Foster care children's attachment and reactive attachment disorder: A scoping review of the qualitative and quantitative evidence

Mackenzie Simmons

doi:10.7273/000003773

Foster care impacts the daily lives of hundreds of thousands of children each year (US Children’s Bureau, 2021). Even though foster care is meant to be positive for children, it is often associated with negative outcomes, including the development of attachment disorders such as reactive attachment disorder. While much research has been done on foster care, attachment, and reactive attachment disorder, few scoping reviews have been conducted to evaluate what the current literature knows thus far and where gaps remain for future research to explore. The purpose of this study was to conduct a scoping review and to evaluate what the literature knows about foster care, reactive attachment disorder, and relational outcomes and any gaps present in the current literature. An inclusion criterion was set and literature from the past ten years, (2011-2021), was evaluated for research related to foster care and reactive attachment disorder based on the scoping review framework of Peters et al., 2015. This scoping review had a sample size of 46 articles after the scoping review framework and inclusion criterion were applied. Based off the scoping review four conceptual themes were found. These themes included early caregiving experiences showing pervasive impacts on attachment later on, being in foster care for extended periods of time exacerbates attachment difficulties, attachment-based interventions work best in alleviating RAD symptoms, and fostering secure attachments with caregivers improves relational outcomes in the future. In addition to these conceptual themes, the scoping review also brought to light gaps and limitations in the literature. These gaps and limitations were demographic data not being provided, small sample sizes, interventions and treatments based off of having consistent caregivers, and failure to evaluate the impacts of reactive attachment disorder across the lifespan. When considering the conceptual themes, gaps, and limitations stated above, this scoping review recommends that future research continue using attachment theory to inform research, treatments, and interventions. Additionally, this scoping reviews recommends addressing the gaps and limitations in the current literature by ensuring future studies include demographic data and larger sample sizes, evaluate treatments and interventions that do not require the presence of a consistent caregiver, and to look at the prevalence of reactive attachment disorder across the lifespan.

Foster care children's attachment and reactive attachment disorder: A scoping review of the qualitative and quantitative evidence

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