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Attachment and Infant Mental Health


Attachment and Infant Mental Health Dipti Aistrop 22 September 2010 Definitions of mental health Importance of early years Mental health needs of babies Attachment ... – PowerPoint PPT presentation

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Title: Attachment and Infant Mental Health

Attachment and Infant Mental Health
  • Dipti Aistrop
  • 22 September 2010

  • Definitions of mental health
  • Importance of early years
  • Mental health needs of babies
  • Attachment and sensitive care giving
  • Brain development in formative years
  • Practice overview

  • Health is the basis for a good quality of life
    and mental health is of over riding importance in
  • (UN Convention Rights of the Child Article24)
  • Children who are mentally healthy will have the
    ability to develop psychologically, emotionally,
    creatively intellectually and spiritually.(Bright
    futures,Mental health foundation 1999)

  • The Significance of infancy for mental health
  • Good parenting is fundamental for the
    development of a child's mental health and well
    being. As children's primary carers, all parents
    need to be supported and helped, but especially
    when they are parenting in difficult
    circumstances or facing uncertainty about the way
    they are bringing up their children.
    Interventions focused during pregnancy and at
    the time around the birth are likely to be the
    most effective in preventing mental health
    problems of a child. .
  • The Mental Health of Children and Young People
    A Framework for
  • Promotion, Prevention and Care, Scottish
    Executive, 2005. (1)

Pre-natal / Early Years
  • Babies thrive when they receive warm, responsive
    early care
  • Early care has a decisive, long lasting impact on
    how people develop, their ability to learn, and
    their capacity to regulate their own emotions

Babies need
  • To be nurtured
  • Security
  • Predictability
  • Support
  • Encouragement
  • Development through expansion
  • To feel loved

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  • Babies are born ready to communicate and relate
    to another human.
  • They are ready to learn and to develop a
  • Attachment is the deep and long lasting
    connection that is established between a child
    and the primary care giver in the early years of
    a childs life
  • Quality of maternal sensitivity determinant of
    babys attachment pattern

Sensitive care giving (Video clip).
  • When parents understand their babys
    communication, it enables them to reciprocate
  • Attachment is the deep and long lasting
    emotional connection established between a child
    and care giver in the first years of life - a
    dyadic process

  • Attachment is developed through reciprocity
  • Reciprocity is a two way communication which
    enables the infant to form a concept of his own
    affect on his environment and on other people
  • Babies are active in engaging their mother in a
    relationship, and through sensitive care giving,
    the mother and baby become attuned to each other.

Secure attachment pattern enables a child to
  • Trust and reciprocate
  • Learn to self regulate
  • Develop self esteem and self worth
  • Have a sense of right and wrong
  • Develop empathy and compassion
  • Develop resilience
  • Have healthy brain development
  • achieve academic success
  • Develop an ability to make and sustain

Insecure Attachment types
  • Attachment Disorder
  • Insecure ambivalent
  • Insecure avoidant
  • Insecure anxious
  • Disorganised

Insecure attachment is more likely to lead to
  • A negative internal working model
  • Self perception The World
  • Unlovable Others are unavailable
  • Uninteresting Neglectful. rejecting
  • Unvalued Unresponsive
  • Ineffective Hostile

Potential effects of insecure attachment
  • Feeding problems
  • Sleep disturbance
  • Toileting/gastric problems
  • Aggression
  • Poor concentration / attention span
  • Lack of co-operation
  • Longer term fears and phobias associated with
    anxiety, emotional disorders, anti social
    behaviours, relationship difficulties

  • Is attention seeking behaviour a manifestation of
    attachment seeking?

Brain Development
  • All behavioral development has to do with the
  • Brain development is dependent upon both
    experience and genetics
  • The brain has a great deal of plasticity and can
    recover over time.

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2 Months
5 Days
28 Years
1 Year
Early Experiences are Crucial
  • By age 3, 80 of synaptic connections are already
  • By the second decade of life growth levels off
    and pruning begins
  • Increased experiences define the wiring of an
    infants brain

Brain development is not automatic but is
'experience dependent'. During the first three
years of life, the brain makes trillions of new
connections between nerve cells known as
synaptic growth. These connections govern the
development of language, emotional, physical,
social and cognitive abilities.
  • Connections that have been repeatedly used
    grow stronger, form well-trodden pathways and are
  • Those connections that have not been used are
    'pruned' and shed by the age of three, resulting
    in literally a smaller, less developed brain with
    fewer connections across which messages can be
    passed between nerve cells

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14 Years Old
6 Years Old
Nature vs. Nurture
  • During the first 10 years of life the brain is
    twice as active as that of an adults
  • 60 of nutrition is used by the brain during the
    first year of life. This decreases to 30 by age
  • Genetic and environmental factors have a more
    dynamic, qualitative interplay that can not be
    reduced to a simple equation

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Building Blocks for Secure Attachment Positive
Mental Health
  • Reciprocity to infant communication and cues
  • Resilience
  • Parental mental health
  • Temperament
  • Impact of child on parents

Sensitivity Responds to cues, reciprocates Insensitivity Intrusiveness reflects parents own wishes/needs
Acceptance Of responsibility with little or no irritation Rejection Displays feelings of anger or resentment and irritation
Co-operation Respectful of childs autonomy Interference Imposes own wishes and expectations
Accessibility Familiar with childs communication will be easily distracted by the child Ignoring Pre occupied with own thoughts, often miss childs communication but notice behaviour outcomes
Parental sensitivity
Factors that build resilience
  • Environment
  • Support networks in community
  • Availability of good housing
  • Easy access to services
  • Lack of poverty
  • Parental involvement with work/educational
  • Child
  • Temperament
  • Secure attachment
  • Communication skills
  • Positivity in approach
  • Ability to problem solve
  • Family
  • Four or fewer children in family
  • At least one parent
  • available for attachment
  • Democratic parenting style
  • Other significant
  • adults

Observation Criteria in assessing mental health
of young children
  • Parent factors
  • Child factors
  • Environmental factors
  • (video clip)

Parent factors
  • Poor parental mental health or post natal
  • Overt family discord or domestic abuse
  • Family breakdown/ bereavement
  • Inconsistent, unclear boundaries with
    contradictory parenting styles
  • Hostile or rejecting relationships
  • Inability to adapt to childs changing needs
  • Parental substance / alcohol misuse
  • Criminality in family
  • Hostile or abusive parenting style

Child factors
  • Genetic make up
  • Likelihood of learning difficulties or low IQ
  • Chronic physical illness
  • Developmental uncertainty or delay
  • Communication difficulties
  • Temperament
  • Low self esteem / resilience

Environmental factors
  • Homelessness
  • Poverty
  • Discrimination
  • Unemployment
  • Difficult to access local services
  • Communication between agencies
  • Frequent moves to new areas

What is needed to Develop a Seamless Service to
Promote Mental Health
Mid Wives
School Health
Universal Services
Sure Start Child Centres
Health Visitors
Targeted Services Including Family Nurse
Social Care
Family Support
Gaps ????
Resources tend to be re-active rather than
  • All parents wish to succeed at parenting
  • What services are we to offer in order to ensure
    they get it right from the beginning?

  • For better outcomes for babies and young
    childrens Mental Health, prevention is necessary
    - it is certainly better than cure.
  • Thank you for listening.