Abstract

The quality of children’s parental attachments has profound, far-reaching implications because immaturity means that they depend on these to progress safely towards independence. Attachment develops through parental attunement to infants’ needs, establishing their preconceptions of relationships and foundations of verbal and non-verbal communication. In giving meaning to feelings and body signals, attuned parenting builds self-awareness. By modulating stress, it contributes to programming of the stress systems, with life-long implications for regulation, behaviour and physical and psychological health, including major causes of mortality.Suboptimal attachment falls on a spectrum ranging from mildly insecure to profoundly dysfunctional. Quality of attachment is relevant to symptom presentation, illness behaviour, service use, and optimal paediatric care. Unsatisfactory childhood attachment frequently underlies intergenerational parenting problems. It is an important consideration in all child protection decisions and their implementation. Enabling children to achieve adequate parental attachment is an overriding priority in working with children in care and in adoptive homes, and is a priority for every child.

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