What Is Disinhibited Social Engagement Disorder?

Medically Reviewed by Dan Brennan, MD on May 20, 2023
Written by WebMD Editorial Contributors
3 min read

‌Disinhibited social engagement disorder (DSED) is a behavioral disorder that occurs in young children. It is an attachment disorder that makes it hard for children to form an emotional bond with others. But you may notice that children with DSED can easily talk to strangers and mingle with them. 

Here is all you need to know about DSED, from causes to treatments and more. 

‌Attachment disorders are common in children who are abandoned or experience trauma at a young age, such as negative experiences or insufficient care by their parents or guardians. This can prevent a child from forming meaningful or close bonds with people. 

Attachment disorders can be of two types based on the affected child’s behavior:

1. Reactive attachment disorder (RAD). Children with RAD find it difficult to have an emotional attachment with their parents or guardians and other people. These children fear interactions with others and have trouble managing or expressing their feelings.‌

2. DSED. Unlike children with RAD, those with DSED appear to be extremely friendly and outgoing. They exhibit socially disinhibited behavior. This means they are impulsive and can easily talk to unknown people and random strangers. However, they may have trouble forming stable or meaningful bonds with others. 

Children with attachment disorders require proper treatment and care. If left untreated, attachment disorders can result in mental disorders at later stages in life. 

‌DSED can occur in children for the following reasons:‌

  • Absence of a caregiver or parent in the first few years of childhood
  • Lack of love, care, or emotional support while growing up
  • Neglect or abandonment by caregivers 
  • Lack of a constant caregiver or repeated changing of caregivers
  • Negative experiences like childhood trauma or sexual abuse
  • Growing up in foster care or orphanages

‌These factors can make it difficult for children to connect deeper with other people. It can also make them behave in a seemingly carefree or overly friendly manner. 

‌Children as young as 9 months old can develop signs for DSED. If a child shows even two of the following symptoms, they may have DSED:‌

  • They are not shy or scared but excited when they meet strangers or unknown people.
  • ‌They are extremely friendly, chatty, or physically close with strangers.
  • ‌They behave in a socially unacceptable manner according to social norms.
  • ‌They leave a safe space and go away with a stranger.
  • ‌They don’t ask their caregiver or hesitate before going away with a stranger.
  • ‌They are impulsive and socially disinhibited.
  • ‌They have not been cared for adequately or have a history of trauma or abuse.

‌Children with DSED have severe difficulty in forming warm, affectionate, or close bonds with other children or adults. If DSED goes undiagnosed, it is associated with the following issues later in life:‌

Remember that not all children who are friendly with strangers have DSED. Your child may be naturally outgoing and talkative with others. However, they will still seek your approval for safety at all times. ‌

A child with DSED is usually detached and doesn’t seek their caregiver’s approval. If your child is not at all afraid of leaving with strangers, you may want to take them to a doctor. ‌

A pediatrician or therapist can diagnose DSED. They observe your child and conduct mental health tests. This helps them understand your child’s history, emotions, mental state, and social behavior. 

‌If diagnosed with DSED, your child will be given all the care they need through a specific treatment plan. This will help your child overcome negative experiences and grow up to form meaningful relationships with you and others. 

‌DSED treatment involves the entire family so that the child can bond with their caregivers. Treatment can include the following therapies depending on the child’s age:‌

  1. Talk therapy 
  2. Play therapy with toys and games
  3. Art therapy

The therapist also helps parents interact with their children to care for and support them to strengthen the bond. This can help children feel stable, safe, and loved so that they recover sooner.

‌DSED can be a serious problem if it remains untreated. Although therapy can take time, it is the most effective treatment for DSED. If you are a caregiver, ensure that you give your child all the love, care, and emotional support they need.