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Family Front and Centre: A Support Resource Promoting Healthy Child Development
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Book 1 : Attachement
| Production of this resource has been made possible through a financial contribution by Health Canada prior to the announcement of the establishment of the Public Health Agency of Canada on September 24, 2004. Any reference to Health Canada should be assumed to be to the Public Health Agency of Canada. |
Table of Content
- What is Attachment ?
- Inside this book
- Infants (0-18 months)
- Toddlers (18 months-3 years)
- Preschoolers (3-6 years)
- Factors That Affect Attachment
- When There May be a Problem with Attachment Relationships
- Strategies and Activities
- Summing It Up
- Glossary
National Advisory Committee
| Nancy Engels Project Coordinator, JFS |
JoAnn Gillan Kristie Gomuwka Myrna Martin Kate O'Brodovich Lynda Stewart Irene Szabla Annette Thexton Michelle Ward |
| Lisa Fiorentino Writer/Researcher |
|
| Susan Karpman Director, Family and Children's Services, JFS |
|
| Marilyn Turnley Health Canada Consultant |
Consultants
Andrea Borod editing
Rebekah Frojmovic research assistant
Jacinte Gauvin translation/adaptation
Carey Gold marketing/website consultant
Davina Mill clinical consultant
Richard F. Schmid evaluation
Rose Marie Scissons research/indexer
David Wells evaluation
Family Front and Centre
A Support Resource Promoting Healthy Child Development
Production of this document has
been made possible by a financial
contribution from the CAPC/CPNP National Projects Fund, Health
Canada.
The views expressed herein do not necessarily represent the
official policies of Health Canada.
c 2004 Jewish Family Services of the Baron de Hirsch
Institute.
ISBN 0-9734557-2-1
What is Attachment ?
Attachment can be defined as the emotional bond that evolves between children and their caregivers. Children grow to trust and feel secure in their environment when they have a strong attachment relationship to a caregiver.
Inside this book:
- A description of the attachment relationship between caregivers and children from infancy until six years of age, highlighting developmental issues for the specific age groups.
- Factors that affect attachment and social relationships and a discussion of when children may be at risk for more serious attachment and social relationship problems.
- A list of strategies and activities to help children with their attachment and social relationships.
- A glossary of terms.
Infants (0-18 months)
After nine months of development infants get the chance to meet their caregivers. While infant bonding begins in the womb, from birth onwards infants build important learning blocks that will encourage the development of their future social relationships.
Infant Needs and Bonding
Infants enter the world with many needs. They are often hungry and need a lot of sleep. Infants communicate their needs through cooing, smiling, crying and frowning. Infants have very little experience with building relationships. Following the early weeks of birth, caregivers and infants spend a lot of time getting to know one another. This early time is called bonding (when trust builds between caregivers and infants). Bonding develops during the early weeks and months following birth, and is the basis for developing trust.
| Emma is 2 months old and already communicates with her mom and dad. Not only does she communicate her needs through crying (e.g., to express hunger or the need for a diaper change), she also smiles and maintains eye contact with her parents. She has already started to make happy gurgling sounds. Emma's parents are delighted that she communicates her interests and pleasures in new ways. |
Emma communicates with her mom and dad by smiling, sharing eye contact, and making happy gurgling sounds. In fact, by 6 months of age, infants communicate a full range of emotions from happiness to sadness.
By 6 months of age infants begin to form an attachment to their caregivers. Attachment is the relationship between infants and their caregivers based on an emotional bond that evolves throughout childhood.
Some people falsely believe that the period for bonding can only occur in the first few moments after birth. Although early bonding and attachment are important, this time period is not the only period for bonding. Some babies (e.g., premature infants who have to stay in the hospital for a period of time) do not have the chance to spend time with their caregivers right away. If immediate contact is not possible, caregivers will have to take the time to catch up with their infants.
Attachment and Temperament
As infants express their personality, caregivers respond by conveying love, acceptance, and a sense of security. An infant's personality or temperament is usually established by 2-3 months of age. Temperamental differences fall within a continuum between easygoing and spirited.
- Infants who have easy going temperaments are relaxed. They are less likely to get irritated and are easier to soothe when upset.
- Infants with spirited temperaments have more active personalities. These infants are irritated more easily and maybe more difficult to soothe when upset.
| Eliot is an easygoing baby. He smiles often and, as a result, so do his caregivers. When Eliot does get upset, Eliot's caregivers soothe him and help him feel better. Eliot is comfortable in new situations and adapts easily to change. |
Eliot has an easygoing temperament. He is generally relaxed and has less intense reactions to new situations and changes in his environment. Babies with temperaments like Eliot's are relatively happy, easy to soothe when upset, and tend to cry very little.
| Abdul is a spirited baby. He tends to cry a lot and it takes his mom a long time to soothe him. Sometimes it seems impossible to calm him down. Abdul also has difficulty adapting to changes in his routines. Abdul's mom tries very hard to make Abdul more comfortable, but she finds his spirited temperament difficult to deal with. |
Infants like Abdul have more spirited temperaments, and this can be trying for some caregivers. Spirited babies can be difficult to soothe, and tend to cry more often.
Keep in mind that all infants may have easygoing as well as spirited days. Infants with the most easygoing temperament may have times in the day where they are easily irritated and difficult to soothe. A spirited infant also experiences calm and relaxed days.
Caregiver Sensitivity
All caregivers want to successfully meet the physical, social, and emotional needs of their infants. This means that caregivers must be sensitive and in tune with their infants' needs.
| Isabelle, 6 months old, plays a game of 'peek-a-boo' with her dad. Isabelle eagerly waits for her dad to surprise her by uncovering his face and saying, "Peek-a-boo!" causing Isabelle to shriek with joy. After a while, Isabelle starts to look around the room and does not seem to be interested in the game. Her father stops playing the game and watches Isabelle to see what she wants to do next. Isabelle eventually starts to yawn and blink her eyes very slowly. Dad decides that it might be naptime for Isabelle. |
Isabelle's dad is sensitive to her needs. When Isabelle seems disinterested in the game, her dad takes a break from playing and observes Isabelle to decide what to do next. Since she starts to yawn and blink slowly, her dad realizes that Isabelle is tired and could use a nap.
Some caregivers have difficulty being in tune with their infants' needs. These caregivers must find a consistent level of responding that serves as a best match for their infant.
Finding a best match includes:
- Responding to the infant's needs appropriately and as soon as possible.
- Being able to read the infant's behaviours and understand what needs are expressed.
- Understanding the infant's temperament and how it can affect infant behaviour and responses to situations.
| Ten month old Emmanuel is hungry and begins to cry. His mom remains unsure as to why he cries since his diaper has just been changed and he was fed an hour and a half ago. His mom is upset and frustrated because she cannot soothe Emmanuel and stop his crying. |
Emmanuel's mom has difficulty understanding what he tries to communicate. Emmanuel may have a physical, social, or emotional need, but his mother remains unsure as to what it is. She would like to respond to his needs quickly, but has trouble doing so, resulting in a sense of frustration.
| Fifteen month old Abby rolls a ball on the floor with her dad. Whenever Abby starts to look away, her dad makes sure his smiling face is directly in Abby's view so that she can see him and keep playing. While Abby sometimes smiles back, Abby no longer seems interested in playing this game. |
Abby's dad is not paying attention to Abby's signals. When Abby looks away, she may need a break from the game or may want to do something else. Her dad has difficulty reading Abby's behaviours and decides instead to maintain the game.
Caregivers must try to find the best way to respond to the infant's cues and do so in a consistent way that will ensure trust.
Consider This...
The relationship between caregivers and infants is a bit like dancing. When we dance, we hope to have a fun time. We also hope not to step on each other's toes. In the event that we do step on each other's toes, we need to make sure that we change our steps so that we can keep dancing and having fun!
Toddlers (18 months-3 years)
Toddlers are explorers. Through their explorations they learn from their caregivers that there are limits as to what behaviours are appropriate. Toddlers sometimes challenge these limits, often to the frustration of caregivers. These challenges have an impact on the attachment relationship, causing it to evolve as toddlers develop their sense of independence.
Independence
The sense of independence that toddlers develop creates changes to the attachment relationship. Toddlers are more aware that they exist as a separate person from their caregivers. Caregiver presence should be a secure base for toddlers to rely on and trust in. Toddlers who have secure attachment relationships are able to be independent yet still rely on their caregivers. Toddlers with insecure relationships feel less confident in their attachment to their caregivers and may engage in resistant or avoidant behaviours.
Secure Relationship
- Caregivers serve as a secure base from which toddlers can explore the world.
- Toddlers become upset when they are separated from their caregivers and become happy when they are reunited with them.
Insecure Relationship
- Toddlers do not feel that their caregivers serve as a secure base from which they can explore the world.
- Toddlers may react with resistant behaviours:
- Resistant toddlers are less likely to explore their environment.
- They often become upset when separated from their caregivers, but are difficult to comfort when reunited with them.
- Toddlers may react with avoidant behaviours:
- Avoidant toddlers do not explore their environment.
- They are less upset when separated from their caregivers but resist interacting with them when reunited
Understanding Limits
Toddlers learn about limits as they explore their surroundings. Initially, the attachment relationship between caregivers and infants develops from the trust built as the caregivers respond to the infants' needs consistently. Toddlers continue to learn about trust as their caregivers establish and maintain limits in the toddlers' lives. Caregivers set parameters for acceptable behaviours and they teach toddlers that there are consequences when they do not follow these limits. This consistency in the environment helps toddlers trust their caregivers, which encourages a strong and secure attachment relationship.
| Priya, 2 years old, is very excited to play with her new pet kitten. In her excitement, she becomes rough and the kitten meows in panic. Mom quickly approaches the situation and tells Priya that she has hurt the kitten and that she should stop petting the kitten that way. She then demonstrates to Priya a gentler petting behaviour. Priya copies her mother's actions and continues to play with her purring pet kitten. |
Priya learns that there is a limit to the type of behavior she can engage in with her pet kitten. She understands this limit because her mother speaks to her immediately after the problem behavior occurred. Her mother models another petting behavior Priya can use. Priya imitates this behavior and is happy that she can continue to play with her pet. As a result, Priya continues to develop trust in her relationship with her mother.
Caregivers who are able to set appropriate limits for their toddlers and be consistent in reminding them of these rules help them feel secure and trusting.
Consider This...
The quality of the caregiver-toddler relationship depends on consistent, evolving care. Maintaining this care is much like riding a bicycle. In order for the ride to be pleasant, consistent trust must be maintained, despite any bumps.
Preschoolers (3-6 years)
As preschoolers explore and continue to become independent, they also begin to branch out from their attachment to their caregivers and engage in relationship building with their peers. However, preschoolers still develop their attachment relationships with their caregivers as their peer relationships grow.
Attachment and Separation
Preschoolers usually spend more time away from their caregivers. They may be attending day care, preschool, or school programs. Preschoolers develop their independence and learn more about the world and themselves through their interactions with their environment and other people.
| Over the summer, Angelina's caregivers talk to Angelina about attending day care and the fun that she will have there. They bring Angelina to the centre where she meets her educator, Blythe. On the first day, Angelina does not want her caregivers to leave and cries in protest. Blythe suggests that they stay until Angelina becomes calmer and participate at least until snack time. Angelina plays games with the other children while her caregivers are near by. Over the course of the week, Angelina's caregivers spend less time at the centre until Angelina is happy and secure in knowing that her caregivers will pick her up at the end of the day. |
Being separated from one's caregivers can be difficult, and sometimes preschoolers feel distressed when they are separated from them as they learn new routines and meet new people. When secure attachment bonds have been built, preschoolers have a smoother transition from the home to other care environments. Still, it is normal for preschoolers to occasionally experience stress over separations, especially if the situations are new.
Peer Relationships and Social Development
As preschoolers branch out and form peer relationships, the level of security in their caregiver relationships affects their social interactions. The more secure these relationships are, the better preschoolers will become at socially engaging with others.
Preschoolers who have secure attachment relationships with their caregivers are more likely to have self confidence and a positive sense of self, which relates to their self esteem. Securely attached preschoolers are more likely to be socially competent. They develop conflict resolution skills, problem solving skills, and empathy towards others' needs. They are also adaptive and self reliant.
Preschool children who have insecure attachments with their caregivers have difficulty with peer relationships and with their overall social development. Insecure children are often withdrawn in social situations and are less likely to explore their environment. Their hesitation and insecurity can lead to fewer peer interactions and friendships of poor quality. Preschoolers who feel insecure may also become victims of peer insults or may victimize other peers through teasing and aggressive behaviour.
Consider This...
Leaving the home environment and meeting same aged peers can be an overwhelming experience. In order to take that first step into the world of social interactions, preschoolers should feel comfortable that their caregivers will provide support.
Factors That Affect Attachment
Health Factors
The experience of a physical illness can have an impact on the attachment relationships that children develop. Pain and discomfort during an illness can lead to children feeling irritated and difficult to soothe. This may have a negative effect on the attachment relationship, as it can be difficult and sometimes impossible for caregivers to attend to their child's needs and alleviate their pain. Some physical illnesses can become serious and may require children to be separated from their caregivers and placed in the care of hospital staff. Separation from one's caregivers is a stressful experience for children, and causes a break in the predictable and safe environment caregivers provide. Spending time in the hospital also prevents children from participating in social activities with their peers. Caregivers help to alleviate the stress through frequent visits. Hospital caregivers also give care and affection to children. If frequent visits are impossible, then quality time must be spent after the hospital stay to help the children adjust to their surroundings and feel secure and comfortable with their caregivers.
Environmental Factors
Factors in children's environments, such as their homes and child care centres, can affect the attachment relationship. Children living in stressful and challenging situations (e.g., a death in the family, parental divorce, substance abuse) may not experience positive interactions with their caregivers and build trusting relationships. Caregivers who experience stress may have difficulty providing a predictable environment where children will feel safe. Caregivers may also have their own stress, which can lead to feelings of depression, disrupt family interactions, and contribute to a lack of sensitivity towards children's needs.
Children who have secure relationships with their caregiver are more likely to feel emotionally healthy, demonstrate self reliance and a positive sense of self, and have social skills that convey warmth and empathy. Children with insecure relationships may not feel that they can depend on their caregivers, and instead feel that they have little control over their environment. Inconsistency in child rearing negatively impacts on the attachment relationship. Inconsistent caregiver interactions with children can lead to feelings of confusion and mistrust. Children do not learn that their environment is predictable and safe with rules and limits. They also do not learn about consequences for their actions. Children need security in their lives in order to feel safe to explore and discover their world.
Personality Factors
Infants are born with different temperaments. Sometimes caregivers and children are a match in temperaments and sometimes they are not. Since the attachment relationship is bidirectional, if a child is spirited or likely to become upset or agitated easily, this can impact on their relationships with others. Some caregivers understand their child's temperament and adjust their reactions to be sensitive to the child's needs. Other caregivers and peers may have trouble understanding a child's temperament, which leads to difficulty in forming social relationships.
When There May be a Problem with Attachment Relationships
Attachment problems can become a serious concern for some children. Serious attachment problems involve difficulty with social relationships, including having relationships that are developmentally inappropriate and atypical for their age. Any serious attachment and social relationship problems should receive the help and guidance of a health care professional when they occur in:
- Intensity (well above normal occurrences of difficulty in social attachments and energy typical of the same aged child);
- Multiple environments (such as the home, child care centre, and/or school environment).
It is common for children to experience separation and stranger anxiety during the toddler years (see Anxiety book) and these anxieties are developmentally normal unless they appear to be strange, persistent, and problematic.
In some cases poor attachment problems develop because of poor caregiving skills. Poor caregiving skills include the following care issues:
- Child's basic emotional needs (e.g., affection, comfort, stimulation) are not met.
- Child's basic physical needs are not met.
- Child has not had an opportunity to format least one stable attachment relationship.
Children react to deficits in caregiving by developing a reactive attachment. Children who have reactive attachments with their caregivers behave contradictory in attachment situations. Contradictory behaviours include being resistant to comfort from caregivers and a lack of discriminatory behaviours towards attachments (i.e., child forms attachment relationships with any individual he/she meets).
Another cluster of serious attachment problems develop in children that are not due to caregiving skills. Some children appear to have difficulty forming attachments with others and display inappropriate social behaviours. These children may have neurological problems that lead to atypical attachment relationships.
If in either of the above cases these problems are intensely present and occur in multiple environments, the child should receive the help of a health care professional.
Strategies and Activities
The following information contains strategies and activities to help infants, toddlers, and preschoolers with their attachment relationships. Some of the following strategies and activities can be used with infants, toddlers, and preschoolers, while others are specific to one age group. All of the strategies and activities can be modified to suit the child's and the setting's needs.
Strategies and Activities for Infants, Toddlers, and Preschoolers
- Regular health and developmental check ups.
- Sometimes children may have health problems that can affect their attachment relationship with caregivers. For this reason, children must regularly see a health care professional such as a doctor or nurse.
- Help caregivers to understand their child's
temperament/personality.
- Educate caregivers about temperament/personality differences.
- Ask questions about their child's personality, including a
discussion of their:
- Routines.
- Levels of crying.
- Moods.
- Activity levels.
- Reactions to change.
- Levels of frustration
- Help caregivers to create routines in the home and other care environments to accommodate their child's needs.
- Encourage talking with the child.
- Talking with a child is important at any age and beneficial for their development.
- As infants get older and make more sounds, repeat their own sounds back to them. The use of rhymes and songs are also excellent ways to enhance a child's language development.
- Use your imagination to make toys and other objects come alive (e.g., make sounds, point, and appear excited about the object). Use songs and rhymes to express stories, emotions, etc.
- Name and describe objects using short phrases (e.g., "What a pretty bird!") to depict some aspect of the object. As children get older, build on the complexity of sentences using more phrases (e.g., "Look, the bird is feeding her babies.").
- Demonstrate the properties of objects (e.g., the different sounds a toy piano makes).
- Direct the child's attention to the properties of objects during daily activities like washing hands (e.g., water, soap, and paper towels for drying hands).
- Encourage playing with the child.
- Opportunities for exploratory play help children learn about their world and encourage them to explore their environment.
- Create stories to accompany the playtime. This will help encourage both their imagination and play in social situations.
- Give positive attention freely and willingly.
- This includes physical (e.g., pat on the back) and emotional (e.g., words of encouragement, sympathy) attention for appropriate behaviours.
- When children speak, let them finish talking before speaking back to them.
- Help children to identify and label their feelings (e.g., Mad, Sad, Glad).
- Try to understand what they are saying. Ask questions such as, "What do you mean?" or, "Can you say that again, but more slowly?"
- Validate children's feelings.
- Empathy is the ability to experience the thoughts and emotions of others.
- If children feel that their caregivers are experiencing similar thoughts and emotions, children will place trust in their caregivers.
- They may also start modelling caregiver behaviours later on.
- Set limits for appropriate and inappropriate behaviours.
- Make sure that the child understands the limits set, and explore how the child feels when they engage in inappropriate behaviours.
- Acknowledging children's feelings also helps them to choose more appropriate behaviours.
- Recognizing appropriate behaviours with positive attention will help preschoolers choose these behaviours over inappropriate behaviours.
- Support caregivers who experience attachment difficulties with
their children.
- Ask the caregivers about their own developmental history. Sometimes earlier experiences may affect the care they provide for their children.
- If a caregiver experiences a stressful situation, a referral to an agency or support group may help.
- Encourage caregivers to support one another by sharing experiences and discussing different techniques and strategies.
- Follow the ABC's when observing behaviours and try to find
patterns in recurring behaviours.
- The ABC's (antecedents, behaviours, consequences) is based on a behavioural model of observing and understanding behaviours. When trying to understand a child's interactions with their caregivers or peers, use the following to understand their behaviours more fully.
- Antecedents
What are the events that happened before the behaviour occurred- Who was involved?
- Where did it happen?
- When did it happen?
- Behaviours
What did the child do or not do in the situation?- Describe all of the behaviours that occurred (i.e., verbal and physical actions) with the child and any one else involved.
- Consequences
What occurred after the behaviour?- What type of intervention was used?
- How did the caregivers/peers respond?
- How did the situation end?
Did the behaviour continue, gain intensity, or stop? - How did the child respond?
Infant Strategies and Activities
- Respond to the infants' needs consistently.
- Encourage caregivers to meet their infant's needs as soon as they are communicated.
- If an infant's needs are met consistently, they will develop a strong sense of trust in their caregivers. This can lead to trust in their environment and eventually in themselves.
- Encourage face-to-face interaction.
- This includes bringing the baby's face close to the caregiver and gazing into each other's eyes.
- If the infant looks away, do not force the face-to-face interaction. Wait for the infant to rest until he/she is ready to resume interacting.
- The infant may also have another need at that time. Be responsive to the various needs he/she may have.
Toddler and Preschool Strategies and Activities
- Give children limits to follow.
- Firm limits provide a safe and predictable environment for children. They also help children trust their caregivers, which is positive for the development of the attachment relationship.
- Children need to understand that there are limits to their behaviours.
- Explain the limits to the children in simple terms.
- Remind children of the limits.
- When children break the limits, tell them that this behaviour has to stop and why.
- Give consequences for inappropriate behaviours.
- Consequences must be learned through consistent care from the caregivers that teaches children about appropriate and inappropriate behaviours.
- Children need to learn that when they engage in an inappropriate behaviour there will be a reasonable consequence.
- Remind children of the consequence using simple language.
- Besure to apply the consequence soon after the inappropriate behaviour occurs.
- Give children choices when possible.
- Let children feel that they have control over their behaviours, and that they can change their behaviours.
- Instilling a feeling of control gives children self confidence and also develops their trust in their caregivers.
Summing It Up
- During infancy, babies often communicate their needs through crying, though as they become more social they also engage in eye contact and smiling. The initial bond that occurs between infants and caregivers soon after birth leads to the development of an attachment that evolves over time. Infants also express their personalities through their temperaments, and caregivers must try to be sensitive and in tune with their infants' needs.
- Toddlers explore their environment and learn about limits that their caregivers set when they engage in inappropriate behaviours. Toddlers who have secure relationships with their caregivers feel comfortable exploring their environment, knowing that they can return to their caregivers for security. Toddlers who have less secure relationships do not feel this sense of trust and predictabilty in their environment, and may react with avoidant or resistant behaviours.
- Preschoolers spend more time away from their caregivers, particularly if they are attending day care centre, preschool or school programs. Along with this independence, preschoolers begin to form important peer relationships that help them develop socially. Preschoolers who do not have a secure relationship with their caregivers can have more difficulty engaging in social relationships, causing them to withdraw from and avoid social exploration and interactions.
Glossary
Attachment: The emotional bond that evolves between children and their caregivers.
Avoidant behaviours: Behaviours of insecurely attached children including a lack of exploration, a lack of upset when separated from their caregivers and a resistance towards interacting with their caregivers upon reuniting.
Bonding: The time shared between caregivers and children; bonding begins during pregnancy and infancy as infants' needs are being consistently met and continues throughout development.
Easygoing temperament: An infant's way of interacting with the environment where he/she is relaxed, not irritated easily, and easy to soothe when upset.
Empathy: The ability to experience the thoughts and emotions of others.
Resistant behaviours: Behaviours of insecurely attached children including a lack of exploration, a feeling of upset when separated from their caregivers, and difficulty in being comforted.
Self esteem: One's self concept; an individual's perception or points of view about one's self.
Spirited temperament: An infant's way of interacting with the environment where he/she has a more active personality; may become irritated more easily and may be more difficult to soothe when upset.
Temperament: An infant's overall style of interacting with the world; typically established by 2-3 months of age.
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