School-age Assessment Of Attachment Research Articles

Child Attachment Representations and Parenting Stress in Mothers and Fathers of School-Age Children with a Diagnosis of Autism Spectrum Disorder: A Pilot Cross-Sectional Study.

Mothers and fathers of autistic children (ASD) tend to report elevated levels of parenting stress. Thus, it is critically important to understand which factors contribute to an imbalance between the perceived demands of parenting and the available psychological resources. To date, little is known about the association between child attachment representations and parenting stress. In this study, we first examined group differences in parenting stress levels based on child diagnosis and parents' gender. Second, we explored the predictive role of child diagnosis, autism severity, and child attachment representations on parenting stress. The study involved 23 school-age children with ASD (IQ > 70), 27 without ASD (7-13 years), and their mothers (n = 50) and fathers (n = 50). Data were collected from 2017 to 2020. Parents completed the Social Responsiveness Scale 2 and the Parenting Stress Index-Short Form, while the children's attachment representations were assessed using the School-age Assessment of Attachment. Parents of children with ASD reported higher stress compared with controls. No differences were found between mothers and fathers. Implicit attachment representations have been found to be associated with parenting stress only in mothers, while the severity of social impairment showed a significant effect on parenting stress in both parents. These findings revealed the potential benefit of adaptive attachment representations not only for children themselves but also for mothers and the family system, suggesting the bidirectional nature of parent-child relationships in the context of ASD. The uniqueness of maternal and paternal parenting experiences should be considered when parenting stress is addressed.

Fix my child: The importance of including siblings in clinical assessments.

This study examined concordance in the attachment strategies of school-aged siblings with reference to environmental risk in terms of poverty and maltreatment. It also investigated the effect of child maltreatment and maternal mental illness on children's psychosocial functioning in terms of the Dynamic-Maturational Model of Attachment and Adaptation (DMM) including unresolved trauma and the DMM Depressed modifier. The attachment strategies of 30 sibling pairs, aged 5-14 years, were assessed using the School-age Assessment of Attachment (SAA). Unlike most previous studies, this study included siblings from large families of two to six children. The main finding was that as environmental risk increases, the diversity of sibling attachment strategies decreases with greater recourse to the DMM Type A3-6 and A/C strategies. Unlike previous studies, the highest level of concordance was found in sibling pairs with the opposite gender. Boys whose mothers had a history of mental illness were significantly more likely than girls to be assessed with the DMM-depression modifier. As danger increases, children in the same family experience more of the same childhood. Further research should focus on single case, intra-familial studies to build a systemic model of the shared environment. Research should also evaluate the effects of environmental risk compared with size of the sibling group on children's attachment strategies. The clinical implications point to the importance of assessing all children in the family using a model built around functional formulation rather than diagnosing the symptoms of a particular child.

Assessing attachment in school-aged children: Do the School-Age Assessment of Attachment and Family Drawings work together as complementary tools?

Our goal was to identify an assessment package that could improve treatment planning for troubled children and their families. To assess the validity of our tools, we tested the relations among the School-Age Assessment of Attachment, the Family Drawing and children's risk status. We used the Dynamic-Maturational Model of Attachment and Adaptation to interpret the assessments in the hope of identifying a gradient of risk, and explore whether a new coding method improved the validity of Family Drawings and their utility as a tool to complement the School-Age Assessment of Attachment. The participants were 89 children, aged between 5 and 12 years; 32 children were involved with mental health services or child protection. Each child completed a School-Age Assessment of Attachment and a Family Drawing. Both assessments differentiated between clinical and normative referrals with moderate effect sizes when dichotomizing risk versus non-risk attachment. When the analysis incorporated a gradient of six attachment classifications, the effect sizes decreased, but specificity of risk increased. The School-Age Assessment of Attachment had greater validity for discriminating risk, and type of risk, than the Family Drawings. With a School-Age Assessment of Attachment and family history, the Family Drawing can provide information about distress that some children do not provide verbally. Integration of the two assessment tools alongside information about parental and family functioning appears to be the key to formulating children's problems.

Are mothers' protective attachment strategies related to their children's strategies?

We explored the relation between mothers' protective attachment strategies and those of their school-age children. In total, 49 child-mother dyads participated in a short longitudinal study when the children were 5.5 and 6.0 years old. Their strategies were first assessed with the Preschool Assessment of Attachment (PAA) and then with the School-age Assessment of Attachment (SAA). Mothers were assessed with the Adult Attachment Interview (AAI). The Dynamic-Maturational Model of Attachment and Adaptation (DMM) was used to classify the assessments. The validity and precision of the DMM-AAI were supported: Mothers' AAI classifications were related to their referral group (normative or clinical) and measures of stress and distress. The DMM categories were more associated with risk than the Ainsworth categories. Types A, C and A/C were differentiated by trauma, triangulation and depression. Mothers' and children's protective attachment strategies were related, with B mothers having B children and A or C mothers having children using the same or opposite strategy. Children whose classification changed from the PAA to the SAA had mothers with complex traumas. When psychosocial treatment is needed, knowing whether mother and child use the same or different strategies and whether mothers have complex trauma can affect treatment success.

Don't forget the siblings: School-aged siblings of children presenting to mental health services show at-risk patterns of attachment.

Family therapists understand that children presenting for treatment are often bearers of symptoms signalling relational problems within the family system. Rather than addressing the children's symptoms in isolation, family therapists typically take those relational problems as their starting point in therapy. This study used the School-aged Assessment of Attachment (SAA) to assess the self-protective (attachment) strategies of the siblings of children presenting for psychiatric evaluation and also of the siblings of control children drawn from the normative population. Siblings of children in the clinical group were much more likely than siblings of control children to use at-risk self-protective strategies and to have markers suggestive of unresolved loss or trauma. School-aged siblings were found to use a broad range of strategies, and the pattern of change from first born to later born involved either a reversal of strategy or a shift to a more complex strategy. The study highlights that siblings of children presenting to mental health services are significantly affected by family relational stress. A family systems approach to assessment, one that enquires about the wellbeing of all family members, will ensure that the emotional needs of siblings are also addressed during the therapy process.

Validation of the School-age Assessment of Attachment in a short-term longitudinal study.

This study tested the validity of the School-aged Assessment of Attachment (SAA) in terms of matches from the well-validated Preschool Assessment of Attachment (PAA) to the SAA 6 months later. It also addressed validity in terms of mental health services and measures of stress, depression and anxiety. Children's SAA classifications were predicted to match their 6 months' previous PAA classifications and indicators of maternal, child and family stress. The study used a two-group comparative design, involving normative and clinical children and their mothers. The participants were 50 children between 5.5 and 5.9 years of age. Each child participated with his or her mother in a PAA, and then 6 months later each child responded to the SAA story cards as well as self-report assessments of stress, anxiety and depression. Concordance of A, B, C and A/C attachment classifications was found between the PAA and SAA in 34 of 48 children. There was a strong relation between referral status (clinical or normative) and both PAA and SAA attachment classifications. In every non-matching case, a normative child had an attachment classification indicative of risk, indicating that the direction of errors was false positives as opposed to false negatives. This evidence supports the validity and clinical utility of the SAA.

Validity of the School-age Assessment of Attachment for moderate-risk, rural early adolescents.

This study provides evidence of validity of the School-age Assessment of Attachment (SAA) through longitudinal comparison with the Preschool Assessment of Attachment (PAA) and with concurrent attachment assessments and measures of risk and parenting. Determining which assessment had the greatest validity with this moderate-risk sample would be of benefit to those working with troubled young people and their families. Children's SAA classifications were expected to correspond to their PAA, a behavioral attachment assessment, parenting, and risk. An attachment questionnaire was predicted to not accurately indicate children's risk status. The design was an 8-year longitudinal follow-up of rural Appalachian American preschoolers. The participants were 21 children and their caregivers. The PAA was completed at age 4. The SAA, a self-report questionnaire, and a parent-child conflict resolution task were completed at age 12. Parents completed assessments of depression, trauma, stress, and perceptions of helplessness. The PAA was related to the SAA and the dyadic behavioral task. The SAA was consistently associated with measures of parenting and family risk. The attachment questionnaire performed poorly for children with higher risk status, suggesting more (not less) sensitive and responsive parenting.

The attachment of prematurely born children at school age: A pilot study.

This prospective longitudinal study compared the psychological development and patterns of attachment of 20 prematurely born children and 20 full-term children at 7 years of age. The School-age Assessment of Attachment (SAA) was used, and hypotheses and interpretation of the findings were drawn from the Dynamic-Maturational Model of Attachment and Adaptation (DMM). Significant differences between prematurely born and full-term children were found: 10% versus 0% at "high" risk, 55% versus 25% at "moderate" risk, and 35% versus 75% at "low" risk. There were no differences in the percentage of psychological trauma between samples, but there was a difference in the types of experiences leading to trauma. For prematurely born children, it was most often illness, whereas for full-term children, it was family problems. We discuss the implications for clinicians.

Assessing attachment in school-age children

The School-age Assessment of Attachment (SAA) is a newly developed clinical tool to identify pattern of attachment using the Dynamic-Maturational Model of attachment and adaptation (DMM). Seven picture cards were used to elicit fantasy stories and recalled episodes. The transcribed discourse was analyzed to yield one of 13 DMM attachment classifications, together with possible unresolved traumas and losses, and modifiers (depression and intrusions). In this article, we outline the steps necessary to validate an assessment tool, describe the development of the SAA, and report data from a preliminary clinical study testing the SAA's reliability, validity, and utility. Concurrent construct, familial, and discriminant validity were evaluated in terms of mental health status and exposure to danger on a sample of 5-12-year-old children, drawn from clinical ( n = 51) and normative (n = 40) populations. The SAA (a) differentiated children referred for psychiatric diagnosis from those in the normative population; (b) accounted for 31% of the variance (46% when family variables were added); (c) identified risk children in the normative sample; and (d) suggested risk factors associated with children's psychiatric disorder.