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Early Child Development and Care
ISSN: 0300-4430 (Print) 1476-8275 (Online) Journal homepage: http://www.tandfonline.com/loi/gecd20
Painful transitions: a study of 1-year-old toddlers’
reactions to separation and reunion with their
mothers after 1 month in childcare
Trine Klette & Kari Killén
To cite this article: Trine Klette & Kari Killén (2018): Painful transitions: a study of 1-year-old
toddlers’ reactions to separation and reunion with their mothers after 1 month in childcare, Early
Child Development and Care, DOI: 10.1080/03004430.2018.1424150
To link to this article: https://doi.org/10.1080/03004430.2018.1424150
Published online: 11 Jan 2018.
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Painful transitions: a study of 1-year-old toddlers’reactions to
separation and reunion with their mothers after 1 month in
Trine Klette and Kari Killén
School of Nursing, Diakonova University College, Oslo, Norway; Center for Welfare and Labour Research, Oslo and
Akershus University College, Oslo, Norway
In this paper, we present findings from the filmed observations of 12 1-
year-old toddlers in 10 different Norwegian childcare centres during
separations and reunions with their mothers. Separations and reunions
are sensitive situations, especially around the age of one, when
separation anxiety normally peaks. The observations were conducted
when the toddlers were between 13 and 15 months old and had been
attending childcare for 1 month. The video recordings were analysed in
light of attachment theory, emphasizing expressions of protest, despair
and detachment among the children. Findings indicate that all the
toddlers struggled with separation anxiety in different phases during the
observed transitions. Few employees present in the early mornings and
late afternoons often made the transitions more difficult. Implications of
the findings are discussed.
Received 4 December 2017
Accepted 2 January 2018
Toddlers; day care; filmed
After childbirth, Norwegian parents are entitled to 49 weeks of parental leave with 100% wage com-
pensation. When the child is 1-year old, families are also entitled to publicly subsidized child care. In
2016, more than 90% of Norwegian 1-year-olds spent, on average, 40 hours a week in paid care
outside the home. This was an increase of almost 30% since 2000 (Statistics Norway, 2017). Many
studies have shown that transitioning from home to day care is stressful for small children, and
that it is crucial that care providers help the children manage their responses to this stress
(Ahnert, Gunnar, Lamb, & Barthel, 2004; Ahnert & Lamb, 2003). Negative experiences with early
care influence the hypothalamic–pituitary–adrenal axis, which is a major part of the system control-
ling among others, our responses to trauma, injury and stress. Significant differences in daytime cor-
tisol levels have been found in toddlers when they are in day care compared with when they are at
home (Ahnert et al., 2004; Drugli et al., 2017). The normal diurnal pattern is for cortisol to be highest in
the morning and gradually decrease during the day, but in day care the opposite has been seen
(Gunnar & Quevedo, 2006; Levine, 2005).
One of the most consistent findings in childcare research is that the quality of the care matters
(Vermeer, van IJzendoorn, Cárcamo, & Harrison, 2016). Childcare quality is often assessed via struc-
tural features, such as child–staff ratio, group size and care provider education and training, and
via observations of interaction, emphasizing sensitivity, responsivity and the richness of language
(Klette, Drugli, & Aandahl, 2016; McCartney, 2007). A recently published study found that the
quality of care in Norwegian childcare centres was just above the minimum (Bjørnestad & Os, in
© 2018 Informa UK Limited, trading as Taylor & Francis Group
CONTACT Trine Klette email@example.com
EARLY CHILD DEVELOPMENT AND CARE, 2018
press). Long hours in care have also been seen to constitute a risk for developmental problems
(Vermeer & van IJzendoorn, (2006)). Long hours combined with stressful parent–child relationships
have been associated with angry aggression in pre-schoolers (Belsky, 2001; Vandell, Burchinal,
Clarke-Stewart, McCartney, & Owenm, 2007).
The emotional quality of our earliest attachment experiences may be the single most important
influence on human development (Datler, Ereky-Stevens, Hover-Reisner, & Malmberg, 2012; Sroufe,
Cooper, & Marshall, 1988). When there are daily interactions with the primary caregiver, an attach-
ment-related behavioural pattern is usually developed, organized and observable starting from
about 8 months. Sensitive and predictable availability from at least one stable person is essential
for infants to be and remain securely attached (Ainsworth, Blehar, Waters, & Wall, 1978). According
to attachment theory, during the first years, attachment needs in humans are almost exclusively
directed at one primary caregiver (Bowlby, 1960). These years are also of prominent importance
with regard to the extent and speed of development, and this is especially true of the brain,
which normally doubles in size during the first two years. Sensitivity, availability, predictability,
empathy and the ability to provide comfort appear to be key features in the care for babies and tod-
dlers (Ainsworth et al., 1978; Crittenden, 2000; Klette, 2007).
During the past 60 years, attachment theory and research has given rise to a huge amount of
methods and practices. Today the theory is widely viewed as one of the most influential and impor-
tant when it comes to understanding human development (Cassidy & Shaver, 2008). Underlying the
theory were numerous observations of separations and reunions between parents and young chil-
dren (Bowlby, 1960; Robertson & Robertson, 1971). Some of the observations were published as com-
mercial films, such as the now classic ‘A two-year-old goes to hospital’(Bowlby & Robertson, 1952;
Robertson, 1952). In this film, we see a little girl, Laura, during a 9-day stay at a London hospital to
undergo a hernia operation. Parents were not allowed to stay with their hospitalized children at
that time. We can see Laura protesting intensely when being separated from her mother on the
first day. After a while, however, she becomes resigned; she stops crying and screaming, and
seems to settle in. But an increasing sadness and passivity is visible in the little girl. After a few
days, she withdraws from her mother when she comes to visit, and later she openly rejects her
mother’s offerings. At that point, we are also told that Laura has started to wet her bed again, and
we also see her hitting a doll quite violently on several occasions.
The process observed in Laura, and in many other children who were separated from their parents,
has been described as occurring in phases, called protest, despair and denial by Robertson (1952), and
protest, despair and detachment by Bowlby (1960). Bowlby, among others, preferred the term detach-
ment, because it was a natural counterpart to attachment. In his view, separation anxiety was inborn
and primary to humans, and a prerequisite for love. He described it as ‘the other side of the coin’in
relation to attachment and as essential for our ability to form deep and lasting relationships (Bowlby,
1960). Separation anxiety is first expressed in babies about 28 weeks old, and the vulnerability to sep-
aration from the primary attachment figure does not diminish until the child is about 2 years and 9
months old. The fear of separation is thought to peak between 8 and 28 months, although there are
considerable variations, according to Bowlby (1960).
When separation anxiety is activated, the most prominent sign of the first phase –protest –is the
child’s acute distress. The child cries, screams and throws him- or herself about, and the behaviour is
agitated and intense (Bowlby, 1960; Robertson & Robertson, 1971). The protest phase may last from a
few hours to weeks, but if the parent fails to return for long, the behaviour will gradually disappear
and be replaced by expressions of the next phase –despair. In this phase, an increasing hopelessness
and passivity becomes visible. Active physical movements diminish or come to an end, the child with-
draws, is inactive and makes no demands on the environment. Bowlby (1960) described this phase as
‘the quiet phase’, and he noted that the quietness is often mistakenly taken to indicate a diminution
of distress. If the separation continues, the despair is gradually replaced by detachment. The hall-
marks of detachment are often welcomed as signs of recovery, as the child no longer protests,
cries or rejects care, food or toys. Alternatively, the child may smile and be sociable. But when the
2T. KLETTE AND K. KILLÉN
primary caregiver returns, there is a striking absence of the behaviour characteristics of strong attach-
ment seen at the infant/toddler age (Ainsworth, 1973; Ainsworth et al., 1978; Bowlby, 1960; Sroufe
et al., 1988).
The long-term effect of toddlers’experiences with daily separations from the primary caregiver in
day care is not yet fully understood. Studies of small children’s behaviour in care are still rare, and the
findings are inconclusive (Datler et al., 2012). There is, however, broad agreement that long hours and
low quality of care pose severe threats to children’s development and welfare. In the present study,
we investigated the reactions and behaviour of 12 toddlers during the transitions in day care. We
asked the following questions: (1) What characterizes the toddlers’reactions and behaviour during
separations and reunions with their primary caregivers? (2) How do the care providers meet the tod-
dlers’needs during the transitions?
The participating families were recruited by public health nurses in a Norwegian municipality, during
the spring of 2014. To make the group of toddlers as similar as possible, the health visitors were asked
to invite only families with an only child to participate in the study. The toddlers were considered to
be generally healthy by the health visitors, and none of them had any special needs. They were all
about 1 year of age and about to attend childcare in autumn 2014. We asked for the children to
be observed with their primary caregivers, which resulted in 12 mothers participating. The study
was approved by the Norwegian Social Science Data Services.
The children were between 13 and 16 months when they were observed for the present study and
had been attending day care for a month. Data were gathered through filmed observations at the
child care centres, and each child was filmed individually on the same day. Appointments with the
mothers and care providers were made well in advance of the observations. Day and time were
decided in accordance with the mothers’preferences. Depending on their working hours, the
mothers would bring the toddlers to the centres between 7 am and 9 am and pick them up
between 3.30 pm and 5 pm We arrived before the mothers, both in the mornings and in the after-
noons. After greeting and introducing ourselves, we found suitable places and started filming with a
small camera. Depending on how much time the mothers spent at the centres, the filmed obser-
vations varied in length from 10 to 30 minutes.
The footage was initially reviewed by the two authors independently and later discussed. To get an
overview, we first watched each film separately, making observational notes. We then observed the
footage again, focusing mainly on the toddlers’attachment behaviour and signs of separation anxiety
(Ainsworth et al., 1978; Bowlby, 1960; Robertson & Robertson, 1971). This approach was chosen
because of its relevance for the study, its theoretical perspective, and the authors’prior experience
with attachment-based methods and observations of toddlers (Bick, Dozier, & Perkins, 2012; Killén,
Klette, & Arnevik, 2006; Klette, 2007; Klette et al., 2016). When analysing the care providers’behaviour,
we focused on their availability and comforting behaviour.
According to Bowlby (1960), the protest phase may last from a couple of hours to weeks in tod-
dlerhood. All crying, clinging, agitated behaviour and attempts to follow the mothers were noted.
Because the phase of despair may follow the protest phase after just hours in toddlers, we also
observed and noted expressions of hopelessness, inactivity and withdrawal, as well as immobility
EARLY CHILD DEVELOPMENT AND CARE 3
and self-soothing among the target toddlers. In the phase of despair, the child seems to be in mourn-
ing, is silent and does not make any demands on the surroundings. If the mother takes too long to
return when the child is in this phase, the detachment phase may set in. In this phase, the child may
appear happy and content, eating, playing and joining in readily, giving the impression of having
settled in. But upon reunion with the mother the child fails to show any of the strong signs of attach-
ment that are normal at this age; ‘far from greeting her, he seems hardly to know her, far from cling-
ing, he may remain remote and apathetic, instead of tears, there is a listless turning away’(Bowlby,
1960, p. 90).
Information about the children, parents and childcare centres
Six girls and six boys were randomly included in the study. At the time of the observations, they
mainly used sounds, signs and cues to communicate, although some of them were able to use a
few words. Ten of the children were able to walk (rather unsteadily) alone, and two needed
support or had to be carried. They had all been through a short adaptation period (usually 3
days), and at the observation time they spent an average of 40 hours a week at the centres. The
mothers’ages ranged from 28 to 38 years. Ten of the mothers were either married to or living
with the child’s father, and two were single parents. Eleven were employed, and one was a
student. Their average income was 48,000 GBP (5,20,000 NOK), which is above the national mean
income (Statistics Norway, 2016). Ten of the mothers were native Norwegians and two were from
other European countries. All spoke Norwegian fluently.
Ten different childcare centres participated in the study. They were randomly included, depending
on the municipality’s offers and the parents’choices. Two of the target toddlers attended the same
group at the same centre, and two others attended different groups at the same centre. Three of the
participating centres were in public ownership and seven were privately owned. They were either
organized in traditional groups (3), open groups (3), or as home-based care (4). The smaller groups
ranged from 9 to 32 children in each group. At 5 of the centres there were fewer than 25 children
in total, and at the other 5 there were between 50 and 140 children. The child–staff ratio was
greater than 3:1 at eight of the centres. The educational level and training among the care providers
varied considerably (Klette et al., 2016). More than half of the observed providers were not native Nor-
wegians and had language problems.
The findings are presented with illustrative examples from the study observations. The examples
were mainly chosen because they demonstrate common features among the toddlers concerned.
Five of the toddlers showed protest-related behaviour during the separations, and six children
demonstrated signs of despair. One girl did not show any visible attachment behaviour during the
separation from her mother.
Three of the boys and one of the girls cried during the separations. Two of these children started to
cry shortly after arrival at the centre, and two only started when their mothers signalled that they
were about to leave. The crying continued for 2–10 minutes after the mothers had left.
The little girl starts to cry when her mother undresses her in the cloakroom. She refuses to leave her mother’s lap,
continues crying, and the mother takes off her clothes while sitting. The girl, still crying, is then put down on the
floor, but the mother picks her up again and walks with her in her arms into another room. The little girl stops
crying for a short while, but when her mother tries to put her down, she starts again. The mother then carries
4T. KLETTE AND K. KILLÉN
the child into the main room and sits down with her on the floor with some toys. The child cries loudly. At this
point, a care provider approaches and sits down beside them. The girl cries even louder, she sobs and leans
against her mother. The mother lifts the child up and hands her over to the care provider. She cries and sobs
louder as her mother leaves. The care provider carries her to a table with crayons, and sits down with her
there. Gradually, the girl stops crying and starts to examine the crayons.
The same toddlers who cried also clung to their mothers during the separations. One girl held on to
her mother, but she did not cry or protest when her mother left.
The mother enters the child care centre, carrying the little girl. She puts the child down on the wardrobe floor and
starts undressing her. The girl leans against her mother and clings to her leg. The mother takes the girl’s hand and
they walk into the main room. No care providers have appeared yet, and there are many other toddlers arriving at
the same time. The mother tries to engage the girl with some toys and other children, but she clings to her
mother’s leg. The mother sits down with the child and stays with her for a little while. When she signals that
she is about to leave, a care provider approaches. The mother talks with him while the girl clings to her leg.
She then lifts the girl up, hands her to the care provider and leaves. The child does not protest. She is quiet
and passive and has a sad expression on her face. She keeps her arms stiff at her sides, but she refuses to be
put down. The care provider carries her around for some time.
None of the toddlers tried to follow their mothers during the observed separations.
Two girls and four boys showed signs of despair during the separations. Passivity and silence were domi-
nant among these toddlers, and their faces were almost expressionless. Two of them used pacifiers.
Mother and child arrive at the child care centre, and the mother undresses the little boy in the wardrobe. When
this is done, she gives him a cup with handles, which he takes and drinks from. Then the mother takes the boy by
the hand, and they walk together into a larger room, where a care provider greets them. The child signals that he
wants to sit at a table and eat, and his mother lifts him up on a high chair. She then kisses him and says ‘bye-bye’.
As she does this, he turns away from her, and he does not reply. When she leaves, she waves to him. He looks after
her, but he does not wave back. He then turns to the table and eats.
One of the observed toddlers failed to demonstrate any attachment behaviour towards her mother
during the separation.
When she is put down, the girl swiftly runs away from her mother into the centre. The mother says goodbye and
waves to her, but the child neither looks at her nor responds. The mother leaves, and the child shows no reaction
to her leaving.
Five of the children approached their mothers when they returned in the afternoon. When picked up,
three of them also leaned well into their mothers, smiling and uttering sounds of delight. Seven of the
target toddlers remained inactive, silent and withdrawn throughout the reunion.
Two of the boys and one of the girls started to cry when their mothers returned. Two of them started
the moment they saw their mothers, and one boy only began after some time. All three continued to
cry throughout the reunion.
The boy has been standing by the gate for some time, whining and trying to open it, when his mother arrives.
When he sees her, he brightens up and runs towards her. While running he makes some strange, complaining
sounds, and then he starts to cry. His mother picks him up and holds him close. He points at something and
pulls a little away from her, still crying.
None of the observed children clung to their mothers during the reunions.
EARLY CHILD DEVELOPMENT AND CARE 5
Five of the boys and two of the girls neither smiled, made utterances nor approached their mothers
when they came back. They remained passive and silent and did not greet their mothers. When
picked up, they tended to draw away from their mothers. Two of them were almost immobile
throughout the reunion, with a peculiar stiffness in the arms.
The girl is sitting on a care provider’s lap when the mother arrives from behind. She turns and looks at her mother
for a moment, then she points at something and looks down. The mother sits down and pats the child, but the girl
keeps her head lowered. When the mother lifts her up, she still keeps her head down, and there is no eye contact
or other visible exchange between them. The child appears sad and tired.
The toddler who had run away from her mother in the morning also ignored and rejected her when
The girl, who is sitting alone outside when her mother comes, does not appear to react to her arrival. She looks
briefly at her mother when she says hello, and then she looks away. She makes no attempt to get up. Her mother
sits down on a bench, a bit away from the child, who still does not look at her. Neither of them makes any further
approaches for some time, but after a while the child gets up. She starts to walk towards her mother, who is still
sitting on the bench. But suddenly she turns and walks in the opposite direction. The mother gets up and follows
the child. She bends down and tries to give her daughter a hug, but the child turns away and walks away. Again,
the mother follows, but the girl seems to ignore her and gives no response to her questions. After a time, the girl
turns and signals that she wants to be picked up. The mother lifts her up, but the child keeps her arms down and
her body away from the mother. There is no eye contact between them.
The main finding in the present study is that after 1 month in childcare, all the observed toddlers
demonstrated signs of separation anxiety. In the mornings, five of the children showed protest-
related behaviour, and six showed signs of despair. In the afternoons three demonstrated protest
behaviour, while seven showed signs of despair. One of the toddlers demonstrated detached behav-
iour during both transitions. Although they all showed clear signs of separation anxiety, the observed
toddlers appeared to be in different phases after 1 month in care. This might be understood in light of
individual and family factors as well as adaption time, length of days and staffing. Half of the boys
demonstrated protest-related behaviour during the separations, but only one of the girls protested.
This may be random or due to individual differences and daily variations, but it may also reflect that
boys are more enduring in their protest than are the girls. In the reunions, some of the toddlers also
demonstrated mixed behaviour. Two of the children, who initially approached their mothers, suddenly
moved or turned away when she came near. Another child signalled to his mother to be picked up, but
when he was lifted, he drew back from her and avoided eye contact. These observations may indicate
that the phases of separation anxiety are better understood as moving dimensions than as fixed cat-
egories. The fact that none of the toddlers tried to follow their mothers at any point during our obser-
vations may indicate an experience-based recognition of the futility of even trying.
From about 8 months, attachment behaviour and separation anxiety are visible in most children. If
separated from, or threatened with separation from, their primary caregiver, toddlers tend to demon-
strate strong feelings and reactions (Bowlby, 1960; Klette, 2007). Whether and how their needs and
anxiety are addressed and handled is believed to have a huge impact on their development and
further functioning, especially with regard to their regulation of emotion and stress (Ahnert et al.,
2004; Bowlby, 2007; Drugli et al., 2016; Gunnar & Quevedo, 2004, 2006; Levine, 2005; Luecken, 2000).
Adequate staffing, with relevant knowledge and experience, may help toddlers to tolerate and
come to terms with the daily separations, through sensitive interaction. In our sample, however,
only 2 of the 10 centres had the recommended 3:1 ratio. Ratios of 4:1 or more were normal, and in
the mornings and afternoons the ratio was often even higher. At one centre, a care provider (who
6T. KLETTE AND K. KILLÉN
was inexperienced and untrained) was looking after eight children during the morning transitions. It is
a paradox that at most of the observed centres, the staffing was at the lowest in the early mornings and
late afternoons, when the toddlers were at their most tired and vulnerable.
Social interaction and learning to walk and talk are just some of the tasks toddlers must handle. At this
time of life, being separated from the main source of security and knowledge for long hours on a daily
basis poses a major challenge. However, research has shown that toddlers do form attachment bonds
with their care providers (Ahnert, Pinquart, & Lamb, 2006), and that the quality of care is important
(McCartney, 2007). The target toddlers who cried did eventually get some attention, but there were
often too many crying children and too few providers present. Although some care providers would
offer to hold or carry the toddler for some time, the number of children in distress often prohibited
the one-to-one interaction that might have soothed them. The staff’s attention also tended to focus
on diversion rather than comfort as the staff often tried to distract the children by using objects. The
silent and passive toddlers were easily ignored and left on their own. For example, two of the children
were observed wandering alone for almost half an hour, without any attention from the providers
present. Low staffing, lack of education and formal training and varied language skills, may help explain
some of these observations. For toddlers to develop secure attachment in childcare settings, access to
stable, sensitive and empathic carers is a prerequisite. Recent studies do, however, indicate that the
quality of care for toddlers in Norwegian child care is low (Bjørnestad & Os, in press; Klette et al., 2016).
The present study is small and the findings cannot be generalized. Only 12 children were observed
during 1 separation and 1 reunion with their mothers. Observations at other times at the same childcare
centres may have given different results. However, the families were recruited randomly from different
areas in the community, and there was also a variety in types of childcare centres. One could also argue
that the toddlers, caregivers and providers were affected by being observed and filmed. However,
based on prior experience, one-year-old toddlers tend to accept and forget observers quite quickly,
and behave as usual. If our presence had made any impact on the caregivers and care providers, we
would have expected to see increased interactional efforts during the transitions.
Overall, our study indicates that 1-year-old toddlers undergo a dramatic and painful transition when
adapting to childcare. All the observed children demonstrated signs of distress, compatible with the
phases of separation anxiety. Although the study is small, it points to a need to discuss how separ-
ation anxiety among toddlers in day care is handled. Longer and more flexible adaption time, shorter
days and better staffing, especially in the early mornings and late afternoons, appear to be important
measures to implement. To prevent development of despair and detachment among Norwegian chil-
dren, there is a need to rethink the provision of care for toddlers in childcare facilities.
No potential conflict of interest was reported by the authors.
Notes on contributors
Trine Klette received her Ph.D degree in Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway in
2007. Her research interests include prevention of child abuse and neglect, attachment development through life and
relationships between early interaction and health.
Kari Killén received her Ph.D degree at Faculty of Medicine, University of Oslo in 1988. Her research interests include child
maltreatment, adult child interaction and attachment.
EARLY CHILD DEVELOPMENT AND CARE 7
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