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

Abstract

Aims:

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.

Method:

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.

Results:

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.

Conclusions:

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.

Keywords

Attachment school-aged assessment of attachment SAA Family Drawings Crittenden DMM

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References

Ainsworth

M. D. S.

Blehar

M. C.

Waters

Wall

S. N.

(1978). Patterns of attachment: A psychological study of the strange situation. Oxford, UK: Lawrence Erlbaum.

Behrens

K. Y.

Kaplan

(2011). Japanese children’s family drawings and their link to attachment. Attachment & Human Development, 13, 437–450.

Crittenden

P. M.

(1997–2005). School-age assessment of Attachment Coding Manual (Unpublished manuscript). Miami, FL.

Crittenden

P. M.

(2015a). Raising parents: Attachment, representation, and treatment (2nd ed.). London, England: Routledge.

Crittenden

P. M.

(2015b). Understanding children: Assessing school-aged children’s self-protective attachment strategies. Clinical Child Psychology and Psychiatry, 20, 341–347.

Crittenden

P. M.

Ainsworth

M. D. S.

(1989). Child maltreatment and attachment theory. In Cicchetti

Carlson

(Eds.), Handbook of child maltreatment (pp. 432–463). New York, NY: Cambridge University Press.

Crittenden

P. M.

Kozlowska

Landini

(2010). Assessing attachment in school-age children. Clinical Child Psychology and Psychiatry, 14, 185–208.

Crittenden

P. M.

Landini

(2011). Assessing adult attachment: A dynamic-maturational approach to discourse analysis. New York, NY: W. W. Norton & Company.

Crittenden

P. M.

Robson

Tooby

(2015). Validation of the School-age assessment of attachment in a short-term longitudinal sample. Clinical Child Psychology and Psychiatry, 20, 348–365.

10.

Crittenden

P. M.

Robson

Tooby

Fleming

(2017) Are mothers’ protective attachment strategies related to their children’s strategies? Clinical Child Psychology Psychiatry, 22(3), 358–377

11.

Department of Health. (2011). Governance arrangements for research ethics committees: A harmonized edition (Section 2.3.10, p. 12). London, England: Author.

12.

Fihrer

McMahon

(2009). Maternal state of mind regarding attachment, maternal depression and children’s family drawings in the early school years. Attachment & Human Development, 11, 537–556.

13.

Fury

Carlson

E. A.

Sroufe

L. A.

(1997). Children’s representations of attachment relationships in family drawings. Child Development, 68, 1154–1164.

14.

Jean-Gilles

Crittenden

P. M.

(1990). Maltreating families: A look at siblings. Family Relations, 39, 323–329.

15.

Kaplan

Main

(1986). Instructions for the classification of children’s family drawings in terms of representation of attachment (Unpublished manuscript). University of California, Berkeley.

16.

Kidwell

S. K.

Sizemore

K. M.

Fugate

K. M.

Deaton

M. S.

Blevins

M. D.

(2015). Validity of the School-age Assessment of Attachment for moderate-risk, rural early adolescents. Clinical Child Psychology and Psychiatry, 20, 366–380.

17.

Kozlowska

Elliott

(2016). Don’t forget the siblings: School-aged siblings of children presenting to mental health services show at-risk patterns of attachment. Clinical Child Psychology and Psychiatry, 22, 245–259.

18.

Kwako

L. E.

Noll

J. G.

Putnam

F. W.

Trickett

P. K.

(2010). Childhood sexual abuse and attachment: An intergenerational perspective. Clinical Child Psychology and Psychiatry, 15, 407–422.

19.

Madigan

Goldberg

Moran

Pederson

D. R.

(2004). Naive observers’ perceptions of family drawings by 7-year-olds with disorganized attachment histories. Attachment & Human Development, 6, 223–239.

20.

Madigan

Ladd

Goldberg

(2003). A picture is worth a thousand words: Children’s representations of family as indicators of early attachment. Attachment & Human Development, 5, 19–37.

21.

Main

Solomon

(1986). Discovery of an insecure disorganized/disoriented attachment pattern: Procedures, findings, and implications for the classification of behavior. In Yogman

Brazelton

T. B.

(Eds.), Affective development in infancy (pp. 121–160). Norwood, NJ: Ablex Publishing.

22.

Nuccini

Paterlini

Gargano

Landini

(2015). The attachment of prematurely born children at school age: A pilot study. Clinical Child Psychology and Psychiatry, 20, 381–394.

23.

Pace

C. S.

Zavattini

G. C.

Tambelli

(2015). Does family drawing assess attachment representations of late-adopted children? A preliminary report. Child and Adolescent Mental Health, 20, 26–33.

24.

Peat

(2001). Health science research: A handbook of quantitative methods. Sydney, New South Wales, Australia: Allen & Unwin.

25.

Pianta

R. C.

Longmaid

Ferguson

J. E.

(1999). Attachment-based classifications of children’s family drawings: Psychometric properties and relations with children’s adjustment in kindergarten. Journal of Clinical Child Psychology, 28, 244–255.

26.

Procaccia

Veronese

Castiglioni

(2014). The impact of attachment style on the family drawings of school-aged children. Open Psychology Journal, 7, 9–17.

27.

Roberts

R. E.

Attkisson

C. C.

Rosenblatt

(1998). Prevalence of psychopathology among children and adolescents. American Journal of Psychiatry, 155, 715–725.

28.

Schechter

D. S.

Zygmunt

Trabka

K. A.

Davies

Colon

Kolodji

. . .McCaw

J. E.

(2007). Child mental representations of attachment when mothers are traumatized: The relationship of family-drawings to story-stem completion. Journal of Early Childhood and Infant Psychology, 3, 119–141.

29.

Shiakou

(2012). Representations of attachment patterns in the family drawings of maltreated and non-maltreated children. Child Abuse Review, 21, 203–218.

30.

Spieker

Crittenden

P. M.

(2009). Comparing the validity of two approaches to attachment theory: Disorganization versus danger-informed organization in the preschool years. Clinical Child Psychology and Psychiatry, 15, 97–120.

31.

Target

Fonagy

Shueli-Goetz

(2003). Attachment representations in school-age children: The development of the child attachment interview (CAI). Journal of Child Psychotherapy, 29, 171–186.