficulties in forming secure attachments and indicates an impaired ability to gauge social cues.

This disorder is distinct from other attachment-related conditions, where children may show avoidance or resistance towards adults. The emotional withdrawal from caregivers would suggest a different diagnostic category, perhaps indicative of Reactive Attachment Disorder (RAD), while hyperactivity in interaction is more typical of attention-deficit/hyperactivity disorder (ADHD) or other behavioral issues, not specifically DSED. Thus, the behavior of engaging without fear of adults, including strangers, distinctly highlights the characteristics associated with DSED.