Reactive Attachment
The first relationship a child will form is with a parent, a relationship that may start forming as early as birth if not earlier. If the process of a parent and child building a relationship is interrupted, regardless of the cause, conflict can arise when the child is trying to form relationships later in life. The ability to form relationships influences many aspects of a child’s life. For better or worse parent-child relationships affect a child’s social development, cognitive growth, temperament, ability to adapt, etc.
So how does this relate to adoption? Increased age of adoption, increases the likelihood of attachment and other trauma. Children adopted at a later age and children who have many caregivers prior to adoption show an increased likelihood in developing attachment issues.
Research shows that those adopted earlier in life fare better in establishing healthy attachments to their new caregivers as they age. Children adopted after the age of twelve months tend to struggle more due to the ruptured attachment previously made to a caregiver or parent. This has a high chance of stunting the cognitive and emotional growth of the child. Children who are adopted at school age most likely were exposed to a form of trauma from the biological parents. This trauma can range from neglect or rejection to physical, sexual, or emotional abuse. Depending on the trauma history, a child could develop negative attachment representations and lose trust in adult figures. This can lead to the development of attachment disorders such as Reactive Attachment Disorder (RAD).
Reactive Attachment is categorized in the DSM as a trauma and stressor related disorder. Some of its presenting symptoms include a lack of affection or focus toward the preferred caregivers, the child does not seek or respond to comfort when distressed, a lowered reciprocity emotionally and socially, and behaviors of fear or anxiety that lack explanation. Even when there is affection and focus shown toward caregivers, the individual often cycles through compliance and dependence to passivity, withdrawal, hostility and rejection. Adoptees show a higher amount of anxiety and avoidance than those in secure biological homes.
Other factors that influence adoption and attachment are things such as prenatal alcohol, tobacco and drug exposure, abuse, and neglect. Additionally, as the number of out-of-home placements increases (foster care, group homes, etc), the influence of such risk factors and insecure attachments increases as well. This can lead to a child becoming harder to adopt. If they are adopted, they may then present negative attachment behaviors as a result of the multiple out-of-home placements.
An increasingly popular framework for understanding attachment issues with adopted and foster care children is attachment theory. Attachment theory presents the idea that infants require a caregiver relationship to have consistent, predictable, and attuned care. This care is critically important in a child’s early years. The caregiver also needs to be emotionally sensitive. This develops an inner model of security and safety for the infant. TBRI and PCIT are very popular modalities in working with parents and young kids in foster care or adoption roles.
It might be worth mentioning as a disclaimer that not every adoptee or foster care child fits criteria for RAD. In fact, most do not. Some of the struggle that comes with adoption is just part of the territory. You can acknowledge and support or you can challenge and chastise. For more information be on the lookout for our Adoption Identity Workshop.
