The inspiration for my latest blog came to me out of the blue and not from a source that I’d naturally find the spark to get me writing. It actually struck me whilst sat at my desk skimming through emails, where it literally jumped off the screen at me – the all too familiar words ‘attachment difficulties’. These words would see most people reaching for the phone to contact IT support but oh no, not me! Not exclusive to the world of IT, this is a broad term heavily used within the world of Adoption and yet (from my experience) is sadly lacking in the field of Foster care.
I was first introduced to the importance of attachment focused parenting when we adopted our eldest child over a decade ago. Our agency recommended a technique referred to by some as ‘funnelling’. This pretty much involved us hibernating with our daughter for weeks on end until we had in some way created a bond between us all. The emphasis is naturally placed on you as the primary care giver(s) tasked with meeting all of your child’s needs with limited interruption from the adults in your support network. Gradually, of course you begin in time to introduce the most important figures in your life whilst continuing (where possible) to ensure that you are still the one(s) the child/ren come to for direct affection, feeding, bathing and consoling.
The training itself recommended we recreate parenting and infant experiences to aid the attachment process and we had two and half years to make up for. So with this in mind we set out to replicate as many as possible. Now this definitely requires the growth of a thicker skin, I cannot begin to tell you how many disapproving stares, tuts and whispers I received from others whilst feeding my (close to three year old) toddler with a babies bottle in public. I rocked her to sleep in my arms, she slept in a cot and ignoring the stares I pushed her around in a pushchair until she was old enough that her feet were practically dragging across the floor; all the while watching parents of her peers encouraging their children to be independent. I continued to baby her as part of the process until the need for socialisation at pre school became a necessity.
Now I’ve been lucky enough to have taken lots of newfangled training with regards to attachment in my time. However nothing drove the message home more as to why it was so critical to build lasting connections with the child/ren in the very early stages of Adoption than when I began my Fostering journey. Now reflecting back, the importance of therapeutic parenting techniques is glaringly obvious and I’d like to share with you why…..
Respite care springs to the forefront of my mind and naturally sparks a debate within me. The first baby we cared for on this basis was about nine months old and from the moment his (well established) carer dropped him off (for his two week stay) he screamed. I had not previously met him nor his carer and after a brief exchange of bags and her telling me what a placid boy he was, I was left quite literally holding the baby!
Rifling around in his bags looking for answers as I jiggled the screaming baby on my hip I found scribbled on a piece of paper a rough guide to his daily routine but that was it. I realised very quickly that I had absolutely no idea how to soothe the unhappy little man! He didn’t want to play, he didn’t want to eat and the only thing that calmed him was laying on my chest whilst I stroked his hair. Hours later my husband walked into a house which resembled a crime scene with us laying on the sofa and the short lived silence was broken once more as the baby looked at him and his bottom lip started to wobble.
Coming from an Adoption background makes it difficult not to scrutinise the care system from a therapeutic perspective and this is something as Foster carers we found we were naturally inclined to do. As hubster and I settled in one night during this time, I contemplated how difficult respite care must be for a pre verbal child and now I find myself curious as to how it must impact on the forming of healthy attachments.
Returning to my story and fast forwarding two weeks (just as the baby had started to settle), a sleep deprived bedraggled me met his bronzed looking Foster carer in the contact centre car park to hand over a very bemused looking baby and his suitcase. Normality resumed and now immersed in silence, my husband and I dissected the respite care process over Dinner and deliberated if the well-being of children in foster care was being considered when allowing these unnecessary (sometimes multiple) moves. We both came to the conclusion that respite care should be reserved only as a support mechanism for the Carers parenting the most challenging children and for unavoidable circumstances.
Now I don’t need to bombard you with Bowlby’s theory and baffle you with neurobabble (at this point anyway) to explain how attachment difficulties can start to manifest themselves even in the youngest of children and the consequences. Instead I can only share a typical experience of a baby in short term foster care based on my own experiences and it may help to shed some light on this topic further.
So rewinding back to the early days of our Fostering career a particular story springs to mind. Having just been linked with a baby and amidst her extended stay in hospital I sat by her cot in a busy neonatal ward. Engulfed by the beeping of medical machinery and the hustle and bustle of the nurses I sat stroking her hand whilst she slept; by this time she had been admitted for over four weeks. Scanning the clipboard attached to her bed I noticed all the different signatures of nurses who had fed her, or administered medication around the clock during the previous week alone which left me momentarily startled. Surely given the number of people involved it was impossible for her to know who her main attachment figure was? This was unavoidable but hopefully you can see the point I’m trying to make? If not, imagine coming home as a child from School and found your Mum or Dad was a different person every time (maybe on a rota)…how confused would you be and how would you be able to seek comfort or help from them as practical strangers? Unsettling yes?
After a week I was allowed to take her home and this of course would be the time where most mothers would establish a much needed routine for their baby and start to form bonds. Sadly, not for the babies in the care system! During the next six months (whilst care proceedings were ongoing) I drove her to and from the contact centre to visit her birth family five days a week. It didn’t take me long to realise that short of a catastrophic event contact was non negotiable and my little Foster bundle’s needs had to be met around the ever evolving contact slots being offered to all manner of relations. Now looking from a child development perspective, during this period her brain like all children her age was developing and she was beginning to view the world of relationships around her. As far as she was concerned I was her main attachment figure (primary care giver), yet how could she trust me (and this is important) when from her perspective I abandoned her (vocalised in the cries I heard as I left the centre) on practically a daily basis? Her feeds and sleeping routine were constantly being disrupted and even on occasion due to poor communication from the contact centre she was left with a random worker as a result of her birth family not turning up.
So when she wasn’t stuck in a car seat travelling to and from the contact centre she was stuck in a car seat travelling to a string of medical appointments which involved yet another sea of faces, and being prodded by yet another set of hands. If this wasn’t bad enough for the child, we experienced what seemed like an endless string of professionals waltzing through my house all innocently interacting with her as they went. Does this feel chaotic and confusing yet? Factor in the potential of respite care (another disruption in attachment), moving to permanency if they are lucky enough and not to mention the potential of exposure to neglect and substance abuse in the womb and voila that’s the early experiences of your Adopted/Fostered child’s life! Now it’s important to be mindful that this is quite a straightforward example and some children may have moved several times in Foster Care in addition to potentially experiencing abuse and trauma within their birth families, which also unsurprisingly impacts on the development of the brain.
Now momentarily flitting back to a different respite experience I will hopefully explain things a little further. On this occasion we offered a two week stay to a slightly younger baby than our previous, who was already on his second respite break due to his jet setting carers. Again having never met the baby or his Carers, he was dropped off to our home one weekend with his belongings. Now to the outside eye, he was the perfect baby as he didn’t cry, accepted a feed from anyone and appeared to not be bothered by unfamiliar faces. He slept, he ate and he barely made a fuss. It was difficult to decide if he was happy, sad or just plain indifferent. Unfortunately on this occasion I didn’t even get the opportunity to say goodbye (to see his face on departure) as I was instructed to drop him off at the contact centre to see his Birth Mother for his Carers then to pick him up at the end. Given the way he presented all week, I honestly don’t think he would have been bothered in the slightest by the change and I found this to be more of a disconcerting experience than the first! Not even a year old this little boy appeared to be detached from the world and I still wonder to this day if he had lost faith in the ever changing sea of faces around him. Which is indescribably sad for one so young and not a solid starting block for his future and his relationships!
I’ve given you some scenarios of where children exhibit attachment behaviours, so what exactly do these ‘difficulties’ look like? Well (due to overlaps in symptoms) as the children grow they look very similar to lots of other conditions, in fact so much so the Coventry Grid was devised to help differentiate between the symptoms of Attachment Vs Autism. On top of this and also blurring the lines are FASD (Featal Alcohol Spectrum Disorder) ADHD, and SPD; making it very difficult for professionals to truly recognise and diagnose despite it being one of the most common labels ironically ‘attached’ to Adopted children. The symptoms can vary from mild to severe, the most severe being Reactive Attachment Disorder.
All Adopted/Fostered children have a level of attachment need (just like any baby being born into a family) however not all children go on to develop attachment difficulties. A prime example of this being my daughter and anyone who is lucky enough to have a relationship with her would concur. Attachments can be strengthened and repaired at any time by ultimately looking at the relationship between the child and the primary care giver. Sounds simple, well I guess it does to someone who doesn’t have to face the very real day to day challenges some parents face. Imagine trying to connect with someone who continually pushes you away or is sometimes controlling, abusive or violent.
It’s safe to say, it’s not as easy to recreate parent and infant experiences with older children as they can be resistant and so this requires some ‘creative thinking’. Skin on skin contact is an important part of bonding with a newborn and therefore I still continue to swim with my children as often as possible and would highly recommend this to other Adoptive Parents and Carers. In addition to this any opportunity I get to slap on the sun cream or play games that involve positive touch I do. If you want to take an older child back to the weaning stage try playing the ‘tasting game’. This involves blindfolding your child and spoon feeding them different foods whilst they attempt to guess what they are. This frequently finds us howling with laughter in our house or spluttering with disgust as the kids think it is hilarious to be fed something obscure like ketchup or Marmite…..oooh I feel a vlog coming on to demonstrate!
Controversially my bed has been the attachment seeking hub over the years and it’s where my children migrate in the night when they are feeling unsettled. I recognise that this is not an appropriate scenario for all families due to children’s backgrounds, ages and status (as this would not be permitted in Foster care). The reason for this is Foster Carers are required to sign a ‘safer caring policy’ document which adheres to certain conditions to help protect the Carers from risk of allegation eg. ensuring that you are appropriately dressed at all times. Now I have viewed these documents a lot over the years in my panel position and whilst I wholeheartedly support the need to protect Carers this needs to be carefully balanced with the attachment need of the child, or the policies are at risk of actually becoming a hindrance to the forming of healthy attachments. In addition to no tickling and no rough play I will quite often see the words ‘Affection needs to be initiated by the child’ which secretly sparks a battle within. One of the main symptoms of an attachment disorder is an aversion to touch and therefore the importance of positive touch needs to be shown (all be it gradually). Equally a child who has been neglected may not know how to show affection and therefore this rule would continue to deprive them of this basic human need.
One of my children once told me that they loved my bed because it smells of me and ultimately I know it makes them feel safe to be snuggled up with Mummy. As they got older (with this comment in mind) I gave them my pillow (when they awoke at night) which appeared to have the same soothing effect and prevented me from getting a foot up my nose in the middle of the night! This could provide a solution to parents with older children and adhere to the rules of safer caring policies. In my opinion there are questions to be asked around these documents, which in my view should be tailor made for individual needs and not copy and pasted for convenience. More importantly we need to be realistic with this, for example when my children reached potty training stage how did they learn? They learnt from me of course, as like anyone with small children the door was always open!
Another significant challenge with Adopted and Fostered children is being separated from their main attachment figure and this often causes difficulties (which is hardly surprising given their past experiences). Sending your child to nursery or school can become a painful experience as a parent especially if there is a distinct lack of awareness and understanding within the school setting. Now from good old Bowlby’s work we know that children are pre programmed from birth to form attachments in order to survive (yes life and death stuff) and attachment styles are applicable to us all. Dr Patricia Crittendens research has gone on to suggest that children do not always stay in one attachment style and can change their behaviour in order to survive ‘in the moment’ and this for me is the biggest explanation as to why I so often hear that Adopted/Fostered children present differently between home and school (or visa versa). As a parent you can help your child remain connected to you during their school day by giving them something that keeps you connected (mine wear an item of jewellery each) or something that smells of you. When your little one is having packed lunch sneak a little note in their box to let them know you are thinking about them whilst you are apart. In the early days of placement do not underestimate the importance of reassuring them that you will be coming back. Ultimately you are entrusting your child to the school and therefore they have a vital role to play in your child’s life too, but alas (given my awful experiences) I feel that this is a blog in itself for another day!
Building and strengthening attachments takes time commitment and an abundance of patience! The biggest skill I have learnt over the years is not to take things personally and to let things go. Holding grudges ultimately stands in the way of making any relationship work. Wipe the slate clean every day (for both of you) and keep persevering, I’m not going to lie some days it’s exhausting and on others your tolerance can wear thin, but when you see that ray of sunshine break through the dark clouds in my eyes it makes it all worth while.
Lastly, in an IT nutshell,‘Attachment difficulties’ are caused when your child’s brain programmes differently. Ultimately you are the technician in the best PLACE to do the reprogramming (see what I did there Dan Hughes!) to help them to view relationships differently. It’s a relentless task and therefore it’s important that you take some time to ‘switch off’ and ‘reboot’. Sometimes these attachments can be restored quickly and other times additional support is required but once you manage to connect securely in my eyes it’s worth every bit of the hard work.