The effects that an early disruptive attachment history can have on brain development, and how the trauma of separation impacts on a child’s ability to access education
Two years ago I gave up my job as Head of Paediatric Speech and Language Therapy to become a foster carer. Since then, I have been asked the question “How long are they with you for?” more times than I can remember. This enquiry has been made every time a new child is placed with us and it highlights the assumption that the child is likely to be moved to another placement, sooner or later. Sadly this assumption is true, and most children in care will have multiple placements in their lives with some experiencing forty plus different foster and care home moves up to the age of eighteen.
All looked after children live with the grim knowledge that, if their behaviour becomes too difficult, the foster carers can “give notice” and the placement will end. Imagine your own child in that situation. Imagine repeatedly being moved to unfamiliar places, without your family to support you. Imagine moving schools, leaving your new friends and starting again – and again and again. Ironically, the more troubled the child, and therefore the more unable they are to cope with the move, the more placements they are likely to have.
It is not surprising then that the life chances of the 60,000 plus children in care remain compromised when compared to their peers. Only 50 per cent achieve one GCSE at grade A-G, as against 96 per cent of the whole peer population, and looked after children are nine times more likely to have a statement of SEN and thirteen times more likely to be excluded from school.
All looked after children suffer the ongoing trauma of separation from their parents, and the majority will have suffered abuse and developed insecure attachments in their early years. The lack of a secure attachment will have a profound effect on the development of the child’s emotional intelligence and also on their ability to cope with the complex feelings involved in this separation and loss. Early attachment experience provides the foundation for the child’s ability to feel empathy, compassion, trust and love in future life.
The main function of attachment behaviour is to keep the primary attachment figure (usually the mother) close by. For the child in care this fundamental human need is unfulfilled. Society may judge a person’s ability to parent as inadequate, but to the child their birth parents are their primary caregivers, and they will feel the ongoing separation from them as an open sore that never heals.
Attachment behaviour is evoked when babies need physical comfort and protection. These behaviours include making eye contact, smiling, cooing, holding out their arms, and crying. When the baby gets an appropriate response, such as a smile, a touch or a quick cuddle, the baby feels safe and is therefore free to relax, play, explore and learn again. As the baby laughs or cries a sensitive caregiver copies the baby’s affect, thus teaching them to become in tune with and to control their emotions. The baby’s brain is flooded with natural “feel good” chemicals and hormones such as oxytocin and opiods that calm the child and promote neural growth in the higher brain.
However, it is unlikely that this will have been the early attachment experience for looked after children. If there is not an appropriate response to attachment behaviour, for example if the baby is ignored or punished, the baby continues to feel anxious or afraid. As the baby’s stress heightens, his/her brain is flooded with toxic chemicals, such as adrenaline, and these chemicals prepare the body to take flight, fight or freeze. Whilst in the flight, fight or freeze mode, the brain shuts down any areas that would slow down the reaction to the situation. This includes the areas involved in reflective thought. A Child who lives in a bullying, abusive environment adapts to that environment and his/her brain develops accordingly. In order to stay safe the baby needs to be hyper vigilant and he/she will grow into a child whose brain tells him/her to “act quickly: don’t think”.
At birth the brain is underdeveloped with 90 per cent of growth occurring in the first five years. The development of the rational brain (located in the frontal lobes) is dictated by early attachment experiences. As the child receives positive care giving, so synaptic pruning occurs and neural pathways are forged that allow:
• Creativity & imagination
• Problem solving
• Reasoning and reflection
• Kindness, empathy and concern.
We are all born with the capacity to develop these skills, but they will only develop if the appropriate stimulation is given through positive attachment experiences.
Many of the children in care also have diagnoses of development conditions such as autistic spectrum disorders and attention deficit hyperactivity disorder. Understanding the impact of early attachment on the development of the child’s ability to mentalise (see things from another’s point of view, develop “theory of mind”, etc.) and to develop executive functions (such as concentration, planning, impulse control, etc.) has, at times, caused me to question the accuracy of these labels. If we are to support the child with the most appropriate intervention, it is essential that we acknowledge the root cause of the behaviour.
The good news is that neuroscience has shown that the presence of a positive attachment figure, such as a foster carer, therapist or learning support assistant, can encourage new neural pathways to be formed. In her book Inside I’m Hurting: Practical Strategies for Supporting Children with Attachment Difficulties in Schools, Louise Bomber advocates providing an adult attachment figure for the child within the school. The usual view is that we should try not to become too attached to the children that we work with but, as Louise Bomber points out, “Relationships and the relative dependency inherent to them should not be frowned upon in schools, as we are merely re-creating something that is humanly necessary for children who have experienced trauma and loss”.
The main lesson I have learnt over my relatively short time as a Foster Carer is to follow my heart not my head. My advice to all those working and living with looked after children is to take the time to learn as much about their history as possible so that you can see how differently the world might appear to them. By making small allowances, in view of what you know, you can make a big difference to a child’s life.
Tania Allen works for of East Kent Hospitals Trust.
Article first published in SEN Magazine issue 41: July/August 2009.