268 Trauma- and Stressor-Related Disorders
tic spectrum disorder exhibit selective impa irments in social communicative behaviors,
such as intentional communication (i.e., im pairment in communication that is deliberate,
goal-directed, and aimed at influencing the be havior of the recipient). Children with reac-
tive attachment disorder show social commu nicative functioning comparable to their
overall level of intellectual functioning. Fina lly, children with autistic spectrum disorder
regularly show attachment behavior typical for their develo pmental level. In contrast,
children with reactive attachment disorder do so only rarely or inconsistently, if at all.
Intellectual disability (intell ectual developmental disorder). Developmental delays of-
ten accompany reactive attachment disorder, but they should not be confused with the
disorder. Children with intellectual disability should exhibit social and emotional skills
comparable to their cognitive skills and do  not demonstrate the profound reduction in
positive affect and emotion regula tion difficulties evident in children with reactive attach-
ment disorder. In addition, developmentall y delayed children who have reached a cogni-
tive age of 7–9 months should demonstrate selective attachments regardless of their
chronological age. In contrast , children with reactive attach ment disorder show lack of
preferred attachment despite ha ving attained a developmental age of at least 9 months.
Depressive disorders. Depression in young children is also associated with reductions
in positive affect. There is limited evidence, ho wever, to suggest that  children with depres-
sive disorders have impairments in attachment . That is, young children who have been di-
agnosed with depressive disord ers still should seek and resp ond to comforting efforts by
caregivers.
Comorbidity
Conditions associated with neglect, includin g cognitive delays, language delays, and ste-