I have some material about attachment that is relevant for adults on my website, http://www.center4familydevelop.com

regards

Art

Another good text for you as a teacher is:
Bomber, L., (2007) Inside I am Hurting: Practical strategies for supporting children with attachment difficulties in schools. Worth Publishing, London. It is a terrific book, written by an professional who is both a teacher and licensed therapist and researcher.

You might also want to look at:
Becker-Weidman, A., & Shell, D., (2005) Creating Capacity for Attachment, Wood N Barnes, Oklahoma City, OK, which describes Dyadic Developmental Psychotherapy, an evidence-based treatment with empirical support that is grounded in current thinking and research on the etiology and treatment of Complex Trauma or Developmental Trauma Disorder.

If you have other questions, let me know. I also have other information that may be useful to you. For several years now I have consulted monthly during the school term with a group of counselors from a regional BOCES program (BOCES stands for Board of Cooperative Educational Services). BOCES is an entity created to provide special education services for a regional group of school districts. The idea being that a school district may not be able to meet the specific needs of a limited number of children, but by pooling resources, the BOCES programs have sufficient numbers to provide pretty decent specialized services for children with severe emotional problems, Autism Spectrum Disorders, etc.
regards
Art

Some researchers consider the possibility that children with symptoms of the inhibited form of RAD actually have anxiety disorders, and/or problems with regulation of emotion. These suggestions are especially notable when we consider that “attachment disorders” were originally– and not so long ago– equated with Failure to Thrive.

Thinking continues to change on this topic, and it is no wonder that people feel confused about it. However, for the sake of children and families, we need to be able to tolerate ambiguity, and to avoid the assumption that disorders of attachment are well understood, easily diagnosed, or all treatable by a specific intervention.

One other point, if you’d like useful information. In addition to the seminal text I referred you to, which all those professionals familiar with this subject refer to, you might also want to look at The Diagnostic Classification of Mental Health and Developmental Disorders (2005) by the Zero to Three group.

Of course the first text is really the primary text in the field, edited by Dr. Zeanah and including scholars (clinician/researchers) of international renown who have real professional experience, training, and who have conducted research into these questions. You will find this material most useful if you want to explore your very good question in more depth.

regards,
Art

One other point. As any clinician who has training, licensure, and experience (or who has conducted actual research) in this area and with, say Autism, would point out, that children can have “no attachment” for a variety of reasons and that this can be one factor in Austism Spectrum Disorders. In fact, this category of no attachment of nonattached attachment disorder is described in the text below. Most practitioners who have real knowledge and experience will point to several very important texts such as:
Zeanah, C., (2005), The Handbook of Infant Mental Health, 2nd. Edition, Guilford Press, NY., among several others.

I hope this is helpful for you…and, of course, if you have other questions, do feel free to post here or to contact me directly. Your post was quite helpful.
Art

Rutgers, A.H. etal. (2004). Autism and attachment: A meta-analytic review. Journal of Child Psychology and Psychiatry, Vol. 45(6), 1123-1134.

This article reports evidence of attachment behavior in autistic children.

However, because attachment is essentially a set of attitudes, feelings, expectations, and behaviors toward other people, and because it is a very robust aspect of development, the idea that there is “no attachment” in an otherwise normally-developing child is difficult to accept. Even children who approach strangers rather than staying with familiar people are displaying their attitudes about human beings, although in a disordered way. A child with “no attachment” would respond to all people (including other children) in about the same way.

If by “no attachment” Gayle means no secure attachment or secure base behavior, as I said before, this might be more likely for some children than for others, because of temperamental factors (inborn, biologically-determined personality components). If she means a lack of obedience or affection to caregivers, these matters are related to many factors other than attachment.

There are unconventional practitioners who claim that some babies are born with great resistance to attachment and refuse to respond to their caregivers. This claim is mistaken, and I would hope that other contributors to goodtherapy would speak against it.

Thank you for that terrific question. My response highlights the importance of looking at causes and not symptoms since we treat causes not merely surface symptoms. The quick answer to your question is a “certainly, yes.” For an extreme example of that one can look at children with severe Autism. In these children the capacity to form emotionally meaningful, cooperative, responsive, and collaborative interpersonal relationships is quite impaired and their “attachment bond,” is quite impaired…but having nothing to do with chronic early maltreatment within a care-giving relationship. Another example might be the child who is born with significant brain-damage to the right orbital frontal cortex.
regards,
Art

I have those references now and hope that they will be helpful to you.

In reading your comments I see that you made a rather astute observation about problems with cause-effect thinking that stem from very early difficulties in the parent-child relationship. As a professional you know from your experience, and as any licensed mental health professional with expertise in this area knows, it is through the early parent-child relationship and attachment that the beginnings of cause-effect thinking develop, as my article describes (you can also look at Infant Mental Health… for more technical details). Bowlby describes this process quite well, as do some other professional researchers with expertise in actually conducting such research in these matters such as Mary Ainsworth, Mary Main, Mary Dozier, etc., and as is amply described in the texts below.

1. Geedes, Healther, (2006), Attachment in the Classroom, Worth Publishing, London.

2. Carnes, Kate, & Stanway, Chris, (2007), Learn the child: helping looked after children to learn. A good practice guide for social workers, careers and teachers. British Association for Adoption & Fostering (BAAF), London.

I think that you will find that these references will be quite helpful in your work. They describe the importance of attachment as a central organizing principle in child development and as a major factor in determining a child’s development and functioning in the classroom. As I mentioned in a previous post, these books are written by educators and professionals and so the authors understands the nature of your work, are professionals like you are, and have real training, licensure, and experience relevant to your work.

I hope you find the texts of use to you and that you will continue to contribute to this site; your comments have been quite informative, knowledgeable, based in real experience and understanding, and valuable.
Thanks.
Art

In any case, how could you tell from behavior that a person can’t relate cause and effect? Would this mean that someone couldn’t learn to open a door by turning a knob? Or do you really mean that the child gets punished a lot, but still misbehaves? If it’s the latter, that could have a lot of explanations other than a cause-and-effect problem.

I think one of the difficultiess here is that people who have made this claim about cause-and-effect problems have based their thinking on Piaget’s outmoded description of the development of that kind of thinking, whereas modern infant development research shows that the capacity to make some cause-and-effect connections is already present at a few months of age. The result of thinking that children can really lack that kind of ability is an unfortunate focus on what the child can or cannot do, rather than on the adult behaviors (e.g. punishment) that may be influential.

Attachment is only one of the many variables that combine to determine the child’s developing characteristics, and we shouldn’t try to make it carry more weight than it’s capable of. It’s important to avoid “criterion creep”– the extension of a concept or a diagnosis to include a lot more than it was ever meant to handle. I believe criterion creep is happening when we begin to hear about “attachment disorders” outside the usual evaluative or diagnostic schemes.

As a professional, you have a lot of real and direct experience with this topic. I don’t think there is any real debate over this particular issue among actual professionals who have training and experience in this area.

In any event, your comments are right on target here. Most of the current writing and research in infant mental health and related topics of treatment, trauma, and behavioral problems focus on attachment, attachment theory, and parent-child relationships.

A wonderful book you may find helpful is
Attachment in the Classroom by Heather Geddes. It is written by an educator. There is another great reference too, but I don’t have that right at my finger tips now, but will post it later for you.

regards.

Art

If you don’t like the results of my edit, feel free to send me an updated comment without slander or request that I delete the comment in full and I will do so.

Regards,
Noah

You write in your comment, “Of course there are severely disturbed kids who have such symptoms, but attachment is not the issue that causes them.” I am frankly and completely dumbfounded by such a misinformed and false generalization. Furthermore, for you to associate Art’s work with “Voodoo Science” (I later removed this statement and a number of others made by Jean) is truly an act of misinformation and potential slander that is not tolerated on this blog. Please state your facts accurately or I will have no choice but to moderate your comments in defense of truth and in protection of consumers who might be influenced by such nonsensical statements. You have been given fair warning.

For more information on our Comment Policy, please see http://www.goodtherapy.org/custom/blog/terms-and-conditions-of-use/

Noah Rubinstein, LMFT
Executive Director