The ability to form affectionate bonds is always impaired in children who had traumatic experiences  (Schore, 2009). This impairment is frequently severe and persistent. Either there is no possibility to form affectionate relationships, or bonds that have already been formed are broken for an extended period of time and maybe repeatedly, with the result that these individuals are predisposed to the development of mental disorders (Bowlby, 1979).

A crucial attachment or link has already been broken when a foster child initially enters care system (Kungl, Gabler, Bovenschen, Lang, Zimmermann, & Spangler, 2019). Until a permanent and stable home can be found, the child is put in a temporary place which is physically safer. Being removed from his/her home and placed in temporary care, sometimes is an emergency. Returning a recently removed foster child to his/her restored family or helping find a new, stable home within the year required by law, is the best rehabilitation for the young person. In many cases, the child may be moved from one foster home to another and eventually end up with no permanent home. This disruption of attachments or bonds often becomes internalized and might lead to a mental disorder in childhood or later in adulthood (Bruce, Young, Turnbull, Rooksby, Chadwick, Oates, & Minnis, 2019).

Many foster children will typically move through five emotional stages, as they wait for the social services to find them permanence (Kenny & Kenny, 2014). At first, the child hopes the family that chose him/her, is the one. As hope fades, fear takes over, thinking for how long this situation will last and having dysphoric mood. After fear comes anger. The child gets mad and often expresses feelings by acting out, temper tantrums, foot-dragging, stealing, destroying property, and failing deliberately in school to frustrate the foster parents. The anger is possible to evolve into sadness and the child starts feeling depressed. Some times, the depression may be replaced by indifference, a lack of caring, a sense of futility. Finally, child has learned not to hope for or trust relationships, while attachment and bonding are perceived as hurtful and dangerous.

It is common that foster children may have poor personal hygiene, immaturity and lack of social skills. In many cases they have conflicts with authority figures, which leads them in feelings of powerlessness. Τhey have strong reactions to stress settings, such as a fire setting, animal abuse, etc. Often they have self-destructive tendencies (lying, stealing, running away, suicide attempts, etc.), difficulty connecting with others (passivity, dissociation, etc.), problems with attachment and separation, psychosomatic symptoms (nightmares, stomach aches, etc.), physical and mental disabilities (Oswald, S. H., Heil, K., & Goldbeck, 2010).

Many other researchers point out the consequences of multiple moves and have reported similar lists of childhood mental disorders caused by disrupted attachments (Schuengel, Oosterman, & Sterkenburg, 2009). One of the consequences of subjecting children to multiple changes and a series of short-term attachments, is the presence of the reactive attachment disorder (RAD), which results in children who are resistant to relationships (van Londen, Juffer, & van IJzendoorn, 2007). This disorder causes difficulties to connect with others and manage their emotions. It can result in a lack of trust and low self-esteem, a fear of getting close to anyone and a need to be in control. A child with RAD rarely seeks comfort when distressed and often feels unsafe and alone. They may be extremely withdrawn, emotionally detached, and resistant to comforting.

According to the American Academy of Pediatrics’ Committee on Early Childhood, Adoption, and Dependent Care (2000), the following important concepts should be noted about the foster child’s care. First of all, biologic parenthood does not necessarily confer the desire or ability to adequately care for a child. It is also highlighted that primary caregivers’ supportive nurturing is critical for early brain development as well as children’s physical, emotional, and developmental needs. Also children require consistency, predictability, and continuity from their caregiver. The child’s attachment, sense of time, and developmental level are important factors in their adjustment to external and internal stresses.


American Academy of Pediatrics (2000). Committee on early childhood, adoption, and dependent care.  “Developmental issues for young children in foster care,”  Pediatrics. 106(5), 1145-50.

Bowlby, J. (1979). The bowlby-ainsworth attachment theory. Behavioral and Brain Sciences2(4), 637-638.

Bruce, M., Young, D., Turnbull, S., Rooksby, M., Chadwick, G., Oates, C., … & Minnis, H. (2019). Reactive attachment disorder in maltreated young children in foster care. Attachment & Human Development21(2), 152-169.

Kenny, J., Kenny P. (2014). Attachment and Bonding in the Foster and Adopted Child.

Kungl, M. T., Gabler, S., Bovenschen, I., Lang, K., Zimmermann, J., & Spangler, G. (2019). Attachment, dependency, and attachment-related behaviors in foster children: A closer look at the nature of the foster child–caregiver relationship. Developmental Child Welfare1(2), 107-123.

Monique van Londen, W., Juffer, F., & van IJzendoorn, M. H. (2007). Attachment, cognitive, and motor development in adopted children: Short-term outcomes after international adoption. Journal of pediatric psychology32(10), 1249-1258.

Oswald, S. H., Heil, K., & Goldbeck, L. (2010). History of maltreatment and mental health problems in foster children: A review of the literature. Journal of pediatric psychology35(5), 462-472.

Schore, A. N. (2009). Relational trauma and the developing right brain: The neurobiology of broken attachment bonds. In Relational trauma in infancy (pp. 39-67). Routledge.

Schuengel, C., Oosterman, M., & Sterkenburg, P. S. (2009). Children with disrupted attachment histories: Interventions and psychophysiological indices of effects. Child and Adolescent Psychiatry and Mental Health3(1), 1-10.