How ACE’s Manifests in Child Attachment Disorder

By | 2017-03-15T15:14:40+00:00 March 15th, 2017|

Often times a discussion about children with attachment disorder eventually leads to the idea of ACE’s, or Adverse Childhood Experiences.

Here we will determine why ACE’s are not a useful tool for predicting if a child has an attachment disorder, but how information from the ACE studies can be helpful when working with a child with attachment disorder.

The concept of ACE’s came about from a study done at Kaiser with obese adults considering bariatric surgery for weight loss. The study discovered that these adults had a much higher occurrence of childhood events than what was reported in the general population.

Since that time, ACE’s have become a widely studied topic. A questionnaire has been developed to help easily calculate an individual’s ACE score. Others have picked up the theme and have gone on to explore other adult diseases that have a correlation with childhood adverse events.  

Measuring a child’s ACE score can be useful in establishing whether that child would be considered a “high-risk child.” This is already being used in the school setting, in order to identify children who might benefit from more services, as well as try to offset some of the adolescent behaviors linked to higher ACE scores, like substance use, gang activity, teen pregnancy, etc.

The ACE score MIGHT even be helpful in predicting whether or not a child will have attachment disorder; however, the ACE score is NOT an accurate predictor.

The ACE score is a measurement of what the name indicates: Adverse Childhood Events.  Attachment disorder rarely occurs through an event, but rather through the pattern of relationship dynamics.

Even in the case of adoption, while the adoption is an event, it is the disrupted relationship that happens before the adoption that may cause a child to have attachment disorder. Thus, since the ACE score does not look at relationships and only events, there are many more children who will have a low ACE score, but who will have attachment disorder.

What has been really useful information from the ACE studies, as it relates to Attachment Disorder, is understanding the biological effects childhood stress and trauma have on a child for the rest of their life. Since attachment disorder is due to relational trauma in a child, this principle from the ACE’s study that states childhood stress and trauma create biological changes in the brain and body can be applied to children with attachment disorder.

Let’s look at two key questions that come up when applying ACE studies to children with attachment disorder:

What will these biological changes in the brain and body be for a child with attachment disorder?

Can a child ever heal from attachment disorder since there are biological changes that have happened in the process?

If a caregiver understands the biological changes that occurs in a child with attachment disorder, they are armored with knowledge that can translate to an immediate decrease in a child’s behaviors and will better know how to help them heal.

What changes come with attachment disorder?  

The biological changes in the brain consists of structural and functional changes of different parts, its wiring (communication between different parts of the brain) and the brain chemicals.

Dan Siegel writes about this concept, known as Hebbian theory, in his talks on Interpersonal Neurobiology – “Neurons that Fire Together, Wire Together.”  

As applied to early childhood relational trauma and attachment disorder, whole systems and pathways in the brain will be wired together to react dramatically to stress, to trust, and to relationships. This will include specific pathways like the Reward Pathway involving Dopamine, and it will involve changes in levels of specific chemicals known as neurotransmitters.

Seeing how these systems are affected as they develop, helps us to better understand why these children do not automatically heal as they grow older or when they have a change to a positive environment. The way the brain is wired to function has already been set; behavioral and relationship patterns are set for life without specific and targeted intervention through attachment work.

The biological changes in the body would include the nerves that run throughout the body, communicating with skin, muscles, and organs giving information from the brain and vice versa. A simple example of this would be the movement of muscles, which is directed by the brain.

As a child is developing, it learns by trial and error how to coordinate its muscles to crawl and then to walk. This again, is an example of parts of the brain that fire together and wire together so that walking, while still orchestrated by the brain, becomes an unconscious process.

The nerves thus connect to the brain and to the body in a very intricate manner, so that the brain and body cannot be separated in their functions; one directly affects the other.

One of the primary biological changes that a caregiver will notice in their child with attachment disorder is that the child has a very sensitive nervous system. They often will startle easily, are hyper-vigilant, and sounds, touch, smells, or the sight of blood can send them immediately over the edge.

On the other hand, often in the same child, their nervous systems can be imbalanced. This can look like having the ability to punch a window, gain a million cuts in their arm, and yet they don’t seem to feel it the injury. Some children even gag and throw up in response to their imbalanced nervous system, due to the biological changes on early childhood stress and trauma. I have seen a few children fall down stairs and they get up as if nothing happened. Yet the next day, they trip over a bag while I am close by, or I accidentally bump into them and the world stops as they cry uncontrollably about how much this hurt.

Because of these biological changes of the nervous system, a wise-caregiver would create an environment that has low stimulation for their nervous systems. A wise-caregiver eliminates things from their environment that either pose a safety risk, given their propensity to do things without having pain as an inhibition, or tends to make them more emotionally dysregulated.

Some of the most well-studied environmental factors include technology, light, music, and weight. Let’s talk about each one!

Technology has a direct effect on the brain and its function. It shuts down important social and emotional parts of the brain that, in other people, are able to recover faster. However, across the board, T.V., computers, video games, games on tablets, and cellphones have been shown to be triggers for subsequent emotional dysregulation in children with attachment disorder.  

Have you ever tried to stop a movie or a technology game with a child with attachment disorder?  Their brain and nervous system has a very hard time changing the wiring pattern and you will often not only get resistance and defiance, but a melt-down. Sometimes these meltdowns occur within the next few hours after being exposed to technology.

It is possible that not only the usually fast-paced movie or game is what offsets their nervous system, but also quite likely, the light from the screen. Light sources are now known to affect the brain and nervous system, changing the brain waves and brain chemicals. Fluorescent lights in a room, mall, or restaurant can also add more stress on a more sensitive nervous system like that of a child with attachment disorder.  

Music can be a powerful tool for a caregiver of a child with attachment disorder! It is like a secret weapon, that when properly used, appears like magic to others unless they also understand its effect on the brain and nervous system. Music actually changes brain waves and activates different parts of the brain that you want activated in a child with attachment disorder, like, the frontal cortex. Music also bypasses all other processing centers of the brain, directly and unconsciously affects the emotional center of your brain (Temporal Lobe).  

Thus, as the caregiver and monitor of the music, you can use music to subconsciously help your child be more calm, regulated, and able to socially connect better.

A fun experiment to do with your child is to play different styles of music and watch how your child’s nervous system responds to it. It will be quite obvious! You can literally watch them change between calm and hyper-vigilant, connected and disconnected with you emotionally just by changing the music.

Another helpful trick with music is to use it to drown out other noises that would normally distract them due to their more sensitive nervous system.

One other trick with music is to include periods of “quiet time” when listening to music, because it is necessary to help guide their nervous system so that they will not always need stimulation to calm down. It’s a process, but in fact, having periods of silence and watching their response to the silence (does it actually make them more hyper and dysregulated) is a very useful home-made trick to monitoring progress in their healing.

For sensitive nervous systems, weight can be very helpful to calm down a nervous system and help focus. The use of weighted blankets can really help a child sleep better at night, and weighted vests or shoulder wraps have been used with success to help a child’s nervous system calm down when doing tasks that require focus.  

As their nervous system heals, their need for these tools and environmental accommodations will decrease. These are tools that they will be able to use for their lifetime, as periods of life will come when they feel dysregulated again. When this happens, they can reuse these tools that you have taught them to calm down their nervous system.

A discussion on helping dysregulated nervous systems would not be complete without also talking about the importance of sleep and diet. We will not go into details in this blog, so I will bypass the science and go straight to the point: sleep and diet are directly correlated to the nervous system. Both can greatly contribute to a dysregulated nervous system, however, that also means that you can really help your child have a better day with the right diet and restful sleep.

Can a child heal from attachment disorder?

As I have referenced in several paragraphs above, a child can heal from attachment disorder despite these biological changes in their brain and body. I have seen it happen many times in families who commit to this work and make the necessary changes in their child’s environment and in their parenting styles.  

Specific therapies focus on healing the nervous system, including Neuro-Reorganization, Neuro-Fit, Neuro-feedback, and Somatic Experiencing. There are direct ways to measure a nervous system through neurofeedback mechanisms and heart rate variability. These are great tools to monitor progress along the way. We can discuss these in more detail in later blogs.

Ultimately, I do believe these children can fully heal, earn a secure attachment, and more importantly, have a healthy and happy rest of their life!

If you have a child with attachment disorder, I am very curious to hear about your experience dealing with your child’s nervous system. What specific things have you noticed about their nervous system? What tools have you found along the way to specifically help their nervous system calm down and regulate?

Cheering You On,

Dr. Aimie

Related: FAQs About Working With Children With Attachment Disorder

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