Attachment theory and children in care
The adoptions of children from overseas orphanages, especially of children who are beyond the infancy period, are often considered to be “special needs” adoptions. The same can be said of adoptions of children who have a history of foster care. A common concern for both of these groups of children is that they may suffer from or be “at risk” for attachment problems. Indeed, in recent years, the term “attachment disorder” has been used frequently and rather loosely in reference to the social, emotional, and behavioral difficulties experienced by some fostered and adopted children. The imprecise use of the term “attachment” has perpetuated a lack of understanding of the specific ways in which care-giving history can affect a fostered or post-institutionalized child and how these children can best be understood by their parents. My aim in this article is to make clear the implications of attachment theory for previously fostered and post-institutionalized children and their adoptive parents. In doing this, a necessary starting point is to consider what attachment is and what it is not.
What is attachment?
Attachment is a unique and very specific form of bond. It does not refer to all the feelings a child has for a caregiver, nor to the feelings a caregiver has for a child. It is a bond that begins in infancy with the baby’s biological predisposition to single out a primary caregiver from whom to seek security. The infant’s predisposition for forming an attachment has a survival function. It is her attachment that keeps the young child near her caregiver and causes her distress when they are separated.
Attachment does not always refer to a positive or healthy bond. As a result of the infant’s biological tendency, attachments of babies to caregivers develop under nearly all circumstances. For this reason, babies of neglectful or abusive caregivers are as likely to form attachments to their caregivers as are babies of warm and caring caregivers. In other words, all babies and young children seek security and protection from their caregivers and become attached. It is the availability of the caregiver, and the manner in which he or she responds to the child’s needs for security and protection, that determines the quality of attachment. So, very rarely is there an issue of whether a child is attached or not. The important concern is what kind of attachment has been formed.
What kind of attachments can form?
The attachment relationships that children have with their caregivers are differentiated on the basis of the extent to which they provide the child with a sense of physical and emotional security; hence, the distinction between securely and insecurely attached children. The security of a child’s attachment to a caregiver is dependent on two things: (1) the continuity of the caregiving relationship, and (2) how sensitive and responsive the caregiver is to the needs of the child. Young children become securely attached when caregivers respond quickly and warmly to their distress, provide them with appropriate stimulation, are affectionate and generally positive with them, and are responsive to their needs and feelings. Insecure attachments develop when caregivers are intrusive, excessively stimulating, punitive and controlling, or are unresponsive and uninvolved. For a secure attachment to form, a sensitive and responsive caregiver must be available to the child on a consistent and continuous basis. Caregiving that is unpredictable or that is disrupted will support the development of an insecure attachment.
Different types of attachment
A child’s early attachment to her caregiver contributes very importantly to the development of her understanding and expectations about relationships and social interactions beyond the attachment relationship. This understanding and set of expectations is referred to as the child’s “internal working model.” Securely attached children will develop an internal working model in which they view themselves as worthy and loveable and others as benevolent and predictable. This optimistic set of expectations typically leads to a prosocial orientation. On the other hand, insecurely attached children develop a sense of themselves as unworthy and, based on their histories, they expect neglect, malice or rejection from others. This negative set of expectations can lead to anger and acting out or depression and withdrawal.
It is important to note that although attachment formation in early life plays a key role in subsequent development, a young child’s internal working model is not completely fixed. The early years of life are a particularly sensitive time for the formation of an internal working model but experiences beyond those years can alter what has already been formed. Positive interactions within the context of a stable and sensitive caregiving relationship can result in an insecure child becoming secure, whereas repeated disruptions in a positive caregiving relationship, due to factors such as parental hospitalizations or discord, can lead a secure child to become insecure.
The post-institutionalized child
As noted above, it is a rare circumstance in which a child is unable to form an attachment to a caregiver. Unfortunately, in some countries orphanages still exist in which this is the case. For example, children who were reared in Romanian orphanages, prior to and shortly after the fall of the dictatorship in 1989/90, lived in conditions of severe deprivation where individualized care was often non-existent and opportunities for attachment formation did not exist. Study of these children who were adopted by Canadian families has shown us that attachment formation can occur later in development, beyond the first years of life. In our study of Romanian orphans, it was found that all were able to form selective attachments to their adoptive parents; however, many of these attachments were insecure and some were very unusual. Many of the children appeared not to discriminate between their parents and unfamiliar adults when it came to expressions of affection or wariness suggesting that their early experiences had prevented the development of an understanding of one’s caregiver as distinct from others as a unique source of security.
The child from foster care
Historically, foster care has been viewed as a solution to the problem of providing continuity of individualized care in an institutional setting. Unfortunately, the current state of affairs falls short of this goal. Multiple foster placements are very common and much of it is purposely planned as short term, with foster parents looking after large numbers of children who rotate in and out of the family. We now know that unless children are returned to their homes quickly after being removed and placed in foster care, there is a tendency for foster care to become long-term with a high likelihood of frequent moves.
Attachment theory, with its emphasis on continuity of the caregiving relationship and sensitive and responsive care, strongly suggests that discontinuity of care in multiple foster homes will have negative ramifications for the development of selective attachments and internal working models. The attachment system of the child who has moved around in the foster care system for any length of time is likely to be organized in such a way as to chronically anticipate rejection and loss. Such children, who still hope for love and care, may be deeply anxious about being neglected, rejected or deserted and, consequently, may behave in attention-seeking ways and experience considerable anger. In other cases, repeated separation and loss can lead the child to develop a defensive protective “shell.” When this happens, the shell can become so thick that it appears that the child no longer feels loss. This immunity to loss comes at a great cost: relationships no longer hold significance for the child.
Implications for parents
It is important that adoptive parents realize the central role of attachment in social and emotional development and that disruptions in previous attachments or the lack of opportunity to form an attachment can explain some of the characteristics of post-institutionalized and fostered children. The formation of an attachment to adoptive parents will be supported by responsive and sensitive caregiving and a period of time immediately post-adoption in which the child spends the majority of her time with her new family. Emphasis on relationships outside the family can come later once the child has the opportunity to come to understand her relationship with her parents as unique.
When a child has had the chance to form an attachment earlier in life, either to a birth parent or a previous caregiver, new parents should recognize that their child has already experienced a loss that will have shaken her sense of security. If the previous attachment was secure, then the child’s internal working model will likely provide a positive foundation on which to build a new attachment. If the previous attachment was insecure, the child’s loss is no less. Indeed, the child may require greater patience and support, as the negative expectations associated with insecurity will need to be overcome. Children who have experienced repeated losses might have great difficulty forming relationships because they are emotionally shut off or because they behave in ways that seem to undermine this goal by expressing deep anger and demanding attention in unacceptable ways. Attachment theory explains these behaviors. Understanding such behavior is not the same as knowing what to do about it; however, it can go a long way in reducing parents’ feelings of confusion and inadequacy.
Although every child is unique, there are some general suggestions that can be made regarding ways parents can support the development of a secure attachment in their child.
- Secure attachments develop through the consistent and appropriate responsiveness of caregivers to their children’s cues. Previously fostered or institutionalized children, because of their histories, may not give clear clues regarding their needs and, hence, can be very difficult for parents to “read.” They may not call out to you when they awaken, they may not cry when they are frightened or hurt themselves, they may not let you know they are hungry. As a result, parents are advised to think about what is typical behaviour in given situations and to respond to their child on that basis. For example, go in to your child’s room when you expect her to awake, greet her and get her up; when your child bumps himself or has a frightening experience, comfort him even if he is not apparently upset; feed your child at mealtimes and always have healthy snacks available.
- For some parenting decisions, as a guide, it can be helpful to think of your child more in terms of her emotional age than her chronological age. For example, a three or four-year-old who has been institutionalized or in foster care may not be socially and emotionally ready to enter preschool even though that is the age at which children with typical upbringings often start school.
by Dr. Lucy LeMare