Attachment Disorder Among Young Children in Foster Care

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Table of Contents

Introduction
Identification and description of problem
Application of two theories
References

Introduction

Attachment refers to a deep connection between a child and a primary caregiver that plays an important role in the optimal growth and development of the child with regard to expression of emotions and creation of relationships (Pearce, 2009). In the United States, many children live in foster care and as result experience numerous physical, emotional, and developmental challenges. Children in foster care experience attachment issues that result from separation from their parents. They find it difficult to form relationships and express their emotions appropriately.

Building relationships is an important skill that children need. Separation from caregivers deprives them of the ability to connect with other people and manage their emotions. The results of this deprivation are low self-esteem, lack of trust, isolation, and irritability (Adamec & Miller, 2007). One of the challenges faced by children in foster care is attachment disorder. This disorder is characterized by inability to create meaningful relationships and express one’s emotions properly. Ramification of attachment disorder include sub-optimal brain development, inability o form stable relationships, poor management of psychological stress, lack of proper sense of time, and poor expression of emotions (Pearce, 2009). The disorder can be explained and understood evolutionary and attachment theories.

Identification and description of problem

Attachment disorder

As mentioned earlier, attachment disorder refers to an individual’s inability to connect to other people and express emotions effectively. This disorder leads to deep feelings of insecurity, loneliness, low self-worth, and isolation. Research has shown that attachment disorders originate from inadequate or ineffective relationships between children and their parents. The success of the attachment process primarily relies on the quality of relationship between a child and the parent. Attachment disorders develop due to unfavourable experiences in the child-parent relationship. Feelings of abandonment, powerlessness, and isolation in childhood teach children that they cannot depend on their parents and as a result lose trust in other people and their ability to help them (Pearce, 2009). Attachment disruptions among children in foster care originate from disruptions in the attachment process between a child and caregiver.

Children in foster care lose their parents and the opportunity to from secure relationships with their parents. The transition to a foster home and the change in the primary caregiver affects the ability of children to form meaningful relationships (Adamec & Miller, 2007). One of the most common causes of disruptions in attachment relationships is reactive attachment disorder. This disorder is characterized by severe disturbances in relationships between a child and the caregiver. Many of the emotional and developmental challenges that children in foster care experience emanate from ineffective relationships with parents (Stone, 2001). Attachment disorder causes numerous developmental problems for children in foster care. For instance, the disorder affects their brain development, response to psychological stress, and expression of emotions.

Problem’s scope and severity

According to statistics, more than 400,000 children live in foster homes in the United States (Pearce, 2009). Majority of these children were victims of physical abuse, abandonment, and neglect that deprived them the opportunity to enjoy warm and nurturing relationships with their parents during their early years of development. The rate of placement in foster care for children under the age of five years is higher than the rate of placement for children above the age of 5 (Prior & Glaser, 2006). The age limit is disturbing because younger children spend more time in foster care than older children and therefore experience more problems. They live in different places including pre-adoptive homes, group homes, foster-family homes, institutions, and runaway shelters. According to the Child Welfare League of America, many children leave foster care because they do not get the help they need for optimal growth and development (Orlans & Levy, 2014).

Reasons for leaving foster care include emancipation, adoption, guardianship, reunification with parents, and transfer to another agency. One of the major challenges that children in foster care face is transfer of caregivers. According to statistics released in 2014, 21% of children in foster care were adopted, 51% were reunified with their primary caregivers, 2% were transferred to other agencies, 7% were released to live with relatives, and 9% were placed under guardianship (Orlans & Levy, 2014). This change of caregivers is detrimental to the proper development of children. Research has shown that when children move between childcare settings they experience difficulties with adjusting socially to new environments. The main challenge of changing caregivers is the child’s inability to form new relationships due to instability and disruptions. This problem is worsened by challenges such as high rates of unemployment that necessitate transfer of children (Stone, 2001). Changes in childcare settings have both social and emotional consequences on the wellbeing of foster children.

It is very important for children to experience nurturing and stable environments during the early years of life because that is the time when they learn to form relationships with primary caregivers. Experiences such as neglect, abuse, and abandonment are critical in the development of a child’s brain and the ability to live effectively with other people (Orlans & Levy, 2014). Research has established that children in foster care experience high rates of physical, developmental, psychological, and mental health problems than children who live with their parents. In addition, they have several medical, emotional, psychological, and mental health care needs that are unmet (Prior & Glaser, 2006). Children are placed under foster care to protect them from physical harm that results from abuse, neglect, and abandonment. However, the age at which many of them are enrolled is critical because it is characterized by high rates of brain growth and development.

Many caregivers understand the emotional, physical, and developmental needs of children in foster care. However, they lack the necessary training and support needed for them to meet those needs (Stone, 2001). Attachment disorder is a major problem because it is caused by a wide variety of problems that are increasing at an alarming rate in contemporary society. For instance, physical violence, drug abuse, crime, and teenage pregnancy are some of the reasons why parents abandon or neglect their children (Orlans & Levy, 2014). The problem will continue to intensify unless these challenges are addressed effectively.

The scope of attachment disorder ranges from mild problems that are easy to identify and address to serious challenges that are difficult to manage (Prior & Glaser, 2006). Several remedies are available for the treatment of attachment disorder. However, its treatment is more effective if it is identified during its early stages when symptoms first appear. Examples of signs and symptoms that help caregivers and medical practitioners to identify attachment problems in children include avoidance of eye contact, incessant crying, loss of interest in many fun activities, isolation, and rejection of attempts by caregivers to connect (Orlans & Levy, 2014).

Attachment disorder is characterized by irritability, aversion to physical contact, control issues, and an underdeveloped conscience (Orlans & Levy, 2014). Children with reactive attachment disorder perceive physical touch as a threat mainly due to negative experiences of physical abuse. They also exhibit control issues. They try to remain in control of their lives by avoiding feelings of helplessness and powerlessness due to prolonged periods of neglect and abandonment (Prior & Glaser, 2006). They often disagree with authoritative figures, defy orders, and argue over many issues. They find it difficult to express their anger appropriately hence their high degree of irritability. They express their anger through tantrums, screaming, and aggressive behaviors. Inability to form relationships with other people makes it difficult for them to show genuine care and affection.

Ramifications of attachment disorder in early childhood

Attachment disorder has several ramifications for development during the early years of childhood. It affects the optimal development and growth of the brain, formation of secure and stable relationships, expression of emotions, sense of time, and response to psychological stress.

Brain development

As mentioned earlier, many children enter foster care before they attain the age of five years, which is a critical stage in the growth and development of the brain. The first 4 years of a child’s life are characterized by rapid growth of anatomic structures that control learning, adjustment to stress, and personality development (Prior & Glaser, 2006). These structures atrophy if they remain unused for prolonged periods. The negative experiences that children encounter during these years determine the nerve connections and networks formed in their brains. Child abuse, lack of emotional stimulation, violence, neglect, and abandonment result in formation of nerve connections that adversely affect development and growth (Stone, 2001). Research studies have shown that emotional and cognitive disruptions possess the potential to impair brain development in children.

Therefore, negative experiences put children at risk of impaired brain development. Children need stability and continuity with regard to the primary caregivers they interact with (Adamec & Miller, 2007). Optimal development of cognitive and language skills is enhanced by stable and continued interactions in various psychological, physical, and social settings (Prior & Glaser, 2006). On the other hand, they encourage formation of socialization skills that are important in childe development. Children in foster care face emotional and developmental challenges that affect the optimal growth of their brains during critical stages in their early lives.

Attachment and formation of relationships

Children need to have stable, nurturing, protective, and secure relationships with parents in order to foster their psychological and emotional growth (Stone, 2001). Attachment is a process that is developed through the relationships that children form with their parents. Children use attachment to develop emotional security and conscience that are critical in formation of long-lasting relationships with other people (Adamec & Miller, 2007). Attachment disorder denies children an opportunity to develop and enjoy respectful, nurturing, and secure relationships with their caregivers. Optimal child development results from formation of stable relationships between a child and an adult who is perceived as the source of physical, emotional, and psychological nourishment (Prior & Glaser, 2006). Attachment is important because it leads to development of trust, self-esteem, and a sense of worth in children. Children who have been subjected to neglect and abuse find it difficult to form lasting relationships with anyone because their psychological and emotional development was compromised during their early years. It is important for a child to experience the love and care of a parent during the first 3-4 years of life because that is a very critical stage in a child’s development (Prior & Glaser, 2006).

Sense of time

A child’s perception of time and self are greatly affected by the effects of attachment disorder in their life. Children who experience constant change of foster care settings find it difficult to differentiate between temporary and permanent life situations. Frequent transfers intensify the adverse effects of poor parenting and psychological stress on development. A child’s inability to cope with different situations and circumstances originate from poor emotional and psychological growth during infancy (Prior & Glaser, 2006). Lack of stable and nurturing relationships with parents during early infancy deny children in foster care an opportunity to establish a positive sense of self because of limited life experiences. Many children in foster care do not have a proper sense of time because of numerous experiences of periods of uncertainty and separation from primary caregivers that caused great psychological stress.

Response to psychological stress

The brain plays a critical role in the body’s response to stress. Negative experiences during a child’s early years of development fix the brain in an acute stress response state that affects a child’s response mechanism (Prior & Glaser, 2006). Many children in foster care respond to experiences in an aggressive and fearful manner due to certain chemical and electrical imbalances in their brains. The age of a child is critical to the developmental response that they exhibit towards stressful situations. Toddlers respond to chronic stress by withdrawing, declining food, and avoiding certain activities (Stone, 2001). Areas of the brain that respond to stress are also involved in control of motor behavior and other functions. Children with attachment disorder regularly experience anxiety, mood swings, impulsiveness, and motor hyperactivity as behavioral responses to stress.

Current attempts at intervention

Current interventions for attachment disorder among children in foster care include therapy, parenting education, and counseling. These interventions are usually combined in order to give more effective results than using them individually. They aim to foster positive child-caregiver connections, create safe living environments, and enhance relationships with other people (Prior & Glaser, 2006). The use of medication is only recommended if other disorders such as anxiety and depression are present. Family therapy, individual psychological counseling, and play therapy are common forms of therapy used to treat attachment disorder. Interventions such as allowing children to live with their others despite the living conditions have failed. For example, allowing children to live with their incarcerated others have been ineffective.

Application of two theories

Attachment theory

Two theories that can be used to understand attachment disorder include attachment theory and evolutionary theory. Attachment theory describes the formation of relationships between people and how individuals respond when these relationships fail (Prior & Glaser, 2006). According to the theory, attachment primarily depends on an individual’s ability to develop trust in the ability of their caregiver to meet their needs. In toddlers, attachment is a behavioral system that makes children seek close relationships with adults with the expectation that they will receive nurturing, secure, and emotional support from them (Stone, 2001). The most important principle of attachment theory is that a child needs to a close relationship with a primary caregiver for optimal social and emotional development (Stone, 2001). Attachment teaches children how to regulate and express their emotions effectively. Infants are usually attached to the person who meets most of their physical, emotional, and social needs. A sensitive and responsive caregiver is necessary in the early life of a toddler because of the need for security and stability. Attachment between toddlers and caregivers develop despite the quality of interactions.

Therefore, the responsiveness, sensitivity, and stability of caregivers are critical to the optimal development of infants. Children cannot differentiate between positive and negative influences and how they affect their development, so the pattern of attachment that a child develops or adopts depends on their experiences within certain environments (Prior & Glaser, 2006). Attachment can be secure, anxious, disorganized, or avoidant. Secure attachment develops from positive interactions between an infant and caregiver. A child feels that the caregiver can protect them and meet all the emotional and physical needs. Anxious attachment occurs when a child experiences abandonment or neglect while avoidant attachment occurs when children avoid their primary caregivers may be due to experiences of abandonment for prolonged periods (Stone, 2001).

Evolutionary theory

Evolutionary theory argues that when children are born, they are biologically pre-programmed to form attachments in order to enhance their survival (Stone, 2001). This pre-programming is characterized by behaviors such as crying and smiling that are important in formation of attachment with others. The major factors that determine attachment between an infant and a parent is the level of care and responsiveness toward the needs of the child (Stone, 2001). According to the theory, children develop attachment to primary caregivers because of the need for survival. He maintained that infants initially form a single primary attachment that serves as a source of care, support, and security (Stone, 2001). The relationship formed with the primary caregiver became a source of support for exploring and understanding the world. The infant uses the relationship to learn how to create relationships with other people. The evolutionary theory also postulates that the period between 0-5 years is a critical period for the development of attachment. Failure to develop attachment before the age of 5 years leads to developmental problems that affect a child’s ability to form relationships and interact with other people.

Attachment disorder in terms of two theories

Attachment disorder can be explained in terms of the aforementioned theories. Attachment theory helps in understanding the development and perpetuation of attachment disorder as well as its impact and ramifications. The theory explains the importance of attachment in terms of social, emotional, and cognitive development in infants. When children fail to receive emotional and psychological support from their parents, they develop problems with their ability to form relationships and interact with other people (Stone, 2001). These problems culminate into what is known as attachment disorder. Out-of-home placement for children has adverse effects on attachment relationships with primary caregivers. Loss of attachment relationship and lack of permanence weaken a child’s efforts to create a stable, nurturing, and secure relationship with a primary caregiver. Disruptions in attachment relationships result in the development of attachment disorder that affects a child’s ability to form relationships (Stone, 2001). The disorder can develop either in infancy or early childhood.

This theory also helps to explain certain behaviors that are observed in children in foster care. For instance, it can be sued to explain why a child is solitary, aggressive, rude, or uncaring. According to the theory, these behaviors result from lack of attachment relationships in early years of development. Infants take risks, grow, develop personalities, and understand the world depending on the quality of the attachment relationships they had with their parents or primary caregivers (Stone, 2001). Such behaviors are exhibited by children who lacked stability and security in their infancy hence the unwillingness to seek out new experiences and learn from them. Isolation often results from fear and lack of trust in other people. For instance, if a child was neglected, it is difficult for them to trust that other people will care for them and meet their needs. Children who lack strong attachment to caregivers spend most of their time and energy trying to understand and meet their needs (Stone, 2001). In contrast, children who have stable and nurturing attachment relationships have their emotional and physical needs met. Therefore, they spend their time and energy exploring the world and learning from new experiences.

Evolutionary theory helps to understand the development of attachment disorder and its impact. The theory postulates that children are born with pre-programmed brains that seek attachment relationships in order to survive. Therefore, attachment is primarily a genetic feature that conforms to human nature. According to Bowlby, attachment is based on adaptive and psychobiological mechanisms that are aimed at enhancing a Childs survival. Attachment disorder renders children in foster care unable to form lasting relationships with other people and express their emotions effectively. These inadequacies result from lack of fulfillment of natural instincts and requirements that are ingrained in a child’s genetic makeup. Attachment helps children to survive. This explains why infants cry and smile without any external conditioning or learning. Smiling and crying are survival mechanisms that are pre-programmed in children to initiate caregiving responses from adults for the fulfillment of physical and emotional needs (Adamec & Miller, 2007).

Lack of attachment denies children the opportunity to learn through nurturing relationships. The theory also helps to explain why many children in foster care develop attachment disorder. The theory suggests that attachment development is most critical during the ages of 0-5 years. Therefore, developmental challenges emerge if a child fails to develop an attachment relationship. Lower intelligence, irritability, isolation, and aggression are examples of behaviors that arise from developmental challenges (Adamec & Miller, 2007). The theory also suggests that infants have an internal working model. Infants who have a sensitive and responsive mother develop a positive sense of worth. In contrast, children who have insensitive and unresponsive caregivers will develop a negative sense of worth. They will feel useless and undeserving of anyone’s love and attention. Finally, the critical period tenet of evolutionary theory explains why many children in foster care suffer from attachment disorder (Adamec & Miller, 2007).

The theory posits that if an attachment between a caregiver and a child is not made before the age of 5, then it will be impossible to develop an attachment with other people. A large portion of children in foster care are below the age of 5 years. This implies that they did not get an opportunity to bond and form attachment relationships with their mothers. In addition, transfers from one foster home to another makes it difficult for them to form strong relationships due to lack of stability and permanence.

Design of intervention

An intervention that will address attachment disorder among children in foster care is filial play therapy. Play therapy is a psychological and behavioral intervention that involves the participation of a child, a caregiver, and a psychotherapist. The main objective of this intervention is to help children express their emotional needs, anxieties, and fears through play. This is possible because children are usually uninhibited while playing and can therefore express themselves freely. In the context of play, caregivers may identify the issues faced by the children such as anger, irritability, and inability to relate to others. On the other hand, children may use play to express certain emotions such as dependency, anger, irritability, and the need to be loved. Play therapy would require the inclusion of certain aspects of positive relationships such as security, stability, and sensitivity. These aspects are aimed at influencing the psychology of the child and inculcating new attitudes and perspectives that stimulate trust and dependency on the caregiver.

Age is a critical factor in the effective treatment of attachment disorder. The critical stage for development of attachment relationships is between 0-5 years. This intervention targets children between the ages of 0-5 years. The specific implementation strategy involves giving children freedom to play with their caregivers, explore ideas, and express their emotions. Interactions with the psychotherapist are aimed at stimulating growth and change in the child. The intervention is child-centered and the caregiver guides the child on the proper use of skills such as empathy and unconditional regard in order to stimulate self actualization. Another role of the psychotherapist is to train the caregiver in order to enhance child-centered play with the child. In addition, the therapist provides feedback and offers advice on how to improve the skills of the child. Filial play therapy develops strong bonds and emotional attachment between children and caregivers.

The rationale for the intervention is to help caregivers practice sensitivity, stability, and security while playing with their children in order to create trust and gradually create dependence. Sense of security helps the child develop a new attachment relationship through release of anxiety and psychological stress. The psychotherapist’s role is to help the caregiver listen and respond to the child without any judgment. The caregiver is required to engage the child in play over a long period of time in order to create a sense of stability and permanence. Children take time to trust and embrace a new care giver. The objective of creating stability and permanence is to instill in the child the idea that their needs can be met by the same person because. The caregiver has to be always present in order to prove to the child that they will always be available to care for them and meet all their needs. Caregivers should also be sensitive to the emotional needs of the children. The psychotherapist guides the caregivers on how to practice sensitivity and respond to children’s emotional needs. For instance, the psychotherapist guides caregivers on what to do when a child cries or reacts aggressively towards another child. Inculcation of sensitivity, security, and stability during play develops feelings of dependency toward the caregiver because the child learns that the caregiver will be always there to address their physical and emotional needs.

References

Adamec, C. A., & Miller, L. C. (2007). The Encyclopedia of Adoption. New York, NY: Infobase Publishing.

Orlans, M., & Levy, T. M. (2014). Attachment, Trauma, and Healing: Understanding and Treating Attachment Disorder in children, Families, and Adults. New York, NY: Jessica Kingsley Publishers.

Pearce, Colby. (2009). A Short Introduction to Attachment and Attachment Disorder. New York, NY: Jessica Kingsley Publishers.

Prior, V., & Glaser, D. (2006). Understanding Attachment and Attachment Disorder: Theory, Evidence and Practice. New York, NY: Jessica Kingsley publishers.

Stone, S. M. (2001). More than Love: Adopting and Surviving Attachment Disorder Children. New York, NY: iUniverse.

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