When infants have a safe, nurturing and protective environment, they learn to develop basic trust and reciprocity in relationships—creating the basic foundation for all future relationships. This foundation helps them to develop self-control, to be able to regulate their emotions, to develop empathy in relationships, to develop appreciation and gratitude, to develop a healthy self-identity and self-esteem, and to have improved resiliency in coping with life stressors.

When infants fail to have this protective environment, such as those that have experienced prenatal drug or alcohol exposure, have been abused or neglected, or have been exposed to chaos or violence in their environment, they fail to develop this basic foundation and are at risk of serious problems in their development. Children are particularly vulnerable from infancy up to 3 years.

Oftentimes these children end up being removed from the care of their primary caretakers and placed with alternate relatives, in a foster home or in an adoptive home. These new caretakers often have the view that if they provide this child with a loving and supportive environment, that they will develop healthy relationships. Due to the damage of their early trauma, however, these children are unable to respond effectively to this new environment and these new relationships. They tend to sabotage these relationships, attempt to control their environment (as opposed to allowing their caretakers to take care of them), and lack reciprocity and appreciation in these relationships. This often leaves the caretakers feeling confused, angry, resentful, overwhelmed and to view themselves as failures. They may seek out help from others, only to be given advice or guidance that does not address the underlying issues, but only tends to exacerbate the problems in that the caretakers begin to feel more hopeless over time when these interventions are not helpful.

Children who have experienced significant trauma and attachment difficulties need treatment (as do their caretakers) that is focused on addressing these underlying issues and is focused on the parent-child relationship.

What do I need to know?

As caretakers of children with attachment issues, it’s important to advocate for these children’s needs. These children can present very differently in different settings, and thus it can be difficult to get an accurate picture of their problems. As the caretaker, you have the most insight into the dynamics they are displaying within the family structure and related to the parent-child relationship. Often these children target the mother figure in their life. They often have underlying anger and rage towards the mother figure due to their past issues, and may even be quick to perceive their present mother as abusive or neglectful based on distorted perceptions they have from their past. This may often lead the mother or others to wonder what the mother is doing wrong, as opposed to recognizing the underlying issues that create this dynamic.

In order to be able to advocate for your child, you must be able to recognize and describe these dynamics to the professionals in order to get an accurate diagnosis and adequate treatment. Educating yourself on these issues will enable you to more accurately describe issues, ask the appropriate questions, and know what’s needed from the professionals involved in your child’s life.

It’s not uncommon for these attachment issues to go unrecognized and untreated for years, which only complicates matters further. These children may end up being diagnosed with a Mood Disorder, Attention-Deficit Hyperactivity Disorder or Oppositional Defiant Disorder. Treatment then might focus more on medication management and behavioral interventions. Parents might be given information on parenting skills to address behavioral difficulties. These tend to fail, as the underlying issue does not relate to the child’s behaviors, but to the child’s relationships. “Normal” parenting skills and “normal” therapies do NOT address these issues.

A more adequate diagnosis for a child with significant attachment issues would be Reactive Attachment Disorder. Parenting and treatment for these children need to focus on relationships, particularly the parent-child relationship, and on resolving past trauma. Treatment then would focus on the parent-child relationship, as opposed to doing a lot of individual work with the child or focusing on behavior modification techniques.

Symptoms of a Disrupted Attachment:

  • Low self-esteem, negative self-image
  • Needy, clingy or pseudo-independence
  • Lack of self-control, very impulsive
  • Lack of cause-and-effect thinking
  • Difficulties in developing and maintaining peer relationships
  • Resistance to being parented (oppositional, controlling and manipulative behaviors)
  • Lack of empathy, compassion and reciprocity in relationships
  • Superficially engaging and charming
  • Difficulties with trust, intimacy and affection
  • Aggressive and destructive behaviors

How can I get help?

Find out if the professionals have training and experience in working with children with trauma and attachment issues. What kind of experience? What do they focus on in treatment? How do they involve you as the parent in treatment? Find out what kind of supervision and consultation is available to them in working with your child. And find out what kind of support and education will be provided for you as the parent.

The more quickly a child’s needs can be recognized and treated properly, even as an infant, the better the prognosis will be. Issues can even be addressed preventatively to help a child with early trauma and attachment begin to bond and attach with their new caretakers.

Resources

If you or someone you know needs help, Youth Home has an outpatient clinic for individuals of all ages located at 10 Corporate Hill Drive in Little Rock. You can reach the outpatient clinic at 954-7470 or for more information about programs for youth ages 12-17, you can call the admissions department at 821-5500. For more information on disrupted attachment or Reactive Attachment Disorder, these websites are also helpful:

Brenda Scheffler, LCSW, is the lead therapist for the Reactive Attachment Disorder Program at Youth Home, Inc, a residential treatment program for adolescents. She has over 25 years of experience in the mental health field, as well as having raised and adopted a child with Reactive Attachment Disorder.