Bonding and Attachment Issues for Children and Parents- Jayne Smith, LPC

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jayne e smi: Kim, thanks so much for asking me to join your chat line this evening. Attachment is that deep enduring relationship between a child and vcaraegiver during the first several years of life. When attachment is disrupted all other stages of development will be distorted. The inability to trust and develop a caring reciprocal relationship is the basis for attactment disorder.

Shannon H: What, in your opinion, is the earliest age it can be accurately diagnosed?

jayne e smi: I think symptoms of attachment difficulty, disorder can be evident by the second year of life or earlier. Infants deprived of contact, essential nurturing begin to refuse efforts by caregivers to care for them, meet their needs. However, most children are not brought by parents, caregivers for a diagnosed attachment disorder that early. Sometime between the age of 2 - 3 would be most likely.

Shannon H: I work with alot of families who adopt internationally. How can they maximize the attachment process when their child comes to them at an already advanced age, from about nine months up?

jayne e smi: When you have a child as young as nine months & without the benefit of any language familiarity, you need to help parents start from day one. Holding, cuddling, all the the behaviors a parent would do with a new baby. The contact a baby needs through touch, voice, significant amounts of human contact are essential. Having the child evaluated for developmental mastery would be beneficial..muscel development, eg. This is where Georgians are so lucky. Babies Can't Wait is a wonderful program that can help parents learn how to close the gap. It is also important to keep in mind that the neurological organization needed for development occurs prior to the first year of life. It will really be important to assume starting from scratch with a nine month old & revisit all those things a really young baby should experience with a parent.

kimw: Jayne could you tell us the difference between Attachement and Bonding?

cindy: what happens when the child is older in many cases our children can be 4yrs. or older how do you start the bonding at that age?

jayne e smi: Attachment is the intimate, emotional relationship we experience with others. Bonding is also a relationship with others but not necessarily implying an intimate, emotional connection. I can be committed, loyal to an individual through a common relationship but not necessarily attached. Does that seem to make sense.

kimw: What are some symptoms families need to look for in attachement disorder?

jayne e smi: At four years or older, one of the goals would be to first decide if a child has attachment issues, attachment problems, diagnosible attachment disorder or reactive attachment disorder. Within attachment disorder, reactive attachment disorder there are variations of how the disorder is represented by the child's behavior.As a parent and/or a therapist I would want to have a developmental profile completed. This would tell me more specifically at what age the child is functioning in each developmental area and give us a good idea of what is not working for the child. As for beginning the attachment process with children 4 and/or older, goals of attachment would be similar or the same as that younger child but the interventions would be more appropriate to the age of the child. Parenting looks different for the child with attachment disorder for one thing. This really doesn't answer much but entire books are written in response to your question.

jayne e smi: Most basic symptoms that get parent's attention right away might be: child's need to control everything; extreme opposition to adult help, intervention because of lack of trust of adults to make good decisions for child; lying that doesn't make sense; lack of eye contact except on child's terms; inability to give or receive affection; childs effort to spoil anything nice for the child indicating his/belief that they are unworthy of love, caring; lack of empathy for others, sometimes including animals. There are others depending on degree or intensity of the attachment disorder but this gives you a start.

kimw: Why is it so important to have a child assessed for Attachment Disorder?

jayne e smi: We all would like to believe that love, common sense parenting is enough to raise a child. And in most cases that is true if the child has not experienced neglect or abuse. However, when a child has experienced neglect or abuse it effects how that child perceives all his/her interactions with the world and that perception is very skewed because of the absence of the kind of human contact & significant caring that was needed during the age that children make the decision to trust the adult world. Without attachment assessment, a parent or caregiver will continue to guide, discipline based on the premise that the child they care for has a 'normal' perception of the world. An assessment can help determine the intensity of attachment disorder, subtype of attachment disorder and begin to formulate a plan of action, reaction that can bring about the possibility of genuine attachment with the child.

kimw: Jayne what do parents of infants need to look for as far as symptoms for attachment disorder?

jayne e smi: In terms of infants, a parent should be concerned if the infant does not respond to efforts by the parent to engage them with the usual cooing, cuddling, etc. An infant going stiff in a parents arms, screaming every time it is picked up, not seeking out eye contact with the parent would all be important indications that the baby is not responding to efforts generally establishing attachment with a parent. There are babies that do not cry much but when a baby has come from an institution, orphanage, etc and does not cry it may indicate that the baby has given up on getting its needs met.

kimw: Could you suggest some books that parents could read that would be helpful? We have a very good library at the center .

kimw: Do you have any suggestions for parents adopting children 10 and above as far as bonding?

jayne e smi: eLaney, Greg Keck, Terry Levy, Elizabeth Randolph, Lisa Eiselman (Especially good for infant, toddler adoption), Nancy Thomas are a few authors with good information & hands on advice.

kimw: We are nearing the end of our chat , does anyone have any last questions?

Shannon H: You are in Decatur, but do you have colleagues that you can recommend in other areas around the state that could help families (outside the metro area)?

jayne e smi: With children ten and above, I think the parent really needs to consider if the child is looking for a mom/dad or a caregiver. It will be important to know the extent and kind of previous trauma in the child's life because without the treatment to decrease or resolve the impact of the trauma the child may be resistant to trusting at any level. This is of course true with children of all ages but children at the age of 10 have a different level of brain development than those under 7. If I were the adopting parent, I would want an attachment disorder assessment within 6 wks to 6mos of my life with the child, a developmental assessment to determine what areeas of development might be delayed. I would want a good support good and a LOT OF INFORMATION on what might indicate problems. this reminds me of another book I consider essential for adoptive parents: Being Adopted by Brodinsky (I think). This author provides practical insight into behavior of children, young adults, adults & what questions related

jayne e smi: adoption the child, young adult might be struggling with. It is very reader friendly & I recommend it a lot.

jayne e smi: Thanks. I hope this has been helpful. PS support good was supposed to be support group.

jayne e smi: There are a few teams around the state that were trained through the special grant for attachment therapists. There is a team in Augusta, Colmbus area, Midway. I will get the specifics to Kim in the next day or so and she will have the information for you. Thanks again for this opportunity. This was my first experience on a chat line. I feel so totally modern and really enjoyed the opportunity to share about attachment.

Bonding and Attachment Issues for Children and Parents- Jayne Smith, LPC

Tuesday, the 6th of June 2006