The importance of attunement in assessing parenting capacity

Dr Bruce Perry MD describes attunement as “reading and responding to the cues of another; synchronous and interactive.”  As child protection practitioners, when we consider the parent’s capacity or ability to meet the child/ren’s needs. These needs are the physical needs, their educational and developmental needs, their social needs and their emotional and psychological needs. All of these needs are crucial for a child’s ability to thrive and survive, but without the parent’s ability to attune to the child, their capacity to meet these needs in a meaningful and ongoing way, is questionable.

Attunement is about the parent/carers ability to respond to the verbal and non-verbal cues given to them by the child. The parent may be physically able and capable to cook, clean, attend appointments and social occasions, but they may not be able to identify what the child is seeking or needing from them, at any given time. Attunement is also the way a child learns emotional regulation, by mirroring and responding to their parents cues.

An example of this, was in a parenting capacity assessment I undertook of two parents whose children were in out of home care and they were seeking the restoration of the children. The parents had sought stable and safe accommodation, had attended a number of parenting courses and were regularly attending birth family contact. One of their daughters, had a medical condition, which meant she had a colostomy bag, that required changing at regular intervals. The child was at a stage of being able to manage her toileting herself, including changing her ‘bag’ and had made it very clear to her parents, carers and supports, that this was a topic she need not want discussed in open forums.

Whilst observing contact between the parents and the children, the daughter expressed, she needed to go to the bathroom and was clearly entering the cubicle to change her bag. The daughter entered the toilet and from outside, in a public place, her mother yelled “do you need help changing your colostomy bag.” The child quickly shouted ‘no’ and when finished, exited the toilet and walked past her mother, ignoring her.

It was clear from this interaction, that the mother was not, at that point in time, attune to her child’s needs. It could be argued that because the daughter was not in the care of her parents, they had lost their ability to read their daughter’s cues. However, the child had expressed her discomfort and wishes around her toileting tasks, which was not read by the parents. Their ability to attune to her needs was compromised. There were, of course, a number of other factors that prevented a recommendation of restoration, but attunement and ability to respond to their children and build positive relationships were a critical factor.

The ability to attune to a child, from birth to adolescence is crucial for any child, at any stage of development. From birth, parents learn how to read the verbal and physical cues of their baby to be able to meet their tired, hungry, uncomfortable signs. Often, other factors, such as substance misuse, domestic violence and mental health, get in the way of a parent being able to recognise and respond to these needs.

Whilst the parent’s ability to attune to their child is limited, there is potential for the parent to learn this skill. Outside of traditional parenting courses that discuss consequences for behaviour, positive reinforcement and consistent routine, comes extra factors that are crucial for a parent to learn how to attune.

For a relationship to be corrected and a parent to be attune to their child, they can provide:

–       Nurture- this includes, rocking, hugging and touching at intermittent periods. A parent needs to be physical and loving

–       ‘Connection before correction’- relationship is key. Often punitive approaches to behavioural difficulties can be counteractive, for children who have had relationships that not have been attune to their needs or their attachment has been disrupted.

–        Consistency, predictability and repetition – Children who have experienced abuse and neglect and relationship breakdowns, require a parent and carer who is predictable. The child needs to know what to expect from the parent, at every interval. In order to learn how to attune to their child, the parent needs to be consistent so that they learn how to read and respond to their child; and

Listen, talk and play with the child. The most important thing a parent can do for a mistreated child, is to sit and ‘be’ with the child. Listen to them, get to know their personalities and have fun with the child. By just being and not constantly doing, the parent has the opportunity to correct the fractures in the relationship and start to understand what their child needs.