Attachment Issues in Children: Causes, Symptoms, Treatment

What are attachment issues?

Attachment issues develop in young children when the attachment bond—the emotional relationship that develops between an infant and their primary caretaker—is disrupted or not developed securely.

Since the quality of the attachment bond profoundly impacts your child’s development, experiencing attachment issues can affect their ability to express emotions, build resilience, trust, and confidence, and enjoy healthy relationships. Some studies show that insecure attachment can even contribute to behavioral problems, such as bullying.

No matter how detached or insecure your child seems, or how frustrated or exhausted you feel from trying to connect with them, it is possible to repair an attachment issue. With the right tools—and a healthy dose of patience and love—you can bond with your child, shape their development, and help them build healthy, meaningful, and loving relationships.

[Read: What is Secure Attachment and Bonding?]

Attachment issues vs. attachment disorders

Children with attachment problems tend to fall on a spectrum, ranging from mild issues to attachment disorders. While mild attachment issues are usually easily addressed, in cases of severe attachment issues, your child may be diagnosed with one of two distinct attachment disorders:

Reactive attachment disorder (RAD). A child with RAD rarely seeks comfort when distressed and often feels unsafe and alone. They may be extremely withdrawn, emotionally detached, and resistant to comforting. They may push you away, ignore you, or even act out aggressively when you try to get close. Read: Reactive attachment disorder (RAD). Read: Reactive Attachment Disorder (RAD).

Disinhibited social engagement disorder (DSED). With DSED, a child doesn’t seem to prefer their parents over other people, even strangers. They’ll seek comfort and attention from virtually anyone, and won’t exhibit any distress when a parent isn’t present. While they are overly familiar with strangers, children with DSED often have trouble forming meaningful connections with others. Read: Disinhibited Social Engagement Disorder (DSED)

Both types of attachment disorder are more common in young children who have been traumatized, abused, spent time in foster care or orphanages, or separated from their primary caregiver after establishing a bond, such as an extended stay in hospital. These children may have difficulty relating to others and can be developmentally delayed.

Causes of attachment issues

About 35 percent of infants have some form of insecure attachment. Attachment difficulties occur when a child has been unable to consistently connect with a parent or primary caregiver.

If a young child repeatedly feels abandoned, isolated, powerless, or uncared for—whatever the reason—they will learn that they can't depend on others and that the world is a dangerous and frightening place.

This can happen for many reasons:

• A baby cries and no one responds or offers comfort.
• A baby is hungry or wet, and they aren't attended to for hours.
• No one looks at, talks to, or smiles at the baby, so the baby feels alone.
• A young child gets attention only by acting out or displaying other extreme behaviors.
• An infant or young child is mistreated, traumatized, or abused.
• Sometimes a child's needs are met, and sometimes they aren't. The child never knows what to expect.
• An infant or young child is hospitalized or separated from their parents.
• A baby or youngster is moved from one caregiver to another (the result of adoption, foster care, or the loss of a parent, for example).
• The parent is emotionally unavailable because of depression, illness, or substance abuse.

Sometimes the circumstances that cause attachment problems are unavoidable, but the child is too young to understand what has happened and why. To a young child, it just feels as if no one cares. They may lose trust in others, and see the world as an unsafe place.

Development of insecure attachment styles

According to attachment theory, different circumstances can lead to different types of insecure attachment styles:

If a parent is sometimes responsive to the child but unavailable at other times, the child might develop an ambivalent (or anxious-preoccupied) attachment style. Children with this attachment style may have low confidence and feel highly distressed when separated from their caregiver. Later in life, they might struggle with anxiety in relationships, making them “clingy” or jealous.

If a parent is often unavailable or distracted, the child is more likely to develop an avoidant-dismissive attachment style. Children with this attachment style have come to believe they cannot rely on others, and this leads them to avoid intimacy later in life.

[Read: How Attachment Styles Affect Adult Relationships]

Childhood trauma or abuse can contribute to a disorganized (or fearful-avoidant) attachment style. In these cases, a baby might see the parent as a source of comfort as well as a threat. This can lead to suspicion, hostility, and lack of commitment in later relationships.

Nature vs. nurture

Studies of twins indicate that attachment security is mostly affected by a child’s environment rather than genetics. However, it’s possible that certain children are genetically more vulnerable to developing attachment disorders, such as reactive attachment disorder.

Signs and symptoms of attachment issues

Although it is never too late to treat and repair attachment issues, the earlier you spot the symptoms of insecure attachment and take steps to repair them, the better. Caught in infancy before they become more serious problems, attachment difficulties are often easy to correct with the right help and support.

A 12- to 20-month-old infant with insecure attachment may:

• Seem emotionally unfazed by your absence or presence.
• Cry inconsolably, even when you try to soothe them.
• Seem fearful of you or angry when you leave and return.

You can also use the following developmental milestones to identify early attachment difficulties. If your child doesn’t seem to be reaching these milestones, talk to your pediatrician:

Around one to two months old, your baby should smile back when you smile and respond to high-pitched sounds you make.

Around four months old, your baby will likely take turns making noises back and forth with you.

At five months of age, they’ll recognize you by sight.

At about eight months, they will follow your gaze when you look at things. This is known as joint attention.

Somewhere between six and 12 months of age, your child should begin actively seeking comfort from you and show a desire to play. When they’re separated from you, they’ll appear upset. They will also show some anxiety around strangers, as they become able to discern between familiar and unfamiliar faces.

At around 12 months, your baby will play games like peek-a-boo with you and use gestures to nonverbally communicate “hi,” “bye,” or “look over there.”

At around 15 months, they will show signs of empathy. Perhaps they look sad when they see a sibling crying.

Between 18 and 24 months of age, the baby will play pretend with toys, such as imitating a conversation on a toy phone or feeding a doll.

Signs of attachment issues in older children

In school-age children, signs of attachment difficulties might show up in their interactions with siblings and classroom peers. Insecurely attached children may be:

• Withdrawn from others and hesitant to join group activities.
• Overly dependent on others.
• Quick to act out to gain attention.
• Prone to bullying peers or being defiant toward parents and teachers.
• Hypervigilant and easily stressed.
• Emotionally volatile, often showing extreme anger, despair, or fear.

Tips for parenting a child with attachment issues

Parenting a child with insecure attachment can be frustrating and emotionally draining. It can be hard to put your best parenting foot forward without the reassurance of a loving connection with your child. Sometimes you may even wonder if your efforts are worth it. But with time, patience, and concerted effort, attachment issues can be repaired..

[Read: Building a Secure Attachment Bond with Your Baby]

The key is to remain calm yet firm and responsive as you interact with your child. This will teach your child that they are safe and can trust you.

Tip 1: Prepare yourself emotionally

A child with insecure attachment is already experiencing a great deal of stress, so it is important that you evaluate and manage your own stress levels before trying to help your child with theirs. HelpGuide's free Emotional Intelligence Toolkit can teach you valuable skills for managing stress and dealing with overwhelming emotions, allowing you to focus on your child's needs.

To help a child with attachment issues, it's also important to:

Have realistic expectations. Helping your child may be a long road. Focus on making small steps forward and celebrate every sign of success.

Stay patient. The process may not be as rapid as you'd like, and you can expect bumps along the way. But by remaining patient and focusing on small improvements, you create an atmosphere of safety for your child.

Foster a sense of humor. Joy and laughter go a long way toward repairing attachment problems and energizing you, even in the midst of hard work. Find at least a couple of people or activities that help you laugh and feel good.

Take care of yourself. Reduce other demands on your time, make time for yourself, and manage stress. Rest, good nutrition, and parenting breaks help you relax and recharge your batteries so you can give your full attention to your child.

Find support. Rely on friends, family, and community resources. Try to ask for help before you really need it to avoid getting stressed to breaking point. You may also want to consider joining a support group for parents.

Stay positive and hopeful. Be sensitive to the fact that children pick up on feelings. If they sense that you're discouraged, it will be discouraging to them. When you are feeling down, turn to others for reassurance.

Tip 2: Provide stability and security

Safety and stability are core issues for children with attachment problems. They are distant and detached because they feel unsafe in the world. They keep their guard up to protect themselves, but it also prevents them from accepting love and support.

It is essential to build up your child's sense of security. You can accomplish this by establishing clear expectations and rules of behavior, and by responding consistently so your child knows what to expect when they act a certain way and—even more importantly—knows that no matter what happens, you can be counted on.

Set limits and boundaries. Consistent, loving boundaries make the world seem more stable and predictable and less scary to children with attachment difficulties. It's important that they understand what behavior is expected of them, what is and isn't acceptable, and the consequences if they disregard the rules. This also teaches them that they have more control over what happens to them.

Take charge, but remain calm when your child is upset or misbehaving. Remember that “bad” behavior means that your child doesn't know how to handle what they're feeling and needs your help. By staying calm, you show your child that the feeling is manageable. If they are being purposefully defiant, follow through with the pre-established consequences in a cool, matter-of-fact manner. But never discipline a child with an attachment issue when you're in an emotionally-charged state. This makes the child feel more unsafe and may even reinforce the bad behavior, since it's clear that it pushes your buttons.

Be immediately available to reconnect following a conflict. Conflict can be especially disturbing for children with attachment issues. After a conflict or tantrum where you've had to discipline your child, be ready to reconnect as soon as they're ready. This reinforces your consistency and love and will help your child develop a trust that you'll be there through thick and thin.

[Read: Conflict Resolution Skills]

Own up to mistakes and initiate repair. When you let frustration or anger get the best of you, or you do something you realize is insensitive, quickly address the mistake. Your willingness to take responsibility and make amends can strengthen the attachment bond. Children with attachment issues need to learn that, although you may not be perfect, you will love them no matter what.

Try to maintain predictable routines and schedules. A child with attachment issues may feel threatened by transition and inconsistency—when traveling or during school vacations, for example. A familiar routine or schedule can provide comfort during times of change.

Tip 3: Support your child’s health

Your child's eating, sleep, and exercise habits are always important, but they're even more so for kids with attachment problems. Healthy lifestyle habits can go a long way toward reducing your child's stress levels and leveling out mood swings. When children with attachment issues are relaxed, well-rested, and feeling good, it will be much easier for them to handle life's challenges.

Diet. Make sure your child eats a healthy diet full of whole grains, fruits, vegetables, and lean protein. Be sure to skip the sugar and add plenty of good fats—like fish, flax seed, avocados, and olive oil—for optimal brain health.

[Read: Healthy Food for Kids]

Sleep. If your child is tired during the day, it will be that much harder for them to focus on learning new things. Making their sleep schedule (bedtime and wake time) consistent can help alleviate childhood sleep problems.

Exercise. Any type of physical activity provides a great antidote to stress, frustration, and pent-up emotion, triggering endorphins to make your child feel good. Physical activity is especially important for an angry child. If your child isn't naturally active, try some different classes or sports to find something that is appealing.

Any one of these things—food, rest, and exercise—can make the difference between a good and a bad day for a child who has attachment difficulties. These basics will help ensure that your child's brain is healthy and ready to connect.

Tip 4: Make your child feel loved

A child who has not bonded early in life will have a hard time accepting love, especially physical expressions of love. But you can help them learn to accept your love with time, consistency, and repetition. Trust and security come from seeing loving actions, hearing reassuring words, and feeling comforted over and over again.

Identify actions that feel good to your child. If possible, show your child love through rocking, cuddling, and holding—attachment experiences they may have missed out on earlier. But always be respectful of what feels comfortable and good to your child. In cases of previous abuse, neglect, and trauma, you may have to go very slowly because your child may be very resistant to physical touch.

Consider your nonverbal cues. Your body language can send all sorts of positive and negative messages. For example, when possible, maintain eye contact when talking with your child. If you frequently seem distracted or disinterested, they will notice your inattentiveness.

Help your child identify emotions and express their needs. Children with attachment problems may not know what they're feeling or how to ask for what they need. Reinforce the idea that all feelings are okay and show them healthy ways to express their emotions.

Listen, talk, and play with your child. Carve out times when you're able to give your child your full, focused attention in ways that feel comfortable to them. It may seem hard to drop everything, eliminate distractions, and just live in the moment, but spending quality time together provides a great opportunity for your child to open up to you and feel your focused attention and care.

Professional treatment

If your child is suffering from a severe attachment issue or either type of attachment disorder, it’s important to seek professional help. Extra support can make a dramatic and positive change in your child’s life, and the earlier you seek help, the better.

Start by consulting with your pediatrician, a child development specialist, or an organization that specializes in child development or attachment disorders.

Treatment for attachment issues and disorders usually involves a combination of therapy, counseling, and parenting education. These are designed to ensure that your child has a safe living environment, improves their peer relationships, and develops positive interactions with you, their parent or caregiver.

While medication may be used to treat associated conditions, such as depression, anxiety, or hyperactivity, there is no quick fix. Your pediatrician may recommend a treatment plan that includes:

Family therapy. Typical therapy for attachment problems includes both your child and you. Therapy often involves fun and rewarding activities that enhance the attachment bond as well as help parents and other children in the family understand the symptoms of the disorder and effective interventions.

Individual psychological counseling. Therapists may also meet with your child individually or while you observe. This is designed to help your child directly with monitoring their emotions and behavior.

Play therapy. Helps your child learn appropriate skills for interacting with peers and handling other social situations.

Special education services. Specifically designed programs within your child's school can help them learn skills required for academic and social success, while also addressing behavioral and emotional difficulties.

Parenting skills classes. Education for parents and caregivers centers on learning about attachment issues as well as other necessary parenting skills.

Raising a child with attachment issues can be a challenging yet rewarding experience. As you provide them with consistent love and mindful care, you'll watch them grow into secure, confident individuals.