Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders diagnosed in children. But parents, caregivers, educators, and even healthcare providers tend to be less familiar with the concepts of attachment theory and how a lack of attachment can impact social and emotional development and behaviors. Yet, the links between ADHD and attachment disorders are significant and can play an important part in helping children and adults struggling with either of these.

Cognitive and emotional dysregulation are central to both ADHD and attachment disorders. And, recent research on understanding the relationships between ADHD and disrupted attachment, suggests that children exhibiting the signs and symptoms associated with ADHD should potentially also be evaluated for an attachment disorder.

ADHD is a developmental disorder that affects a person’s behavior and can include symptoms of inattention, hyperactivity, and impulsivity. Symptoms can begin in childhood and continue into adolescence and adulthood. Meanwhile, attachment is the deep and enduring connection established between a child and caregiver in the first several years of life. It profoundly influences every aspect of the human condition — mind, body, emotions, relationships and morality.

Attachment theory identifies four main attachment styles: Secure – autonomous; Avoidant – dismissing; Anxious – preoccupied; and Disorganized – unresolved. These attachment styles can significantly impact an individual’s relationships, emotional regulation, behavior and ability to cope. Children who are securely attached are healthier and more well-adjusted over time. Individuals who lack loving and caring caregivers or experience trauma, neglect or abuse in early childhood are at higher risk for emotional and behavioral problems later in life.

According to a recent article in Psychology Today, studying early childhood attachment relationships may provide a more complete picture of the causes behind the signs and symptoms of ADHD and result in more effective ADHD treatment plans.

“If the cause is strictly biological, then treatment would likely include medication along with psychotherapy or coaching to teach compensatory strategies,” the article states, citing a 2023 study by Cavicchioli, Stefanazzi, Tobia, and Ogliari. “If, however, the cause involved childhood chaotic environments, trauma, or other attachment disruption, then treatment should include a trauma-focused or attachment-based intervention. If you treat the surface symptoms without addressing the cause, you may get some relief, but you are not actually fixing the problem.”

Furthermore, attachment experiences influence the presentation and management of ADHD symptoms. For example, a child who is securely attached may be better at coping with their ADHD. At the same time, avoidant attachment, characterized by the tendency to avoid intimacy in relationships, may further exacerbate a child with ADHD’s interpersonal problems while ADHD symptoms like impulsivity and difficulty maintaining attention may exacerbate the anxiety and uncertainty of a child with anxious attachment. Finally, Disorganised attachment patterns may intersect with ADHD symptoms, particularly those related to impulsivity, emotional dysregulation, and difficulty with interpersonal boundaries.

The recent research concludes that by identifying attachment concerns and providing personalized support early on, caregivers and professionals may be able to mitigate the impact of disrupted attachment on a child with ADHD and vice versa.