Healthy attachment formation of infants and children depends on the development of a complex web of social awareness. Children with Attachment Disorders suffer from a severe type of social confusion. Reactive Attachment Disorder, RAD, and Disinhibited Social Engagement Disorder, or DSED, are both associated with missing or skewed social awareness of infants and children. Effective intervention of RAD and DSED requires little ones to acquire a healthy awareness of social rules, boundaries, and standards of conduct. These capacities are critical components of Bowlby’s Attachment Theory. Teaching young children the rules of socialization through healthy relationships is key to promoting healthy attachment formation that can begin to heal RAD and DSED.
Understanding the role of Social Development in Disorders of Attachment can provide insight to support an effective and meaningful treatment and intervention. The first social interaction takes place between mother and child. The newborn gazes into the face of Mother, hearing her coo and croon in response to the tiny baby’s focused attention. Over time, the eye gaze between mother and child will develop into casual games like “matching the facial expression” and “follow me”. These social interactions between mother and child are so natural that few people give them serious attention. Yet, they are the very foundation of an infant’s ability to socialize with others throughout life.
Those precious moments when infant and mother gaze at one another intently help program the infant’s brain for socialization. The infant is equipped with powerful mirror neurons in the brain that will observe, remember, and copy all the facial expressions, sounds, and movements of the mother during those first days and months of life. As an infant yawns and stretches, the mother is likely to yawn back. As the baby coos and gurgles, the mother is likely to respond by cooing back. When the infant cries the mother is likely to make a sad face and croon “It’s okay little one. I am here.”
In this way, infants begin to develop powerful abilities to notice the facial expressions and sounds of others, and begin to link them to emotions and physical sensation. The physical sensation of hunger is often met with feeding. The sensation of pain is often met with cuddling and rocking. The uncomfortable sensation of a wet or clammy diaper is often met with gentle caressing and re-diapering. Over time, little babies begin to develop a complex set of social rules about how caretakers respond to the messages broadcast by the infant.
These social rules are the foundation of all social interaction that the child will face throughout a lifetime. Infant social development gives rise to effective parent-child interactions. Sibling, friendship, and even romantic relationships will be built upon the foundation of early mother-child bonding and social interaction. Even the ability to work, be a parent, and be a good neighbor will depend on early social development during infancy. Children who lack healthy social development during those critical weeks and months must catch up in order to establish sound attachment formation.
Parents and caregivers of children with RAD or DSED must rehabilitate the child’s social awareness. This means attending to the quality and content of each parent-child interaction to ensure that it is nurturing, responsive, and sensitive. The goal of socialization training in children with DSED and RAD is to provide additional opportunity for the child to learn effective rules of socialization. Sometimes it is confounding to see a 5 year old who is unable to play a simple facial expression copycat game. Yet, this is an example of the fundamental and critical retraining required by children with disordered attachment.
Some other activities to reestablish healthy social awareness includes rocking, giving a bottle, singing or gently cooing while eye gazing, cuddling, and stroking. Parents are able to essentially recreate the early parent-child dynamics typically present during the newborn and infancy period. This type of Therapeutic Parenting activity takes time to learn, but is a critical aspect of treatment and intervention of disorders of attachment. Over time, the child’s social confusion is slowly and systematically replaced with a solid and useful understanding of the rules of social engagement between an adult and a child, and this is when the healing can really begin to take place.
Children with disordered attachment are generally victims of unfortunate circumstances that deprive them of rich social learning and development. Some children suffer unthinkable trauma or abuse that leads to RAD or DSED. Other children are born into situations that lack sufficient nurturing and meaningful human interaction to stimulate effective social awareness. Some examples of unfortunate circumstances that may contribute to poor social development include parental depression, mental illness, substance use disorder, medical problem, deployment, death, and incarceration.
Darleen Claire Wodzenski, MA ESE, MA CMHC, QPPE is a counselor, parent trainer, and special education interventionist who specializes in helping families with children who suffer from disorders of attachment. As the founder and program developer of Orchard Human Services, Inc., Darleen Claire provides parent and teacher training on the subject of Attachment Development as well as individual and family counseling in the greater Metropolitan Atlanta area. She provides Internet-based support to those who live outside the Atlanta area by way of Webinars and Parent Coaching.