seeks comfort when distressed

greets the caregiver after a separation

shows affection

welcomes contact on reunion with the caregiver

uses the caregiver as a safe base for exploration

interacts (checks back, makes eye contact) when exploring or from a distance

relies on the caregiver for help

is more comfortable with the caregiver than with a stranger.

a lack of comfort seeking when hurt, frightened or ill, or comfort seeking in an odd or ambivalent manner

a failure to reestablish interaction after separations, including active ignoring/avoiding behaviours, intense anger, or obvious lack of affection

a lack of affectionate interchanges across a range of social settings or promiscuous affection with relatively unfamiliar adults

active avoidance or resistance to physical contact on reunion

a failure to check back with the caregiver or near complete unwillingness to leave the caregiver to explore

either excessive dependence on or independence from caregiver

with respect to strangers, immediate engagement without initial wariness, extensive physical contact without referencing the caregiver, willingness to leave the caregiver and go with a stranger without protest.

infants of teen mothers

infants with neurological disorders (CP, Autism, Down Syndrome)

infants who are victims of maltreatment

infants exposed to domestic violence (a very high risk indicator).

the absence of feelings of love for their infant 1 month or more postpartum or obvious expressions of rage at the infant (follow closely and reassess)

the death of a parent and if so, when

depression (chronic, episodal or post partum)

substance abuse (current, past, during pregnancy)

marital discord or divorce

poverty (increases the likelihood of other risk factors such as depression and lack of supports)

history of maltreatment

domestic violence

multiple hospitalizations early in caregiver's life (especially in the first 3 years)

caregiver's history of childhood placement in foster care (especially in the first 3 years of life)

prolonged separations of the caregivers from own parents due to parental separation or divorce (especially in the first 3 years of life).

Who do you live with?

Do you have a lot of “ups” and “downs” in your mood?

Do you often feel sadness or despair?

Do you ever worry that you might not have enough money to pay your rent and buy food?

Are your own parents still alive? If not, When did they die? (If the caregiver's relationship with her/his own parents was problematic, the parent's death may cause intrusive memories of harsh or painful interactions. A referral to counselling may be indicated.)

Did you plan this pregnancy? Were you happy about it when you found out you were pregnant?

Have there been any times when the baby had to spend more than a full day away from you? If so, When? What were the circumstances? (i.e., Was this a time when the infant was likely to have been hurt, sick, or scared?) How often has this happened?

Some mothers (fathers) feel that they don't love their babies the way they think they should. Do you sometimes feel that you don't really love your baby? Do you sometimes feel really angry or frustrated with your baby?

Is there a lot of arguing in your home? Does anyone ever hit, slap, push, or shout at you?

Does anyone hit, slap, shake, handle roughly, or shout at the infant? Ever? If answer seems uncertain, hesitant or evasive, you might question further with: What happens if you or another caregiver is really stressed or ‘fed up' and the baby is cranky, uncooperative, or crying a lot?