Attachment: Who Loves You, Baby?
By Lisa Belisle, MD, MPH

The goal of raising readers is to get books to children. We supply books to medical providers who pass them along to their patients at well-child visits. The hope is that children will cherish these books and the process of reading itself. Ultimately, however, a book is simply a tool–one that is only as effective as the person reading it to the child. Brain development depends less on the tools a child can access than his attachment to those who teach him to use those tools.

Attachment theory has been explored by various child development experts for more than forty years. John Bowlby uses the term 'attachment' to describe a "pattern of interaction that develops over time as the infant and caregiver interact." (1) Attachment has also been called 'bonding,' which denotes the connection between caregiver and child. Early bonding has a significant impact on the way a child deals with future relationships, and in his ability to learn.

Learning begins in infancy. An infant begins to observe life processes through his experiences with those who care for him. A child is first exposed to the idea of cause-and-effect in his interactions with his caregiver. He learns that when he cries, he can expect attention to his needs. He understands that he can have some control over his environment. He also gains a sense of what he may encounter in different situations. "The repeated experiences of an infant become encoded in memory as expectations about the world that, over time, become a lasting mental model." (2) If a child has appropriate expectations, he will more readily engage in new relationships and learn new activities.

Children who have secure attachments to their caregivers are observed to:

have higher self esteem, to positively engage and respond to other children, and to be more empathetic [as preschoolers],
be more self-reliant [but also] more effective in using adults when appropriate,
be more likely to be accepted by their classmates and were better at forming close relationships with friends [in middle childhood],
show capacity for intimacy, self-disclosure and successful functioning in mixed gender peer groups [in adolescence], and
interact in a more positive way with romantic partners [as young adults].(3)

A child who has a normal attachment to his caregiver has a 'secure base' from which to explore new things. This base becomes a place of safety and solace when a child feels threatened. Children who do not have a secure base are very tentative in their explorations. They focus on basic survival, rather than trying to better understand their environment by learning new tasks.

The importance of a child's relationship to his environment cannot be understated. Children are born with genetic potential. How this potential is manifested depends on a child's interactions with the world.

Environmental factors play a crucial role in the establishment of synaptic connections after birth. For the infant and young child, attachment relationships are the major environmental factors that shape the development of the brain during its period of maximal growth. Therefore, caregivers are the architects of the way in which experience influences the unfolding of genetically preprogrammed, but experience-dependent brain development. Genetic potential is expressed within the setting of social experiences, which directly influence how neurons connect to one another. Human connections create neuronal connections. (4)

As the "architect" of a child's brain development, a child's caregiver plays a crucial role. Most synapses are made before the age of five. Once these are forged, the brain operates on a "use it or lose it" model. The synapses must be utilized in order to be maintained. Children depend on their caregivers to facilitate exposure to ongoing stimuli that keep the connections intact.

One way of facilitating this exposure is by reading to children. Reading provides a multi-sensory experience in the setting of a loving environment. It is an emotionally satisfying activity. It is also a way of modeling a desirable behavior. Children who enjoy this type of association are more likely to mimic the behavior as they grow older. Reading begets readers.

Readers are not born–they are made. Learning to read requires good genetic potential, coupled with sufficient exposure to relevant tools (i.e. books). Both of these are only minimally useful without positive child-caregiver interactions. Make this your focus at your next well-child visit. As you hand over a beautiful, new raising readers book, be sure to ask the question

"Who loves you, Baby?"

References:
(1) Zero to Three Bulletin: Attachment Theory and Research, Volume 20, Number 2, October/November 1999.
(2) Brainwatch, Wisconsin Council on Children and Families, Volume 1, Issue 5, April 2000.
(3) Zero to Three Bulletin: Attachment Theory and Research, Volume 20, Number 2, October/November 1999.
(4) Brainwatch, Wisconsin Council on Children and Families, Volume 1, Issue 5, April 2000.