It's kind of a different story... or isn't it? Parent-child attachment in children with severe or profound intellectual disabilities.

Developing consolidated, secure attachment relationships with one's primary caregivers at a young age yields great benefits for children's social-emotional growth, now and later in life. Especially among children with severe or profound intellectual disabilities (SPID), who are, compared to the general population, more likely to acquire mental health problems, the importance of the parent as attachment figure is significant. However, empirical attachment research in this target group lags behind. The present doctoral project examined some of the basic propositions of attachment theory in children with SPID and searched for tailored ways to support parents in strengthening these relationships (fitted to their strengths and needs). First, a pilot interview study (manuscript 1) revealed that, while most parents certainly recognised certain aspects of their role as attachment figures, a number of them also uttered (almost existential) insecurities that they had about their unique role in the emotional life of their child with SPID. These insecurities highlighted the relevance of the current doctoral project. Second, a home-based observation paradigm with separations (manuscript 2) was carried out in 20 parent-child dyads with children with SPID (2-7 years). On a group-level, first evidence was found for differentiated expressions of attachment behaviours, as described in the literature (such as contact-seeking). Children with additional (motor) disabilities differentiated, however, to a lesser extent in their behaviours. Therefore, third, an experimental home observation including episodes of stress and comfort, and complemented by continuous psychophysiological measurements, was done with 38 parent-child dyads with children with SPID (2-9 years). By including psychophysiology, more equal chances were created to show differentiation for all children, independent of their motor competences. From an intraindividual perspective (manuscript 3), indications were found that children with SPID differentiated (both behaviourally and physiologically) between their parents as attachment figures and a stranger. This provided empirical support for the emotion-regulating function that parents have in the context of the selective attachment relationships developed by their children. From an interindividual perspective (manuscript 4), it became clear that individual differences across children were mainly explained by their (fine) motor skills, rather than their parents' sensitivity levels. Fourth, a second part of this project focused on supporting families with children with SPID on the domain of their (attachment) relationships. A semi-structured interview was elaborated, called the Attachment Strengths and Needs interview, and was positively received by parents and professionals in terms of its feasibility and acceptability (manuscript 5). Next, an online vignette study (manuscript 6) with 22 experts showed that a number of intervention components could be matched with individual families based on different argumentations (at different levels). Finally, a pilot intervention study (manuscript 7) with 16 parents revealed promising results concerning the acceptability and implementation of a newly-developed psychoeducational video series on attachment, though its results on parenting self-efficacy were not (yet) demonstrated. The current doctoral project took first steps in filling the gaps in attachment research among children with SPID. Next to creating a deeper understanding of some basic assumptions of attachment theory, the project made an impetus to provide attachment-related support to these families, tailored to their individual strengths and needs. In the long run, this will hopefully not only lead to an increase in these parents' self-efficacy, but also to a decrease in the behavioural and mental health problems in children with SPID, which might stem from inadequate emotion regulation and/or supporting relationships with their caregivers.

Jaar van publicatie:2021

Toegankelijkheid:Closed