• By Laura Whybra
  • Posted on Wednesday 05th November, 2014

Fostering stronger bonds of attachment may help maltreated children

strong>Training for foster parents that promotes more sensitive caregiving and stronger bonds of attachment could lead to more stable care placements for abused and neglected toddlers, according to researchers in the United States.Their study took place against the background of worrying evidence that when it becomes necessary to protect maltreated children through the welfare system, their healthy development is often disrupted in other ways. The more infants are bounced from one foster placement to the next, or removed and returned repeatedly to their birth-parents, the less likely they are to settle and overcome the maltreatment they have experienced. The impact of a disrupted placement risks being worse for children under three, as the early years are a critical period in social and emotional development and a period when children need to build trusting and secure relationships with their caregivers. Children who have experienced many disrupted placements often go on to develop emotional and behavioral difficulties and, as a result, become more challenging to look after. Home visiting programsThe University of Washington researchers wanted to find out whether training caregivers – birth parents as well as foster and kin carers - in the importance of sensitive, caring relationships and attachment would lead to them providing more stable and permanent placements for the children in their care. The study followed 210 toddlers, aged 10 to 24 months, who had recently been placed with a new primary caregiver as a result of a court order. Their carers were randomly allocated either to take part in Promoting First Relationships (PFR), a ten-week home visiting intervention designed to strengthen carer-child attachment, or a comparison group where home visitors called every three months to provide Early Education Support (EES), including child development guidance and referrals to other services, such as Early Head Start.The carers taking part in the PFR program were visited at home each week by a mental health professional for hour-long sessions. Video recordings of the caregiver and the child interacting were used as a basis for discussions about the strengths of the relationship and the cues that children exhibit. The professional also shared handouts on topics such as “Staying Together During Difficult Moments”, which explained that challenging behavior could be a signal of distress or unmet needs and the role of the caregiver in this behavior. All of the discussion between the professional and the caregiver were reflective and strength-based, emphasizing the importance of a responsive caregiver and consistent relationship with the child.The caregivers in the PFR group did not receive explicit support on child development strategies, while the EES caregivers did not receive the same strength-based discussion and feedback on their relationship with the child.Foster carers benefited, birth parents did notTwo years after the study started the researchers examined what had happened to the children in terms of the “stability” and “permanence” of their placements. A stable placement was defined as one without any change throughout the two years. A permanent placement was defined as one where the caregiver had provided a stable placement and then adopted or become the child’s legal guardian.Contrary to the initial hypothesis for the study, the attachment-based training provided through PFR was not associated significantly more strongly with either stable or permanent placements than the EES that was given to the comparison group. However, significantly more foster and kin carers who had received the PFR attachment training had adopted the children in their care or become their legal guardian than in the comparison group. The difference in outcomes between the foster/kin carers and birth parents who took part in PFR suggested that problems in the latter’s lives – substance abuse, mental illness, homelessness and domestic violence – might have overwhelmed whatever positive effects the program produced and lowered the likelihood that their child would be allowed to live with them permanently.However, systematically measuring outcomes among children placed in care is complex because their ages, original circumstances and trajectories through the child welfare system vary so widely. While the Washington State study did take statistical account of factors other than parenting support services that could have affected the stability of a placement, there were many others that were not measured. That makes it harder to generalize the benefits of attachment-based training found among the sub-group of 78 foster and kin carers who took part in PFR to the child welfare system as a whole.There was, nevertheless, a useful indication that training foster and kin caregivers in the importance of secure, attached relationships in the early years may lead to more stable and permanent, placements for young children – and that attachment theory could usefully move closer to the heart of policies for the care children in the welfare system. *********Reference:Spieker, S.J., Oxford, M. L. & Fleming, C.B. (2014). Permanency outcomes for toddlers in child welfare two years after a randomized trial of a parenting intervention. Children and Youth Services Review. 44, 201-206.

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