The problematic use of attachment theory in assessing parents with disabilities
DOI:
https://doi.org/10.24270/netla.2026/8Keywords:
disability, attachment, child protection, custody, visitation, psychologyAbstract
The authors of this contribution have collectively observed in their varied clinical, academic and research-based experiences a noticeable recent emphasis on the use of attachment theory in child protection cases in Iceland. The factor of parent-child bonding has always played some role in child protection cases. However, we have detected a shift whereby attachment has come to play a predominant role in the argumentation and justification for custody and visitation deprivation, as well as increased efforts to enhance the scientific legitimacy of measures of attachment. This is troubling for several reasons. The first contention is that while attachment theory has its supporters as well as utility in child protection work, there is also a wealth of counter-evidence that challenges the core premises of attachment theory, its instruments of measure, its use as a form of evidence in court and its appropriateness for parents and children with disabilities, particularly those who have a diagnosis of intellectual disability, ASD or other forms of neurodivergence. Researchers have argued that the concept of attachment is rather vague and unsatisfactory and has no broadly agreed or clearly defined meaning. Basic assumptions that underpin the theory, such as that infants have only one preferred person, have also been contested. Questions have been posed to attachment theory such as whether current attachment state predicts future conduct, which is particularly relevant for child protection matters. Diversity among parents and children in terms of, among other factors, class, ethnicity and neurodivergence regarding parenting techniques and issues relating to attachment need to be considered. Scholars have criticised attachment theory for being too Eurocentric in nature and claiming universality in all its components. Attachment theory evolved from notions of family life and relationship dynamics that were shaped by societies of the Global North in a specific historical context, together with specific forms of the family and practices that were seen as normative. The premises of attachment theory are therefore essentially based on the dominant childcare model of the Global Northern middle class. Failure to recognise these limitations may lead to incorrect applications with major detrimental implications. A parallel critique applies regarding disability and neurodivergence pertaining to both parents as well as children.
Clinicians tend to report significant overlap in symptoms between attachment issues and autism spectrum disorder. There are problematic assumptions that children with ASD do not form bonds with caregivers or do so in substandard ways, while empirical research has shown that children with autism do in fact ordinarily build attachments with their main caregivers, with a sizable proportion forming stable bonds. Standardised measures are often used to categorise attachment in adulthood and, as such, there are problematic issues with utilising measures intended for neurotypical populations to evaluate attachment in people with autism. The research evidence, that parents with disabilities (particularly those with intellectual disabilities and/or are neuroatypical) are routinely discriminated against in child welfare, family law and child protection systems is well known and well documented. The overreliance on such scientifically questionable measures should not form the basis for the justification for custody termination, particularly in cases arguably driven by prejudice and which could be resolved through the implementation of appropriate and meaningful support. Attachment approaches should not be exempt from close scrutiny, nor should credence be given to extremely casual applications, such as only briefly observing the parent and child to determine attachment or other qualities of the relationship. The theory and its application are not agreed upon by practitioners and researchers and there exist divisions within attachment theory research communities about what attachment behaviours are, how they can be assessed and what these behaviours mean. Courts need to be made aware that attachment theory and its application are controversial and not received science. The critical literature does not suggest that attachment theory has no role to play in child protection investigations or custody hearings. However, appropriate and measured cautions must be employed. The core purpose of this contribution is to present a collaborative, inter-disciplinary statement (clinical and academic psychology, disability studies and anthropology) to raise awareness of these issues for parents, their supporters and advocates, practitioners and scholars as well as to educate the general public. It will conclude with a brief overview of some recent exploratory findings to point to a way forward for further research.
Downloads
References
Ainsworth, M. D. S., Blehar, M. C., Waters, E. og Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Lawrence Erlbaum.
Alexius, K. og Hollander, A. (2014). Care assessments concerning involuntary removal of children from intellectually disabled parents. Journal of Social Welfare and Family Law, 36(3), 295–310. https://doi.org/10.1080/09649069.2014.933591
Allen, B. (2016). A RADical idea: A call to eliminate attachment disorder and attachment therapy from the clinical lexicon – Evidence-based practice. Child and Adolescent Mental Health, 1(1), 60–71. https://doi.org/10.1080/23794925.2016.1172945
Aunos, M., Feldman, M. og Pacheco, L. (2024). Capacity-based competency assessment and its impact on child custody cases amongst parents with intellectual disabilities. Í A. Bianchi og J. A. Vogt (ritstjórar), Intellectual disabilities and autism: Ethics and practice (bls. 79–91). Springer Nature. https://doi.org/10.1007/978-3-031-61565-8_7
Belsky, J. og Rovine, M. (1987). Temperament and attachment security in the strange situation: An empirical rapprochement. Child Development, 58(3), 787–795. https://doi.org/10.2307/1130215
Berghaus, B. J. (2011). A new look at attachment theory and adult attachment behavior. Behaviorology Today, 14(2), 3–10. https://www.behaviorology.org/oldsite/pdf/AttachmentTheoryBeh.pdf
Bilson, A. og Martin, K. E. (2017). Referrals and child protection in England: One in five children referred to children’s services and one in nineteen investigated before the age of five. British Journal of Social Work, 47(3), 793–811. doi.org/10.1093/bjsw/bcw054
Bowlby, J. (1969). Attachment and loss, vol. 1: Attachment. Basic Books.
Brennan, K. A., Clark, C. L. og Shaver, P. R. (1998). Self-report measurement of adult attachment: An integrative overview. Í J. A. Simpson og W. S. Rholes (ritstjórar), Attachment theory and close relationships (bls. 46–76). The Guilford Press.
Bruer, T. J. (1999). The myth of the first three years: A new understanding of early brain development and lifelong learning. Simon and Schuster.
Bullens, R. A. R. (2003). Diagnostiek van hechting van een pleegkind: Stiefkind binnen de diagnostiek? Í C. Schuengel, N. W. Slot og R. A. R. Bullens (ritstjórar), Gehechtheid en kinderbescherming (bls. 55–74). SWP.
Chaffin, M., Hanson, R. og Saunders, E. B. (2006). Reply to letters. Child Maltreatment, 11(4), 381–386. https://doi.org/10.1177/1077559506292636
Choate, P. og Torotelli, P. (2022). Attachment theory: A barrier for indigenous children involved with child protection. International Journal of Environmental Research and Public Health, 19(14), 8754. https://doi.org/10.3390/ijerph19148754
Clark, C., Prior, M. og Kinsella, G. (2002). The relationship between executive function abilities, adaptive behaviour, and academic achievement in children with externalising behaviour problems. Journal of Child Psychology and Psychiatry, 43(6), 785–796. https://doi.org/10.1111/1469-7610.00084
Crittenden, P. M. (1981). Abusing, neglecting, problematic, and adequate dyads: Differentiating by patterns of interaction. Merrill-Palmer Quarterly, 27(3), 201–218.
Crittenden, P. M. (1983). Sociological aspects of attribution. Annual Review of Sociology, 9, 425–446. https://doi.org/10.1146/annurev.so.09.080183.002233
Crittenden, P. M. (1988). Relationships at risk. Í J. Belsky og T. Nezworski (ritstjórar), Clinical implications of attachment (bls. 136–174). Lawrence Erlbaum.
Crittenden, P. M. (1992). Childrenʼs strategies for coping with adverse home environments: An interpretation using attachment theory. Child Abuse & Neglect, 16(3), 329–343. https://doi.org/10.1016/0145-2134(92)90043-Q
Crittenden, P. M. (1995). Attachment and psychopathology. Í S. Goldberg, R. Muir og J. Kerr (ritstjórar), Attachment theory: Social, developmental, and clinical perspectives (bls. 367–406). Analytic Press.
Crittenden, P. M. (1998). Dangerous behavior and dangerous contexts: A 35-year perspective on research on the developmental effects of child physical abuse. Í P. K. Trickett og C. J. Schellenbach (ritstjórar), Violence against children in the family and the community (bls. 11–38). American Psychological Association. https://doi.org/10.1037/10292-001
Crittenden, P. M. (1999). Atypical attachment in infancy and early childhood among children at development risk. Danger and development: The organization of self-protective strategies. Monographs of the Society for Research in Child Development, 64(3), 145–171. https://doi.org/10.1111/1540-5834.00037
Crittenden, P. M. (2007). CARE-Index. Toddlers: Coding manual [óútgefið handrit].
Crittenden, P. M. (2008). Raising parents: Attachment, parenting and child safety. Willan Publishing.
Crittenden, P. M. (2015). Raising parents: Attachment, representation, and treatment (2. útgáfa). Routledge.
Crittenden, P. M., Farnfield, S., Landini, A. og Grey, B. (2013). Assessing attachment for family court decision making. Journal of Forensic Practice, 15(4), 237–248. https://doi.org/10.1108/JFP-08-2012-0002
Crittenden, P. M. og Landini, A. (2011). Assessing adult attachment: A dynamic maturational approach to discourse analysis. W. W. Norton.
Crittenden, P. M. og Spieker, S. (2018). Attachment theory and research in a developmental framework. Í N. Jones, M. Platt, K. D. Mize og J. Hardin (ritstjórar), Conducting research in developmental psychology: A topical guide for research methods utilized across the lifespan (bls. 122–133). Routledge. https://doi.org/10.4324/9780429352065-9
Davis, A. M. B. og Kramer, R. S. S. (2021). Commentary: Does cry it out really have no adverse effects on attachment? Reflections on Bilgin and Wolke (2020). Journal of Child Psychology and Psychiatry, 62(12), 1488–1490. https://doi.org/10.1111/jcpp.13390
Family Relations Institute. (e.d.). Forensic services: Court: IASA protocol. https://familyrelationsinstitute.org/forensic-services/
Farnfield, S., Hautamäki, A., Nørbech, P. og Sahhar, N. (2010). DMM assessments of attachment and adaption: Procedures, validity and utility. Clinical Child Psychology and Psychiatry, 15(3), 313–328. https://doi.org/10.1177/1359104510364315
Fearon, R. P. og Roisman, G. I. (2017). Attachment theory: Progress and future directions. Current Opinion in Psychology, 15, 131–136. https://doi.org/10.1016/j.copsyc.2017.03.002
Field, T. (1996). Attachment and separation in young children. Annual Review of Psychology, 47, 541–562. https://doi.org/10.1146/annurev.psych.47.1.541
Fierros, E. G. (2006). One size does not fit all: A response to institutionalizing inequity. Disability Studies Quarterly, 26(2). https://doi.org/10.18061/dsq.v26i2.683
Forslund, T. og Duschinsky, R. (ritstjórar). (2021). Attachment theory and research: A reader. Wiley.
Forslund, T., Granquist, P., van IJzendoorn, M. H., Sagi-Schwartz, A., Glaser, D., Steele, M., Hammarlund, M., Schuengel, C., Bakermans-Kranenburg, M. J., Steele, H., Shaver, P. R., Lux, U., Simmonds, J., Jacobvitz, D., Groh, A. M., Bernard, K., Cyr, C., Hazen, N., Foster, S., … Duschinsky, R. (2021). Attachment goes to court: Child protection and custody issues. Attachment & Human Development, 24(1), 1–52. https://doi.org/10.1080/14616734.2020.1840762
Foster, S. L. og Duschinsky, R. (2025). ‘In practice we don’t use that much theory’: Questioning claims of the dominance of attachment theory in children’s safeguarding social work. The British Journal of Social Work, 55(6), 2716–2733. https://doi.org/10.1093/bjsw/bcaf068
Foster, S. L., Schofield, G., Geoghegan, L., Hood, R., Sagi-Schwartz, A., Bakkum, L., Hutchinson, D., Balk, W., Devine, R., Steele, M., Steele, H., Duncan, R., Guthrie, J., Mannes, J., Talia, A., Pickerden, J. E., Senior, L., Bailey, L., Stanton, C., … Duschinsky, R. (2025). Attachment theory and research: What should be on the core curriculum for child and family social workers? Social Work Education, 45(3), 803–820. https://doi.org/10.1080/02615479.2025.2531859
Galliher, K. E. (1973). Termination of the parent-child relationship: Should parental I.Q. be an important factor? Law and the Social Order, 4, 855–879.
Granqvist, P. (2016). Observations of disorganized behaviour yield no magic wand: Response to Shemmings. Attachment & Human Development, 18(6), 529–533. https://doi.org/10.1080/14616734.2016.1189994
Hamadi, L. og Fletcher, H. K. (2019). Are people with an intellectual disability at increased risk of attachment difficulties? A critical review. Journal of Intellectual Disabilities, 25(1), 114–130. https://doi.org/10.1177/1744629519864772
Hanna Björg Sigurjónsdóttir, Harwick, R. og Rice, J. (2019). Balancing the scales: Custody deprivation and fostering in Iceland. International Social Work, 62(4), 1304–1309. https://doi.org/10.1177/0020872818819045
Hanna Björg Sigurjónsdóttir og Rice, J. G. (2016). Stigmatic representation of intellectual disability and termination of parental custody rights. Í K. Scior og S. Werner (ritstjórar), Intellectual disability and stigma (bls. 77–90). Palgrave Macmillan. https://doi.org/10.1057/978-1-137-52499-7_6
Hanna Björg Sigurjónsdóttir og Rice, J. G. (2017). ‘Framed’: Terminating the parenting rights of parents with intellectual disability in Iceland. Journal of Applied Research in Intellectual Disabilities, 30(3), 543–552. https://doi.org/10.1111/jar.12301
Hanna Björg Sigurjónsdóttir og Rice, J. G. (2018). ‘Evidence’ of neglect as a form of structural violence: Parents with intellectual disabilities and custody deprivation. Social Inclusion, 6(2), 66–73. https://doi.org/10.17645/si.v6i2.1344
Hanna Björg Sigurjónsdóttir og Rice, J. G. (2023). “Alleged disabilities”: The evolving tactics of child protection in a disability rights environment. Laws, 12(2), 30. https://doi.org/10.3390/laws12020030
Hautamäki, A. (2015). Mothers and infants: Screening for maternal relationships at risk with the CARE-Index. Í S. Farnfield og P. Holmes (ritstjórar), The Routledge handbook of attachment: Assessment (bls. 37–52). Routledge. https://doi.org/10.13140/RG.2.1.3809.2005
Isaacs, M. B., George, C. og Marvin, R. S. (2009). Utilizing attachment measures in child custody evaluations: Incremental validity. Journal of Child Custody, 6(1-2), 139–162. https://doi.org/10.1080/15379410902894882
Kahane, L. og El-Tahir, M. (2015). Attachment behavior in children with autistic spectrum disorders. Advances in Mental Health and Intellectual Disabilities, 9(2), 79–89. https://doi.org/10.1108/AMHID-06-2014-0026
Keller, H. (2018). Universality claim of attachment theory: Children’s socioemotional development across cultures. Proceedings of the National Academy of Sciences, 115(45), 11414–11419. https://doi.org/10.1073/pnas.1720325115
Keller, H. og Chaudhary, N. (2017). Is the mother essential for attachment? Models of care in different cultures. Í H. Keller og K. A. Bard (ritstjórar), The cultural nature of attachment: Contextualizing relationships and development (bls. 109–138). MIT Press. https://doi.org/10.7551/mitpress/11425.003.0007
Kong, P., Collings, S. og Spencer, M. (2025). Assessments, assumptions and ableism: Examining court-ordered parenting capacity assessments of parents with intellectual disability and cognitive difficulties. Journal of Intellectual & Developmental Disability, 50(2), 196–210. https://doi.org/10.3109/13668250.2024.2417425
LaLiberte, T., Piescher, K., Mickelson, N. og Lee, M. (2017). Child protection services and parents with intellectual and development disabilities. Journal of Applied Research in Intellectual Disabilities, 30(3), 521–532. https://doi.org/10.1111/jar.12323
Lau, W. og Peterson, C. C. (2011). Adults and children with Asperger syndrome: Exploring adult attachment style, marital satisfaction and satisfaction with parenthood. Research in Autism Spectrum Disorders, 5(1), 392–399. https://doi.org/10.1016/j.rasd.2010.06.001
Lightfoot, E., LaLiberte, T. og Hill, K. (2007). Guide to creating legislative change: Disability status in termination of parental rights and other child custody statutes. University of Minnesota Press.
Lindberg, L., Fransson, M., Forslund, T., Springer, L. og Granqvist, P. (2016). Maternal sensitivity in mothers with mild intellectual disabilities is related to experiences of maltreatment and predictive of child attachment: A matched-comparison study. Journal of Applied Research in Intellectual Disabilities, 30(3), 445–455. https://doi.org/10.1111/jar.12300
Lorenz, K. (1935). Der Kumpan in der Umwelt des Vogels: Der Artgenosse als auslösendes Moment sozialer Verhaltensweisen. Journal für Ornithologie, 83, 137–215, 289–413.
Ludolph, P. S. og Dale, M. D. (2012). Attachment in child custody: An additive factor, not a determinative one. Family Law Quarterly, 46(1), 1–40. http://www.jstor.org/stable/23240374
Main, M., Hesse, E. og Hesse, S. (2011). Attachment theory and research: Overview with suggested applications to child custody. Family Court Review, 49(3), 426–463. https://doi.org/10.1111/j.1744-1617.2011.01383.x
McConnell, D. og Llewellyn, G. (2000). Disability and discrimination in statutory child protection proceedings. Disability & Society, 15(6), 883–895. https://doi.org/10.1080/713662015
McConnell, D. og Llewellyn, G. (2002). Stereotypes, parents with intellectual disability and child protection. Journal of Social Welfare and Family Law, 24(3), 297–317. https://doi.org/10.1080/09649060210161294
McKenzie, R. og Dallos, R. (2017). Autism and attachment difficulties: Overlap of symptoms, implications and innovative solutions. Clinical Child Psychology and Psychiatry, 22(4), 632–648. https://doi.org/10.1177/1359104517707323
Mesman, J., van IJzendoorn, M. H. og Sagi-Schwartz, A. (2016). Cross-cultural patterns of attachment. Í J. Cassidy og P. R. Shaver (ritstjórar), Handbook of attachment: Theory, research, and clinical applications (3. útgáfa, bls. 852–877). Guilford Press.
Mikulincer, M. og Shaver, P. R. (2007). Attachment in adulthood: Structure, dynamics, and change. Guilford Press.
Mullen, G. (2018). Intellectual disability and attachment theory among adults: An early systematic review. Journal of Intellectual & Developmental Disability, 43(3), 252–263. https://doi.org/10.3109/13668250.2017.1410769
Neal, T. M., Slobogin, C., Saks, M. J., Faigman, D. L. og Geisinger, K. F. (2019). Psychological assessments in legal contexts: Are courts keeping “junk science” out of the courtroom? Psychological Science in the Public Interest, 20(3), 135–164. https://doi.org/10.1177/1529100619888860
OʼConnor, T. G., Rutter, M. og English & Romanian Adoptees Study Team. (2000). Attachment disorder behavior following early severe deprivation: Extension and longitudinal follow-up. Journal of the American Academy of Child & Adolescent Psychiatry, 39(6), 703–712. https://doi.org/10.1097/00004583-200006000-00008
Potharst, E. S., Schuengel, C., Last, B. F., van Wassenaer, A. G., Kok, J. H. og Houtzager, B. A. (2012). Difference in mother-child interaction between pre-term and term-born preschoolers with and without disabilities. Acta Paediatrica, 101(6), 597–603. https://doi.org/10.1111/j.1651-2227.2012.02599.x
Riggs, S. A. (2005). Is the approximation rule in the child’s best interests? A critique from the perspective of attachment theory. Family Court Review, 43(3), 481–493. https://doi.org/10.1111/j.1744-1617.2005.00048.x
Rutgers, A. H., Bakermans‐Kranenburg, M. J., van IJzendoorn, M. H. og van Berckelaer‐Onnes, I. A. (2004). Autism and attachment: A meta‐analytic review. Journal of Child Psychology and Psychiatry, 45(6), 1123–1134. https://doi.org/10.1111/j.1469-7610.2004.t01-1-00305.x
Röttger-Rössler, B. (2014). Bonding and belonging beyond WEIRD worlds: Rethinking attachment theory on the basis of cross-cultural anthropological data. Í H. Otto og H. Keller (ritstjórar), Different faces of attachment: Cultural variations on a universal human need (bls. 141–168). Cambridge University Press.
Schofield, G. og Walsh, J. (2010). Young carers – or children in need of care? Decision making for children of parents with mental health problems. Child and Family Law Quarterly, 22(2), 223–233.
Schore, J. R. og Schore, A. N. (2008). Modern attachment theory: The central role of affect regulation in development and treatment. Clinical Social Work Journal, 36(1), 9–20. https://doi.org/10.1007/s10615-007-0111-7
Smith, G. A. (1986). Observer drift: A drifting definition. The Behavior Analyst, 9(1), 127–128. https://doi.org/10.1007/BF03391937
Smith, C. J., Rozga, A., Matthews, N., Oberleitner, R., Nazneen, N. og Abowd, G. (2017). Investigating the accuracy of a novel telehealth diagnostic approach for autism spectrum disorder. Psychological Assessment, 29(3), 245–252. https://doi.org/10.1037/pas0000317
Smith, M., Cameron, C. og Reimer, D. (2017). From attachment to recognition for children in care. British Journal of Social Work, 47(6), 1606–1623. https://doi.org/10.1093/bjsw/bcx096
Sroufe, A. og McIntosh, J. (2011). Divorce and attachment relationships: The longitudinal journey. Family Court Review, 49(3), 464–473. https://doi.org/10.1111/j.1744-1617.2011.01384.x
Taylor, E. L., Target, M. og Charman, T. (2008). Attachment in adults with high-functioning autism. Attachment & Human Development, 10(2), 143–163. https://doi.org/10.1080/14616730802113687
Tengslamat – Ráðgjöf & rannsóknir. (e.d.). Þjónusta. https://www.tengslamat.is/
Tengslamat – Ráðgjöf & rannsóknir. (2023, 7. desember). Námskeið í DMM tengslafræðum á Íslandi. https://www.tengslamat.is/post/tengslafr%C3%A6%C3%B0in%C3%A1mskei%C3%B0-%C3%A1-%C3%ADslandi
Thompson, R. A. (2000). The legacy of early attachments. Child Development, 71(1), 145–152. https://doi.org/10.1111/1467-8624.00128
Thompson, R. A. og Raikes, H. A. (2003). Toward the next quarter-century: Conceptual and methodological challenges for attachment theory. Development and Psychopathology, 15(3), 691–718. https://doi.org/10.1017/S0954579403000348
van IJzendoorn, M. H., Bakermans, J. J. W., Steele, M. og Granqvist, P. (2018). Diagnostic use of Crittendenʼs attachment measures in family court is not beyond a reasonable doubt. Infant Mental Health Journal, 39(6), 642–646. https://doi.org/10.1002/imhj.21747
van IJzendoorn, M. H. og Bakermans-Kranenburg, M. J. (2012). Differential susceptibility experiments: Going beyond correlational evidence: Comment on beyond mental health, differential susceptibility articles. Developmental Psychology, 48(3), 769–774. https://doi.org/10.1037/a0027536
van IJzendoorn, M. H., Schuengel, C. og Bakermans-Kranenburg, M. J. (1999). Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae. Development and Psychopathology, 11(2), 225–250. https://doi.org/10.1017/S0954579499002035
White, M. P., Elliott, L. R., Grellier, J., Economou, T., Bell, S., Bratman, G. N., Cirach, M., Gascon, M., Lima, M. L., Löhmus, M., Nieuwenhuijsen, M., Ojala, A., Roiko, A., Schultz, P. W., van den Bosch, M. og Fleming, L. E. (2021). Associations between green/blue spaces and mental health across 18 countries. Scientific Reports, 11, 8903. https://doi.org/10.1038/s41598-021-87675-0
Woolgar, M. og Scott, S. (2014). The negative consequences of over-diagnosing attachment disorders in adopted children: The importance of comprehensive formulations. Clinical Child Psychology and Psychiatry, 19(3), 355–366. https://doi.org/10.1177/1359104513478545
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Hanna Björg Sigfúsdóttir, Zuilma Gabriela Sigurðardóttir, James Gordon Rice, Ásdís Bergþórsdóttir

This work is licensed under a Creative Commons Attribution 4.0 International License.