Provided by David Satcher, M.D., Ph.D.
Surgeon General of the United States of America
Chapter 3: Children and Mental Health
Social and Language Development
Parent-Child Relationships
It is common knowledge that infants and, for the most part,
their principal caretakers typically develop a close bond during the first year
of life, and that in the second year of life children become distressed when
they are forcibly separated from their mothers. However, the clinical importance
of these bonds was not fully appreciated until John Bowlby introduced the
concept of attachment in a report on the effects of maternal deprivation (Bowlby,
1951). Bowlby (1969) postulated that the pattern of an infant’s early attachment
to parents would form the basis for all later social relationships. On the basis
of his experience with disturbed children, he hypothesized that, when the mother
was unavailable or only partially available during the first months of the
child’s life, the attachment process would be interrupted, leaving enduring
emotional scars and predisposing a child to behavioral problems.
A mother’s bond with her child often starts when she feels fetal movements
during pregnancy. Immediately after birth, most, but by no means all, mothers
experience a surge of affection that is followed by a feeling that the baby
belongs to them. This experience may not occur at all or be delayed under
conditions of addiction or postnatal depression (Robson & Kumar, 1980; Kumar,
1997). Yet, like all enduring relationships, it seems that the relationship
between mother and child develops gradually and strengthens over time. Some
infants who experience severe neglect in early life may develop mentally and
emotionally without lasting consequences, for example, if they are adopted and
their adoptive parents provide sensitive, stable, and enriching care, or if
depressed or substance-abusing mothers recover fully (Koluchova, 1972; Dennis,
1973; Downey & Coyne, 1990). Unfortunately, however, early neglect is all too
often the precursor of later neglect. When the child remains subject to
deprivation, inadequate or insensitive care, lack of affection, low levels of
stimulation, and poor education over long periods of time, later adjustment is
likely to be severely compromised (Dennis, 1973; Curtiss, 1977).
In general, it appears that the particular caregiver with whom infants interact
(i.e., biological mother or another) is less important for the development of
good social relationships than the fact that infants interact over a period of
time with someone who is familiar and sensitive (Lamb, 1975; Bowlby, 1988). One
of the problems in the later development of children who experience early
institutionalization or significant neglect is that there may have been no
opportunities for the caretakers and the infants to establish strong and mutual
attachments in a reciprocating relationship.
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