How to Support Children with Attachment Disorder

Mia Simpson

April 17, 2024

5 min read

A child’s ability to form healthy emotional bonds during the first years of their life is vital for their social and emotional development. If they aren’t able to do this, this can lead them to develop an attachment disorder that affects them for the rest of their lives. Children with attachment difficulties can struggle with social situations, as well as regulating their emotions and behaviour, making it difficult to cope day-to-day, including at school.

These children require strategies and interventions to ensure they can lead happy and fulfilling lives. In this article, we will outline what attachment disorder is and what causes attachment disorder in children. We will also cover the signs that indicate a child is experiencing attachment difficulties and provide guidance for teachers and caregivers on providing support for children with attachment disorder.

What is Attachment Disorder in Children?

Babies usually develop a close attachment to their primary caregiver in the first few months of their life. This is the person who provides the closest care for the baby from birth. The attachment forms as a result of them consistently providing for the baby’s needs, from food when they’re hungry, to comfort when they’re upset.

According to attachment theory, this provision of care teaches the baby that the primary caregiver will always be there to fulfil their needs. This gives the baby a sense of security, known as a ‘secure base’, from which they can then begin to explore their environment and deal with new situations. This allows them to learn how to express their emotions and build healthy relationships.

Research has shown that forming a secure attachment during this time increases the likelihood that a child will develop emotional intelligence, good social skills and strong mental wellbeing.

However, some children do not have the opportunity to form a secure attachment with their primary caregiver during their early life, due to that person not consistently fulfilling their needs. If a baby is not comforted when they cry, or not changed or fed as soon as they need it, these are examples of their fundamental needs not being met. This can lead to them developing attachment difficulties.

It can also develop if a child only has their needs met occasionally or conditionally, as this teaches them not to expect consistent care, or if a child only gets attention when they are exhibiting ‘naughty’ behaviour.

Without this attachment, a child may lack the sense of security and safety they need to explore their environment, emotions and relationships. This also means that they won’t have the opportunity to practise overcoming stressors and anxieties and, as a result, may struggle to cope with managing their emotions and behaviour, new experiences and building relationships with others as they grow up.

Attachment difficulties can affect a child’s emotional, cognitive and physical development and fall under the category of social, emotional and mental health (SEMH) needs. In severe cases, children with attachment difficulties may be diagnosed with an attachment disorder.

As an adult, attachment difficulties can also affect someone’s ability to form stable and secure relationships, as they can perceive other people as inherently unreliable or untrustworthy. This puts them at greater risk of entering into abusive relationships. Additionally, they may have poor parenting skills and struggle to form an attachment with their own children.

If you’d like to find out more about how a child’s early development can affect them in later life, take a look at our article Why is Child Development So Important in Early Years?

Causes of Attachment Disorder

Some of the circumstances that lead to a child developing attachment disorder are unavoidable and are not necessarily due to the caregiver intentionally withholding care from their child. However, regardless of the circumstances leading to a lack of secure attachment, it always has the potential to negatively impact a child.

The following circumstances may prevent a child from forming a secure attachment with their primary caregiver:

The child is separated from their primary caregiver for an extended period or periods of time or permanently. For example, if the child or caregiver is hospitalised, the caregiver goes to prison, they are separated due to war, the caregiver passes away or the child is put into care.
The child is frequently moved from one caregiver to another. This means they do not have the time to form a secure attachment with one adult and could occur if the child is in foster care.
The caregiver suffers from physical or mental illness. This could mean they are unable to sufficiently provide for their own needs, let alone their child’s needs.
The child or caregiver has experienced abuse, neglect or maltreatment.
The caregiver is suffering from substance misuse.
Difficulties during pregnancy or birth, including if the parent is separated from their baby immediately after birth, for example for neonatal care.

This is not an exhaustive list of the circumstances that could cause a child to develop attachment difficulties. Anything that causes a caregiver to be unable to consistently provide for their child’s needs may cause an attachment disorder to develop.

Signs of Unhealthy Child Attachment

Children with attachment difficulties may adapt different ways of communicating in order to have their needs met, including particular behaviours. Many of these behaviours may be interpreted as being ‘bad’ or ‘disruptive’, particularly when seen in the classroom.

The longer attachment difficulties go unmanaged, the more severe they can become and the greater impact they can have on a child’s development. It’s therefore important that adults are able to identify the signs of attachment difficulties in children as early as possible, so that they can give the child the support and care they need.

Some common signs of attachment difficulties in children include:

Poor academic performance.
Lack of focus and/or engagement (including with other children or adults).
Limited or unsuccessful social interactions and inability to build relationships.
Inability to calm themselves down.
Frequent overstimulation.
Low self-esteem.
Stress and low-mood.
Resistance to change and desire for control.
Inappropriate familiarity with strangers.
Unwillingness to seek help.
Anger and aggression, often without obvious reason.
Not smiling.
‘Attention-seeking behaviours’ that can be extreme and dangerous.
Hyperactivity and fidgeting.
Dislike of physical touch.
Never seeming truly happy.
Lack of understanding of ‘unacceptable’ behaviour.
Lying.

As the child gets older, symptoms may also include self-injury, substance misuse and criminal behaviour.

This list is not exhaustive and not all children with attachment difficulties will show all of the signs listed above. Every child is different and may show different signs, even if they have had very similar circumstances. Some behaviours may also only be apparent at certain times, such as only when the child is with their primary caregiver or when they are apart from them, or when the child is at school.

It can be challenging to understand why a child is exhibiting ‘bad’ behaviour, whether at school or at home. However, as an adult supporting a child with attachment difficulties, it’s important to recognise that this type of behaviour is an indicator that the child is struggling with how they are feeling and how to express it. It is your responsibility to find ways to help the child manage these difficulties, in order for them to lead happier and more fulfilling lives.

You can learn more about supporting children who have suffered adverse childhood experiences to succeed in school in our article, here.

How to Help a Child with Attachment Disorder

Children with attachment difficulties or attachment disorder will require additional support in order to have the same opportunities as other children, particularly in the classroom.

Attachment difficulties can make it particularly challenging for a child to succeed in the school setting. For example, their memory and comprehension skills can be affected and they may have trouble forming friendships and trusting adults. Children with attachment difficulties can also struggle with communicating and expressing themselves and their emotions. This struggle to express themselves may then present itself as ‘outbursts’ or ‘bad behaviour’.

Looking for a Course?

We offer a range of Courses for Teaching and Education that will help you to provide the appropriate care and support for children in schools, including children with additional needs, such as our Challenging Behaviour and Child Mental Health courses.

The treatment for attachment difficulties involves making significant, practical changes in the child’s life. While there is no medication for treating attachment difficulties, if the child suffers from related symptoms, like anxiety, ADHD or depression, medication may be beneficial. Additionally, certain therapies, such as talking therapies, can be used to help the child to work through their negative experiences.

The following list of strategies can also be used to support a child with attachment difficulties, However, it is important to remember that what works best for one child may not work for another. Every child is unique and will require a tailored plan for support and intervention. These interventions may need to be long-term, spanning a child’s entire school life, in order to ensure they can succeed in a mainstream setting.

Providing a secure base

For a child who has never formed a secure attachment with an adult, providing them with a secure base is essential. This will create opportunities for them to develop a sense of safety, security and confidence that allows them to begin exploring their environment, their feelings and their relationships in a healthy way.

As an adult working with children with attachment difficulties, it’s vital that you show them you are secure, reliable, fair, kind and trustworthy. These children can benefit from having a ‘champion’, a key adult who will always be available to them and who sees the best in them. Repeated good experiences with this adult will help to challenge their previous conception of adults and, ideally, teach them that some adults can be trusted.

In school, a champion can be a designated member of staff who is always available to support the child, should they need it. Additionally, having the opportunity to work together with others can give a child a sense of impact and purpose, so it can be beneficial to appoint a key person who can work alongside the child when required.

De-escalation

Children with attachment difficulties can struggle to regulate their emotions, meaning they can be prone to becoming overwhelmed, resulting in agitation and sometimes physical aggression. As a teacher or caregiver, you need to know how to respond appropriately in these situations to prevent them from escalating.

De-escalation involves remaining calm and professional during challenging situations, something that, whilst not always easy, is vital when working with children with attachment difficulties.

De-escalation requires the adult to reduce the negative feelings a child is experiencing to the point that discussion is possible, before they become physically aggressive. To achieve this, you must be able to identify the early signs that a child is becoming agitated. These can include:

Sudden outbursts.
Disruptive or impulsive behaviours.
Fidgeting and difficulty sitting still.
Excessive talking or movement, including pacing.
Lack of focus or ‘zoning out’.
Irritability and/or anxiety.
Clenched fists or wringing hands.

When a child is becoming agitated or angry, the last thing you should do is ignore them or use separation to punish them, such as by giving them a ‘time out’. This can create a sense of abandonment and lack of security and attention that can increase a child’s emotional state and lead to worse behaviour. You need to be there to support them in regulating their emotions, as this is something they can struggle to do alone.

You can use the following tips to help you de-escalate a child:

Be calm and self-assured. Even if you are feeling agitated or upset yourself, you should avoid showing this to the child where possible. Try not to show any of the signs listed above as doing so could encourage the child to mirror you. Additionally, excessive eye contact can be perceived as threatening to the child.
Maintain a neutral facial expression. Our facial features can easily give away how we are feeling, for example a furrowed brow and downturned mouth can show we are upset. Maintaining a neutral expression can help to reduce tension in these situations.
Allow the child space. While you shouldn’t ignore or leave the child alone as punishment for behaviour, you should avoid taking over their personal space as this can be perceived as a threat, increasing the risk of an aggressive response.
Control your breathing. Taking slow, deep breaths will calm you down and may encourage the child to match your breathing, calming them down also.
Distract the child. When agitated, children can struggle to think clearly, making them more likely to behave inappropriately without thinking. You should try to distract them and encourage them to focus on something other than their emotions, rather than arguing with them. However, it is important to let the child know that you are listening to them and acknowledging their feelings.
Give them time. It can be hard for a child to talk or process what others are saying to them in a state of high emotion. You should wait for them to calm down before trying to engage them in conversation.

Following a conflict, it’s important that you are there for the child in order to reinforce your status as a stable and consistent figure in their lives. You should debrief, repair and rebuild to ensure you maintain the secure attachment you are forming with the child.

Consistency

Consistent boundaries help to create predictability and stability for a child with attachment difficulties. It is important to teach them what behaviour is acceptable and what isn’t, and to outline consequences before incidents occur.

Children with attachment difficulties can struggle with change and a lack of structure and this can make them feel unsafe. Consider implementing routines and schedules for unstructured times, such as lunchtimes as this will give the child a sense of stability, consistency and predictability.

Patience

When a child is being ‘naughty’ or ‘acting out’, try to avoid responding emotionally, as this can heighten their emotions, resulting in a conflict. Instead, keep calm and follow through with the previously established consequences.

You can use a ‘calming box’ to provide a child with sensory regulation. This provides them with a range of sensory tools and activities that can give them a sense of control and distract them from their agitation, calming them.

Recognising and expressing emotion

Practise recognising and expressing emotion with the child. If you recognise that a child is becoming overwhelmed and agitated, you can use the ‘Wondering Aloud’ strategy. Try to speak to them about how they are feeling using phrases like ‘I wonder if…’ or ‘Maybe we can…’. This can help to re-engage them in a more positive way. However, you should avoid telling the child what you think they are feeling.

Starting a feelings display or feelings diary in school can help children with emotional regulation, strengthening their ability to manage difficult emotions. This will allow them to practise self-analysing and recognising their own emotional state

Building self-esteem

Children with attachment difficulties often feel ‘destined to fail’ or that they lack worth. Giving them low-stakes tasks where success is guaranteed can help to make them feel important and good about themselves. One way you could do this in the classroom is by giving them a specific role to play, such as handing out resources. You can also build self-esteem by offering specific praise or by having them create a ‘success book’ where they record their accomplishments.

Roleplay is another way to give children opportunities to experience success, giving the child a chance to practise having real-life situations, without the pressure of real-life consequences. This can increase their confidence in exploring the world around them.

Managing the environment

Children with attachment disorder are prone to overstimulation which can make it hard for them to manage their emotions, even positive ones. Overstimulation occurs when someone has more experiences than they can cope with, and can result in ‘bad’ behaviour.

For this reason, it’s important to keep the child’s environment as lighthearted and calm as possible. This teaches the child that life should and can be fun and enjoyable by giving them the opportunity to discover what they like to do, without the pressure of failure. Play has been shown to reduce stress, strengthen attachments and reduce behaviour problems.

Skills training

Every new relationship a child enters into has the potential to challenge what has come previously. For caregivers, the main treatment you can provide for a child with attachment difficulties is to build a secure relationship with them, ensuring they feel loved and cared for. If you struggle to recognise the needs of your child you may consider parenting skills training. This teaches carers how to recognise and respond appropriately to the needs of their child.

Research shows that when a child is placed in a suitably caring environment, where their needs are consistently met and they feel safe, the signs of attachment disorder can improve very quickly.

Some children require more support than others in the classroom and at home, including those with attachment difficulties or disorder. It is vital you can identify the signs of attachment difficulties and that you are able to provide appropriate care and support for children experiencing them. Behaviour is an indicator that a child needs something from you and, as a responsible adult, it is your role to recognise this and ensure these needs are met, so that the child can lead a happy and fulfilling life.