Why Attachment Matters in Children's Development - Helen Minnis
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Transcript of 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?
Anxiety attachment behaviours
comfort from caregiver
reduction in anxiety
Bowlby, 1973
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
Why does attachment matter for children’s development?
Insecure-avoidant attachment
•Infant doesn’t use parent for soothing
Why does attachment matter for children’s development?
Insecure-resistant/ambivalent attachment
•Infant goes to parent when stressed
•But not easily comforted
Some insecure attachment patterns make perfect sense!
Why does attachment matter for children’s development?
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-schoolDozier
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 disordersApparent 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 MedicineMaguire 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
Why does attachment matter for children’s development?
Why does attachment matter for children’s development?
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?
Why does attachment matter for children’s development?
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