Piloting attachment psychoeducation provided to parents of children with severe disabilities: Testing the feasibility of a digital micro-intervention.

BackgroundA digital micro-intervention offering attachment psychoeducational videos was explored regarding its feasibility in parents of children with severe disabilities. Method: A mixed-methods study (including daily diaries and one-time questionnaires) with 16 parents (75.0% female) of children with severe disabilities (up to 10 years of age) was done during a three-week intervention. Results: Parents were positive about the video series and almost no drop-out occurred. The videos stimulated their learning and thinking and offered parents some personal meaning. Preliminary efficacy tests showed no major changes in parents' parenting self-efficacy (PSE) or perceptions of statements on parent-child attachment. Conclusions: The study showed promising results regarding the micro-interventions' acceptability and implementation. The limited efficacy testing did not show major changes in parents' PSE. Further research is needed to investigate the differential relevance of the micro-intervention, based on parents' needs, as well as its optimal embeddedness in a broader intervention trajectory.

Attachment and the Development of Depressive Symptoms in Adolescence: The Role of Regulating Positive and Negative Affect.

Although widely accepted, attachment theory's hypothesis that insecure attachment is associated with the development of depressive symptoms through emotion regulation strategies has never been longitudinally tested in adolescence. Additionally, previous research only focused on strategies for regulating negative affect, whereas strategies for regulating positive affect may also serve as a mechanism linking insecure attachment to depressive symptoms. This study aimed to fill these research gaps by testing whether the association between attachment and change in depressive symptoms over time is explained by strategies for regulating negative and positive affect in adolescence. Adolescents (N = 1706; 53% girls; Mage = 12.78 years, SDage = 1.54 at Time 1) were tested three times, with a 1-year interval between measurement times. They reported on their attachment anxiety and avoidance at Time 1, depressive symptoms at Times 1 and 3, and regulation of negative affect (brooding and dampening) and positive affect (focusing and reflection) at Time 2. The results from multiple mediation analyses showed that more anxiously attached adolescents developed more depressive symptoms via increased brooding and dampening. More avoidantly attached adolescents developed more depressive symptoms via decreased focusing. These findings provide longitudinal support for attachment theory's emotion regulation hypothesis, and show that the regulation of both negative and positive affect is important.

Looking back, looking forward: Methodological challenges and future directions in research on persons with profound intellectual and multiple disabilities.

BACKGROUND: Within the context of the Special Interest Research Group (SIRG) on Persons with Profound Intellectual and Multiple Disabilities (PIMD), researchers often discuss the methodological problems and challenges they are confronted with. The aim of the current article was to give an overview of these challenges. METHODS: The challenges are centred on six topics. These reflect the main components of a study's design: (a) participant demarcation, (b) participant recruitment, (c) data collection and instruments, (d) data analysis, (e) ethics/including the "voice" of persons with PIMD and (f) theoretical models. RESULTS: Next, to describing the specific challenges, possible solutions and pathways to address them are discussed. These are illustrated by recent studies by the authors and other researchers in the field. CONCLUSIONS: The current contribution wants to stimulate further discussion and exchange of ideas, and the development of creative research techniques.

Comfort provided by parents versus strangers after eliciting stress in children with severe or profound intellectual disabilities: does it make a difference?

The relationships between children with severe or profound intellectual disabilities (ID) and their parents may fulfil attachment functions, such as regulating emotional responses to stress. This study examined the extent to which children with severe or profound ID differentiate between their parents and a stranger as a resource for stress-regulation. A home-based experimental paradigm was conducted and video-recorded in 38 families. Children (1-8 years) were exposed to four naturalistic stressors followed by comfort, randomly provided by the parents or the stranger. Emotional behaviour (arousal and valence) and the skin conductance level were simultaneously recorded. With regard to both emotional behaviour and skin conductance, children significantly differentiated between their parents as attachment figures and the stranger during stress and comfort, despite their impairments on various developmental domains. Behavioural observation and physiology show complementary manifestations of parent-child attachment in this population.

Young children with significant developmental delay differentiate home observed attachment behaviour towards their parents.

BACKGROUND: The hallmark of attachment is that contact, proximity and relief from stress are sought from specific individuals, laying important groundwork for healthy socioemotional functioning. This study investigated the extent to which differentiated attachment behaviour can be observed in young children with significant developmental delay (DD). METHOD: Video-taped observations of the parent-child and stranger-child interaction were conducted at home and complemented with questionnaires in 20 families with a child with significant DD (age 2-7 years with an average DD of 49 months). RESULTS: Children displayed more intense and persistent contact-seeking, contact-maintaining and resistant behaviour in the episodes with their parent compared to the episodes with the stranger. Parent-reported secure attachment behaviour was slightly more characteristic towards mother compared to father. CONCLUSIONS: Even children with significant DD develop differentiated attachment behaviour. Detailed observations may support parents in identifying the interactions that make the attachment relationship with their child special.

The social-emotional functioning of young children with a significant cognitive and motor developmental delay.

Children with a significant cognitive and motor developmental delay (SDD) are vulnerable for the development of (future) behavioral and mental health problems. This paper aims to assess the social-emotional functioning of these children, both globally and in various domains. Semi-structured interviews with one or more primary caregiver(s) of 45 children were conducted and analyzed on 13 domains of social-emotional functioning, according to the Scale for Emotional Development - Revised (SED-R). The SED-R scoring system was slightly adapted in the current study in order to elucidate more subtle differences between children. A general delayed social-emotional development was found, with children functioning within different phases across domains and certain domains generally showing higher or lower scores. To capture the emotional needs of children with SDD, a more disaggregated scoring system seems valuable so that both the global level and the level per domain can be taken in consideration in designing interventions.

Changes in the social-emotional functioning of young children with a significant cognitive and motor developmental delay across a two-year period.

Children with a significant cognitive and motor developmental delay (SDD) are vulnerable for the development of (future) behavioral and mental health problems. To support children within this target group, knowledge on their social-emotional development is necessary. Therefore, in this paper, an explorative assessment of the changes in the social-emotional functioning of children with SDD over a two-year period was done. Yearly semi-structured interviews with one or more primary caregiver(s) of 25 children were conducted and analyzed on 13 domains of social-emotional functioning, according to an adapted version of the Scale for Emotional Development - Revised (SED-R). This study showed a lot of variation in individual and group patterns of change across the two-year period. Charting the social-emotional development in this target group is challenging and requires further in-depth analysis of individual trajectories as well as more fine-grained and long-term data collection.

Can I be your safe haven and secure base? A parental perspective on parent-child attachment in young children with a severe or profound intellectual disability.

BACKGROUND: The general developmental as well as the disability specific literature has stressed the crucial influence of parents on their child's social-emotional development. Attachment theory provides a framework to describe parental roles within the parent-child attachment relationship. The current study explored parents' perspectives on their role as attachment figure and the preconditions they consider necessary to establish secure attachment in children with severe or profound intellectual disability (ID). METHODS: Semi-structured interviews with 54 parents on their child's social-emotional development, attachment behaviour and the parent-child attachment bond were analysed using the Framework Method. All children were between 15 months and seven years old and had a severe or profound ID. RESULTS: Parents reported their child's clear preference towards them and acknowledged the role they fulfil as stress regulator. Children differed in the extent to which they use their parent to explore new environments. Overall, parents described the attachment relationship with their child as positive but challenging. CONCLUSIONS: Parents acknowledged the roles they fulfil both as a safe haven for their child, and (to a lesser extent) as a secure base. Clinical practice could benefit from a parental perspective to identify particular challenges parents encounter in building a secure attachment relationship.

Parent-child interaction: A micro-level sequential approach in children with a significant cognitive and motor developmental delay.

BACKGROUND & AIMS: Previous research indicates that young children with a significant cognitive and motor developmental delay show low levels of interactive engagement, their parents are generally responsive towards them and these variables are positively correlated. Adapting a micro-level approach, we aim to go beyond macro-level and correlational analyses by charting the frequency, intra-individual co-occurrence and inter-individual temporal dependency of specific interactive behaviors. METHODS & PROCEDURES: Twenty-nine parent-child dyads (with children aged 6-59 months) were video-taped during a 15-minute unstructured play situation. Based on a self-developed coding scheme, interactive behaviors were coded continuously and analyzed using a three-step sequential analysis approach. OUTCOMES & RESULTS: Parents and children systematically combine either more socially-oriented or more object-oriented behaviors. Socially-oriented behaviors are less frequent in children, especially looking at and touching the partner occurs less. Socially- and object-oriented behavioral clusters are generally independent from each other and instigate/maintain the same type of behaviors in the interaction partner. While children's socially oriented behavior(al cluster)s seem to need a parental 'trigger', parents will more often independently engage with their child despite low child responsiveness. CONCLUSIONS AND IMPLICATIONS: Further intervention-oriented research is needed to confirm this study's results and translate them into concrete guidelines for parents.