Often characterised by persistent abnormalities in the child’s pattern of social relationships, which are associated with emotional disturbance and reactive to changes in environmental circumstances. Fearfulness and hyper-vigilance that do not respond to comforting are characteristic, poor social interaction with peers is typical. Aggression towards to self and others is very frequent, misery is usual.
The disorder occurs as a direct result of severe parental neglect, abuse, or serious mishandling. These children show strong contradictory or ambivalent social responses that may be most evident at times of partings and reunions. In disinhibited attachment disorder children show an unusual spread of selective attachments during the first five years and this is associated with generally clinging behaviour in infancy and/or indiscriminately friendly, attention seeking behaviour in early or middle childhood.
First line support from Health Visitor, School Nurse, Action for Children, Children’s Centre,
Thrive approaches through school setting, pastoral support team, Family Support Worker etc. Community Paediatrics can assess for attachment disorder.
General factors to consider include;
- The severity of the current difficulty.
- The complexity of the young person’s history.
- Whether there have been enduring difficulties over a period of time.
- The level of commitment from the young person and their family to engage with the service.
- Whether Early Help, or other assessment framework identifies significant mental health concerns.
- Whether the mental health/emotional needs of the child can be met by the professionals currently involved or whether a range of primary mental health interventions have been tried and proved unsuccessful.
- When a parent is struggling with a severe mental illness.
For young people known to the Youth Offending Team, or at risk of offending, the YOT CAMHS Practitioner can provide consultation, advice and some direct work and can be contacted via the Torbay
For adopted children referral to Torbay Post Adoption support service
For Looked After Children ensure child’s social worker and fostering agency are involved in joined up planning.
CAMHS CLA worker is based within Children’s Services and liaises directly with Children’s Services staff. CAMHS Advanced Practitioners provide regular consultation services to Children’s Services and are accessed at Tor Hill House.
0-8yrs Health Visiting service can work with the family using the Solihull approach.
Schools may wish to involve the Social, Emotional and Behaviour Support/Thrive advisory teachers or Educational Psychology Service.
Support for education professionals and intervention from school based PMHW to include training. The Torbay Virtual School have provided a training programme to staff from all schools on how to implement strategies within the classroom which will benefit children with unstable attachments.