Attachment is a clinical term used to describe "a lasting psychological connectedness between human beings” (Bowlby,
1997)1. In particular, attachment theory highlights the importance of a child’s emotional bond with their primary caregivers. Disruption to or loss of this bond can affect a child emotionally and psychologically into adulthood, and have an impact on their future relationships. Only specially trained and qualified professionals should assess a child’s attachment style.
However, it’s important for all adults working with children to understand what attachment is and know how to help parents and carers become attuned to their child’s needs. You might do this by working with them directly, or by signposting families to other appropriate services. In the long term, this can help improve wellbeing and provide positive outcomes for both the child and their caregivers. Children can form attachments with more
than one caregiver, but the bond with the people who have provided close care from early infancy is the most important and enduring (Bowlby, 1997)2. It’s important that parents and carers are attuned and responsive to their baby’s needs and are able to provide appropriate care. This includes recognising if their baby is hungry, feeling unwell or in need of closeness and
affection (Howe, 2011)3. Forming an attachment is something that develops over time for a child, but parents and carers can start to form an emotional bond with their child before they are born. Sometimes a parent or carer may have difficulty forming this bond, for example if they are experiencing mental health issues or don’t have an effective support network. On
this page, you’ll find information on: Our information specialists are here to help you find research, guidance and best practice. Find out more The first two years of a child’s life are the most critical for forming attachments (Prior and Glaser, 2006)1. During this period, children develop an ‘internal working model’ that shapes the way they view relationships and operate socially. This can affect their sense of trust in others, self-worth and their confidence interacting with others
(Bowlby, 1997)2. Attachments are formed in different ways during the phases of a child’s development. During the antenatal period, parents and carers can form a bond with their child. Any bonds formed before birth can have a positive impact on the relationship between babies and their caregivers
once the child is born (Condon and Corkindale, 1997)3. This is sometimes referred to as the pre-attachment phase because the baby doesn’t appear to show an attachment to any specific caregiver. However, parents and carers who provide a nurturing environment and are responsive to their babies needs can lay the foundation for secure attachments
to form (Bowlby, 1997)4. During this stage of their development, a baby might start to show a preference for their primary and secondary caregivers (often the mother and father). During this period a child begins to show a strong attachment to their primary caregivers. Babies start to
develop separation anxiety during this phase and can become upset when their caregiver leaves, even for short periods (Bowlby, 1997)5. At this point children are likely to become less dependent on their primary caregiver, particularly if they feel secure and confident the caregiver will return and be responsive in times of need
(Bowlby, 1997)6. A child’s need for attachment is part of the
process of seeking safety and security from their caregiver. In secure caregiver-child relationships, the caregiver is usually sensitive and tuned in to the child’s needs. They are able to provide care that is predictably loving, responsive and consistent. Young children who have formed a secure attachment to their caregiver may display the following patterns of behaviour during times of stress or exploration: (Ainsworth et al, 2015)1. When caregivers react sensitively to ease their child’s distress and help them regulate their emotions, it has a positive impact on the child’s neurological, physiological and psychosocial development
(Howe, 2011)2. Children with secure attachments are more likely to develop emotional intelligence, good social skills and robust mental health (Howe, 2011)3. Not receiving comfort and security in the early
years can have a negative effect on children’s neurological, psychological, emotional and physical development and functioning (Newman, 2015)4. Babies and young children who have attachment issues may be more likely to develop behavioural problems such as attention deficit hyperactivity disorder (ADHD) or conduct disorder (Fearon et al,
2010)5. Children who have attachment issues can have difficulty forming healthy relationships when they grow up. This may be because their experiences have taught them to believe that other people are unreliable or untrustworthy (Bowlby, 1997)6. Adults with attachment issues are at a higher risk of entering into volatile relationships and having poor parenting skills, behavioural difficulties and mental health problems (Howe, 2011)7. > Find out more about how trauma affects child brain development Take a look at our reading list on child attachment. > View
the reading list on the NSPCC Library catalogue Some circumstances can make it more challenging for a child and their caregivers to form a pattern of
secure attachment. These may include: (Bowlby, 1989)1. Children’s behaviour can be influenced by a wide range of circumstances and emotions. What is attachment theory and why is it important?
Understanding attachment in the early years
Need specific information?
Stages
of attachment
When are attachments formed?
Antenatal (before birth)
Birth until 6 weeks
6 weeks until 6-8 months
6-8 months until 18 months-2 years
18 months – 2 years onwards
Types of attachment
What does secure attachment look like?
Benefits of secure attachment
Effects of insecure attachment
Further reading
Attachment issues
Factors affecting attachment
Signs that a child may have attachment issues
Indicators that a baby or toddler might not have a secure attachment with their caregiver will emerge as a pattern of behaviour over time, particularly during moments of stress or exploration. This pattern might include:
- being fearful or avoidant of a parent or carer
- becoming extremely distressed when their carer leaves them, even for a short amount of time
- rejecting their caregiver’s efforts to calm, soothe, and connect with them
- not seeming to notice or care when their caregiver leaves the room or when they return
- being passive or non-responsive to their carer
- seeming to be depressed or angry
- not being interested in playing with toys or exploring their environment
(Howe, 2011)2.
As children with attachment issues get older, these behaviour patterns might evolve. As well as being evident during times of stress, some behaviours may start to become obvious at other times. These may include the child:
- finding it difficult to ask for help
- struggling to form positive relationships with adults and peers
- struggling to concentrate
- struggling to calm themselves down
- both demanding and rejecting attention or support at the same time
- becoming quickly or disproportionately angry or upset, at times with no clear triggers
- appearing withdrawn or disengaged from activities
- daydreaming, being hyperactive or constantly fidgeting or moving
(Mentally Healthy Schools, 2020)3.
If you think a child may have attachment issues, you should refer them to a suitably trained health and social care professional for a full assessment. You should follow your organisation’s procedures to make a health and social care referral, or contact your local authority children’s social care services.
Trauma and attachment
The signs of attachment issues can be similar to indicators that a child is experiencing other challenges, such as:
- mental health problems
- additional needs
- abuse and neglect.
This means it’s important to consider everything that’s going on in a child’s life and make sure they and their family are provided with appropriate support.
Think about all your previous experiences with the child and their caregivers, to help you build a clear picture of their relationships and recognise any concerning patterns of behaviour.
The impact of trauma and attachment
Children who have experienced abuse, neglect and trauma might develop coping strategies that can make it more complicated to recognise attachment issues.
For example, one sign of secure attachment is that children see their caregiver as a secure base to explore from. But children who have experienced neglect, for example, might display independent behaviour in order to protect themselves from the emotional pain of not having their needs met (Marvin et al, 2002)1.
It is also possible for a child to develop an attachment to someone who is maltreating them (Blizard & Bluhm, 1994)2.
As well as affecting attachment, experiencing trauma can have an impact on a child’s brain development. Children might need extra support to help strengthen the architecture of their brain.
> Find out more about how trauma affects child brain development
What to do if you’re worried that a child is experiencing or at risk of abuse or neglect
If a child is in immediate danger, call the police on 999.
If you’re worried about a child but they are not in immediate danger, you should share your concerns.
- Follow your organisation’s child protection procedures without delay. These should provide clear guidelines on the steps you need to take if a child discloses abuse. They will state who in your organisation has responsibility for safeguarding or child protection and who you should report your concerns to.
- Contact your local child protection services. Their contact details can be found on the website for the local authority the child lives in.
- Contact the police. They will assess the situation and take the appropriate action to protect the child.
- Contact the NSPCC Helpline on 0808 800 5000 or by emailing . Our trained professionals will talk through your concerns with you, give you expert advice and take action to protect the child as appropriate. This may include making a referral to the local authority.
> Find out more about recognising and responding to abuse
Supporting children and families
Building positive relationships
It’s important for anyone who works with children and families to support parents and carers in building positive relationships with their child. Having positive interaction and play with caregivers can help a child’s brain to develop healthily.
> See our early years resources which you can share with parents and caregivers
Video feedback programmes can also be used by specially trained social care professionals to help caregivers improve their interactions with their child. This involves caregivers being filmed when they are interacting with their child and then watching the recording with a trained practitioner, who gives them feedback and helps them build on their strengths.
Support for parents and carers
If parents are struggling with their own issues, it may make it harder for them to bond with their child and provide consistant and responsive care. They may have:
- experienced abuse of trauma themselves
- drug and/or alcohol dependencies
- mental health issues.
> Find out more about parental mental health
> Learn more about parental substance misuse
Services for children and families
The NSPCC has many services that children and families can be referred to, from supporting parents and carers in taking care of their children to preventing sexual abuse and overcoming abuse.
Our services might be suitable for children and families you are working with:
- Pregnancy in Mind helps parents who are at risk of or experiencing mild to moderate anxiety and depression during pregnancy. The service helps build parents’ capacity to provide sensitive, responsive care to their babies and keep these skills developed postnatally and as their children develop
Browse for more services
Further reading
Take a look at our reading list about child attachment interventions, support and treatment.
> View the list on the NSPCC Library catalogue
Supporting children’s mental health
Children with attachment issues may have problems expressing or controlling their emotions and forming positive relationships, which might affect their mental health.
It’s important to make sure children and young people have access to mental health support.
> Find out more about child mental health
> See the NSPCC’s advice for parents and carers on how to support their child’s mental health
Childline
If a child or young person needs confidential help and advice you can always direct them to Childline. Calls to 0800 1111 are free and children can also contact Childline online. Children under the age of 12 can be directed to the Childline Kids website.
We also have a series of posters and wallet cards you can download for free or you can buy printed versions via our online shop. These can be displayed in your setting to encourage children to contact Childline if they need to talk.