Working with culturally diverse groups

I've been reading and thinking, recently, about work with culturally diverse groups and wonder if any of you do and what your experience has been.

In thinking about treatment it seems that family and DDP therapists (who are primarily European-American) may tend to:
* Allow and encourage expressing emotions freely and openly
* View each member as having a right to the member's own unique self: to individuate from the family as a primary unit of identity
* Strive for equal division of labor among members of the family
* Consider egalitarian role relationships between spouses as preferred
* Focus on the nuclear family as the standard.
* Value a present-future time perspective

A variety of other cultures have differing values and orientations (Asian, South-Asian, Black American, First Nations/Native American, Hispanic, to name a few).

It might be interesting to have a discussion about working with culturally diverse groups...if any of us do work with such groups (I do, so that's what prompted my readings and thinking).

regards

art

Spanking lowers IQ scores

A comprehensive study of the literature in the Canadian Medical Journal finds that spanking children results in poor outcomes: lower IQ scores.

The arguments against spanking and corporal punishment are even stronger when considering its re-traumatizing effects on children who have experienced complex trauma.

Tips for parents

Tips for parents on Halloween safety:

http://www.huffingtonpost.com/mary-l-pulido-phd/protecting-kids-first-a-s_b_991354.html

Reactive Attachment Disorder: For Educators

The following is a handout that a colleague produced for Educators. You may find this valuable.

A few references that may also be helpful:

Becker-Weidman, A., 2010, Dyadic Developmental Psychotherapy: Essential Practices & Methods, Lanham, MD: Jason Aronson.
Becker-Weidman, A., & Shell, D., 2010, Attachment Parenting, Lanham, MD: Jason Aronson.
Becker-Weidman, A., & Shell, D., 3rd printing, 2011: Creating Capacity for Attachment.
Becker-Weidman, A., 2006, Principles of Attachment Parenting, DVD, order from Amazon.com


FACT SHEET FOR EDUCATORS
by
Connie Hornyak, LCSW
chlcsw@pacbell.net

Children with disorders of attachment are the victims of abuse, neglect, abandonment, physical illness, multiple placements and/or in-utero drug/alcohol exposure. Their problems are rooted in the first five years of their lives, when trauma occurred. Stable attachments cannot be formed when a child experiences frequent changes in daycare or foster care, or when the child’s social, emotional, physical, and cognitive needs are unmet.

While many children with disorders of attachment have grown up in foster care and/or adoptive homes, these disorders occur in children who are growing up with their biological parents as well. It is estimated that one-third of elementary school children in the United States have some form of an attachment issue, if not the full blown disorder, due to divorce, inappropriate daycare programs, and multiple caregivers. Children who have experienced medical events such as hospitalization, placement in an incubator or a body cast can also develop these disorders.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, published by the American Psychiatric Association, there are two types of Reactive Attachment Disorder. In the Inhibited Type the child persistently fails to initiate and to respond to most social interactions in a developmentally appropriate way. The child shows a pattern of excessively inhibited, hyper vigilant or highly ambivalent responses (for example, frozen watchfulness, resistance to comfort, or mixture of approach and avoidance). In the Disinhibited Type, there is a pattern of diffused attachments. The child exhibits indiscriminate sociability or a lack of selectivity in the choice of attachment figures. For example, the child may be extremely charming and friendly with those who are not trying to be his or her parents, while acting violently toward parents who are attempting to become emotionally close to the child.

What is a Disorder of Attachment?

A person with a disorder of attachment has difficulty forming loving, lasting, intimate relationships. These individuals are unable to be genuinely affectionate with others, have not experienced conscience development, and cannot trust others. Attachment is necessary for the development of an emotionally healthy person who has conscience development, experiences empathy, attains full intellectual potential, thinks logically, copes with stress and frustration, becomes self reliant, develops healthy personal and business relationships, and handles the ups and downs of everyday life. Attachment Disorder is Helen Keller.



Children with disorders of attachment do not respect authority, especially that of their parents. They are sometimes oppositional and defiant in the school setting, although many of these children behave perfectly with those who are not parenting them. It is not uncommon for a child with a disorder of attachment to be a good student as well as the most helpful child in the class. The same child may go home and threaten his mother with a knife, set fires, and/or kill animals. Children with attachment disorder have been so damaged that they cannot trust. Their behavior meets their subconscious need to keep those who love them most at a distance. They are fearful that, if they become emotionally close to their parents, they will somehow be hurt again as they were in the past. These children are terrified of closeness, and will do anything they can to create distance between themselves and their parents. One way this is manifested is in children’s ability to triangulate; that is, to pit one adult against the other. Children with disorders of attachment frequently lie to their teachers, accusing their parents of emotional abuse, physical abuse or neglect, and lie so convincingly that their teachers believe them. Many parents have been erroneously reported for suspected child abuse when school personnel have listened to the child without checking the facts with the parent.

What’s a teacher to do?

• Develop and maintain constant communication with the child’s parents. This will greatly increase the chance of all adults being consistent in the child’s life at home and at school. Be sure to check with parents if you suspect that the child’s story could be untrue. Ask parents to do the same for you. For example, if the child comes home and says that his teacher hit him, yelled at him or otherwise behaved inappropriately, please ask the parents to check out the child’s story with you before acting upon it.
• Children with attachment disorders need a tight, loving, structured environment where the rules never change but the consequences often do.
• These children need a tightly structured environment in order to feel safe. They do not need an overly permissive environment which makes them feel unsafe. Please respect the need of the parents to be the primary attachment figures in this child’s life. While many teachers, especially in younger grades, tend to hug children and openly display affection for them, this type of treatment is inappropriate for a child with a disorder of attachment. If this type of treatment is given in the school setting, the child will simply triangulate, manipulating the teacher into thinking that he or she is an important attachment figure in a child’s life, and using the teacher’s affection to manipulate the parents at home.
• Follow through on any and all consequences. The child’s safety and that of others depends on it.
• Hold the child responsible for his or her actions. Understand that, until the child’s behavior becomes more positive, he or she will have an extremely depressing life. Even though the child has problems and may have a painful past, it is important to hold the child responsible for his or her actions and not excuse those actions because of the child’s previous trauma.
• Remember that these children are superficially charming with strangers and others who are not their parents. These children lack the ability to have true closeness with their parents and other family members.
• Please understand that if this child criticizes his parents and asks to go home with you, this is a means of distancing from closeness with the parents. The child is fearful of closeness with parents because previous parents have left the child or traumatized him/her.
• Children with disorders of attachment need to regress and experience being infants and toddlers, as well as young children, before they can behave in an age-appropriate fashion. Please realize that there are days when the child may need to stay home from school in order to receive therapy, or because the child simply needs to be close to his or her parents. Once attachment issues are resolved, the child will have plenty of energy to make up for lost time at school.







For more information about disorders of attachment, please access the following web sites: www.icfd.net and www.attach.org.










4/26/11

Fathers matter!

Most psychological research into parenting concentrates on the role of mothers but having a good relationship with one's father can also help people to cope better in later life. Researchers from California State University, Fullerton studied 912 people between the ages of 25 and 74. Over eight days they interviewed the participants about that day's experiences asking them about their mental state and any stressful events. The participants were also asked about the quality of their childhood relationships with their parents. The study found that more people were likely to say their childhood relationship was better with their mother than with their father; a difference that was more pronounced among men. People who had had a good relationship with their mother reported 3% less psychological distress compared to those who reported a poor relationship. Men who had had a good relationship with their father also reported less psychological distress but this effect was not as strong among women.

Researchers spoke to more than 900 men and women aged from 25 to 74 before reaching their conclusion.

Psychology Professor Melanie Mallers, of California State University-Fullerton, who led the research team, said: "Most studies on parenting focus on the relationship with the mother.
"But, as our study shows, fathers do play a unique and important role in the mental health of their children much later in life."

As part of the study, 912 adult men and women completed short daily telephone interviews about that day's experiences over an eight-day period.

The interviews focused on the participants' psychological and emotional distress - such as whether they were depressed, nervous, or sad - and if they had experienced any stressful events that day. These events were described as arguments, disagreements, work-related and family-related tensions and discrimination.

The participants also reported on the quality of their childhood relationships with their mother and father. For example, they answered questions such as: "How would you rate your relationship with your mother during the years when you were growing up?" and "How much time and attention did your mother give you when you needed it?"

The same questions were asked about fathers. The research took into account age, childhood and current family income, neuroticism and whether or not their parents were still alive.

Prof Mallers and her team found participants were more likely to say their childhood relationship with their mother was better than with their father, with more men reporting a better mother-child relationship than women.

People who reported they had a good mother-child relationship reported three per cent less psychological distress compared to those who reported a poor relationship.

Prof Mallers said: "I don't think these results are surprising, given that past research has shown mothers are often the primary care-giver and often the primary source of comfort.

"It got interesting when we examined the participants' relationship with their fathers and their daily emotional reaction to stress."

They also found that men who reported having a good relationship with their father during childhood were more likely to be less emotional when reacting to stressful events in their current daily lives than those who had a poor relationship. This was not found to be as common for the women in the study.

And Prof Mallers said the quality of mother and father relationships was significantly associated with how many stressful events the participants confronted on a daily basis. In other words, if they had a poor childhood relationship with both parents, they reported more stressful incidents over the eight-day study when compared to those who had a good relationship with their parents.

Prof Mallers said: "Perhaps having attentive and caring parents equips children with the experiences and skills necessary to more successfully navigate their relationships with other people throughout childhood and into adulthood."

She said it was difficult to come up with a concrete theory as to why men's relationship with their father had such an influence on their emotional reaction to stress, especially since this study included adults of all ages who were raised during very different eras in the United States.

Prof Mallers added: "The role of fathers has changed dramatically from the time the oldest participants were children.

"We do know that fathers have a unique style of interacting with their children, especially their sons.

"We need more research to help us uncover further influences of both mothers and fathers on the enduring emotional experiences of their children."

Prof Mallers presented the findings at the 118th Annual Convention of the American Psychological Association in San Diego.

New book for parents

Attachment Parenting, a new book edited by Arthur Becker-Weidman, Ph.D., & Deborah Shell, will be out in May of this year. Many of the chapters are written by myself and Deb. In addition, there are a number of chapters by various experts in the fields of Theraplay, Sensory-Integration, and Neuropsychology. The book is for parents and professionals and provides a home-based approach for parents to use to help children with complex trauma and disorders of attachment. The book is grounded in Dyadic Developmental Psychotherapy, which is an evidence-based, effective, and empirically validated treatment.

John Rosemond got it wrong

In a Baltimore Sun article, Sept 2nd 09, John Rosemond, wrote an article that is inaccurate regarding the factors sometimes associated with adoption. He claims that "Attachment Disorder lacks scientific proof," and goes on to state, "The facts: A consistent body of hard, objectively gathered scientific evidence to the effect that adopted children are more prone to psychological problems than children who live with one or two biological parents is lacking." The article goes on to criticize "adoption specialists," and describes the "case" of a three-year old to bolster his point. I find that the article is simplistic and distorted.

Mr. Rosemond has little or no training on the subject about which he is writing here. Mr. Rosemont is a "Psychological Associate," holding a MS. His background does not qualify him to offer expert advice on this particular topic.

Mr. Rosemond's statement is just wrong. Many children adopted through the child welfare system and internationally have suffered years of maltreatment (abuse and/or neglect). As you know, in the US and most countries, it is very difficult to remove a child from the parents and even more difficult to terminate parental rights. Things have to be pretty gruesome to have a parent's rights terminated and the child placed for adoption. So, the facts are: There is a consistent body of hard, objectively gathered scientific evidence to the effect that adopted children are more prone to psychological problems than children raised from birth. For example, Approximately 2% of the population is adopted, and between 50% and 80% of such children have attachment disorder symptoms (Carlson, Cicchetti, Barnett, & Braunwald, 1995; Cicchetti, Cummings, Greenberg, & Marvin, 1990).Children who have experienced chronic maltreatment and resulting complex trauma are at significant risk for a variety of other behavioural, neuropsychological, cognitive, emotional, interpersonal and psychobiological disorders (Cook et al. 2005; van der Kolk 2005). Many children with histories of maltreatment are violent (Robins 1978) and aggressive (Prino & Peyrot 1994) and as adults are at risk of developing
a variety of psychological problems (Schreiber & Lyddon 1998) and personality disorders, including antisocial personality disorder (Finzi et al. 2000), narcissistic personality disorder, borderline personality disorder and psychopathic personality disorder (Dozier et al. 1999). Neglected children are at risk of social withdrawal, social rejection and pervasive feelings
of incompetence (Finzi et al. 2000). Children who have histories of abuse and neglect are at significant risk of developing PostTraumatic Stress Disorder as adults (Andrews et al. 2000; Allan 2001). Children who have been sexually abused are at significant risk of developing anxiety disorders (2.0 times the average), major depressive disorders (3.4 times average), alcohol abuse (2.5 times average), drug abuse (3.8 times average) and antisocial behaviour (4.3 times average) (MacMillian 2001). The effective treatment of such children is a public health concern (Walker et al. 1992).


Mr. Rosemont goes on to state, " On the other hand, there is significant evidence to the effect that even orphaned children exposed during their early, supposedly "formative" years to severe conditions of emotional deprivation and material neglect recover quite nicely when adopted by loving parents." This statement does have an element of truth to it. One element of helping children who have experienced chronic early maltreatment within a caregiving relationship is loving parents. But there are other elements necessary to address and resolve the underlying traumas that may be continuing to distort the child's relationships and psychological functioning.

New Book

The book I co-edited with a colleague, Attachment Parenting: Developing Connections
and Healing Children, will be published in early 2010. The book has a number of chapters on topics such as sensory-integration, activities for parents, theory, use of media and other subjects that parents and therapists will find useful.


The pervasive effects of maltreatment on child development can be repaired when parents use effective, empirically validated, and evidence-based methods. This book describes a comprehensive approach to parenting that discusses a variety of issues including attachment, trauma, neuro-psychological impairments, sensory-integration, and treatment approaches as well as the use of media, play, and narratives to create connections. Professors teaching family-therapy, child-welfare, and child-treatment courses will find the book a good adjunct text.

People who live or work with children who have histories of maltreatment or institutional care, complex trauma, or disorders of attachment. Parents, psychologists, social workers, mental health professionals, child welfare staff, residential treatment program staff, and educators will find this book of value. In addition, those who teach classes in child welfare, family therapy, and the treatment of children will find the book to be a useful adjunctive text.



This book describes a comprehensive approach to parenting children. Grounded in attachment theory, this book will give parents, therapists, educators, and child welfare and residential treatment professionals the tools and skills necessary to help children who have a history of neglect, abuse, orphanage care, or other experiences that may interfere with the normal development of attachment between parent and child. The approach is rooted in Dyadic Developmental Psychotherapy, which is an evidence-based, effective, and empirically validated treatment for complex trauma and disorders of attachment.

The book provides practical and immediately usable approaches and methods to help children develop a healthier and more secure attachment. The book covers a wide range of topics. The first few chapters will appeal to professionals who work with parents. These chapters describe the basic principles of this approach. The book then moves on to discuss how to select a therapist and who to expect from a comprehensive evaluation. The chapter on logistics will be particularly valuable for parents and residential treatment staff. This chapter provides detailed suggestions for everything from how to organize the child's room, schools concerns, and problem solving. The chapters on sensory-integration, art therapy for parents, narratives, and Theraplay give parents specific therapeutic activities that can be done at home to improve the quality of the child's attachment with the parent. Other chapters on neuropsychological issues, mindfulness, and parent's use of self will help parents directly. The two chapters by parents on their story and what worked for them provide inspiration to parents and demonstrate that there is hope. Finally, the book ends with a comprehensive chapter on resources for parents and a summary of various professional standards regarding attachment, treatment, and parenting.

Overall, this comprehensive book covers a broad range of topics that are of concern to parents who raise and others who work with children with difficult histories, trauma, and disorders of attachment.

Therapeutic Parent Manual

The new Parent Manual, put out by the Association for the Treatment and Training in the Attachment of Children, is a wonderful resource for parents. It has a wealth of information and practical suggestions.

It covers many issues that children with Complex Trauma and disorders of attachment face.

copies can be ordered on Amazon.com or at www.attach.org

Orphan: boycott

The bad press this movie is getting is heating up as more and more adoption groups and outraged parents voice their objections to this movie.

I encourage people to contact Warner Brothers. More to the point, I encourage you to contact your local theater and request that they do not screen the movie. Getting many people to contact the theater and to state that you will not attend that theater as long as that movie is showing may get them to not screen the film.

Editorials in the local paper would also help.

Therapeuctic Crisis Intervention

I found this article quite interesting and valuable:

Josh Lechter, assistant director of child care for the Community-Based Acute Treatment program at Walker, has written a paper featured in the most recent issue of Refocus, the Residential Child Care Project newsletter published by Cornell University.tci


His paper, Using TCI’s Family Care Provider Training To Break Down Language Barriers Between Residential Treatment and Life at Home, discusses the success of a new initiative at Walker to share therapeutic crisis intervention training and techniques with the families of Walker students.

Therapeutic Crisis Intervention For Family Care Providers (TCIF) is a curriculum-based class adapted from the same crisis prevention and behavior management skills taught to The Walker School staff. Developed by the The Family Life Development Center at Cornell University, the 5-day course involves modeling and role playing to familiarize family members with strategies and techniques for deescalating problems and emotionally volatile situations with their children at home. According to the developers at Cornell, Walker is the first organization to offer TCIF training to the families of children with serious emotional and behavior issues.

Judging from the enthusiastic response of participating families, the availability of this specialized training for parents and caregivers will help to improve the likelihood of a child’s successful transition from residential treatment to home and community. In the paper, Lechter recounts the comments of several grateful parents, including one who said, “the course was a blessing. I now do not feel alone in helping my children with their mental health needs.”
See this article for more details

http://www.walkerschool.org/upload/REFOCUS_VOL_14.pdf

Learning Disabilities Explained

Noah felt like he was always hitting the books. While his friends were meeting for pickup soccer games after school, he was back home in his room reading and rereading the same material. But no matter how hard Noah studied, he had difficulty remembering things and his grades stayed average. Meanwhile, his friend Sean, who never seemed to study, always aced tests. It didn't seem fair.

Because Noah was so frustrated, his dad and teachers made an appointment with the school psychologist. She diagnosed Noah with a learning disability. Although Noah felt relieved to know what was going on, he was also worried. He didn't like the "disability" label. And he was concerned about what it might mean for his future. Would he be able to go to college and study engineering as he'd hoped?

What Are Learning Disabilities?

For someone diagnosed with a learning disability, it can seem scary at first. But a learning disability doesn't have anything to do with a person's intelligence - after all, such successful people as Walt Disney, Alexander Graham Bell, and Winston Churchill all had learning disabilities.

Learning disabilities are problems that affect the brain's ability to receive, process, analyze, or store information. These problems can make it difficult for a student to learn as quickly as someone who isn't affected by learning disabilities. There are many kinds of learning disabilities. Most students affected by learning disabilities have more than one kind. Certain kinds of learning disabilities can interfere with a person's ability to concentrate or focus and can cause someone's mind to wander too much. Other learning disabilities can make it difficult for a student to read, write, spell, or solve math problems.

The way our brains process information is extremely complex - it's no wonder things can get messed up sometimes. Take the simple act of looking at a picture, for example: Our brains not only have to form the lines into an image, they also have to recognize what the image stands for, relate that image to other facts stored in our memories, and then store this new information. It's the same thing with speech - we have to recognize the words, interpret the meaning, and figure out the significance of the statement to us. Many of these activities take place in separate parts of the brain, and it's up to our minds to link them all together.

If, like Noah, you've been diagnosed with a learning disability, you're not alone. Nearly four million school-age children and teens have learning disabilities, and at least 20% of them have a type of disorder that makes it difficult to focus.

What Are the Signs of Learning Disabilities?

You can't tell by looking that a person has a learning disability, which can make learning disabilities hard to diagnose. Learning disabilities typically first show up when a person has difficulty speaking, reading, writing, figuring out a math problem, communicating with a parent, or paying attention in class. Some kids' learning disabilities are diagnosed in grade school when a parent or a teacher notices a kid can't follow directions for a game or is struggling to do work he or she should be able to do easily. But other kids develop sophisticated ways of covering up their learning issues, so learning disabilities don't show up until the teen years when schoolwork - and life - gets more complicated.

Most learning disabilities fall into one of two categories: verbal and nonverbal.

People with verbal learning disabilities have difficulty with words, both spoken and written. The most common and best-known verbal learning disability is dyslexia, which causes people to have trouble recognizing or processing letters and the sounds associated with them. For this reason, people with dyslexia have trouble with reading and writing tasks or assignments.

Some people with verbal learning disabilities may be able to read or write just fine but they have trouble with other aspects of language. For example, they may be able to sound out a sentence or paragraph perfectly, making them good readers, but they can't relate to the words in ways that will allow them to make sense of what they're reading (such as forming a picture of a thing or situation). And some people have trouble with the act of writing as their brains struggle to control the many things that go into it - from moving their hand to form letter shapes to remembering the correct grammar rules involved in writing down a sentence.

People with nonverbal learning disabilities may have difficulty processing what they see. They may have trouble making sense of visual details like numbers on a blackboard. Someone with a nonverbal learning disability may confuse the plus sign with the sign for division, for example. Some abstract concepts like fractions may be difficult to master for people with nonverbal learning disabilities.

A behavioral condition called attention deficit hyperactivity disorder (ADHD) is often associated with learning disabilities because people with ADHD may also have a hard time focusing enough to learn and study. Students with ADHD are often easily distracted and have trouble concentrating. They may also be excessively active or have trouble controlling their impulses.

What Causes Them?

No one's exactly sure what causes learning disabilities. But researchers do have some theories as to why they develop. They include:

• Genetic influences. Experts have noticed that learning disabilities tend to run in families and they think that heredity may play a role. However, researchers are still debating whether learning disabilities are, in fact, genetic, or if they show up in families because kids learn and model what their parents do.
• Brain development. Some experts think that learning disabilities can be traced to brain development, both before and after birth. For this reason, problems such as low birth weight, lack of oxygen, or premature birth may have something to do with learning disabilities. Young children who receive head injuries may also be at risk of developing learning disabilities.
• Environmental impacts. Infants and young children are susceptible to environmental toxins (poisons). For example, you may have heard how lead (which may be found in some old homes in the form of lead paint or lead water pipes) is sometimes thought to contribute to learning disabilities. Poor nutrition early in life may also lead to learning disabilities later in life.

How Do You Know If You Have a Learning Disability?

Just because you have trouble studying for a test doesn't mean you have a learning disability. There are as many learning styles as there are individuals. For example, some people learn by doing and practicing, others learn by listening (such as in class), and others prefer to read material. Some people are just naturally slower readers or learners than others, but they still perform well for their age and abilities. Sometimes, what seems to be a learning disability is simply a delay in development; the person will eventually catch up with - and perhaps even surpass - his or her peers.

But many people with learning disabilities struggle for a long time before someone realizes that there's a reason they're having so much trouble learning. For most people in their teen years, the first telltale sign of most learning disabilities occurs when they notice that there's a disconnect between how much they studied for a test and how well they performed. Or it may just be a feeling a person has that something isn't right. If you're worried, don't hesitate to share your thoughts with a parent or a teacher.

The first step in diagnosing a learning disability is ruling out vision or hearing problems. A person may then work with a psychologist or learning specialist who will use specific tests to help diagnose the disability. Often, these can help pinpoint that person's learning strengths and weaknesses in addition to revealing a particular learning disability.

Coping With a Learning Disability

Although a diagnosis of a learning disability can feel upsetting, it's actually the first step in resolving the condition. Once an expert has pinpointed a person's particular problem, he or she can then follow strategies or take medicines to help cope with the disability. And taking steps to manage the disability can often help restore a student's self-esteem and confidence.

Some students who have been diagnosed with a learning disability work with a special teacher or tutor for a few hours a week to learn special study skills, note-taking strategies, or organizational techniques that can help them compensate for their learning disability. If you've been diagnosed with a learning disability, you may need support just for the subjects that give you the most trouble. Your school may have a special classroom with a teacher who is trained to help students overcome learning problems.

Some schools develop what is called an Individualized Education Program (or IEP), which helps define a person's learning strengths and weaknesses and make a plan for the learning activities that will help the student do his or her best in school. A student's IEP might include some regular time with a tutor or in a specialized classroom for a certain subject, or the use of some special equipment to help with learning, such as books on tape or laptop computers for students who have dyslexia.

Medication is often prescribed to help students with ADHD. There are several medicines on the market today to help improve a student's attention span and ability to focus and to help control impulses and other hyperactive behavior.

There's no cure for a learning disability. And you don't outgrow it. But it's never too late to get help. Most people with learning disabilities learn to adapt to their learning differences, and they learn strategies that help them accomplish their goals and dreams.

Reviewed by: D'Arcy Lyness, PhD

http://kidshealth.org/teen/diseases_conditions/learning/learning_disabilities.html?tracking=T_RelatedArticle

Schools

This is a review of two excellent books for educators, parents, social workers, psychologists, and therapists.

The first book, Attachment in the Classroom by Heather Geddes, (2006), London: Worth Publishing, is a superior resource and should be on your book shelf. The subtitle says it all, “The links between children’s early experience, emotional well-being and performance in schools.” In this book, Dr. Geddes uses the research categories of patterns of attachment (secure, avoidant, ambivalent, and disorganized) to describe how each pattern affects a child’s ability to function in the classroom, use the teacher, and approach the task at hand. She offers extensive examples from the classroom and provides specific suggestions for educators to use for each pattern of attachment. The book should be of general utility to many teachers, not just special education teachers or those who work with children with Reactive Attachment Disorder. This is the real beauty of the book: its general utility as an approach to pedagogy.

Dr. Geddes begins by describing “The Learning Triangle,” which is the relationships among teacher, pupil, and task. Her chapter, “Behavior has meaning,” is a wonderful description of how and why it is vital to focus on the cause, motivation, or driver of behavior and not merely the surface behavior. Dr. Geddes chapter, “Outline of Attachment Theory,” is a good refresher for those who know Attachment Theory and an excellent introduction for those new to it. Her next several chapters on avoidant attachment, ambivalent attachment, and disorganized attachment in the classroom are wonder. Her use of examples, explanations of behavior, and then the provision of specific suggestions and recommendations for teachers will be very helpful for parents, educators, and those who work with educators. She presents clear recommendations that are soundly connected to each attachment style’s pattern of relating. I have been able to use this material in my work with schools with great success. Dr. Geddes as an educator herself provides enormous credibility for this work with school personnel.

I found this book to be very readable and wonderfully informative. I can, without reservation, recommend it to parents, therapists, and educators.

The second book want to recommend to you is, “Learn the Child,” by Kate Cairns and Chris Stanway, (2007), London: British Association for Adoption and Fostering. This book will be of interest primarily to educators and those who train educators. The book begins with an overview of the issues presented by “looked after children,” (British for children in care) and is primarily about UK laws and their evolution and impact on education. However, there are several very detailed case-studies of children in care and how they functioned in educational settings. These case examples will be familiar with anyone who works in our field and highlight the impact on educational processes of chronic early maltreatment. The bulk of the book is a set of forty-eight PowerPoint slides with detailed explanations of each slide. This is the part of the book I found most useful. While the material may be familiar to many of us, it is presented in a format that is easy to understand and that will be very helpful for educators and educational administrators and policy makers. I can envision using this material in presentations to school personal, special education staff, the education staff at residential treatment centers, and policy makers and administrators. The book comes with the PowerPoint slides on a CD for easy of use. Also included in the CD are the case examples, handouts, and other useful material.

While the book is narrow in focus, it should be on the book shelf of anyone who regularly provides training for educators, administrators, and policy makers. The book is expensive, 33.75 pounds, including shipping, but I think it is worth it.

Continued Schooling for Violent Students is Required

I read this and think it is an important article

IDEA DISCIPLINE RULES ENSURE CONTINUED SCHOOLING FOR VIOLENT STUDENTS
Sunday, April 19, 2009

WASHINGTON -- Schools can no longer drop educational services for special education students while they are suspended from school for violent incidents, under new regulations approved this spring for the 1997 Individuals with Disabilities Education Act. This may become a difficult issue for schools that do not have the resources to continue educating a student in an "alternative setting," as prescribed by the law, American Institutes of Research Senior Research Scientist Mary Magee Quinn says.

Outlining the new rules during the American Federation of Teachers' QuEST '99 Conference, Quinn noted the rules require a school district to continue educating a suspended student in an alternative setting if the suspension lasts longer than 10 days. The students must get all services required for them to continue progressing under their individualized education plans, and any therapies prescribed in the IEP must also be provided as scheduled, the rules state.

The continuation of services rule, as well as several other complexities in the new regulations, helped draw dozens of teachers and other faculty members to hear Quinn speak at the four-day teachers' conference. As deputy director of the Center for Effective Collaboration and Practice, Quinn and her staff have studied the new regulations and consulted with government officials and attorneys to clarify the new rules and help school districts implement the changes. The center also offers extensive information about IDEA '97 and other special education issues on its Internet site: www.air-dc.org/cecp/.

Defining the Problem

Among other confusing issues: determining whether the student's conduct is a manifestation of his or her disability and whether the conduct is part of a larger pattern. For the purposes of determining how a school district can discipline special ed. students who exhibit violent behavior, those questions can determine whether the student is treated like a mainstream student or one who is not accountable for his or her actions. For example, if the student's action is deemed not a manifestation of his or her disability, the student can be suspended for as long as school policy says a general ed. student would be suspended. The difference, however, is the special ed. student must receive educational services after the first 10 days of the suspension.

If the student frequently or repeatedly breaks rules, even if they seem like different rules and separate incidents, the student may be exhibiting a pattern of behavior that calls for a change in his or her IEP, Quinn noted. One red flag that could indicate such a pattern is the repeated suspension of the student. While special ed. students may be repeatedly suspended for up to 10 days at a time for various rule violations, they must be reevaluated if those suspensions constitute a pattern of behavior.

Getting to the Root of the Problem

If a special ed. student is removed for more than 10 cumulative days from school, a functional behavioral assessment must be conducted, according to the law. However, IDEA does not specify what the assessment should be, Quinn said. CECP offers what it calls "best practices" or guidelines to reevaluating students. Quinn also argued IEP teams should take the assessments seriously rather than consider it another mandatory set of forms to fill out to keep a child in school. "If you have to do a functional assessment, you might as well do it to the point where you are actually going to get information you can use from it," she told the teachers. "It's a long process, but it does yield very good information that will make your lives as teachers infinitely easier."
In addition to continuing services for suspended special ed. students and reassessing whether their IEPs are appropriate and effective, Quinn said the law requires IEP teams to add a behavioral intervention plan to students' IEPs if they do not already have them. Before IDEA '97, only 8 percent of students with behavioral problems had such intervention plans in place, she said. The intervention plan should be based on conclusions the IEP team draws from the functional behavioral assessment, Quinn said, and should incorporate other people and settings in the child's life besides school. For example, she said, families, peer support programs, speech and language therapists and community agencies, such as religious or community programs, can all reinforce the positive behaviors the IEP team is trying to teach a child.8

A few articles that may be of interest to professionals and parents

Amminger GP, Berger GE, Schäfer MR. Omega-3 fatty acids supplementation in children with autism: A double-blind randomized, placebo controlled pilot study. Biol Psychiatry 2007; 61(4):551-553.

Researchers found that treatment with Omega-3 fatty acids was superior to placebo in controlling symptoms autism and associated symptoms including hyperactivity and stereotypy. Amminger and colleagues conducted a double-blind, randomized, placebo-controlled pilot study. The primary outcome measure was a change in scores from baseline to week 6 on the Aberrant Behavior Checklist (ABC).

Cicchetti, D. (2001). The impact of child maltreatment and psychopathology on neuroednocrine functioning. Development and Psychopathology 13, 783-804.

The findings of this study concluded that maltreated children with reported clinical-level internalizing problems have higher cortisol levels compared to non-maltreated boys who had lower levels of cortisol. The findings conclude that maltreatment and different forms of psychopathology have an effect on neuroendocrine regulation.

Chisholm, K. (1998). A Three year follow-up of attachment and indiscriminate friendliness in children adopted from Romanian orphanages. Child Development, 69 (4), 1092-1106.

This research article examines attachment and indiscriminately friendly behavior in children who spent at least 8 months in a Romanian orphanage (RO). The findings of this research indicate that RO children displayed significantly more insecure attachment behaviors in comparison to the control groups. These children had significantly more indiscriminately friendly behavior, behavior problems, and parents reported more parenting stress.

Delahanty, D., Nugent N., Christopher, N., Waltsh, M. (2005). Initial urinary epinephrine and cortisol levels predict acute PTSD symptoms in child trauma victims. Psychoneuroendocrinology, 121 (2).

Results of this study indicated that elevated initial cortisol and epinephrine levels immediately following a traumatic event continued to predict the development of acute PTSD symptoms; particularly in boys.

Forbes, H., Dziegielewski, S. (2003) “Issues facing adoptive mothers of children with special needs.” Journal of Social Work, 3 (3): 301-320.

The purpose of this article is to identify and understand the challenges that mothers face after they adopt special needs children. The study examines adoptive mothers who sought therapeutic assistance after the placement of their child and the difficulties they endured.


Ghuman J. K., (2007). Comorbidity moderates response to methylphenidate in the preschoolers with attention deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology, 17 (5), 563-580.

According to a recent analysis of data from the Preschoolers with ADHD Treatment Study (PATS), funded by the National Institutes of Health’s National Institute of Mental Health (NIMH), preschoolers who are diagnosed with ADHD and who also have three or more coexisting disorders, are not likely to respond to treatment with the stimulant methylphenidate, regardless of dosage,

Goodman, W.K., Murphy, T.K, Storch, E.A. (2007). Risk of adverse behavioral effects with pediatric use of antidepressants. Psychopharmacology, 191 (1), 87-96.

This article reviews the Food and Drug Administration’s (FDA) decision to issue a “black box” warning about the risks associated with children and adolescents during the treatment of antidepressants.

Gunnar, M. (2001). Effects of early deprivation. Findings from orphanage-reared infants and children. In C. Nelson and M. Luciana (Eds.) Handbook of developmental cognitive neuroscience (617-629).

The focus of this article is to discuss and review the research concerning physical, cognitive, and emotional development of children adopted from Romanian orphanages over the last 15 years. The trends of early deprivation and possible outcomes are also evaluated.

Gunnar, M. & Cheatham, C. (2003). “ Brain and behavior interface: stress and the developing brain.” Infant Mental Health Journal, 24 (3), 195-211.

Research on infants and children who have been maltreated early in life is reviewed to show stress hormone activity. The researchers focus on enhancing care later in development and the possible reversal of the effects on behavior and neurobiology of early experiences. The authors review literature in the field and conclude that the longer the child is neglected the higher degree of developmental delays occur. Studies on the neuroendocrin systems show the effects on the HPA system and CORT systems in response these stressors.

Hughes, J.W., Watkins, L., Blumenthal, J.A., Kuhn, C., Sherwood, A. (2004). Depression and anxiety symptoms are related to increased 24-hour urinary norepinephrine excretion among healthy middle-aged women. Journal of Psychosomatic Research, 57; 353-358.

The objective of this study was to evaluate the relationship between levels of self-reported symptoms of depression and anxiety and 24-hour urinary catecholamine excretion. Norepinephrine, epinephrine and cortisol are examined.

Levy, F., Swanson, J. M. (2001). Timing space and ADHD: the dopamine theory revisited. Australian and > New Zealand Journal of Psychiatry, 35, 504-511.

The objective of this study was to review the dopamine theory of Attention Deficit Hyperactivity Disorder (ADHD) in terms of the advances made in research over the past decade. Serotonergic agents were found to have a calming affect on psycho-stimulants in which the dopamine transporter (DAT) gene was disrupted.

Moms who dine on fish could boost baby’s brain (2007). Pharmacy Times, 82.

This article comments on research from the US National Institutes of Health (NIH), which found that women who eat seafood during pregnancy may increase brainpower of their children. The authors list fish oil supplements as an alternative, and found that women who took these supplements during pregnancy had children with better developmental skills.

Oades, R.D. (2005). The control of repsonsiveness in ADHD by catecholamines: evidence for dopaminergic, noradrenergic and interactive roles. Developmental Science, 8 (2), 122-131.

The neurological base of Attention Deficit Hyperactivity Disorder (ADHD) from a neurochemistry and psychopharmacology standpoint, as well as the catecholamine based behavioral systems, are evaluated by Oades and colleagues. Dopamine and noradrenalin neurotransmission to the motor and cognitive symptoms of ADHD were studied.

Purvis, K.B., Cross, D.R., & Kellerman, G. (2006). “An experimental evaluation of targeted amino acid therapy with at-risk children. Journal of Alternative and Complementary Medicine, 12 (6), 591-592.

This article explains the connection that neurotransmitter levels and ratios have on the behavior of at-risk youth. This comprehensive study found that targeted amino acid therapy, in conjunction with scheduled feedings and behavioral interventions, regulated the brain chemistry in children adopted from Russian orphanages.

Watts-English, T., Fortson, B., Gibler, N., Hooper, S. De Bellis, M. (2006).“ The psychobiology of maltreatment in childhood.” Journal of Social Issues, 62 (4) 717-736.

Authors of this article review empirical findings of neuropsychological functioning in children with Post Traumatic Stress Disorder (PTSD). Serotonin deregulation, cortisol, the limbic system and neuro-imaging techniques are evaluated in regards to brain development.

Weidman-Becker, A. (n.d.). Child Abuse and neglect: effects on child development, brain development, and interpersonal relationships. International Adoption Article Directory. Retrieved October 17, 2007 from http://www.adoptionarticlesdirectory.com/article.php?id=42&act=print

This article is intended for parents and individuals in the mental health field. It clearly defines the correlation between neglect and abuse early in life and the long lasting effects it has on brain development.

Weidman-Becker, A. (n.d.). Recognizing attachment concerns in children. International Adoption Article Directory. Retrieved October 17, 2007 from http://www.adoptionarticlesdirectory.com/article.php?id=45&act=print

The focus of this article is to provide the audience with background information on attachment, how attachment disorders develop, and why healthy brain chemistry is reflective of healthy attachment in the first two years of life. The author describes what attachment disorders look like in all developmental stages of childhood.

Yehuda, R., Southwick, S., Giller, E.L., Ma, X., Mason, J.W., (1992). Urinary catecholamine excreation and severtiy of PTSD symptoms in Vietnam combat veterans. Journal of Nerv. Mental Disorders, 180 (5), 321-325.

This study found that urinary dopamine and norepinephrine levels were significantly correlated with the severity of PTSD symptoms. The researchers concluded that these findings supported the theory that enhanced sympathetic nervous system (SNS) activation plays a major role in PTSD and that increased SNS arousal may be closely linked to the severity of certain PTSD clusters.

Attachment Facilitating Parenting

Attachment Facilitating Parenting
Arthur Becker-Weidman, Ph.D.
Center For Family Development

Many adopted and foster children have had very difficult and painful histories with their first parents. These children have experienced chronic early maltreatment within a caregiving relationship. Such a history can lead to the development of Complex Trauma (Cook et. al., 2003; Cook et. al., 2005), disorders of attachment, and Reactive Attachment Disorder. Children with histories of maltreatment, such as physical and psychological neglect, physical abuse, and sexual abuse, are at risk of developing severe psychiatric problems (Gauthier, Stollak, Messe, & Arnoff, 1996; Malinosky-Rummell & Hansen, 1993). These children are likely to develop Reactive Attachment Disorder (Greenberg, 1999; Lyons-Ruth & Jacobvitz, 1999). Approximately 2% of the population is adopted, and between 50% and 80% of such children have attachment disorder symptoms (Carlson, Cicchetti, Barnett, & Braunwald, 1995; Cicchetti, Cummings, Greenberg, & Marvin, 1990). Many of these children are violent (Robins, 1978) and aggressive (Prino & Peyrot, 1994) and as adults are at risk of developing a variety of psychological problems (Schreiber & Lyddon, 1998) and personality disorders, including antisocial personality disorder (Finzi, Cohen, Sapir, & Weizman, 2000), narcissistic personality disorder, borderline personality disorder, and psychopathic personality disorder (Dozier, Stovall, & Albus, 1999). Therapeutic Parenting is often necessary to help these children heal (Becker-Weidman, A., & Shell, D., 2005/2008). This approach to parenting is often not familiar to most parents and requires a significant amount of work and preparation. Attachment facilitating parenting is grounded in attachment theory and is based on a set of principles that include:

• Sensitivity
• Responsiveness
• Following the child’s lead
• The sharing of congruent intersubjective experiences
• Creating a sense of safety and security

The effective implementation of these principles requires parents who:
• Are strongly committed to the child.
• Have well developed reflective abilities
• Have good insightfulness
• Have a relatively secure state of mind with respect to attachment

This type of parenting is consistent with Dyadic Developmental Psychotherapy, which is an evidence-based and effective treatment for children with trauma and attachment disorders (Becker-Weidman & Hughes, 2008). Many foster and adoptive parents find their children’s behaviors strange, frightening, disturbing, and upsetting. They often don’t understand why their child behaves as the child does; “after all, my child is now safe, doesn’t he get it?” It can be difficult to appreciate the depth and pervasiveness of the damage caused by earlier maltreatment.

Therapeutic parenting based on Dyadic Developmental Psychotherapy relies of helping parents understand what is causing the child’s behaviors. Looking deeper in order to understand what is motivating the child. All behavior is adaptive and functional; however sometimes the behaviors that were adaptive in one environment are ill-suited for the new home. If your first parents were neglectful, unreliable, and inconsistent so that you were often hungry and left alone for long periods of time, hoarding food, gorging, and going to “anyone” for help is adaptive. When that child is placed in a foster or adoptive home with caring, responsive, sensitive parents, that same behavior is no longer adaptive. By understanding what is driving the behavior and appreciating the child’s fear, anxieties, shame, and anger, the new parent will be better able to respond to the emotions driving the behavior rather than the surface behavior or symptoms. Unless the underlying emotions are addressed with sensitivity and within a safe, unconditionally loving, and supportive home, the behavior or symptoms are not likely to stop…they may change into other problems, but if the underlying cause remains, then the problems will surface again and again.

Let’s discuss the principles required. These principles are more fully elaborated elsewhere (Becker-Weidman & Shell, 2005; Becker-Weidman, 2007)

SENSITIVITY. Because children with trauma and attachment disorders are often unable to describe their internal states, emotions, or thoughts, it becomes the job of the parent to do this with and for the child so that the child learns to do this. Of course, this is precisely what one does with a newborn, toddler, and child. We often help children manage their internal states by doing that with them. When a baby cries, we pick up the baby, comfort the child, and by so doing, regulate the child’s level of arousal. Over time the infant becomes increasingly proficient at doing this independently. The parent of a foster or adopted child must be sensitive to the internal states of their child so that the parent can respond to the underlying emotions driving behavior.

RESPONSIVENESS. Once the underlying emotion is identified, the parent must respond to this need or emotion, with sensitivity. By meeting the child’s need (to feel safe, loved, cared about, for food, drink, joy, etc) the child will internalize new and healthier models of relationships and parents.

FOLLOWING THE CHILD’S LEAD. By this I mean that the parent will need to respond to the child and follow the child’s lead in the sense of providing what the child is needing (comfort, affection, support, structure, etc) and at the child’s pace. It is very important to move at the child’s pace to create the necessary sense of safety and security that these children need.

THE SHARING OF CONGRUENT INTERSUBJECTIVE EXPERIENCES. Intersubjectivity refers to shared emotion (also called attunement), share attention, and share intention. You can understand this if you think of playing a board game with your child. When you are playing some game together and enjoying the experience, you are sharing emotions (joy and a sense of competence), sharing attention (focusing on the game), and sharing intention (playing by the rules, both trying to win, having fun, etc.). Or another example, when talking about the death of the child’s loved grandparent, you both may share the same emotions (grief), both are recalling memories of the grandparent (shared intention and attention). It is the sharing of congruent intersubjective experiences, experiences in which all three elements are the shared, that helps the child heal and learn about intimacy and relationships.

CREATING A SENSE OF SAFETY AND SECURITY. Safety comes first. Unless the child is physically, emotionally, and psychologically safe, healing cannot occur. So, it is the job of the parent to create safety and security for the child. This then allows for the exploration of underlying feelings, thoughts, and memories. Without an alliance there can be no secure base. Without a secure base there can be no exploration. Without exploration there can be no integration. Without integration there can be no healing.
Unless the child feels safe, exploration is not possible.

So, what sort of parent is needed? We know form extensive research, that one of the best predictors of placement stability is the parent’s commitment to the child (Dozier, Grasso, Lindhiem, & Lewis, 2007). Therefore, building or rebuilding parental commitment is an important first step. Unless there is strong commitment, the child cannot feel safe and, as discussed above, safety is the most important first step in helping a hurt child heal.

Reflective capacity is also vital to placement stability and to the healing of adopted and foster children. The parent must be able to reflect on the child’s underlying emotions, how the past may be re-enacted in the present, and what in the parent’s own past is being triggered by the child. A well developed reflective function is necessary if the parent is to respond to the child in a healthy and healing manner. We all have buttons. The job of the therapeutic parent is to understand one’s buttons so that these can be disconnected so that when pushed, nothing happens.

Insightfulness (Koren-Karie, Oppenheim, Dolev, Sher, & Etzion-Carasso, 2002; Oppenheim, Koren-Karie, & Sagi, 2001; Oppenheim, & Koren-Karie, 2002; Oppenheim, Goldsmith, & Koren-Karie, 2005) is related to reflective capacity.

A parent’s state of mind with respect to attachment is the best predictor of the child’s. (Main, & Cassidy, 1988; Main, & Hesse, 1990). If the parent has a Secure state of mind with respect to attachment, then the adopted or foster child is more likely to develop a healthy and secure pattern of attachment and heal (Steele, Hodges, Kaniuk, Steele, Hillman, & Asquith, 2008). We know that when young children are placed in a foster home, the child will begin to develop a pattern of attachment that is the same as the foster parent’s state of mind with respect to attachment (Dozier, Stovall, Albus, & Bates, 2001). Obviously, in older children, this is a more difficult task. In the general population, about 60% of the adults have a secure state of mind with respect to attachment. For parents who have an insecure state of mind with respect to attachment, they can still learn to parent effectively with help (Becker-Weidman, A., & Shell, D., 2005/2008; Bick & Dozier, 2008).

USEFUL RESOURCES FOR PARENTS
1. Becker-Weidman, A., (2007). Principles of Attachment Parenting. 3-set DVD. Williamsville, NY: Center for Family Development.
2. Becker-Weidman, A., & Shell, D., (Eds.) (2005/2008) Creating Capacity for Attachment, Oklahoma City, OK: Wood N Barnes/ Williamsville, NY: Center For Family Development.
3. Golding, K., (2008). Nurturing Attachments. London: Jessica Kingsley.
4. Hughes, D. (2006) Building the Bonds of Attachment, 2nd edition, Jason Aronson, Lanham, MD. .
5. Siegel, D., & Hartzell, M., (2003). Parenting from the Inside out. Tarcher.







REFERENCES

Becker-Weidman, A., & Shell, D., (Eds.) (2005, 2008). Creating Capacity for Attachment, Oklahoma City, OK: Wood N Barnes & Williamsville, NY: Center for Family Development.

Becker-Weidman, A., (2007). Principles of Attachment Parenting. 3-set DVD. Williamsville, NY: Center for Family Development.

Becker-Weidman, A., & Hughes, D., (2008) “Dyadic Developmental Psychotherapy: An evidence-based treatment for children with complex trauma and disorders of attachment,” Child & Adolescent Social Work, 13, pp.329-337.

Bick, J., & Dozier, M., (2008). Helping Foster Parents Change. In H. Steele & M. Steele (Eds.), Clinical Applications of the Adult Attachment Interview (pp. 452-471). NY: Guilford.

Carlson, V., Cicchetti, D., Barnett, D., & Braunwald, K. (1995). Finding order in disorganization: Lessons from research on maltreated infants’ attachments to their caregivers. In D. Cicchetti & V. Carlson (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 135–157). NY: Cambridge University Press.

Cicchetti, D., Cummings, E. M., Greenberg, M. T., & Marvin, R. S. (1990). An organizational perspective on attachment beyond infancy. In M. Greenberg, D. Cicchetti & M. Cummings (Eds.), Attachment in the preschool years (pp. 3–50). Chicago: University of Chicago Press.

Cook, A., Blaustein, M., Spinazolla, J. & van der Kolk, B. (2003) Complex Trauma in Children and Adolescents. White Paper from the National Child Traumatic Stress Network Complex Trauma Task Force. National Center for Child Traumatic Stress, Los Angeles, CA.

Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M. et al. (2005) Complex trauma in children and adolescents. Psychiatric Annals, 35, 390–398.

Dozier, M., Stovall, K., Albus, K., & Bates, B. (2001). Attachment for infants in foster care: The role of caregiver state of mind. Child Development, 72, 1467-1477.

Dozier, M., Grasso, D., Lindhiem, O., & Lewis, E., (2007) “The role of caregiver commitment in foster care,” in D. Oppenheim & D. Goldsmith, (Eds.) Attachment Theory in Clinical Work with Children. NY: Guilford.


Dozier, M., Stovall, K. C., & Albus, K. (1999). Attachment and psychopathology in adulthood. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment (pp. 497–519). NY: Guilford Press.

Finzi, R., Cohen, O., Sapir, Y., & Weizman, A. (2000). Attachment styles in maltreated children: A comparative study. Child Development and Human Development, 31, 113–128.

Gauthier, L., Stollak, G., Messe, L., & Arnoff, J. (1996). Recall of childhood neglect and physical abuse as differential predictors of current psychological functioning. Child Abuse and Neglect, 20, 549–559.

Greenberg, M. (1999). Attachment and psychopathology in childhood. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment (pp. 469–496). NY: Guilford Press.

Koren-Karie, N., Oppenheim, D., Dolev S., Sher, E., & Etzion-Carasso, E. (2002). Mothers’ insightfulness regarding their infants’ internal experience: Relations with maternal sensitivity and infant attachment. Developmental Psychology, 38, 534-542.


Lyons-Ruth, K., & Jacobvitz, D. (1999). Attachment disorganization: Unresolved loss, relational violence and lapses in behavioral and attentional strategies. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment (pp. 520–554). NY: Guilford Press.

Main, M., & Cassidy, J. (1988). Categories of response to reunion with the parent at age six: Predictable from infant attachment classifications and stable over a one-month period. Developmental Psychology, 24, 415–426.

Main, M., & Hesse, E. (1990). Parents’ unresolved traumatic experiences are related to infant disorganized attachment status. In M. T. Greenberg, D. Ciccehetti & E. M. Cummings (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 161–184). Chicago: University of Chicago Press.

Malinosky-Rummell, R., & Hansen, D. J. (1993). Long-term consequences of childhood physical abuse. Psychological Bulletin, 114, 68–69.

Oppenheim, D., Koren-Karie, N., & Sagi, A. (2001). Mothers’ empathic understanding of their preschoolers’ internal experience: Relations with early attachment. International Journal of Behavioral Development., 25, 16-26.

Oppenheim, D. & Koren-Karie, N. (2002). Mothers’ Insightfulness Regarding their Children’s Internal Worlds: The capacity underlying secure child-mother relationships. Infant Mental Health Journal, 23(6), 593-605.

Oppenheim, D., Goldsmith, D., & Koren-Karie, N. (2005). Maternal Insightfulness and preschoolers’ emotion and behavior problems: Reciprocal influences in a day-treatment program. Infant Mental Health Journal.

Prino, C. T., & Peyrot, M. (1994). The effect of child physical abuse and neglect on aggressive withdrawn, and prosocial behavior. Child Abuse and Neglect, 18, 871–884.

Robins, L. N. (1978). Longitudinal studies: Sturdy childhood predictors of adult antisocial behavior. Psychological Medicine, 8, 611–622.

Schreiber, R., & Lyddon, W. J. (1998). Parental bonding and current psychological functioning among childhood sexual abuse survivors. Journal of Counseling Psychology, 45, 358–362.

Steele, M., Hodges, J., Kaniuk, J., Steele, H., Hillman, S., & Asquith, K., (2008). Forcasting Outcomes in Previously Maltreated Children. In H. Steele & M. Steele (Eds.), Clinical Applications of the Adult Attachment Interview (pp. 427-452). NY: Guilford.