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they have biological children of their own. Yet, adoptive parents, while thoroughly
scrutinized by adopting agencies, are often given little information about their adopted
child, in terms of family history or specific parenting skills that will help their adopted
children develop strong emotional attachments. Only recently have post-adoption
resources become available for adoptive families. Though these resources are few
nationwide, adoption and post-adoption agencies are becoming more aware of the need
to inform parents of a child's prior history and the potential for cognitive, behavior and
attachment problems.
What is attachment and why is it important?
Attachment is a term that refers to a psychological and biological event- it is the
affectional bond that develops between a primary caregiver, usually the mother, and her
infant. The process of attachment often begins in utero when the mother feels affection
for her developing baby and looks forward to the baby's birth. For other mothers it may
begin after their baby's birth and is a process that takes time through a series of daily
caring interactions. Developing a secure attachment to a primary caregiver is extremely
important as the child's mental representations of intimate relationships and the
foundation trust often carry over into adulthood, affecting future adult relationships.
"Studies of attachment have revealed that the patterning or organization of attachment
relationships during infancy is associated with characteristic processes of emotional
regulation, social relatedness, access to autobiographical memory and the development
of self reflection and narrative." (13) For the past forty years, attachment researchers
have concluded that there are 4 basic categories of attachment; secure, insecureambivalent, insecure-avoidant, insecure-disorganized. Attachment researchers still use
an instrument called The Strange Situation developed by Dr. Mary Ainsworth to
determine these categories during the 1960's. The Strange Situation creates a situation
where a baby is separated briefly several times from her mother while in a lab room with
a stranger (research assistant). The researchers record how the baby reacts to mother's
departure with the stranger, without the stranger and upon reunion with the mother. The
behaviors of babies in these different categories are described below:
1) Secure- these infants actively explore, they get upset when their mother leaves, are
happy upon reunion and seek physical contact with their mother. Mothers of secure
babies are typically loving and responsive to their infant, quick to pick them up when they
cried, hold them longer and "with more apparent pleasure."
2) Insecure-ambivalent (anxious/resistant): these infants stays close to their mothers,
there is limited exploration, they become very distressed upon separation and ambivalent
toward their mother upon reunion but remain near her. Mothers of anxious babies were
observed to be "more mean-spirited to merely cool, from chaotic to pleasantly
incompetent. Though well meaning, these mothers have difficulty responding to their
babies "in a loving, attuned, consistent way."
3) Insecure-avoidant: these infants show little distress when separated, ignore their
mother's attempts to interact, are often sociable with strangers or may ignore them as
they ignore their mother. These mothers often have an aversion to physical contact
themselves and speak sarcastically to their babies.
4) Insecure-disorganized/disoriented: these infants are the most distressed upon
separation and are considered the most insecure. They seem confused upon reunion
and exhibit behaviors that appear to be a combination of resistant and avoidant. (15)
When adopted children don't attach
Unfortunately, for a large number of adoptive parents, their experiences with their
adopted children have been devastating due to the lack of critical information and/or
training in working with children from abusive, neglectful home environments resulting in
attachment disorders. Some of the first heartbreaking examples of attachment disordered
children to garner worldwide attention were the children adopted from Romania and other
East Bloc countries. When the Soviet empire crumbled in the early 1990's, suddenly
thousands of children, who had been languishing in orphanages, became available for
adoption. Since 1991, adoption of Eastern Bloc children continued to increase to a
staggering 3,700 in one year alone. Doctors found that nearly two-thirds of these children
adjusted well, some with only minor problems such as developmental delays or learning
problems. One third, however, displayed major problems such as an inability to form a
close emotional attachment to their parents, destructive behaviors with a host of
emotional and learning problems. These children took everyone by surprise. There were
no appropriate resources, therapies or financial assistance for these children and their
families. Many parents gave the children back because they were totally unprepared to
cope with the severity of the problems, proving to be catastrophic for the parents and the
children. (2)
These situations have opened our eyes and minds to the tragic consequences when
young children's psychological and emotional needs are not met, creating this failure of
attachment. Psychologists are much more aware of the behaviors of the attachment
disordered child, frequently called Reactive Attachment Disorder.
What is Reactive Attachment Disorder and its causes?
Reactive Attachment Disorder (RAD) is usually the result of a disruption of or trauma to
the attachment process such as a history of physical or sexual abuse, neglect and/or
frequent change in caregivers within the first three years of a child's life. Sometimes other
factors can contribute to the break in attachment as listed in the box below.
Death of a parent
Cruelty to animals
Stealing
Learning Lags
Lack of conscience
Researchers have found that skin-to-skin closeness has incredible physiological benefits
while separation can have equal detrimental affects. "Kangaroo care" a term which
simply means the parent holds the infant skin -to-skin, has been studied for over a
decade and found to have substantial benefits for the baby and mother. Susan Ludington
of UCLA found that a mother's temperature fluctuates to maintain her baby's thermo
neutral range. In other words, when the baby's temperature goes down the mother's
temperature rises. "When her baby reaches the thermo neutral range, the mother's
temperature returns to baseline." A case study was done on a critically ill preterm infant
who was going to be adopted. Though the infant was mechanically ventilated, the
hospital offered the parents "kangaroo care". The authors observed that the infant thrived
and that the experience was "profoundly beneficial" for the infant. (6)
When studying our closest relative, the primate researchers found that "Separation is so
traumatic for the infant monkey that their whole system rebels: They experience loss of
body temperature, release of stress hormones (cortisol), cardiac arrhythmias, increased
heart rate, agitation, sleep disturbances, and immunological compromises. And although
hormones stabilize when they are reunited with their mothers, there are long-term effectsfor instance in sleep and immunological efficiency." We know human infants experience
similar effects. (6)
What does the future hold for adoptive families?
While a smaller percentage of adopted children will be diagnosed with RAD, others may
exhibit milder versions of attachment disorders or insecure attachment. Some experts
believe that the majority of attachment problems in children are caused by parental
ignorance about child development rather than abuse. This has resulted in an estimated
1 in 3 people with avoidant, ambivalent or resistant attachment. (11) Whatever the
causes, adoptive families need the appropriate information, training and support in
raising children with attachment difficulties.
In 1997, the Federal government passed the Adoption and Safe Families Act that
authorized funds to be made available for post-adoption services. The President's
Adoption 2002 Initiative made available approximately 20 million dollars that have been
allocated for adoption agencies to use as bonuses for families of "special needs" children
to help them to pay for therapeutic and other necessary services. (1)
While it may appear that adopting children can be risky, the good news is that the
preliminary finding of a new comprehensive study being conducted at the University of
Minnesota indicates that there is minimal difference in psychological functioning between
children raised in adoptive families and those in biological families. (5) Adoption can be
successful and adopted children can form strong emotional attachments when parents
and children are given appropriate information, resources and support. The painful
lessons of the past have finally broken through the walls of ignorance, shedding new light
and giving renewed hope to adoptive parents who have opened their hearts and homes
to thousands of children in need.
References:
1. Barth, R.P.; Miller, J.M. (2000). Building effective post-adoption services: what is the
empirical foundation? Family Relations. 49; 447-455.
2. Deane, D. (1997, December 26). Some Americans give up trouble East bloc
kids. USA Today, pp. A6, A9.
3. Festinger, T. (2002). After adoption: Dissolution or permanence? Child Welfare. 81;
515-534.
4. Fonagy, P.(2001). The human genome and the representational world: The role of
early mother-infant interaction in creating an interpersonal interpretive
mechanism.Bulletin of the Menninger Clinic. 65; 427-449.
5. Freivalds, S. (2002 March/April). Nature & Nurture: A new look at how families
work. Adoptive Families. 27-30.
6. Heller, S. (1997). The Vital Touch. New York, Henry Hold and Company.
7. Horner, D.R. (2000). A practitioner looks at adoption research. Family Relations.
49;473-478.
8. Johnston, P.I. (1997). Promoting attachment through the senses. Retrieved on
February 15, 2008 fromhttp://www.perspectivespress.com/pjsenses.html.
9. Parker, L.Anderson, G.C. (2002). Kangaroo care for adoptive parents and their
critically ill preterm infant. The American Journal of Maternal/Child Nursing. 27;230-232.
10. Perry, B.D. (2002). Principles of working with traumatized children: special
considerations for parents, caregivers, and teachers. Retrieved February 15, 2008
fromhttp://www.childtrauma.org/ctamaterials/principles_TC.asp.
11. Perry, B.D. (2001). Bonding and attachment in maltreated children: consequences of
emotional neglect in childhood. Retrieved February 15, 2008
fromhttp://www.childtrauma.org/CTAMATERIALS/Attach_ca.asp.