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The Importance of Touch in the Development of Attachment Lenora Duhn, Msc, RN

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The Importance of Touch in the Development of Attachment Lenora Duhn, Msc, RN ANC200144.qxp 11/12/10 3:26 PM Page 294 LINDA IKUTA, RN, MN, CCNS, PHN • Section Editor The Importance of Touch in the Development of Attachment Lenora Duhn, MSc, RN ABSTRACT Until recently the role of human touch in the social world of the developing infant has not been given special attention. Instead the focus, in part due to John Bowlby’s Attachment Theory, has centered on the critical need for a child to develop a secure attachment to his caregiver. To be sure, this has provided a valuable contribution to understanding and pro- moting a child’s well-being in his early years and beyond. Yet Bowlby’s theory is limited in its discussion of the meaning of human touch and its role in development of attachment. As such, it now becomes more critical to delve into the fac- tors that significantly foster development of attachment, specifically the concept of human touch. With recognition of the importance for a child to develop secure attachment to his caregiver, the essential function that human nurturing touch provides in facilitating that connection is explored. KEY WORDS: attachment, infant development, touch he health of future families and communities is the early years of child development. Their recom- rooted in the health and well-being of the mendations for optimal child care are grounded in the Tinfants and children we care for today. A child’s notion that the early years of development are funda- well-being has implications that are far-reaching. The mental for future learning, behavior, and health. goal of optimal health for children, in its broadest Profiled in the study is the premise that nurturing by sense of the definition, has long inspired the efforts of parents in the early years has an integral and decisive parents, health care practitioners, researchers, and influence on human development. Furthermore, they policy makers. Now more than ever, there is greater highlight that it is important for a child to have a understanding of the complex, multifaceted nature of secure attachment to his or her caregiver. This secure early human development and heightened apprecia- attachment allows the child to discover his or her tion of the positive and negative influences that world through independent exploration and to impact its unfolding. develop other relationships. This caregiver nurturing The 1999 Report from the Early Years Study1 is fosters optimal early brain development that mani- one example of recent efforts undertaken to profile fests itself in later learning and behavior. what we know about early brain development, partic- In keeping with this pursuit of inquiry, the ularly during the first 3 years, and its link to compe- National Research Council and the Institute of tence and coping skills in later life. This study was Medicine established the Committee on Integrating commissioned by the Government of Ontario with a the Science of Early Childhood Development to fur- primary focus to explore current literature regarding ther elucidate the nature of early development and the meaning of early childhood experiences.2 Their report echoes that of the Early Years Study, detailing Author Affiliation: Kingston General Hospital, Kingston, Ontario, Canada. again the importance of the first 5 years of the child’s life as a time when they are rapidly developing capa- Correspondence: Lenora Duhn, MSc, RN, Kingston General bilities that will serve as the foundation from which Hospital, 76 Stuart St, Kingston, ON K7L 2V7, Canada future development will occur. It also highlights as a ([email protected]). core concept the importance of human relationships Copyright © 2010 by the National Association of as the building blocks of healthy development. Neonatal Nurses. Underpinning their recommendations for develop- DOI:10.1097/ANC.0b013e3181fd2263 mental promotion and early childhood interventions 294 Advances in Neonatal Care • Vol. 10, No. 6 • pp. 294-300 Copyright © 2010 National Association of Neonatal Nurses. Unauthorized reproduction of this article is prohibited. ANC200144.qxp 11/12/10 3:26 PM Page 295 The Importance of Touch in the Development of Attachment 295 is the theme that secure attachments with significant touch, or their mere presence. Through this process, caregivers are essential features of healthy human the child’s attachment behavior of crying, for exam- development. Cradled in this relationship, this child’s ple, subsides and a sense of security is achieved. As cognitive, linguistic, emotional, social, and moral the child approaches his first birthday, he comes to development can occur.2 Recognizing that develop- understand in a more meaningful way the conditions ment proceeds at an unprecedented pace during this that decrease his distress and make him feel secure, early period, and that it is not immune to risk and vul- and behaviors such as clinging evolve to become nerability, the report emphasizes the critical nature of goal-corrected as opposed to simple reflex healthy development in ensuring the well-being and responses.4 It is this infant-attachment figure interac- “well-becoming” of children.2 Given the importance tion, characterized as a progression of signals and of secure attachment as a fundamental formative ele- responses, which is central in shaping the infant’s ment that is integral to this process, an understanding quality of attachment. of the factors that contribute to and facilitate mean- Although Bowlby’s attachment theory provides ingful attachment is paramount. important insights into the concept of attachment, and an understanding of how it relates to the organi- zation of attachment behaviors in connection with CONCEPTS OF ATTACHMENT THEORY the attachment figure in various situations, it does not Bowlby3,4 made significant contribution to the articu- thoroughly delve into the significance of particular lation of modern attachment theory. The influential actions taken by the caregiving system and their and vital role of the child’s first relationship, the ori- resulting implications. Specifically, caregiver touch as gins of which begin at birth, is clearly evident in his an influential response to infant attachment behav- writings. Within this perspective attachment is con- iors, and its role in shaping the infant’s expectations ceptualized as an innate behavioral system monitor- regarding caregiver responsiveness, is not fully 4 ing events indicative of potential danger or stress, as expounded. Bowlby offers that depending on the well as accessibility to the attachment figure, wherein intensity of the activation of the behavioral system this desire for proximity becomes a set goal of the sys- and the resulting attachment behavior, its termina- tem.4 As such, he suggests that a child’s attachment to tion might be achieved only by physical contact. Yet his or her caregiver, typically the child’s mother, sig- further explanation as to why physical contact or nifies the child’s desire to obtain connection and con- touch is most critical, and how contact communicates tact with that individual during a stressful period.4 comfort and a sense of security to the infant like no When the attachment behavioral system is intensely other action, is not presented. This is an essential part activated in times of stress attachment behaviors such of understanding the infant-caregiver relationship as crying, clinging, or following the attachment figure and how it relates to satisfactory development of signal the infant’s need of attention and desire for attachment. caregiver proximity. When the intensity of the system is low, interaction with the attachment figure via TOUCH AS AN ANTECEDENT TO 4 behaviors such as smiling or touching is common. SECURE ATTACHMENT The theory acknowledges the strong emotional com- ponent in attachment behaviors, suggesting that no Heller5 describes touch as a baby’s lifeline, like a silent other form of behavior is accompanied by such strong language connecting infant with parent, with the feelings.4 Organized within the attachment behavioral experience of each touch fostering a stronger tie. In system, a child is seen to develop an inner cognitive humans, touch is the first sensory system to develop.6 working model of his relation with the attachment fig- The tactile (touch) system that is the system responsi- ure; for instance, aiding the child’s decision making ble for the infant’s ability to respond to any form of for the type of attachment behavior that would be touch is a complex one, composed of 4 different sen- most effective in achieving contact with the caregiver. sory abilities, and their corresponding and unique Linked with the child’s attachment to his or her neural pathways.7 The 4 sensory abilities are cuta- attachment figure is the response and interaction on neous: pressure (the feeling of the skin contacting an the part of the attachment figure or caregiving sys- object), temperature, pain, and proprioception (the tem.4 In describing maternal caregiving, Bowlby4 sense of position and movement).7 It is through these speaks of “retrieving” as any action of the parent that sensory pathways that the effects of nurturing parental promotes and ensures proximity of the child to them. touch are registered with the infant. The impact that This retrieval behavior, from possible danger, is sim- touch has in the development of the infant and their ilar to attachment behavior in its biological function, relationship with the parent has been explored by a a protective function, and means of survival for the number of investigators. Highlights from some of the infant. Bowlby4 proposes that the attachment figure is earliest studies regarding touch will be presented ini- the one who can deactivate the child’s attachment tially to help frame our current understanding of its behavioral system with the sound of their voice, their role in development of attachment. Advances in Neonatal Care • Vol. 10, No. 6 Copyright © 2010 National Association of Neonatal Nurses. Unauthorized reproduction of this article is prohibited.
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