Post – Qualification Doctorate in Educational Psychology Academic Assignment Understanding and Identifying Attachment Problems in People with Severe Learning Difficulties: Living in Residential Care. – October 2009 INTRODUCTION Local Authorities have always been reluctant to refer children to residential settings, not only due to the financial implications, but because of the
In contrast, the disinhibited form is characterised by indiscriminate sociability and excessive familiarity with relative strangers. Although, effective in getting his/her needs met, the child is not selective from whom he/she receives comfort and (Prior & Glaser, 2006, p.220). Heinz Brisch (2004) states that before a diagnosis of attachment disorders can be made, these deviant behaviour patterns (inhibited or disinhibited) must have been observed by different caregivers for a period of at least 6 months”. Diagnostic Factors The possible reasons why factors of attachment are overlooked, when students are referred and/or re-assessed in residential care, partially stem from the complexities of Reactive Attachment Disorder (RAD) is the singular recognised disorder/condition quoted in the Diagnostic Manual – Intellectual Disability (DM-ID), with its formalised diagnostic criteria. The remainder seem to be of secondary importance as “styles”, “patterns” and “types”, and therefore, given less credence by clinicians. The diagnostic criteria identified in DM-ID, is solely based on observable attachment behaviours amongst a study group of children with average intelligence and normal child development patterns. The main study was based on the Ainsworth Strange Situation Test, during which she and her colleagues devised a method for assessing how well attached a child is to his/her main caregiver (Ainsworth et al, 1978). Consequently, there is insubstantial data
The similarities in diagnostic criteria, and symptoms between different disorders/conditions have contributed to the existence of “overshadowing”. The concept of “diagnostic overshadowing”, according to Coughlan (2001), was developed by Reiss, Levitan and Szyszko (1982) and refers to when the learning disability itself overshadows any additional impairments, specifically mental illness and/or psychiatric conditions. Pearce (2009) postulates a theory as to how attachment problems can be “overshadowed” by other conditions, leading to situations of misdiagnosis. She states that children with attachment problems or disorders are chronically due to the emotional effects of loss and traumatisation. This over-arousal manifests itself in acute inattention difficulties, aggressive, destructive, hyperactive and disengaged behaviours. All of which are equally attributable to Attention Deficit Hyperactive Disorder (ADHD), Conduct Disorder and Oppositional Defiant Disorder (ODD). Newman and Mares (2007) also refer to how the controlling, aggressive and delinquent behaviours of older children are attributed to ODD and Conduct Disorder, thereby excluding the possibility of attachment patterns or disorder. Heinz Brisch (2004) mentions that there is a type of attachment disorder referred to as No Signs of Attachment Behaviour. Children with this disorder are remarkable in that they demonstrate absolutely no attachment behaviour towards anyone. Even in dangerous situations, these children do not turn towards a preferred attachment figure. The children most likely to experience this subtype are those who have undergone numerous relational shifts in infancy or were
possibly because of withdrawal form primary caregivers. Loss and trauma can be the overriding symptoms caused by the effects of withdrawal. To help us appreciate how these scenarios might occur in a residential placement, such as Sunfield, research evidence is extracted from the experiences of what are termed “looked after children”. These children have either been placed for adoption or residential care. In respect of adopted children, it can be highly problematic for them to form new attachment bonds with their adoptive parents, so much so that any forgings of intimacy are resisted (BAAF Position Statement 4). This is due to a strong and continuous “affectionate bond” between these children (adoptees) and their birth parents. Even in extreme cases of neglect or abuse, there is an enduring loving and longing for the birth parent(s) (Burnell and Archer, 2003). The loss and trauma experienced by being separated from his/ her birth parents comes into competition alongside feelings of rejection and a complete breakdown of trust towards the birth parent(s). The primal relationship between the child and his/her birthmother is broken and can never be perfectly rectified (Verrier, 1993). What is described as the “foundation stones” for building and sustaining relationships have been so dismantled that reparative healing is extremely difficult to achieve (Guishard-Pine, McCall & Hamilton, 2007). In order to protect themselves from the fear of further rejection, these children either withdraw and isolate themselves, or resort to “testing-out” behaviours (Verrier, 1993). Steele (2008) quotes the experiences of adoptive parents of