Attachment in institutionalised and community children in China

INTRODUCTION: This thesis critically applies Attachment Theory concepts and methodology with two large and previously understudied populations: family and institutionally reared infants in Mainland China. METHOD: Study 1, assessing 61 infants (aged 12-38 months, mean = 21) with their mothers, provides both an exploration/validation of the Strange Situation Procedure (SSP) in a Chinese cultural context and a community comparison group for Study 2, which assesses 78 infants (12-37 months, mean = 20) with caregivers in institutional care. The institutionalised sample includes 4 different units with differing qualities of care, across 3 cities. RESULTS: Study 1. As predicted, upon the basis of previous findings, the majority (57%) of infants assessed with their mothers demonstrated secure attachment patterns, and only 13% were found to be disorganised. Study 2. For the entire institutionalised sample, prevalence of secure attachments was extremely low (average 17%, range = 8-50% across Units) and disorganised classifications extremely high (average 50%, range = 42-70% across Units), consistent with similar studies in other countries. Whilst among family-reared infants insecure-avoidant attachments were low by comparison to Western norms, they were markedly high among institutionally-reared infants compared to previous studies. Neither caregiver-to-infant ratio nor the provision of a dedicated caregiver was significantly associated with attachment classification. Only the unanticipated variable of previous placement in a foster care family was significantly associated with organised, but not secure, attachment. DISCUSSION: The findings provide support for the utilisation of Attachment Theory within these settings, whilst suggesting the need for both conceptual and methodological adaptation. Overall, the findings confirm that resources should be channelled into enhancing caregiving across institutions where they are necessary – increasing the valuation, training, and benefits to caregivers which is likely to enhance their role and retention – whilst reducing exposure to high numbers of transient caregivers, minimizing transitions, and moving toward early and stable family-based care wherever possible