How does parenting influence attachment: The CARE Model

Consider infants. They are not born with a sophisticated language system. They cannot successfully be reasoned with about who their parents are and, therefore, who they should form an attachment to, and who not to. Rather, they form an attachment to the person or persons who they experience to care for them, physically and emotionally, on a continuous basis. A key concept here is what infants experience.

In the same way that infants’ attachment to their primary attachment figure(s) develops in association with their experience of who cares for them, the type of attachment relationship or attachment style is very much dependent on infants’ experience of the care they receive. That is, an infant’s attachment style is strongly influenced by the type of care they receive. By care, I refer to how consistent, accessible, responsive and emotionallyconnected infants experience their primary attachment figure(s) to be:

  • Consistency
  • Accessibility
  • Responsiveness
  • Emotional- Connectedness.


In the 1930s psychologist B.F. Skinner developed an apparatus to study the conditions under which our repertoire of behaviour develops. Referred to later as the Skinner Box (Skinner, 1948), the box-like apparatus incorporated a button or lever that electronically controlled the release of food into the box via a feed chute. In his original experiments, Skinner used rats or pigeons, which were placed into the Skinner Box and studied for what they learnt about accessing food by pressing the button or lever.

Skinner hypothesised that behaviours become learnt and integrated into our behavioural repertoire when, in the performance of the behaviour, a desired outcome is achieved. He referred to this desired outcome as reinforcement (Skinner, 1938).

Skinner’s first task was to determine whether rats and pigeons could learn what was required to access food in a novel environment (i.e. the Skinner Box). He discovered that they could. He then began to study the learning process the animals went through under different reinforcement conditions (Ferster and Skinner, 1957).

First, Skinner randomly allocated a new group of animals to one of three learning conditions. In condition one the animals received a food reward for each and every press of the button or lever in the Skinner Box. Skinner referred to this condition as continuous reinforcement and the animals received food on a consistent basis. The animals in this condition were the quickest to learn that they could access food by pressing the button or lever, but pressed the button or lever at a slower rate than the animals in the second condition.

The animals in the second condition received a food reward inconsistently, such as on the first, third or even fifth time they pressed the button or lever. It was unpredictable. Skinner referred to this condition as intermittent reinforcement. The animals in this condition were slower to learn that they could access food by pressing the button or lever than the animals in the continuous reinforcement condition. In contrast to the animals that received a food reinforcement on a consistent basis, the animals in the intermittent reinforcement condition were more active in pressing the button or lever and spent more time doing so, reflecting an apparent understanding that the button or lever could not always be relied upon for the delivery of food.

The animals in the third condition never received food for pressing the button or lever. These animals did not incorporate pressing the button or lever into their behavioural repertoire, as it never led to a desired outcome. In effect, they never learnt that they could rely on the button or lever for food.

What has all this got to do with human infants, I hear you ask? Well, what Skinner demonstrated in his experiments using the Skinner Box is that the optimal condition for learning is one where an action is consistently followed by a desired outcome. That is, what human infants learns about how dependable their attachment figures are for satisfaction of their needs is dependent on how consistently they receive a satisfying, caregiving response to their cues and signals.


‘Accessibility’ means that the parent is present and available, physically and emotionally, to the infant and child (Delaney, 2006). Harlow’s monkeys fared relatively better when they had reliable access to a warm mothersurrogate that offered them contact comfort. Having access to this important source of needs provision appeared to play an important role in buffering against the emotionally harmful and behaviourally restricting effects of stressful situations. The same is true of human infants who have yet to learn that their attachment figure continues to exist and be accessible when they do not have direct sensory experience of them.

To fully appreciate the importance of accessibility it is helpful to consider the concepts of ‘object constancy’ and ‘object permanency’ (Bower, 1967; Piaget, 1954). In the early part of the first year, infants appear to believe that the only things that exist are what they can see, hear, smell, touch or taste at that moment. When something is removed from their sensory experience, it is as if it ceases to exist. When the same object is re-presented to the infants they react as if it is the first time they have ever seen it. This may, in part, explain an infant’s distress when a warm and interactive carer leaves the room and their interest in (but not necessarily recognition of) the caregiver who returns to the infant. As the first year progresses, infants increasingly recognise stable properties or characteristics of persons and objects with whom they interact on a continuous and consistent basis (object constancy). That is, infants increasingly recognise continuously existing people and objects based on the continuity and consistency of the infant’s experience of them. Certain people and objects become familiar aspects of the infant’s world with stable and predictable characteristics and qualities. Most often, this is reassuring to infants, as it represents an emerging capacity to perceive their world as consistent and predictable. Other people and objects are less predictable or have predictable characteristics that invoke distress in infants.

Hand in hand with the concept of ‘object constancy’ is the related concept of ‘object permanence’. In association with the process by which infants recognise certain people and objects as having stable and recognisable properties based on their continuous experience of them, infants develop the capacity to form a mental picture of an object or person that is independent of their direct sensory experience of the person or object. This further reinforces the infant’s sense of the continuous existence of the person or object independent of sensory experience of them (object permanence). This can be a source of comfort and reassurance to infants, allow them to explore their physical world without anxiety and promote their tolerance of separations. It also has wide and lasting implications in terms of how infants relate to people and objects with whom they come into contact through their exploration and experience.

In order for infants and small children to fully develop a belief in there being a person (or persons) who satisfies their needs and helps them cope with the world, that person (or persons) needs to be a continuous and consistent feature of the infant’s life; that is, accessible to them.


Remember the tale of four mice at the beginning of this book? The tale of the fourth mouse reflects further experiments conducted by Skinner, in which animals placed in the Skinner Box were subject to painful electric current that could only be turned off by pressing the lever. Skinner observed that the animals learnt that they could switch off the electrical current in this way, usually by jumping around until they accidently pressed the lever. In much the same way, in usual circumstances infants learn about the extent to which they can depend on their caregivers to alleviate their distress by way of the response of their caregiver to the infant’s distress.

Responsiveness refers to a process by which the attachment figures sensitively, accurately and directly addresses the needs of the infant (Delaney, 2006). Responsiveness involves the attachment figure observing the infant, the context and the infant’s signals, and responding to the infant’s needs with understanding. Consistency is an important determinant of the infant’s experience of the responsiveness of their attachment figures. Responsiveness plays an important role in shaping the infant’s mental representation of what a caregiver is and what can be expected of a caregiver. Consistency, accessibility and responsiveness are interrelated aspects of the infant’s experience of CARE. The infant’s experience that needs are consistently understood by an accessible attachment figure promotes feelings of wellbeing and dependency on the attachment figure. Experiences of understanding that arise under conditions of parental responsiveness promote experiences of self-worth and wellbeing that act as a powerful buffer against distress that can arise in conditions of adversity.


The fourth aspect of the infant’s experience of CARE that plays an influential role in the development of attachment relationships and attachment style relates to the infant’s experience of emotional connectedness to their attachment figures. This is commonly referred to in the attachment literature as affective attunement and describes the process by which attachment figures tunein to the expressed emotion of the infant and reflects the same or a very similar emotion back to the infant. This connection to the infant’s emotional experience is communicated by attachment figures through tone of voice, facial expression and gesture. It is readily observed during playful interactions and when the infant is distressed. This shared emotional experience is not merely pretended by the attachment figure. Rather, through tuning in to the emotions of the infant the attachment figure experiences an instinctive and congruent emotional response; much like when you cannot help laughing at the laughing baby video, or tearing up in response to distress in a loved one. That these episodes of emotional union between infant and attachment figure(s) occur is supported by research that tracked the heart-rate curves of mothers and infants during play and found that they parallel each other(Reite and Fields, 1985). Heart-rate is considered to be a sign of physiological arousal and changes in arousal are a key component of emotional experience (Livingstone and Thompson, 2009). Affective attunement is not considered a one-way process, as even very young infants tune in to the expressed emotion of the attachment figure. This is vividly illustrated in the so-called ‘still-face experiments’ (Tronick et al, 1978) whereby, after a short period of playful interaction with their five-month old baby, mothers were instructed to adopt a ‘dead-pan’ expression. The infants immediately recognised this change and were distressed by it, only for their distress to be relieved a short time later when the mother tuned in to their distress, thereby re-establishing a connection, and returned to happy, playful interaction.

Through repeated attunement experiences, children’s emotions are validated and regulated through the responsiveness of the caregiver, thus promoting children’s experience and perception of emotional connectedness with others and facilitating the safe exploration of a range of emotions, emotional self-awareness and, later, a capacity for empathy.

As mentioned earlier, the type of attachment infants form to their primary attachment figures is strongly influenced by their experiences of CARE. Securelyattached infants have experienced their primary attachment figures as consistent, and as consistently accessible, responsive and emotionally connected. Insecure-avoidant infants are most likely to have experienced their primary attachment figures as inconsistent, distant, unresponsive and emotionally unavailable. Insecure-ambivalent infants are most likely to have experienced their primary attachment figures as inconsistent, inconsistently accessible and responsive and overly reactive to the infant’s distress. Disorganised infants are most likely to have experienced their primary attachment figures as inconsistent, inaccessible, unresponsive, emotionally disengaged and the source of fear and distress.

Source: Pearce, C. (2016). A Short Introduction to Attachment and Attachment Disorder – Second Edition. London: Jessica Kingsley

For more information the CARE Model and its relationship with attachment and attachment disorders, continue reading via A Short Introduction to Attachment and Attachment Disorder (Second Edition), details of which can be accessed via the link or by clicking on the image below.

Colby Pearce - Attachment


Bower, T.G.R. (1967). The development of object-permanence: Some studies of existence constancy. Perception and Psychophysics, 2(9): 411-418

Delaney, R.J. (2006). Fostering Changes: Myth, Meaning and Magic Bullets in Attachment Theory. Oklahoma: Wood ‘N’ Barnes

Ferster, C.B. and Skinner, B.F. (1957). Schedules of Reinforcement. New York: Appleton-Century-Crofts

Livingstone, S.R. and Thompson, W.F. (2009). The emergence of music from theory of mind. Musicae Scientae – Special Issue 2009-2010, 83-115

Piaget, J. (1954). The Construction of Reality in the Child. New York: Basic Books

Reite, M. and Fields, T. (eds) (1985). The Psychobiology of Attachment and Separation. Florida: Academic Press

Skinner, B.F. (1938). The Behavior of Organisms: An Experimental Analysis. New York: Appleton-Century

Skinner, B.F. (1948), Superstition in the pigeon. Journal of Experimental Psychology, 38, 168-172.

Tronick, E., Heidelise, A., Adamson, L., Wise, S. and Berry Brazilton, T. (1978), The Infant’s Response to Entrapment Between Contradictory Messages in Face-to-Face Interaction. Journal of the American Academy of Child Psychiatry, 17 (1), 1-13

About colbypearce

I am a practising Clinical Psychologist with twenty-seven years’ experience working with children and young people recovering from abuse and neglect. I am also an author and educator in trauma-informed, therapeutic caregiving. My programs are implemented in Australia and Ireland, and I am well-known for my practical and accessible guidance for caregivers and professionals alike.
This entry was posted in AAA Caregiving, Adoption, Attachment, Fostering, kinship care, trauma informed and tagged , , , , , . Bookmark the permalink.

2 Responses to How does parenting influence attachment: The CARE Model

  1. Maggie Toner says:

    Can you please point me in the direction of any research in relation to attachment and disabled children/ children with Down’s Syndrome? Thanks Maggie

    On Sun, 21 Jul 2019 at 9:46 am, Attachment and Resilience wrote:

    > colbypearce posted: ” Consider infants. They are not born with a > sophisticated language system. They cannot successfully be reasoned with > about who their parents are and, therefore, who they should form an > attachment to, and who not to. Rather, they form an attachment to the ” >

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