| Attachment Theory by John Bowlby and Mary Ainsworth |
| Attachment is the deep and enduring connection established between a child and caregiver in the first several years of life. It profoundly influences every component of the human condition - mind, body, emotions, relationships and values. Attachment is not something that parents do to their children; rather, it is something that children and parents create together, in an ongoing reciprocal relationship. Attachment to a protective and loving caregiver who provides guidance and support is a basic human need, rooted in millions of years of evolution. There is an instinct to attach: babies instinctively reach out for the safety and security of the "secure base" with caregivers; parents instinctively protect and nurture their offspring. Attachment is a physiological, emotional, cognitive and social phenomenon. Instinctual attachment behaviors in the baby are activated by cues or signals from the caregiver. Thus, the attachment process is defined as the baby and the caregiver influencing one another over time. (http://www.attachmentexperts.com) |
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| SECURE attachment: (Approximately 65% of babies assessed showed this type of attachment). The baby prefers the parent as a safe base for exploring the room. Baby prefers parent over stranger. Baby may show distress when separated from parent. Baby seeks proximity and contact with parent on reunion. |
| INSECURE-AVOIDANT attachment: (approximately 20% of assessed babies showed this type of attachment). This kind of attachment is unhealthy and associated with tense or irritable parenting; shows little interest in child, handling in a mechanical fashion, failing to adjust feedings to the baby's pace, less responsive to their cries and calls, resentful, negative. Baby in assessment does not show preference for parent over stranger. Avoids contact with parent by looking away or turning away. This baby doesn't usually cry on separation with parent; little or no proximity seeking when parent returns. Baby seems unemotional; focuses on toys or environment throughout procedure. |
| INSECURE-RESISTANT attachment: (approximately 15% of assessed babies). Description of parenting similar to insecure-avoidant; parent may also be intrusive, overstimulating, or hostile. Baby shows ambivalent approach-resist behaviour; seeks proximity with parent, but then resists contact; baby does not avoid parent; shows anger or overly passive; little or no exploration with toys. |
| INSECURE- DISORGANIZED/ DISORIENTED attachment: (a very small percentage of babies). This type of attachment was added later for babies who were unable to easily be categorized into another category. Associated with parents who were abusive and/or have themselves suffered childhood traumas, have unresolved difficulties with their own parents, or are still mourning the death of their own attachment figure. Babies in this category have been frightened by their caregiver and are confused about how to respond when they are stressed. Baby is assessment acts confused, dazed, and may show contradictory behaviors; or baby may be calm and then angry; baby may be motionless or show apprehension; their behaviors are not consistently avoidant or resistant as in other categories. The baby may cling to the parent while crying hard and leaning away with gaze averted. |
| STRANGE SITUATION ASSESSMENT TOOL generally for 1 year old children, designed by MARY AINSWORTH; baby's behavior described is "secure." EPISODE Behavior of infant __________________________________________________________ 1. Introduction __________________________________________________________ Assistant introduces parent and Baby held by parent. baby to the room. The episode lasts 30 seconds; the other episodes last approximately 3 minutes each. __________________________________________________________ 2. Unfamiliar room __________________________________________________________ Parent places the baby on the floor Baby may be wary of room at first with toys and sits in chair. Parent but uses parent as a safe secure is told not to direct baby's actions, base. Baby plays with toys while but otherwise to respond normally. parent is present. Usually maintains visual contact with parent during play. __________________________________________________________ 3. Stranger enters __________________________________________________________ Unfamiliar female adult knocks on Baby may show stranger anxiety door, then enters. Stranger speaks and clearly prefers parent over with parent, then approaches the stranger. While parent, baby may baby to play. allow stranger to approach and play. __________________________________________________________ 4. Parent leaves ___________________________________________________________________________ Parent quietly leaves the room, Baby shows separation anxiety leaving baby with the stranger. and renewed stranger anxiety. Stranger returns to sit in the chair. May be somewhat comforted by the stranger, but clearly wants parent. __________________________________________________________ 5. Parent returns, stranger leaves __________________________________________________________ Parent returns and stranger leaves. Baby seeks contact with parent for Parent comforts baby, if baby wishes, joyful reunion. Seeks proximity, and returns baby to play with the toys. clings. May continue playing while parent is present. __________________________________________________________ 6. Parent leaves again __________________________________________________________ Parent says "bye bye" and leaves Baby shows separation anxiety, the infant alone in the room. distress. __________________________________________________________ 7. Stranger enters again __________________________________________________________ While baby is still alone, the same Baby may show stranger anxiety, stranger enters again. Stranger sits clearly prefers that parent return. on chair, then calls or approaches the baby to play. __________________________________________________________ 8. Reunion, stranger leaves __________________________________________________________ Parent returns and stranger leaves. Joy on reunion. Baby seeks Parent picks up baby for a reunion proximity and contact with that ends the procedure. parent. ___________________________________________________________________________ |
| Diagnostic criteria for 313.89 Reactive Attachment Disorder of Infancy or Early Childhood A. Markedly disturbed and developmentally inappropriate social relatedness in most contexts, beginning before age 5 years, as evidenced by either (1) or (2): (1) persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions, as manifest by excessively inhibited, hypervigilant, or highly ambivalent and contradictory responses (e.g., the child may respond to caregivers with a mixture of approach, avoidance, and resistance to comforting, or may exhibit frozen watchfulness) (2) diffuse attachments as manifest by indiscriminate sociability with marked inability to exhibit appropriate selective attachments (e.g., excessive familiarity with relative strangers or lack of selectivity in choice of attachment figures) B. The disturbance in Criterion A is not accounted for solely by developmental delay (as in Mental Retardation) and does not meet criteria for a Pervasive Developmental Disorder. C. Pathogenic care as evidenced by at least one of the following: (1) persistent disregard of the child's basic emotional needs for comfort, stimulation, and affection (2) persistent disregard of the child's basic physical needs (3) repeated changes of primary caregiver that prevent formation of stable attachments (e.g., frequent changes in foster care) D. There is a presumption that the care in Criterion C is responsible for the disturbed behavior in Criterion A (e.g., the disturbances in Criterion A began following the pathogenic care in Criterion C). Specify type: Inhibited Type: if Criterion A1 predominates in the clinical presentation. Disinhibited Type: if Criterion A2 predominates in the clinical presentation. Reprinted from the Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994 American Psychiatric Association |
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