All the adoptive parents of children with disabilities who I know will eventually ask me if I believe it is important to work on attachment FIRST, before treating other disabilities. I have this discussion most often with parents whose children have sensory integration issues, FAS, speech delays, ADHD,or PDD. So many of the symptoms and behaviors associated with each of these can be masked by or can mask attachment issues. And so many of the children with these issues who have been in less-than-ideal conditions (i.e. abusive homes or orphanages), have many overlapping issues, including learning disabilities that may not be apparent until the child reaches school-age.

I used to say an emphatic YES you MUST work on attachment issues FIRST! But as I ponder it, I'd say that maybe there are times when other factors need to be mitigated first. So how is a parent to know what to do? Well, from one parent of a special kid to another...here is when I'd treat attachment issues first:

1. If your child is rejecting of you -- especially you -- I'd work on the attachment first. No other interventions will take root when a basic trust between the child and their primary caregiver does not exist.

2. If your child is prone to overtly seek out the affection of others -- instead of you -- taking him/her to lots of therapists (speech, OT, etc.) gives him/her additional "mommy shopping" practice. If your child's need for these therapists seems to be paramount, look for therapists who will understand the need for Mommy to be involved in the therapy and facilitate bonding -- a therapist who will show Mommy how to assist with the therapy at home.

3. If your child is prone to shutting down when certain triggers are present, then I'd look toward strong attachment parenting and a therapist versed in PTSD. (Yes, I know that other disabilities, like autism, can be manifested in total withdrawal and shutting down.) But if your child is not attaching well to you -- attachment parenting is truly the first step, and can't hurt when trying to reach a child with these other issues as well.


When would I NOT lead with working on the attachment first?

When the sensory and neurological issues were getting in the way and impeding the attachment and bonding efforts the parent is making. I've talked with several parents (and in many ways LuLu fell into this category as well) who report that they did attachment parenting and sought out attachment therapy and made little to no progress. It wasn't until they added interventions that addressed their child's sensory or neurological issues that they saw improvement. Those interventions can include sensory integration therapy, neurofeedback, psychotropic medications, or biomedical interventions. In fact, because these interventions/tools are needed as part of the toolkit for healing that many of our children need, many attachment therapists and adoption professionals are recommending these interventions and even adding those specialties to their attachment therapy practices.

It is true that our children's disabilities can inhibit their ability to attach to us. But it's important to note that even though I might not LEAD with working on the attachment first in these scenarios, the attachment piece still must be worked on. Parents I've talked to report more progress when they are working on attachment along with seeking therapies and interventions for their child's other issues.