a relationship have become dominant and are linked to a growing recognition in psychoanalysis of the importance of infant development in the context of relationships and internalized representations. Psychoanalysis has recognized the formative nature of a child's early environment including the issue of childhood trauma. A psychoanalytically based exploration of the attachment system and an accompanying clinical approach has emerged together with a recognition of the need for measurement of outcomes of interventions. One focus of attachment research has been the difficulties of children whose attachment history was poor, including those with extensive non-parental child care experiences. Concern with the effects of child care was intense during the so-called "day care wars" of the late-20th century, during which some authors stressed the deleterious effects of day care. As a result of this controversy, training of child care professionals has come to stress attachment issues, including the need for relationship-building by the assignment of a child to a specific care-giver. Although only high-quality child care settings are likely to provide this, more infants in child care receive attachment-friendly care than in the past. A natural experiment permitted extensive study of attachment issues as researchers followed thousands of Romanian orphans adopted into Western families after the end of the Nicolae Ceaușescu regime. The English and Romanian Adoptees Study Team, led by Michael Rutter, followed some of the children into their teens, attempting to unravel the effects of poor attachment, adoption, new relationships, physical problems and medical issues associated with their early lives. Studies of these adoptees, whose initial conditions were shocking, yielded reason for optimism as many of the children developed quite well. Researchers noted that separation from familiar people is only one of many factors that help to determine the quality of development. Although higher rates of atypical insecure attachment patterns were found compared to native-born or early-adopted samples, 70% of later-adopted children exhibited no marked or severe attachment disorder behaviours. Authors considering attachment in non-Western cultures have noted the connection of attachment theory with Western family and child care patterns characteristic of Bowlby's time. As children's experience of care changes, so may attachment-related experiences. For example, changes in attitudes toward female sexuality have greatly increased the numbers of children living with their never-married mothers or being cared for outside the home while the mothers work. This social change has made it more difficult for childless people to adopt infants in