Normal Attachment and Attachment Disorders in the Early Years Dawn Viers, PhD, Prevention Supervisor...
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Transcript of Normal Attachment and Attachment Disorders in the Early Years Dawn Viers, PhD, Prevention Supervisor...
Normal Attachment and Normal Attachment and Attachment Disorders in the Attachment Disorders in the
Early YearsEarly YearsDawn Viers, PhD, Prevention Supervisor
Susan Lindsey, BS, Family Resource Specialist Mary Talbert, BS, Family Resource Specialist
New River Valley Community Services
Blacksburg, VA
Attachment DefinitionAttachment Definition
Attachment is a profound, reciprocal, physical and
emotional relationship between a parent and a child that
endures and sets the stage for all future intimate and trusting
relationships.
Attachment Behavior DefinitionAttachment Behavior Definition
“Any form of behavior that results in a person attaining or maintaining proximity to some other clearly defined individual who is conceived as better able to cope with the world”
Why Is Attachment Important?Why Is Attachment Important?
Early infant-caregiver attachment sets the stage for the infant’s future intimate and trusting relationships
Development of ability to regulate emotions linked to attachment relationship
Child develops a set of beliefs (“Working Model”) about whether:1. The attachment figure is capable of respond helpfully in time of need2. The child is the sort of person to whom the figure might respond
Center for Evidence Based Practice: Young Children with Challenging Behavior
www.challengingbehavior.org
Children who are identified as hard to Children who are identified as hard to manage at ages 3 and 4 have a high manage at ages 3 and 4 have a high probability (50:50) of continuing to have probability (50:50) of continuing to have difficulties into adolescence (Campbell & difficulties into adolescence (Campbell & Ewing, 1990; Egeland et al., 1990; Fischer, Ewing, 1990; Egeland et al., 1990; Fischer, Rolf, Hasazi, & Cummings, 1984).Rolf, Hasazi, & Cummings, 1984).
Center for Evidence Based Practice: Young Children with Challenging Behavior www.challengingbehavior.org
Early Predictors
•Temperamental Difficulties
•Early Aggression
•Language Difficulties
•NoncomplianceCenter for Evidence Based Practice: Young Children with Challenging Behavior
www.challengingbehavior.org
Family Factors
•Maternal Depression
•Harsh Parenting
•Stressful Family Life Events
•Low Social Support
•Family Instability
Center for Evidence Based Practice: Young Children with Challenging Behavior www.challengingbehavior.org
WHAT PREDICTS THE WHAT PREDICTS THE MALADAPTED CHILD?MALADAPTED CHILD?
Insecure Attachment
+
High Family Adversity (maybe)
+
Ineffective Parenting
+
Atypical Child Characteristics (temperament, activity level, intelligence, etc)
Early appearing Early appearing aggressive behaviors are aggressive behaviors are
the best predictor of the best predictor of juvenile gang juvenile gang membership membership and violence.and violence.
(Reid, 1993)(Reid, 1993)
Center for Evidence Based Practice: Young Children with Challenging Behavior www.challengingbehavior.org
Young Children with Young Children with Challenging Behavior:Challenging Behavior:
Are rejected by peersAre rejected by peersReceive less positive Receive less positive
feedbackfeedbackDo worse in schoolDo worse in schoolAre less likely to be Are less likely to be
successful in successful in kindergartenkindergarten
Center for Evidence Based Practice: Young Children with Challenging Behavior www.challengingbehavior.org
Of the young children who show Of the young children who show early signs of problem behavior, it early signs of problem behavior, it has been estimated that fewer has been estimated that fewer than 10% receive services for than 10% receive services for these difficulties. these difficulties.
(Kazdin & Kendall, 1998) (Kazdin & Kendall, 1998) Center for Evidence Based Practice: Young Children with Challenging Behavior www.challengingbehavior.org
Child’s Contribution to Child’s Contribution to AttachmentAttachment
Proximity promoting 0-6 months
Snuggle, mold to body
Smile- very powerful
Cry if leave
Eye contact
“Being” a baby
Child’s Contribution to Child’s Contribution to AttachmentAttachment
Proximity seeking 6-12 months
Cling
Crawl toward
Reach to be picked up
Receive comfort when upset
What Parents Do to Promote What Parents Do to Promote a Secure Attachmenta Secure Attachment
Adaptations, e.g. child with colic
Behavioral adaptations, e.g. pick up child
Affective state, e.g. diaper change
The Concept of Affective The Concept of Affective Attunement, Mirroring, Attunement, Mirroring,
MatchingMatching Babies are more active and show more
proximity promoting behaviors when parents imitate rather than initiate
A dance, the baby leads
Affective Attunement Affective Attunement CommunicatesCommunicates
“Yes, I know what your experience was like, and by my response, I’m confirming your experience of it, and thus, I confirm you. This helps you to develop a sense of your self as separate from me and yet attached”
Steps in AttachmentSteps in Attachment
Indiscriminate 0-3 months
Preference for the familiar 3-6 months
Selective attachment 6-8 months
Multiple attachments, thereafter
EstimatedEstimated Time for Ability Time for Ability
To keep one as a psychological parent0-2 years - a few days2-3 years - weeks3-5 years - months5-12 years - years or more12+ years - a few years
Strange SituationStrange Situation
Reflect strategies to manage anxiety
Not a quality of the child or the parent, but a quality of the relationship
E.g. can look different with different parents
Strange SituationStrange SituationSecure AttachmentSecure Attachment
Past experiences of available, responsive caregiver, so infant believes caregiver will be available
Explores, checking back with caregiver Distressed when separated, less play On reunion seeks out caregiver, is comforted and
goes back to play May be comforted by stranger, but more so by
caregiver 65% of cases
Strange Situation – Insecure Strange Situation – Insecure AttachmentsAttachments
Avoidant- child suppresses the attachment, dismisses the parent, and explores without security concerns – 21% of cases
Ambivalent- child preoccupied with the attachment. Much less exploration even when the parent is present – 14% of cases
Strange SituationStrange Situation
Disorganized attachment- No coherent strategy for coping
Seen most often in children of abuse and neglect
ResilienceResilience
Secure attachment helps protect children, so that when adversity
comes they can cope!
AttachmentAttachment
All attachment behaviors reflect an attempt to modulate emotions, specifically anxiety
Attachment types or styles do not reflect specific personality traits, but styles of engaging in relationships
Most Children AttachMost Children Attach
Most children who are adopted out of orphanages attach to adopted parents
Most children who are abused attach to their abusive parents
Attachment disorders usually atypical, insecure, disorganized
Minimize distress shut off feelings/deny parents’ wrong-doing more likely to be aggressive and oppositional
Maximum focus on distress desperate not to lose caregiver increased risk for depression and anxiety
Insecure Attachment = Increased Risk forInsecure Attachment = Increased Risk for Behavioral/Emotional ProblemsBehavioral/Emotional Problems
Securely Attached Infants in Securely Attached Infants in the 6the 6thth Grade Grade
Cheerful Cooperative Popular Resilient Resourceful Confident Hopeful
Avoidant Attached Infants in Avoidant Attached Infants in 66thth Grade Grade
Emotionally insulated
Hostile
Antisocial
Unduly seeking attention
Ambivalent Attached Infants in Ambivalent Attached Infants in 6 6thth Grade Grade
Tense
Impulsive
Easily frustrated
Passive
Helpless
““Use it or Lose it”Use it or Lose it”
•The Brain is over wired and prepared for a The Brain is over wired and prepared for a lot of environmental contingencies!lot of environmental contingencies!
•Concept of Pruning - new synapses form as Concept of Pruning - new synapses form as the result of stimulation; however others the result of stimulation; however others weaken or remain the same. Weaker cells weaken or remain the same. Weaker cells die off and are lost forever. die off and are lost forever.
Neglect/Abuse Changes Neglect/Abuse Changes BrainsBrains
• CIVITAS Child Trauma Programs– Brains are 20-30 % smaller
• Romanian Orphans– Speech Delays– Hearing Problems– Gross and Fine Motor Problems– SOCIAL DEFICITS
Symptoms and Behaviors Symptoms and Behaviors Associated with Problematic Associated with Problematic
AttachmentAttachment Superficially engaging and charming Indiscriminately affectionate with strangers Lack of eye contact and affection on parent’s terms Inappropriately demanding and clingy Compulsive, often crazy, lying Poor impulse controls Learning and speech lags Lack of cause and effect thinking Abnormal eating patterns Poor peer relationships Nonsense questions and chatter Destructive to self, materials things, others Stealing Cruel to animals Preoccupation with fire, blood, gore, etc.
Multiple Transitions: A Young Multiple Transitions: A Young Child’s Point of view on Foster Child’s Point of view on Foster
Care and AdoptionCare and Adoption
Written and Produced
by Michael Trout,
Director of the Infant-Parent Institute, Champlaign, Ill
Problems with DiagnosingProblems with Diagnosing
Criteria focuses on individual behavior instead of attachment relationship
Comorbid and differential diagnoses Misses attachment disorders that develop in stable,
unhealthy relationships where there is not severe maltreatment
No description of how attachment behaviors change with development
Not clear how much of symptoms are actually trauma-related
A Continuum of InterventionsA Continuum of Interventions
Building Positive Relationships with Children and Families
Prevention Practices in Home Classroom Settings & Courts
Social/EmotionalLearning Strategies
Intense RX
Positive relationships form the foundation of the triangle
Level 1 PracticesLevel 1 Practices Relationships between practitioners and
parents play an important role in children’s development. – Time to know families– Welcoming parents to observe– Consulting parents about child’s abilities– Sharing information with parents– Valuing parent’s concerns– Conducting home visits
Level 2 PracticesLevel 2 Practices
–Clear rules and consistent consequences
–Help with transitions–Spaces to allow for interactions and
for quiet times–Giving good directions (how to
later)
Anxiety precipitates problematic behaviors; recognize anxiety, help prevent it
Recognize that anxiety triggers are different in traumatized children (e.g. unexpected schedule change, intruder alert)
Relationships are more important than learning Get help Persist
- Response to the perceived trauma can be fear, aggression, sexual acting out, splitting, avoidance, uncontrolled emotional reaction
- In the child’s past such behaviors were the only way they knew to cope with frightening events
- Understand that traumatized children likely to experience anything novel (including rules and protective interventions) as punishments
- Tend to regard teachers, foster care parents, and therapists who try to establish safety as perpetrators
- Don’t take it personally - Avoid passion
Level 3 PracticesLevel 3 Practices
Use good behavioral principles– Ignoring the ignorable–Reward the desired behavior– If you say it, mean it and follow
through– Intermittent re-enforcement is most
powerful
Find opportunities to develop intimacy, eye contact, asking about them in social terms
Expect regression Have long term goals Get your self esteem needs met in other ways Avoid punitive practices (expelling, denying
recess, arguing ) Promote feelings of belonging to the larger
culture
YOUR VALUE!YOUR VALUE! Regular caregivers (teachers, foster
parents, day care workers, therapists, etc.) are the “active ingredients” of any treatment.
The relationship is what allows a child to grow and thrive.
Without at least one such relationship, development is disrupted and the consequences can be severe.
A sensitive, caring relationship can foster remarkable recovery
We are guilty of many errors and many faultsWe are guilty of many errors and many faultsbut our worst crime is abandoning the childrenbut our worst crime is abandoning the children
neglecting the fountain of life.neglecting the fountain of life.Many of the things we needMany of the things we needcan wait. The child cannot.can wait. The child cannot.
Right now is the time his bones are being formed, Right now is the time his bones are being formed, his blood is being made, and his blood is being made, and
his his sensessenses are being developed. are being developed.To him we cannot answerTo him we cannot answer
‘‘Tomorrow.’Tomorrow.’His name is ‘His name is ‘TodayToday.’.’
Gabriela MistralGabriela MistralNobel Prize-winning poet from ChileNobel Prize-winning poet from Chile