The Chat with Dr.

Dave
Therapeutic Thoughts of the Week
David P. Sanchez, Psy.D., LMFT

Attachment in the Context of Multiple Caregivers

Recently I participated in the Early Childhood Service Intensity Instrument (ECSII) training
which is a tool to assist providers caring for young children to determine intensity of services for
infants, toddlers, and children from ages 0-5 years. The ECSII is targeted to children and their
families with emotional, behavioral, and/or developmental needs, including those who are
experiencing environmental stressors that may put them at risk for such problems. Domain II
assesses the quality of the child-caregiver relationship and the ECSII scoring worksheet allows
for 3 caregiving relationships to be assessed and scored. Due to the proximity of timing for my
participation in this training this weeks Dr. Daves Therapeutic Thoughts of the Week
pertains to the concept of attachment in the context of multiple caregivers.
John Bowlbys (1969/1982) work on attachment proposes that a child develops a hierarchy of
attachment relationships. Bowlby proposed that the infant becomes attached to the mother first
as the primary caregiver and then to others, specifically the father. Mary Ainsworths (1967)
work on attachment proposes that during the time that the infant builds an attachment with his
mother that he is also building attachments with others during this time which may be the
father, grandmother, older sibling, or other adult figure in the home. For the context of the
population in which I provide services to (Foster Care) we will broaden the concept of
attachment and consider attachment as a network of attachment relationships i.e. (foster
parents/coaches/daycare providers). The inclusion of multiple caregivers in the study of
attachment relationships adds new dimensions to be examined within the field of attachment
research.
Who is an attachment figure?
Within most westernized cultures there is little dispute or controversy acknowledging that the
mother and the father are viewed as attachment figures. However, may the grandmother, foster
parent, or the full-time daycare provider may also be viewed as an attachment figure?

The Chat with Dr. Dave

Therapeutic Thoughts of the Week
David P. Sanchez, Psy.D., LMFT
What criterion do we use to determine who is an attachment figure?
We may take into consideration the emotional connection developed over time between the
infant/toddler and their attachment figure. Van Ilzendoorn et al research indicates that the level
of caregiver sensitivity and attachment security also plays into the development of an attachment
figure. Howes et al research proposes the following three criteria necessary for identification of
an attachment figure: 1) provision of physical and emotional care; 2) continuity or consistency in
a childs life; and 3) emotional investment in the child. These criteria are principally meant to be
applied to adults within the individual childrens social networks. Within a network of
attachment relationships we must determine who these attachments figures are and in what
developmental context and timeframe did this attachment relationship enter the infant/toddlers
life.
Early childhood (initial) Attachment is pivotal and directs the formation of future
relationships. Howes, Hamilton, and Phillipsen, 1998 indicate that childrens attachment
security with their first child care providers will predict the childs perception of their
relationships with their current teachers.
This weeks Dr. Daves Therapeutic Thoughts of the Week is to provoke insight and reflection
around the idea of our foster children possessing a network of attachment figures and to
provide a conceptualization on how to determine a primary attachment figure in the childs life.

Resources:
Ainsworth, M.D.S. (1967). Infancy in Uganda: Infant care and the growth of love. Baltimore:
John Hopkins University Press.
Ainsworth, M.D.S., Blehar, M., Waters, E., & Wall, S. (1978). Patterns of attachment. Hillsdale,
NJ: Erlbaum.
Bowlby, J. (1958). The nature of the childs to his mother. International Journal of PsychoAnalysis, 39, 350-373.
Bowlby, J. (1969/1982) Attachment and loss: Vol. 1. Attachment. New York: Basic Books.

The Chat with Dr. Dave

Therapeutic Thoughts of the Week
David P. Sanchez, Psy.D., LMFT
Howes, C., Hamilton, C.E., & Phillipsen, L.C. (1998). Stability and continuity of child-caregiver
relationships. Child Development, 69, 418-426.
Van Ijzendoorn, M.H., Sagi, A., & Lambermon, M. (1992). The multiple caregiver paradox:
Data from Holland and Israel. In R. C. Pianta (Ed.), New directions for child
development: No. 57. Beyond the parent: The role of other adults in childrens lives (pp.
5-27). San Francisco: Jossey-Bass.