Although caregiver factors are generally considered the more potent in determining children's attachment organization, a number of child factors have also been considered. Among these have been temperament and disabilities. The present paper examines the effect of various types of children's disability on parent–child interactions, including how disabilities affect parental sensitivity and communications. A brief outline of attachment theory and patterns of organization is followed by a review of the research evidence that has looked at children with disabilities and insecure attachments. A complex picture emerges in which it is not a child's disability per se that is associated with insecure attachments but rather an interaction between children with disabilities and the caregiver's state of mind with respect to attachment. Transactions between both child and caregiver vulnerability factors affect sensitivity, communications and security of attachment. Practice implications for prevention, advice and support are considered.