Attachment Disorders in Infancy and Childhood

Attachment Disorders in Infancy and Childhood

The Reactive Attachment Disorder normally is observed before a child’s fifth birthday. The inhibited type refers to children who do not respond to, or initiate, social interactions in ways appropriate to their age. These children may be very inhibited around others, show anxiety, be overly vigilant, seem “frozen” in social situations, and not accept comfort from others. The disinhibited type is hyper-social and will seek contact and interaction with many people. They are not selective in their attachments and their search for those to be close with is inappropriately uninhibited. These behavior patterns are not caused solely by other developmental disorders like retardation or autistic spectrum disorders.

Suspected Causes:

This disorder is associated with extremely abnormal child care practices. Children raised with a “persistent” failure to meet their basic emotional needs  (stimulation, affection, and comfort) or physical needs are at increased risk. Infants and young children who experience frequent changes in those who are their primary caretakers are also at increased risk for these emotional disturbances. Children with this disorder are more likely to have had extended hospital stays, be raised in extreme poverty, or raised by very inexperienced ( or negligent) care-takers. There is sometimes evidence of failure to thrive (growth delays) and physical abuse.

Although prevalence estimates are uncertain, Attachment Disorder is reported to be uncommon. This reported low prevalence may be true using the formal definition given, but I have some major concerns with this estimate.

I am convinced that very similar attachment problems among our infants and children are, sadly, quit common. In my own practice, over the past several decades, I have increasingly seen children who have had chronic medical problems with many hospitalizations or inconsistent, negligent, or abusive care who show problems similar to those identified as Reactive Attachment Disorder. 

I have also increasingly seen other attachment-related problems in children who have had mothers who go to work and leave them with day care centers, or with multiple other care-takers, during infancy or early childhood.

Many of these children desperately seek attention from their mother’s and others and they often develop extreme behavior problems in order to gain attention; even if it is angry and punitive attention from parents, relatives, and others. These children frequently behave in dramatically disruptive ways in preschools or grade schools until their mothers are forced to leave work and go to the school to “settle them down”.

In some instances, the mothers have had to take them home with them. When a child is successful in gaining parental contact in this way, it rewards their damaging behavioral antics and teaches them to behave similarly more often in the future.

One of the causes of this sort of emotional/behavior problem is disrupted  emotional attachment-needs which naturally leads to the children’s  desperate quest for contact with their mothers, or others.

I believe this problem is far more common than is currently recognized and it is a problem of tragic proportions that afflicts all of our social classes for different reasons (poverty, working to survive, or working to “keep up” with friends and neighbors, or personal enrichment/fulfillment, etc).

I am also convinced that  early attachment problems with infants and children increase the frequency of many other child, adolescent and adult disorders that are yet to be discussed.

V. Thomas Mawhinney, Ph.D., Health Services Provider in Psychology, 10/29/09


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