Disorder Refers to the Clinical

¶ … disorder refers to the clinical implications evidenced by and experienced by children who experience adverse early care, usually in the foster care system or who were adopted after having endured institutional deprivation from abroad. The problem is that there are a great deal of theoretical and interpretative papers on the topic but relatively few empirical reports, causing this state of affairs to become confusing to professionals and to caretakers who are uncertain about which approach to take in regards to treating and caring for the child

Regardless of the type of institutional care that these children received, studies consistently show that children who experienced institutional care identify a similar pattern of disturbed and alienated behavior towards strangers (Chisholm, 1998). It seems to be that it is the absence of a consistent caregiver and the lack of selective attention that prompts the characteristics and etiology of attachment disorders. A similar phenomenon seems to be replicated by animals (Carter, 1998). Although originally thought to be similar if not associated with the type of behavioral / emotional problems that is often evidenced by young children, recent research shows attachment disorder to be mostly non-associated (O'Connor & Zeannah, 2003). More so, the few reports that conducted long-term follow up of these problems found that attachment disorder did not diminish with time.

O'Connor and Zeannah (2003) report two studies where it was found that children adopted from Romanian institutions still exhibited their same inhibited conduct to strangers even in middle childhood, whilst another study by Tirzad and colleagues (quoted by O'Connor and Zeannah (2003)) noted that whilst these children's inhibited or 'over-friendly' behavior to strangers might have diminished over time, much of their conduct was still pronounced in their adolescence and adult years where "disturbances in their social behavior and relationships were evident" (225). This same inhibited conduct is also displayed towards foster or adoptive parents despite the fact that these children may have been living with these adoptive families for many years.

The state of affairs of attachment disorders is a paradox to O'Connor and Zeannah (2003). On the one hand, it has been rated as a severe and engrossing clinical disease; on the other hand, there is no clear consensus or protocol in defining and assessing it. Much about it still remains to be understood.

The most popular form of therapy for children with attachment disorders is 'holding therapy'. 'Holding therapy' describes a form of intervention that consists of close physical contact with one or more therapists. The child is held across the lap of one or two therapists, whilst touch and eye contact between child and therapists are encouraged strongly through the session. Although 'holding' is supposed to provide the child with the care and security that she missed during her developmental years, and although it is also thought to be the way to break through to the child, and perhaps contain the child's distress or frustration, considerable controversy surrounds the practice. There has been no empirical evidence that this therapy works; it is seen as intrusive, insensitive and therefore counter-therapeutic. In the U.S.A. alone, six reported deaths have been traced to this system either due to therapists practicing the 'holding' or to caregivers who were advised to do so by therapists.