Why Attachment Matters in Children's Development - Helen Minnis

Why does attachment matter for children’s development? The importance of soothing

Why does attachment matter for children’s development? Bowlby, 1973 Anxiety attachment behaviours comfort from caregiver reduction in anxiety

Attachment behaviours present from birth
Selective attachment present from around 6 or 7 months
Attachment patterns are a measure of the relationship , not of the child
Attachment and Attachment Disorders

Why does attachment matter for children’s development? General population: ~70% secure ~30% insecure Ainsworth, 1979
Attachment can be measured at 12-18 months using the strange situation procedure

Why does attachment matter for children’s development?
Secure attachment
Infant goes to parent when stressed
Easily comforted
Back to the job of exploring/learning

Insecure-avoidant attachment
Infant doesn’t use parent for soothing

Insecure-resistant/ambivalent attachment
Infant goes to parent when stressed
But not easily comforted
Some insecure attachment patterns make perfect sense!

Insecure-disorganised/disorientated attachment
Acts as if not sure what to do when stressed
Higher risk of aggressive behaviour later

What happens if children are not soothed as babies? Why does attachment matter for children’s development?

Normal diurnal rhythm of cortisol Stress Why does attachment matter for children’s development?

Romanian orphans Response to stress ca n be unpredictable Stress Why does attachment matter for children’s development?

Maltreated children pre-school Dozier Stress Why does attachment matter for children’s development?

Why does attachment matter for children’s development? Edlington boys Exposed to neglect and violence, alcohol and cannabis

Why does attachment matter for children’s development? The parts most affected are those which have the most rapid development after birth What can happen to the brain with maltreatment in early life?

Hippocampus Why does attachment matter for children’s development? Role in dissociative states, anxiety disorders Apparent hippocampal shrinkage with PTSD but twin study suggests small hippocampus might predispose to PTSD

Hippocampus retains its ability to generate neurons throughout life e.g. taxi drivers “knowledge” Eriksson et al 1998 Nature Medicine Maguire et al 1997 Journal of Neuroscience “ Its not grey matter that I’ve got in mine… its faecal matter because of all the s**t that comes through that partition!” Glasgow Taxi Driver But there is always hope… Why does attachment matter for children’s development?

Amygdala Why does attachment matter for children’s development? Role in fear conditioning, control of aggressive and sexual behaviours

Corpus callosum and interhemispheric integration
Left hemisphere - language and logical thought
Right hemisphere - perception and expression of emotion, particularly negative
Reduced corpus callosum size in childhood maltreatment, especially in boys

Neurobiology of Maltreatment Cerebellum
Role in attention, language, cognition, affect and movement
Very high density of stress hormone receptors – may be very susceptible to stress postnatally

Neurobiology of Maltreatment Cerebral cortex
Lots of stress hormone receptors – may be very susceptible to stress in postnatal period
Fronto-temporal area is particularly important – involved in “executive functioning” i.e. planning, complex social interaction

Neurobiology of Maltreatment
Cerebral cortex
maltreatment may cause a precociously mature cerebral cortex with “stunted final capacity”
Teicher, 2003

Neurobiology of Maltreatment HPA axis and stress Adapts, in a situation of neglect/violence, to deal with stressful early environment: fight, flight, freeze Stress thermostat -Adaptive in situations of high stress -Maladaptive or leading to psychiatric disorders in situations of low stress

Neurobiology of Maltreatment Gunnar 2002 Psychoneuroendocrinology Doctors for a jag

Neurobiology of Maltreatment
HPA axis and stress
At 3 months, children cry and see cortisol peak on immunisation
By 12-18 months, securely attached infants cry but no longer see cortisol peak
In insecurely attached or temperamentally inhibited children, still see a cortisol peak in presence of caregiver
Gunnar 2002 Psychoneuroendocrinology

Infants:
Attachment and Biobehavioural Catch-up (ABC) –
Trains carers of maltreated children to be extra-nurturing
Randomised Controlled Trial evidence that can return cortisol patterns to normal
Treatment? Attachment Disorders

Older children:
Dyadic Developmental Psychotherapy
Good US pilot study suggests very effective in reducing behaviour problems
Needs Randomised Controlled Trial – plans for this in Glasgow
Treatment? Attachment Disorders

Neurobiology of Maltreatment Who is right? Ed Balls asks 'Can we sort out the problems in the family?' Martin Nary (Barnardos) says more children should be adopted at birth Prevention?

New Orleans Model:
Every maltreated child under 5 and their family has an intensive attachment-based assessment
Intensive intervention for birth family (while child in foster care) to maximise chance of rehabilitation
Time limit of 15 months , then decision:
Adoption or Rehabilitation?
Prevention? Attachment Disorders

New Orleans Results:
Increased freeing for adoption
BUT
Where rehabilitated, reduction in maltreatment of both that child and subsequent siblings
i.e. good decisions
Plan for Glasgow pilot and trial
Attachment Disorders Prevention?

Final points:
Lets support parents to get attachment right in the first place
Lets prevent damage to development by making decisions about children early
Lets find and test ways of helping when there have been problems
These are some of the core aims of Scottish Attachment in Action

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Why Attachment Matters in Children's Development - Helen Minnis

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