ADHD, autism, adoption, foster care, parent/child relationship, school problems, social isolation, depression, anxiety, stress, child abuse

Children's Attachment Relationships

ADHD, autism, adoption, foster care, parent/child relationship,
school problems and social isolation

A number of childhood problems are particularly worrisome to parents. Lying, stealing, anger or aggression, refusal to follow family rules, withdrawal, and depression are just a few of them. In addition, parents may be troubled because they do not feel a sense of connection with their child even at a very early age, or they secretly find their child unusually frustrating or even unlikable. A common feature of parent-child relationships that underlies or runs parallel to many of these troublesome problems is an insecure attachment. Because children's early attachment relationships govern other relationships throughout life, early intervention is a key to reducing the long-term effects of attachment difficulties.

What Should I Know About Attachment Relationships?

Attachment is a biologically based strategy that provides emotional and physical protection for children. Even before birth, a foundation is laid for the bond between a mother and her infant. Attachment relationships begin developing at birth and are generally fully established by eighteen months of age. Infant behaviors such as crying when separated from the parent, seeking proximity to the parent, using the parent as a secure base, and joyfully greeting the parent after separation are attachment-based. Secure attachment results when parents respond sensitively to their children's cues and responses. Research has indicated that school-age children who are securely attached are more cooperative with their parents, more inclined to competently explore the environment, and more likely to get along with their peers.

Unfortunately, as many as 30% of children develop insecure attachment relationships with their parents. Insecure attachment may take the form of avoidant, distant behavior or anxious clinging behavior. When children have insecure attachments with their parents, any number of negative consequences can follow, such as depression, anxiety, a lowered ability to cope with stress, and poor relationships with others. A disruption in the development of secure attachment could occur due to parental illness, parental unavailability because of other life commitments, or the serious illness of the child. Children who move from foster home to foster home or spend the early years of their lives in orphanages can experience long-term attachment difficulties. In addition, children sometimes have inborn temperaments or disabilities that can impede the attachment process. Finally, children who are abused or neglected or otherwise traumatized will often show signs of impaired attachment.

When Should I Seek Help?

Therapy for attachment difficulties may be the primary treatment or may be used along with other therapy. The following are signs of distress that should not be ignored:

When your child-

Parents should also consider treatment for a child who is affected by autism and other pervasive developmental disorders such Asperger's Syndrome; for a child who experiences attentional difficulties like Attention-Deficit/Hyperactivity Disorder (ADHD); as well as for a foster or adoptive child who is having difficulty forming relationships. In all of these childhood problems, children have difficulties interacting with other people, and attachment therapies can effectively address and treat these problems.

What Is Therapy Like?

There are various models of therapy that are used for treating attachment problems. Parents should explore the treatment options available by consulting with a licensed marriage and family therapist. Because attachment has to do with family relationships, therapists with degrees and licenses in family therapy are an excellent choice.

Typical therapy for attachment problems will include both the parent(s) and child. Initially, parents meet with the therapist or, in some models, a team of two therapists, who will ask the parents to describe their experiences with the child during pregnancy, and from birth to the present. Parents will also discuss their current concerns regarding the child. Therapists may meet with the individual child for a period of time while the parents observe, meet with the parents alone, or with parents and the child together, but parents fully participate in attachment therapy from beginning to end. Attachment therapies often involve fun and rewarding activities that enhance the attachment bond while dealing with serious issues. In some cases, attachment therapies can reach their therapeutic goals within approximately twenty sessions.

Secure and insecure attachment relationships are present in every racial and ethnic group. However, how attachment relationships are expressed within these groups can vary greatly. A sensitive therapist will recognize that your child's attachment relationship may well be influenced by cultural differences and adapt their therapy accordingly.

Consumer Resources:


ATTACh (Association for the Treatment and Training in the Attachment of Children)
P.O. Box 9348
Newport Beach, CA 95658
(949) 760-9109

This national organization recognizes the critical importance of attachment to human development and is dedicated to promoting healthy attachment in parent-child relationships. They embrace a diverse spectrum of intervention models designed to build and/or strengthen attachments. They hold an annual conference each fall. They will provide information on contacting a therapist in your area. Parents should ask each of these contacts in which attachment therapy they have been trained.

The Attachment and Bonding Center of Ohio
12608 State Road
Cleveland, OH 44133
(440) 230-1960

The Attachment and Bonding Center of Ohio specializes in treating children who have experienced developmental interruptions. The staff also treats individuals and families who are experiencing a variety of problems in the areas of adoption, attachment, substance abuse, sexual abuse, and adolescent difficulties.

The Theraplay Institute
3330 Old Glenview Road
Wilmette, IL 60091
(847) 256-7334

This 33 year old not-for-profit organization provides Theraplay treatment at two offices in the Chicago area. Both parents and children are involved in the therapy and numerous childhood difficulties are treated. Staff at the institute train in the Theraplay model in Chicago several times a year as well as across the U.S. and in other countries. The institute manages a referral clearinghouse of therapists in the U.S. and other countries trained in Theraplay.

Books for Adults

Hughes, D. (1999). Building the bonds of attachment: Awakening the love of deeply troubled children. Northvale, NJ: Jason Aronson.

Jernberg, A., & Booth, P. (1999). Theraplay: Helping parents and children build better relationships through attachment-based play. 2nd edition. San Francisco: Jossey-Bass.

Keck, G., & Kupecky, R. (1995). Adopting the hurt child: Hope for families with special-needs kids. Colorado Springs, CO: Pinon Press.

Books to Read to Children

Brown, M.W. (1942). The runaway bunny.
Hazen, B.S. (1981). Even if I did something awful.
Melmed, L.K. (1993). I love you as much....
Pringle, L. (1996). Octopus hug.
Steig, W. (1998). Pete's a pizza.

Williams, V.B. (1990). More, more, more, said the baby.

The text for this brochure was written by Phyllis B. Booth, M.A. and Linda Wark, Ph.D.

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