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Does daycare cause attachment issues?

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      Available data indicate that, for most children, parental attachment processes are not disrupted by daycare participation. ... In fact, for some children, secure attachment with caregivers in daycare may compensate for the adverse effects of insecure parent-child relations.

      According to research, enrollment in a high-quality daycare center can have a significant, long-lasting impact on children's social and emotional development. Consistent socialization and play in early childhood have been associated with higher levels of empathy, resilience, and prosocial behavior later in life.

      Insecure attachments develop if early interactions between a child and their caregiver are negative, inconsistent, inappropriate, neglectful or abusive. When a child's care giver and home environment is a source of fear rather than a source of safety, this can be highly toxic to a child's development.

      Whether and how non-maternal childcare experience affects children's development has been of long-standing interest to parents, policymakers and developmental scholars. Ever since Bowlby promulgated attachment theory, thinking derived from it has led some to expect daycare, especially when initiated in the earliest years of life, to undermine the security of infant-parent attachment relationships. To some, this was because daycare involved the infant's separation from the mother (or another principal caregiver), as separation from the attachment figure was inherently stressful. 

      Separation could also undermine the mother's capacity to provide sensitive care, the primary determinant of security, thereby fostering insecurity indirectly (i.e., separation-insensitivity-insecurity). 

      A final reason for anticipating a link between daycare and attachment security was because security reflected general emotional well-being, so adverse effects of daycare in infancy would manifest themselves as insecure attachment.

      What Is Attachment?

      In Child Care, Today: Getting It Right for Everyone, Penelope Leach, a British psychologist, says that mothers are generally the first "attachment figures" because of biology, but not necessarily the only potential caregiver. "A mother does not have to be with the baby every moment to love her… Babies can form attachments to fathers (and other loving caregivers) that are not secondary to, but distinct from, attachments to mothers," Leach explains.2

      John Bowlby, a British psychiatrist and the father of attachment theory, along with Mary Ainsworth, an American psychologist, emphasized the significance of the first infant/mother bond in historical studies in Attachment and Loss3. He found the prerequisite to a successful learner lies within a safe, secure and stable home with an empathic and nurturing environment.

      When we don't meet the attachment needs of children, adverse behaviours are the result. As a school social worker and parent educator for twenty years working with children from kindergarten to grade 12 and their families, I have seen many clever children who functioned poorly because of behavioural, emotional and psychological problems.

      Developmental psychologist Gordon Neufeld identifies the order of priorities for parents: first, pursue good attachment with children, then maturation (in the context of solid attachment), and only then, socialization.4 It is always the adult's responsibility to establish and maintain a good relationship with the child as a first-order priority, regardless of who cares for the child during the day.

      Developing Reactive Attachment Disorder: Is it Avoidable?

      What causes RAD?

      Young children may be at risk for developing reactive attachment disorder when they have received insufficient care and little to no emotional response from their caregivers. Researchers have found that there is a link between the duration of deprivation and the severity of symptoms. The primary cause is neglect; however, there are many ways where a caregiver can neglect a child.

      • Not receiving comfort, affection, and appropriate stimulation from caregivers: A child needs constant physical affection and emotional affection and mental stimulation. A child requires physical touch, food, baths, and social interactions, and when any one of these factors is reduced or eliminated, it could create an attachment issue in the child. Leaving a child in the crib or playpen constantly, skipping late-night feedings, or not speaking to the child are also forms of neglect.
      • Lack of stable attachments due to repeated changing of primary caregiver: Parenting can be extremely difficult, especially if you are managing a full-time job or have the role of a single parent. Babysitters and daycare are necessary; however, constantly changing childcare providers can be harmful. A frequent change in babysitters, daycares, or nannies can cause emotional distress in the child due to the constant change. Children need stable environments where they can interact with the same person over a long period to feel safe and trust their caregivers.
      • Receiving care in settings that offer a limited possibility for attachment: If a parent is incarcerated or in and out of the hospital, the child may need to live in another setting, such as a foster home. Often, when a child enters a foster home, they may move between families, which prevents the child from forming an attachment to their caregiver.

      Risk Factors for RAD

      • Being socially neglected
      • Growing up in an institutional setting such as an orphanage
      • Moving amongst multiple foster homes
      • Being forcefully removed from an abusive or neglectful home
      • Having a mother who suffers from severe postpartum depression
      • Going through other kinds of traumatic losses or significant changes with a primary caregiver

      Preventing RAD

      RAD may not be avoidable when parents adopt or foster their children, but RAD is preventable. Biological parents and caretakers play the biggest role in preventing RAD by giving their children enough emotional engagement, physical affection, and mental stimulation. Some parents cannot do this because they struggle with their mental health or maybe have a substance abuse problem. In this case, these parents must seek professional help immediately since they are at risk of gravely affecting their child. Caregivers who emotionally engage with their infants can prevent the development of reactive attachment disorder. Emotional engagement can look like this:

      • Making eye contact
      • Reflecting the baby's emotions in facial expressions and words
      • Limiting distractions such as technology
      • Interacting with the child when changing a diaper or bathing him
      • Singing to the baby
      • Smiling at the baby
      • Playing with the baby

      Get help for yourself

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      As a parent, raising a child with RAD can seem nearly impossible sometimes, and therefore you must be taking care of yourself. Joining community groups, self-help groups, and support groups can help you bond with other parents who have children with RAD. Make sure you are exercising, getting enough sleep, and enjoying yourself, so you can properly take care of your child in a healthy manner.

      Kristen Fuller, M.D., is a clinical content writer and enjoys writing about evidence-based topics in the cutting-edge world of mental health and addiction medicine. She is a family medicine physician and author who also teaches and contributes to medicine board education. Her passion lies in educating the public on preventable diseases, including mental health disorders and their stigma. She is also an outdoor activist and spends most of her free time empowering other women to get outside into the backcountry.

      Six Ideas to Develop Good Attachments Regardless of Care Type

      Losing a job is hardly the ideal solution to attachment disorders in children. Rather, parents caring for children, grandparents, nannies and daycare workers must aspire to the same shared goal, encouraging a child's attachment to love and stable adult role models.

      Neufeld suggests re-creating the attachment village model from previous generations to develop and maintain attachments to alternate adult caregivers. Here are six practical tips toward building your attachment village:

      • Neufeld counsels parents to foster connections among family, friends, and other reliable and responsible adults as a first method to develop good parent-child attachment. This extends the network of positive adults involved and caring about your child's life. Cultivating social relations in familiar settings like neighbourhoods allows children to feel at home without being at home.
      • Create trust with the caregiver. In whatever form of child care, you use, spend time with the caregiver, showing your child you trust the daycare provider. As the child sees how their parent has a good relationship with the caregiver, they learn to trust the caregiver.
      • Ensure the caregiver is mindful of attachment principles. The caregiver should purposefully invite the child into the space. Neufeld recounts from his memory how his grade one teacher welcomed him with tremendous effect. He calls it "collecting" our children, which is part of inviting them into a relationship with you. "After my mother deposited me in the doorway of my first-grade class, and before I had a chance to be distracted by another child, this wonderful smiling woman came gliding across the room and engaged me in a most friendly way, greeting me by name, telling me how glad she was that I was in her class, and assuring me what a good year we were going to have. I am sure it took her very little time to collect me. After that, I was all hers and rather immune to other attachments. I didn't need them; I was already taken," he describes.
      • Understand that attachments to different adults don't compete. They cooperate. Adults and children alike need to realize that increasing attachment for another adult does not mean decreasing attachment to a parent. The caregiver can say nice things about the parent, and the parent can likewise complement the caregiver. "Our job is to make sure a working attachment covers the child with an adult at all times and that we function as an attachment relay team. We need to make sure we have successfully passed the attachment baton before we let go.
      • Slow down morning routines, so you do not rush small children out the door. Gordon Neufeld writes about how meaningful it was to wake up ten minutes earlier with his children: "We designated two comfortable chairs in our den as warm-up chairs. Right after the boys woke up, my wife Joy and I put them on our laps, held them, played and joked with them until the eyes were engaged, the smiles were forthcoming, and the nods were working. After that, everything went much more smoothly. It was well worth the investment of getting up ten minutes earlier to start the day with this collecting ritual instead of going directly into high-gear parenting.
      • Giving your child a locket or other memento with your picture on it so that s/he can look at it will remind a child of a parent's love even when apart. There are different ways to nurture this connection, including little notes or a phone call during the day. The latter may not be possible for busy caregivers. However, ideals are important quite apart from what is feasible in the care systems we have created. It also helps if parents can tell their children as much as possible about their work. It's something we do with loved adults, and children can benefit from understanding (to whatever extent is realistic) of a parent's work activities.

      A study conducted by the National Institute of Child Health and Youth Development found that family life has more impact on mother-child attachment than daycare. One of the most significant findings was that "cognition, language, and social development at ages 2 years, 3 years, and 4½ years showed almost no evidence suggesting that child outcomes were related to whether or not the child experienced routine child care." So what did seem to make a difference? The quality, frequency, and consistency of the interactions between mother and child.

      This means that creating and nurturing a bond with your child strengthens the relationship between the two of you and should ease your worries about daycare dismantling what you've built. To foster that bond with your child, Psych Central suggested various ways to create a secure attachment with your child that will make all the difference in the long run. Showing affection, responding when your baby is distressed, and keeping a predictable routine are just a few of the ways you can feel confident that the relationship between you and your child is meaningful and connective.

      Understanding how parent-child connections are formed should offer some hope for those parents fretting over starting their child in daycare. Instead of focusing on the possible negative outcomes, try staying focused on all the ways you can maximize your together time. Hopefully, spending quality time with your child, and knowing the facts about this common concern, will help you and your child feel more confident about the transition to daycare.

      How to parent for a secure attachment and how to know if it's working.

      "The baby needs to know that they're massively important". "A caregiver should be involved, attentive, sensitive, and responsive."

      "The baby will tell you what to do," Sroufe explains. "They have a limited way of expressing their needs, so they're not that difficult to read: If they're fussing, they need something. If their arms are out, they want to be picked up. And if you misread them, they will keep on signalling until you get it right." He gives the example of bottle-feeding a baby: "The baby might want a break, and she looks around. What does the baby want? To look around! If the parent misreads and forces the bottle back, the baby will insist, maybe snap her head away, or pull away harder."

      "How can I know if my baby is securely attached?" a client asked me about her six-month-old. Observable attachment doesn't emerge until around nine months, but here are some clues that a secure attachment is underway:

      0-3 months:

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      • The baby's physiology is just settling as the baby cycles quickly among feeding, sleeping, and alert wakefulness. Meeting the baby's needs at different points in the cycle helps establish stability.
      • At this point, the baby has no clear preference for one person over another.
      • In her quiet, alert state, the baby is interested in the faces and voices around her.

      4-8 months:

      • Attempts to soothe the baby are usually effective at calming her down. (Caveat: An inability to soothe might not be predictive of insecurity but rather point to one of a host of other possible issues.)
      • The primary caregiver has positive interactions with the baby where the back-and-forth is pleasant.
      • The baby has calm periods where she is interested in the world around her. She explores and experiments to the extent she is physically able to—looking, grasping, reaching, babbling, beginning crawling, exploring objects with her mouth, hands, etc.
      • Infants begin to discriminate between people and start to show preferences. They direct most of their emotions (smiles, cries) toward the caregiver but are still interested in strangers.
      • They are very interested in the people they often see, especially siblings.

      9 months:

      • The baby shows a clear preference for a primary caregiver.
      • The baby shows wariness toward strangers, though the degree varies with temperament.
      • The baby is easily upset when separated from her primary caregiver, though that, too, goes with temperament.
      • The baby is easily soothed after separation and can resume her exploration or play.

      9 months – 3 years:

      • The child shows a clear emotional bond with a primary person.
      • The child stays close to that person but forms close relationships with other people around a lot, too, e.g., babysitter, siblings.

      Our challenge, more than ever, is to hold on to our children, particularly when they are very small. Fortunately, parents have nature on their side because, in the end, children want to be with them and want to look up to them. In a recent Ted Talk, children learn more in their first four years of life informally than all their formal education put together.

      It is in the context of nurturing relationships (attachments) that children realize their learning potential. Nurturing adult orientation and attachment to trustworthy, mature adults is far more important than most parents, and caregivers realize. This importance increases when you aren't able to achieve the child care you desire. The good news is we can all work toward better attachment and adult-oriented children, regardless of the care situation.

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