Attachment and resilience in early-deprived children REACH Seminar, October 19, 2010

Lucy Le MareSimon Fraser University

Outline

Attachment What is it? Its importance in development

Attachment in IC adoptees Meta-analytic evidence Longitudinal evidence Evidence from case studies

What is Attachment?

“To say of a child that he has an attachment to someone means that he is strongly disposed to seek proximity to and contact with a specific figure and to do so in certain situations, notably when he is frightened, tired, or ill.”

John Bowlby, 1982

The Development of Attachment

The tendency to form an attachment is innate and universal

Under “normal” rearing circumstances, by 6 or 7 months of age, babies have identified a primary attachment figure

All babies form attachments but the quality of those attachments vary

Quality of Attachment and Internal Working Models

Secure Insecure avoidant Insecure resistant Insecure

Disorganized

Internal Working Model

Importance of attachment

Development of a secure attachment has long-term benefits for childrenDevelopment of emotion regulationBasic trust in their parents & others and in

their own abilities to influence the worldAbility to function autonomously and with

confidence

Attachment and Intercountry Adoption

Risks for IC adoptees

Experience of institutional deprivation and neglect

What does the research show?

Meta-analytic studiesE.g., Van den Dries, Juffer, van IJzendoorn, &

Bakermans-Kranenburg (2009) Longitudinal studies

E.g., Audet & Le Mare (in press) Case studies

E.g., Kurytnik & Le Mare (in prep.)

Meta-analysis of attachment in adopted children

Van den Dries, Juffer, van IJzendoorn, & Bakermans-Kranenburg (2009) 17 studies; N = 772 adopted children Moderator variables:

Age at placement Time spent in the new family Continent of origin Type of placement (international or domestic) Age of attachment assessment

Secure Attachment (Van den Dries et al., 2009)

Summary of Meta-analysis – Attachment SecurityIC adoptees have similar rates of

attachment security as domestic adoptees Adopted children have lower rates of

security than non-adopted children ONLY if they are adopted after 12 months of age

IC adoptees have HIGHER rates of attachment security than children in institutions

Romanian Adoption Study- Participants Romanian Orphan Group (RO)

On average spent 18 months (since birth) in an institution before adoption

Early Adopted Group (EA) Adopted from Romania prior to 4 months of age.

Canadian Born Group (CB) Non-adopted, raised in birth families Matched to ROs and EA’s on sex, age, and family

demographic variables.

Romanian Adoption Study Design

Phase 1 – 11 months post adoption Age range = 18 to 76 months

Phase 2 – 4.5 years old

Phase 3 – 10.5 years old

Phase 4 – 17 years old

Romanian Adoption Project:Security 11 mos. post-adoption (Ames, 1997)

Romanian Adoption Project:Attachment at age 4.5 years (Chisholm, 1998)

Romanian Adoption Project:Attachment at age 10.5 years

(Fernyhough, Audet, & Le Mare, 2002)

Summary of longitudinal findings Two groups of IC adoptees (RO & EA)

differed in attachment security across time At all 3 times, the late adopted RO group

showed higher rates of insecurity and lower rates of security than the CB and EA groups.

At all 3 times the EA group did not differ from the CB group in rates of security

Qualitative case studies (Kurytnik & Le Mare, in prep)

9 RO (adopted > 9 months) participants

5 demonstrated “resilience” at age 17

4 demonstrated “non-resilience” at 17

Selection Criteria

Parent reports on the Child Behaviour Checklist (CBCL; Achenbach 1991)

Parents open-ended written comments on strengths and challenges

Researchers’ overall impression of functioning based on many written comments

Examples of resilient and non-resilient participants Mitch (R4) had a total CBCL score of 2, indicating very few behavioural

difficulties. Parent reported strengths included being hard working, musical, a good listener, focused on school, and devoted to his family. He excelled in sports, music and school. He planned to go to medical school. He worked part-time as a lifeguard, volunteered as a referee, and was on the student

executive at school. Regarding challenges, his parents had no concerns. Cory (NR3) had a total CBCL score of 74, indicating behavioural difficulties

in the clinical range, He was failing all school subjects and repeating 9th grade. His parents were most concerned about his very low self-esteem and social immaturity. He enjoyed soccer, but had no other hobbies or interests, and no employment. He was living with foster parents who commented, “he frequently engages in impulsive behaviour leading to poor choices”.

Data sources

Multiple informants at each assessment (teachers, parents, peers, researchers)

Quantitative and qualitative data

Data Sources cont….

11 mos. Post adoption

4.5 years 10.5 years 17 years

Intellectual X X X X

Behaviour X X X X

Parent-child relationship

X X X X

Peer relations X X X

Self-concept X X X

Family functioning

X X X X

Findings

R1 R2 R3 R4* R5 NR1 NR2 NR3* NR4

Age @ adoption

17 22 22 24 16 15 12 14 10

# Dev delays

4 1 3 1 0 3 2 1 0

Gesell delays

N/A 3 4 1 1 N/A 3 1 0

IQ 115 85 84 99 116 86 73 93 89

Income $75K $35K $35K $100K $85K $50K $75K $55K $55K

Parents ages

36, 37

33, 38

3338

4647

4348

3640

2930

3335

3838

Parents educ

1 1 1 3 2 1 1 3 1

Caregiving in Early Childhood

Resilient participants all cared for by their mothers.

Non-resilient participants all cared for by non-familial babysitters, nannies, or daycare providers.

Family Structure

Amount of individual attention available

Number of siblings

Closeness in age of siblings

Parenting styles

“Mitch’s (R4) family is very sensitive to his needs and provides him with experiences to encourage development in a natural and loving manner. His mother recognizes that using isolation as a discipline technique was inappropriate for this child” (IDP specialist)

“Allison’s (NR1) mother doesn’t seem harsh, but not nurturing either. There is far too much talking about the kids in front of them” (Researcher notes)

Parental outlook

“Mitch (R4) is often immature, but so are all 10-year-old boys”

“I know something is going to happen but it’s not my fault. I’m fully prepared that Cory (NR3) will be arrested someday…he’s not changing…he’ll never change”

Parenting stress

“This strikes me as a very happy and well-adjusted family despite the fact that the parents are divorced” (Researcher describing Liam’s (R1) family)

“My parents disowned me for what I had done” (Allison’s (NR1) mother referring to the adoptions of her two daughters)

Attachment

“Heather (R3) is managing well in her new household, and is becoming increasingly more outgoing and secure. She appears to have bonded well with her adoptive mother” (age 2.5 years)

“I enrolled her (Allison – NR1) twice in a stranger program and it may have helped a little but I still don’t trust her” (age 10.5)

Conclusions

IC adoptees adopted < 12 months are at no increased risk of attachment insecurity

IC adoptees adopted > 12 months are at elevated risk for attachment insecurity

BUT, IC adoptees with lengthy and extreme early deprivation can form secure attachments and develop positively into healthy, happy, and productive teens.

Implications

Pre-adoption education for families Post-adoption support for families