When babies are born they rely on parents or caregivers to protect them, care for them and look after both their emotional and physical needs. Having these needs met allows them to form a bond with their parents, or 'attach'. Forming this attachment helps children learn to love and trust others, to regulate emotions, become aware of others' feelings and develop healthy bonds in the future.
If for some reason this bond isn't formed, children can develop attachment issues - including attachment disorder. It may be that the child felt abandoned, isolated or uncared for during their early years. The reasons behind such experiences can be complex, but for a young child all they understand is that they cannot depend on others.
Sadly this lack of attachment can lead to future behavioural issues and may affect relationships and social bonds. On this page we will look into the complicated nature of attachment disorder, including symptoms, treatment and how to care for a child with attachment disorder.
On this page
- What is attachment disorder?
- Attachment disorder symptoms
- Reactive attachment disorder
- What can attachment disorder lead to?
What is attachment disorder?
The term attachment disorder can relate to specific disorders of mood or behaviour, and the inability to form social relationships due to a failure to form attachments at a young age. Typically, attachment disorder affects young children, but if left untreated it can apply to school-age children and even adults. At its worst, attachment issues can develop into reactive attachment disorder, a condition that is likely to require professional help.
It is generally believed that attachment disorder and reactive attachment disorder is uncommon. The true number of children affected is unknown however, as many affected families don't seek help.
What causes attachment disorder?
Attachment issues come about when a child fails to form an attachment to its parent or caregiver in its early years. The reasons behind this vary, but may include the following:
- no one responds or offers comfort when the baby cries
- the baby isn't tended to when it's hungry or needs changing
- the baby is abused or mistreated
- the baby is hospitalised or separated from its parents
- the baby is repeatedly moved from one caregiver to another
- the baby receives no attention, so feels alone
- the baby's parent/s are emotionally unavailable due to illness, mental health problems or substance abuse.
Some circumstances are unavoidable, but as the child is too young to understand what has happened they simply feel alone and as if the world is an unsafe place to be.
If the attachment disorder is left untreated, it can have a negative impact on the child's emotional, social and behavioural development. A child with attachment disorder may therefore be at higher risk for a number of emotional and mental health problems in later life.
Attachment disorder symptoms
Attachment issues fall on a spectrum, from mild problems that can be easily addressed to the more serious condition, known as reactive attachment disorder. This means that symptoms can vary in severity from person to person and may resemble other disorders such as autism or ADHD.
The following list shows examples of attachment disorder symptoms in young children:
- cries inconsolably
- doesn't smile
- doesn't reach out to be picked up
- avoids eye contact
- self-comforts by rocking
- doesn't make cooing sounds
- doesn't follow people with his or her eyes
- doesn't notice when they are left alone.
While it is never too late to treat attachment disorder, the earlier symptoms are recognised and attended to - the better chance the child has of recovery. If you think your child is suffering from the above symptoms it is important to seek help from a medical professional.
Diagnosis of attachment disorder will be based on the signs and symptoms that are presented. Your doctor is likely to perform some medical tests to ensure there is no underlying physical cause before referring your child to a mental health professional.
Reactive attachment disorder
Considered one of the more serious attachment issues, reactive attachment disorder often occurs when a child has been neglected or abused. There are two types of reactive attachment disorder - inhibited and disinhibited.
Children with inhibited symptoms will be extremely withdrawn and emotionally detached. They may push people away, be resistant to any form of comforting and are often hyper-vigilant of their surroundings (although they are unlikely to react to what is going on around them).
Children with disinhibited symptoms on the other hand are likely to seek comfort from anyone, not preferring his or her parents to strangers. They are often extremely dependent and may act younger than they really are.
Signs and symptoms of reactive attachment disorder are similar to those of other attachment disorders and may include:
- an aversion to physical contact
- issues surrounding control
- problems with anger
- difficulty showing affection
- an underdeveloped conscience.
If attachment issues are recognised early enough and receive appropriate treatment, reactive attachment disorder can potentially be avoided.
What can attachment disorder lead to?
Left untreated, attachment disorder can evolve and cause other mental health problems, including the following:
Children with attachment issues learn from a young age that they cannot trust other people and must rely on themselves. When they grow older this can lead to behavioural problems. For example, in school the child may not trust or respect their teacher, leading to negative behaviour.
Having a sense of isolation and abandonment as a child can link to depression later in life. The sufferer may also feel anxious about social situations, or feel anxious when they are left alone.
Forming a loving attachment to our parents is one of the key ways in which we learn as a child. If a child does not form a bond during childhood, they may experience learning difficulties as they grow older.
Being left alone as a child can result in feelings of worthlessness. As the child grows older this can lead to a low sense of self-esteem and low self-confidence. Such feelings can greatly affect the child's social life and mental well-being in the future.
The relationships we form with our parents often teach us how to form relationships in the future. If this relationship or attachment isn't formed as a child, this can cause confusion in later life. Those with attachment disorder may find it difficult to trust other people, making it hard to maintain relationships - both romantic ones and platonic friendships.
If a child has had to self-comfort as an infant, this pattern may continue in more unhealthy ways in adulthood. They may turn to alcohol and/or drugs to 'soothe' themselves. Alternatively, the child may learn such habits from parents with substance abuse problems.
Failure to form attachments in childhood can cause social difficulties in the future. The child may find it hard to understand others, or they may be wary of other people's attempts to socialise. Some children may experience social anxiety and find it difficult to speak to others.
Treatment for attachment disorder
Treatment for attachment disorders tends to have two aims. The first is to ensure that the affected child is in a safe environment - a key factor when dealing with cases of abuse and neglect. The second aim is to help the child form a healthy bond with an appropriate caregiver and deal with any residual problems.
Treatment will vary depending on the individual's circumstances, but typically a combination of psychological therapy and parenting education is used. The following methods are examples of what may be recommended:
It is quite usual for therapies to include both the child and the parents when dealing with attachment disorder. Family therapy does not only help the child to bond with their parents, it also teaches the parents/caregivers how they can help with the child's recovery. Family therapy can also help to encourage positive interaction through activities and games.
For children, play therapy can be an important way to hold attention and make learning more fun. Play therapy can also be an important way of teaching social skills.
Sometimes the therapist may want to spend time with the child alone, or with parents observing. This can help the therapist monitor emotions and behaviour more accurately.
Parenting skills classes
A key element to the child's recovery lies within the education of the parents or caregivers. Parenting classes can help parents learn more about attachment disorders as well as any other necessary parenting skills.
Special education services
Some special education services are able to offer a programme to help the child learn the skills required for both academic and social success while addressing any emotional and behavioural difficulties.
While there is no medication for attachment disorder, your doctor may recommend certain medications to help with related symptoms. It is important to discuss all of these options with a medical professional.
Tips for those parenting a child with attachment disorder
Parenting a child with attachment issues can be frustrating and emotionally trying. Rebuilding this bond often takes a considerable amount of time, effort and patience. It can be especially hard if you have adopted a child with attachment issues. Whatever the situation may be however - there are ways you can help.
Talking through any treatment plan with a qualified professional is advised, however the following tips may offer some help for those parenting a child with attachment issues:
Be realistic with your expectations
Helping your child with an attachment disorder can be a long and trying process. Ensure you are focussing on every step forward you take (no matter how small) and celebrate any signs of success.
Patience is key
Remaining patient when setbacks occur is essential. Keeping calm despite any bumps in the road will help to create an atmosphere of safety and security for your child - and it is this sense of safety that children with attachment disorder crave the most.
Take care of yourself
Children suffering from attachment disorder are already experiencing high levels of stress, so it is imperative that you keep stress to a minimum. It is important therefore to manage your own stress levels before attempting to help them with theirs. Make time for yourself to ensure you get enough rest, eat well and reduce sources of stress.
Lean on others for support
As well as professional help, be sure to look to friends and family for support when times get tough. Try not to let things get to breaking point and consider joining a support group if you are struggling to cope.
Children are brilliant at picking up on other people's feelings, and if they sense you are feeling discouraged, they are likely to feel discouraged themselves. Try to stay hopeful and optimistic, and turn to others for reassurance when you're feeling low.
Set limits and boundaries
Children with attachment disorder need consistent, loving boundaries to make the world more predictable and less scary. Setting limits helps them to understand what is expected from them, while having consequences for their actions will instill a sense of control.
Be available immediately after conflict
Conflict is likely to happen in any parenting situation. Remaining calm during this conflict and being readily available to reconnect after it happens reinforces your consistency and love towards your child. This will help your child trust you and teaches them that you will be there for them no matter what.
Own up to mistakes
If you do let your emotions get the better of you during an argument, be quick to own up to your mistakes and look to reconcile quickly. Your willingness to make amends will help to strengthen the attachment bond.
Keep a routine
Consistent and familiar routines offer a sense of comfort to those with attachment disorder. Explain why any changes to routine take place and look to keep other elements in their life as consistent as possible.
Help your child feel loved
Listen, talk and play with your child. Ensure you are dedicating time to your relationship and if possible, show your child love through cuddling, rocking and holding - things your child may have missed out on in early life.
Support your child's health
Healthy lifestyle habits such as a good sleep routine and nutritious diet can make a big difference when it comes to children's moods. If you need help with this, be sure to speak to your doctor for advice.
What should I be looking for in a counsellor or psychotherapist?
Whilst there are currently no official rules or regulations in place that stipulate what level of training a counsellor needs when dealing with attachment disorder, it is recommended that you check to see if your therapist is experienced in this area.
While some aspects of counselling remain the same regardless of age, there are certain issues and developmental intricacies that often require an alternative approach when it comes to counselling children.
A Diploma level qualification (or equivalent) in child/youth counselling or a related topic will provide assurance and peace of mind that your counsellor has developed the necessary skills.
Another way to assure they have undergone this type of specialist training is to check if they belong to a relevant professional organisation representing child/youth counsellors or those dealing with attachment disorder.
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