Attachment Difficulties
WHAT IS AN ATTACHMENT DIFFICULTY?
As soon as we are born, we develop a close attachment with our main caregivers (usually parents). This attachment helps a child to learn and to develop trust. However, a few children do not form this attachment. There are many reasons for this but usually it is because of a situation where the caregiver was unable to provide what was needed and this can lead to attachment difficulties. Attachment difficulties can present in a variety of ways and can range in severity. An attachment difficulty can mean that forming a relationship can be problematic and that a child's sense of fight, flight, freeze, flop or fawn may be triggered regularly as they feel under threat.
SYMPTOMS OF ATTACHMENT DIFFICULTIES
Attachment difficulties can present in very similar ways to ADHD and Autism so can be tricky to identify.
In younger children, you may see:
Not looking for a trusted adult when upset
Showing little affection
Withdrawn behaviours
Appearing fearful
Not smiling back
A dislike of touch
Aggression
Avoidance of interaction with others
In older CYP, you may see:
Anger expressed in unusual ways e.g. patting others on the head but doing it too roughly
A dislike of eye contact
A wish to control all situations
Seeking affection from relative strangers
An apparent lack of conscience - e.g. not caring if they have hurt someone
A dislike of / difficulty showing affection
HOW IS AN ATTACHMENT DIFFICULTY DIAGNOSED?
The first thing is for parents / carers to talk to their GP who can suggest the appropriate service. There may be a need to refer to CAMHS or to the paediatricians. Only a medical professional can diagnose an attachment disorder; schools and parents/ carers CANNOT diagnose. An assessment will involve a thorough exploration of other likely causes and may include discussions with parents / carers, school, psychiatrists, psychologists, play therapists and other professionals involved with the CYP; meeting the CYP and assessing their levels/ styles of attachment.
WHAT HAPPENS AFTER DIAGNOSIS?
There are many ways to help an attachment difficulty and there is a debate about whether a difficulty is lifelong as some strategies are extremely effective and symptoms can disappear. Help can include using Family Therapy; focused parent groups; Theraplay and, in some cases, using Dyadic Developmental Psychotherapy (DDP).
HOW CAN I FIND OUT MORE ABOUT ATTACHMENT DIAGNOSIS?
Please see here for further information.
HOW CAN I HELP IN SCHOOL?
Please see below for ideas on how to help.
Understanding Instructions
Break reading tasks, comprehension and other literacy based activities into manageable segments
Break tasks into manageable steps to ensure clarity and understanding
Be calm, predictable, consistent and repetitive
Always be explicit and keep language clear, precise and simple
Following Classroom Rules
Have explicit rules and apply them consistently
State why the behaviours are wrong in a firm, precise and unemotional manner
ALWAYS separate the behaviour from the CYP
Avoid showing anger even if the CYP displays no remorse for their behaviour
Do not enter into power struggles
Use a visual for the CYP to see what the consequences may be (agreed with the CYP when not heightened)
Be fair
Coping with Change
Give the CYP plenty of warning about any forthcoming change
Ensure that the any CYP support is kept informed of any change, so that they can remind
Be predictable and consistent
Teach explicit strategies to cope with unexpected change
Accepting Consequences
Avoid using the word ‘lying’ or ‘manipulating’; replace with words like ‘can’ or ‘trick’
Do not use emotive language, keep factual and fair
Do listen to the CYP
Remind the CYP of the visual consequences - this needs to have been pre agreed with the CYP
Be consistent. If the CYP does not accept the consequence, move to the next stage (with reference to to visual)
Use a safe space if needed