ABA Help for Attachment Issues

Reactive Attachment Disorder (RAD) and associated attachment issues often manifest as challenging behavior in children. These diagnoses are typical for children whose caregiver attachments have been seriously disrupted. Disrupted caregiver attachments may refer to primary caregivers who suddenly became unavailable (i.e. incarceration or needing to leave the parental relationship), or have been inconsistently available (i.e. substance use or severe mental health issues). Attachment issues can also arise when parenting styles are too punitive, too permissive, or just highly inconsistent and unpredictable, when matched with the child’s personality style and needs. Most children who are in the position of being adopted have experienced one or more of these things, and as a result, many adopted children exhibit significantly challenging behavior.

There are many experts in the field of attachment theory who have stated that behavioral approaches do not work with children who have attachment issues. While it is true that children with disrupted attachment and/or trauma histories often have behavioral challenges that can be difficult to remediate, it simply does not make sense to claim that behavioral strategies don’t work. Why? Because the laws governing behavior do not change just because a child has experienced these hardships in their young lives. Behavior that is rewarded will be maintained or will increase, and behavior that is “punished” (i.e. things that a child doesn’t like happen as a result) will diminish.

The very big difference is in the fact that children with attachment issues often have been parented in ways that did not teach them the same “rules” about how one should behave. Either there were no rules, or the rules were inconsistently or unfairly enforced. This means that these children will need a LOT more exposure to consistent rules and consequences for behavior (reinforcement for doing the right thing, and fair, appropriate punishment for doing the wrong thing) than most other children.

Additionally, children with these types of histories often do not seem motivated by the things that other children seem to be motivated by, like getting prizes or getting positive adult attention. An even more frustrating situation is when they seem to like a certain reward (i.e. a prize used as reinforcement) for a little while, but then they lose interest and adults are left with nothing to use as effective reinforcement. By the way, these issues with finding effective reinforcers are common to all children, they just can be quite a bit more pronounced with children who have had traumatic or disrupted attachment histories. The trick is to stay ahead of the game a little bit by planning for adding in or changing up the things you are using to reinforce the behavior that you want to see. And while children sometimes do not seem to care about your positive attention and therefore may not be reinforced by it, we should always pair any kind of “reward” with our praise and approval. By pairing our positive attention with a reward, eventually praise and approval will also become reinforcing. We know this is true, because gobs and gobs of research has shown us how pairing a reinforcer with another neutral stimulus (i.e. our positive attention), will eventually result in that neutral stimulus becoming a reinforcer in and of itself. This is why points or token systems work. I will take this opportunity to point out that this is why points or token systems will also work with children with trauma or attachment problems.

It is very unfortunate that so many experts have proclaimed that behavioral approaches do not work for children who have attachment issues. I personally feel like this is a tremendous disservice to all of the families who have poured their hearts and souls into parenting these needy children, and whose families have sometimes been destroyed by the experience. I want these parents to know that ABA can help them, although it does take a little bit of extra work and a whole lot of patience and creativity.