The Importance of Attachment

Written by Christine Milano, LMHC, Mecklenburg County CDSA

As an early intervention provider, every time you walk through the door of a family’s home, you assess multiple variables.  Am I safe?  What’s the mood of the family? Where is the dog?  Is the family distracted with texting? How is the child using communication or motor skills in daily routines?  We should also be assessing bonding.

Babies naturally seek a bond with their parents or caregiver to survive.  Attachment is the ability to form close, lasting relationships with others; bonding.  A strong bond between a child and a parent can act as a buffer against stress.

Sometimes, when a parent has a child with special needs, that time of natural attachment is somewhat interrupted.  Parents may become stressed and distracted by doctor’s appointments, evaluations, therapies and worry.  They do not know what to do.  This is not what they signed up for.  They may have guilt.  They may feel they caused the child to have a delay or disability and distance themselves from the child so as not to hurt them further. They may feel inadequate to help their child and leave it to the professionals.  But that bond between parent and child is needed more than ever when there is a child with special needs.

Here are some things to look for in a well-bonded parent and child relationship:

• The child seeks out the parent for comfort, affection and praise.
• The child reacts to the parent in a positive manner and appears to trust the parent.
• The child is happy to play with the parent, but can also play well on their own and with the provider while the parent is in the room.
• The parent gives comfort, affection and praise to the child.
• The parent reacts to the child in a positive manner.
• The parent allows healthy exploration of the world for their child, while keeping them safe at arm’s length.

Below are some attachment or bonding issues that you may encounter:

• Reactive:  often happens when a child has multiple caregivers. Child is inhibited and hyper- vigilant
• Insecure:  lack of trust, child doesn’t try new things
• Avoidant:  child is unaffectionate, flat affect
• Ambivalent:  child is anxious and indecisive
• Disorganized:  child is confused, approaches parents then rejects them or flees interactions

What early interventionists, evaluators and Services Coordinators can do to promote bonding, not only between the parent and child, but also within the team:

• Gain the parent or caregivers trust.  Be on time.  Follow through on whatever you say you will do for the family.  Gain their trust, and they will open up and allow you to work with them in a deeper and more meaningful capacity.
• Turn your phone off and encourage them to do the same.  Be light-hearted about it.  Just turn it off and say, “We don’t want any distractions while I am here,” and smile.
• Engage the parent in conversation before interacting with the child.  “How has your week been?” is a great open ended question, sure to bring a variety of answers. Listen and respond.
• Praise parents when you see bonding moments between them and their child.  “You did a great job holding firm when you told Billy ‘no.’ And I see that when he calmed down, you let go of your anger and gave him a hug. He enjoyed that, too.”  Increasing a parent’s confidence can have a positive affect on bonding and attachment with their child.
• Work within the IFSP outcomes.  Those routines (and challenges within them) were something the parent identified that they wanted help with.  They should be natural times of day when bonding is important.  For example, the simple outcome of the “Billy will enjoy mealtime with his family” is a huge bonding opportunity for the family. Maybe mom was concerned because Billy doesn’t use a spoon, or bangs his head repeatedly on the back of the highchair, or throws his food and refuses to eat.  There is a disruption in the bonding for the family because Billy doesn’t enjoy mealtime. Work on the outcomes and bonding will likely increase.
• Work together as an IFSP Team.  It is important for everyone to be on the same page regarding supports for the family.  Sometimes, this means talking with each other if team members feel that they haven’t been able to make a good connection with the family.  Other times, it may mean that providers are noticing some potential concerns around the bond between the parents/caregivers and the child that could be nurtured during everyone’s visits.
• Be looking for the need for additional information and/or support for the family.  Maybe you don’t have a specific Family Training and Counseling provider on the team, and an assessment might give more information about ways to support the bonding and attachment process.  Discussing this with the family and team during a review can help everyone figure out the best next steps to address this important need.

Bonding and attachment are so important in children’s development and in the success of daily routines with families.  We have a great opportunity to see how things go within natural family environments, where children should feel the most comfortable and secure.  Need more information about bonding and attachment?  Take a look at Attachment Parenting International for more topics about attachment as it applies to a variety of ages and family situations.  Have you had some successes or challenges in the field with supporting strong bonds between parents/caregivers and children?  Leave us a comment and share your thoughts!