Q: Is John really attached to you? If so, how did you develop this relationship?

A: I never really know how to answer this question. At first, he was not able to form any sort of attachment at all. I took him home from the hospital at 8 weeks of age, and have been his only mother. I was trained as a foster parent in how to encourage healthy bonding and attachment. There was very little eye contact for years. Not until Ritalin, as a matter of fact. I had to cup my hands around his eyes to make him look at me, and then his eyes still tried to look away. I believe it was as much a sensory input issue as an emotional issue. Then he developed a late case of separation anxiety and cried and cried if I left the house, even when he was left with his daddy. He was two then, and this normally happens around 6 months. He never had a fear of strangers that healthy children develop by age one.

Today I can say that he loves me and is attached to me and that we have a healthy parent-child relationship. I think it happened naturally, but over a very long period of time, many years. Only as an adult has he been able to express his love with reflections of healthy attachment, telling me how much he appreciates my parenting him and how grateful he is to be adopted by me. He often tells that me he loves me and will give me a great big hug. But he can also say to some mother-type woman whom he has known only 5 minutes, "I love you so much" and will give her a great big hug. That is not normal. (But it is normal for the alcohol affected child.)

John could attach to anyone anywhere. He could even attach to someone who has been abusive to him. He holds no grudges. Forgive and forget. Or should I say, forget and forget. Don't have to forgive something you can't remember anyway.

It is my observation that all kids with FAS/ARND have some attachment issues. Most are friendly inappropriately and are easily led to go with strangers. Some have more serious attachment issues and could be classified as RAD - Reactive Attachment Disorder. This is sometimes the result of neglect and lack of normal bonding at birth, but sometimes it is just a part of the individual's specific brain dysfunction. I have seen this in children adopted by healthy families at birth, so it is not always a matter of neglect and early parenting issues. It could be part of the brain damage of FAS/ARND, or it could be both together.

When I received my foster parent training, I remember the instructor asking the question, "What is the most important thing you can give your foster child?" Of course, everyone said, "Love." No, the answer was this: The child needs to know that you will take CARE of him/her, that they will be safe with you, that they can trust you. Love will come later.

The bottom line for healthy attachment is trust. The child needs to be able to trust the caregiver/parent. I worked on ensuring John's feeling of safety, letting him know ahead of time when I was going to leave, how long I would be gone (in terms he could understand), and when I would be back. My commitment to him, which I verbalize when I see anxiety in John, is that I will do whatever I can to make sure he gets what he needs to be safe and protected (from his FAS) and as happy as he can be in the protective, restrictive environment he requires to ensure that safety. He is very aware that I am the ONE person he can trust to take care of him, and I believe that is the basis of the bond we have.