1. Understanding Disorganised Attachment Professor David Shemmings PhD University of Kent UK Visiting Professor of Child Protection Research Royal Holloway University of London Director of the ADAM Project and co-Director of the University of Kent’s online Child Protection Centre Director of the West London Advanced Child Protection Pathway d.shemmings@kent.ac.uk

5. importance of ‘base rate’ in risk assessment  Mental ill-health  27% in SCRs  But 25% in Gen Pop  Substance misuse  44% in SCRs  But 34% in Gen Pop (9% drug; 25% alcohol)  Domestic Violence  34% from SCRs  But 24% in Gen Pop  Disorganised Attachment  75% among maltreated children  But 14% among non-maltreated children Ratio 1:1 Ratio 1.3:1 Ratio 1.4:1 Ratio 5.4:1

6. ADAM Project members Lewisham (x6) Tower Hamlets (x3) Croydon (x3) Merton (x2) Enfield (x6) Hounslow Essex (x6) SW Essex NHS PIMH Surrey NHS Bromley (x3) Camden (x3) Surrey NHS (x9) Barnet (x4) Richmond (x4) Bedford (x2) Caldecott, Kent (x3) Stoke Surrey (x6) Stockholm (x2) Dusseldorf (MoD x 2) Cyprus (MoD) Southwark (x2) Nottingham Coventry Manchester St Michael’s, London (x4)

7. Maltreatment Pathway Model disconnected parenting disorganised attachment behaviour unresolved loss and trauma low mentalisation/ reflective function Dissociation/ PTSD Child maltreatment Carer risk factors extremely insensitive parenting Impulsivity, low distress tolerance, low consequence appraisal