Contributions from: Malka Margalit
Abstract
The objectives of the study were to examine the different perspectives of risk factors in explaining the adaptation directions among developmentally delayed children in inclusive kindergartens. The risk factors consisted of, (a) Child characteristics, (b) Maternal and familial ecological variables and (c) Child's attachment style as perceived by the mother's stories. The study examined the differences in adaptation styles among kindergartners aged 5-6.5 years. The sample included 185 mother-child dyads: 98 mothers and their children with developmental delays- at risk for learning disorders (71 boys, 27 girls) and 87 mothers and their average development children (54 boys, 33 girls), The instruments consisted of different sources of information (children's self reports, mothers' narratives and teachers' ratings). Path analysis was used to examine the multidimensional risk model for tile two groups. The study indicated a high fit between the theoretical model. And the empirical findings as well as a different pattern of relations between the model's components for the two populations studied. Implications of this model regarding the maternal and familial ecological components and the attachment style call for the inclusion of these components in the intervention planning.
Studies have emphasized the importance of exploring the nature and course of behavior problems and maladaptive behaviors in the preschool, kindergarten, and early school years (Belsky, Hsieh, & Crinc, 1998; Campbell, 1995, 1998; Greenberg, Speltz, & DeKlyen, 1993; Harrist et al., 1997; Lyons-Ruth, Easterbrooks, & Davidson Cibelli, 1997; Moss et al., 1996).
Two major reasons have been cited to warrant this focus:
According to these findings, the objective of this study was to examine a multidimensional model of risk factors contributing to the explanation of adaptive functioning among developmentally delayed children in inclusive kindergartens. This multidimensional model of risk factors taps different sources of information (self-reports, parents, and teachers).
Adaptive and maladaptive behaviors: Definitions
Studies have underscored two major components in the definition of "adaptive functioning" and "adaptive behavior" (Cicchetti, Rogosch, Lynch, & Holt, 1993; Easterbrooks & Goldberg, 1992):
According to this definition, "adaptive behavior" reflects the child's social and personal functioning. Therefore, adaptive functioning at the kindergarten age would consist of displaying flexibility and persistence in different tasks and situations (high ego-resiliency), as well as the capacity to regulate impulses and emotions and to express them in appropriate ways (moderate ego-control). High or low ego-control may reflect internalizing or externalizing emotional and behavior difficulties, respectively.
There is general consensus from large numbers of studies that behavior problems and maladaptive functioning in kindergartners fall into two categories of disorders (Achenbach, Edelbrock, & Howell, 1987):
Models of risk factors and protective factors:
Considerable agreement may be found regarding the multidimensional models of risk factors for behavioral and maladaptive problems (Campbell, 1998; Lyons-Ruth, 1996). Recent models place a greater focus on the role of the attachment variable and emphasize the perception of different factors as interactive and reciprocal (Campbell, 1995, 1998; Greenberg et al., 1993; Shaw et al., 1996)
In light of these recent models, the multidimensional model of risk factors developed in the present study considers multiple perspectives of risk factors, consisting of three components (see Figure 1):
| 1. | Child characteristics such as developmental status, temperament, and gender. |
| 2. | Maternal and familial ecological variables such as mother's sense of coherence and family cohesion. |
| 3. | Child's attachment style as perceived by the mother. |
As represented in the hypothesis model in Figure 1, the exogenic factors (in other words: independent variables) - 'gender' and 'temperament' - are presented within rectangles. The andogenic/latent factors (that is dependent variables) and the mediating factors are presented within ovals. The small circles reflect residual or disturbance variables (variances).
The assumptions of the study consist of the followings hypothesis: The gender and temperament variables (in the right column) would be related, on the one hand, with each of the andogenic (in other word adaptation) factors (in the left column) - loneliness, child's sense of coherence, teacher-evaluated child adaptation, and mother-child fitness of friendship measure - and, on the other hand, with the mediators (in the center column): attachment pattern, mother's sense of coherence, and family cohesion.
The mediating factors would be related with each of the andogenic variables.
The study was conducted in two stages: a pilot and the research study. The pilot study was conducted to develop the Attachment Memories Interview, and to test its suitability for samples with different educational and cultural backgrounds. The sample included 101 Israeli mothers of normal children aged 4.5-10 years. During the process of evaluating the instrument, it emerged that this interview enabled the collection of important information on the central motifs characterizing attachment style.
The research study included 145 kindergartners aged 5-6.5 years (M = 5.48 , SD = 0.40) and their mothers. These dyads were divided into two groups: 70 mothers and their sons and daughters with developmental delays who were considered at risk for developing learning disabilities (51 boys, 19 girls) and 75 mothers and their normally developing children (46 boys, 29 girls). All of these dyads were from the central region of Israel. The children attended inclusive regular kindergartens. The group of children at risk (n =70 ) for developing learning disabilities showed an average IQ level (IQ range = 85-115) but, demonstrated delays in one or more of the following developmental aspects: language, motor, and/or perceptual (visual or auditory). These kindergartners evidenced difficulties in domains of age-appropriate task performance, including poor vocabulary, low phonological awareness, motor coordination problems, difficulties in writing or coping numbers and letters.
Due to these expressed developmental delays, these children were considered to be at risk for developing learning disabilities in school and were referred for special assistance.
Special assistance was provided in two different ways: (a) at the kindergartens during school hours, and (b) at local therapeutic centers during afternoon hours. Due to the variegation of children's developmental delays, the special assistance was provided by a range of professionals: special education teachers, occupational therapists, communication therapists, and expressive therapists.
Mothers' ages ranged from 26-57 years (M = 36.91, SD = 5.69), and their education ranged from 8-25 years (M = 14.00, SD = 2.78). Maternal marital status was: 128 married, 12 divorced, and 5 single. Regarding maternal work status: 96 worked full time, 5 worked part time, and 44 did not work outside the home. The number of children in these families ranged from 1 to 6 (M = 2.57, SD = .88).
In this lecture I will focus my discussion on only two factors of the model: the attachment relationship and the mothers' sense of coherence.
Attachment theory and attachment style
Bowlby (1969, 1973, 1980) developed the construct of attachment to highlight the role that interaction with significant others plays in personality development. Over the course of the first year of life, infants develop a specific and enduring relationship with primary caretakers (usually parents), which has been termed as attachment (Ainsworth, 1969; Bowlby, 1969). Proximity to an available and responsive caregiver provides the infant with a "secure base" that enables the infant to handle distress, form new close relationships, and develop his or her individuality.
According to Bowlby (1988), interactions with unavailable and rejecting caretakers lead to a sense of mistrust in the world, serious doubts about self-worth, and chronic distress.
Bowlby (1988) also proposed that these experiences are internalized into "working models of attachment"-a mental representation of the significant other and the self, resulting in unique attachment styles. Attachment style may be defined as stable patterns of emotions, cognitions, and behaviors in social interactions.
Most measures of attachment are based on Ainsworth's observations of infants in the Strange Situation (Ainsworth et al., 1978), which reported three patterns - one considered secure and two considered insecure (avoidant and anxious-ambivalent). Each of these represents a primary strategy for maintaining the attention of the attachment figure. A fourth pattern-also considered as insecure pattern - the disorganized-was added later by Main and Solomon (1986).
Several measures were developed in order to study attachment patterns across the life span, but they focused on toddlers and preschoolers. (including: the Strange Situation laboratory observation for toddlers (Ainsworth et al., 1978), the Q-Sort Questionnaire (Waters & Deane, 1985), and the Preschool Attachment Assessment System (PAAS) for children 3 to 4 years old (Cassidy & Marvin, 1989).
Due to the paucity of instruments for kindergarten ages (5-6.5 years), and in light of the need for an instrument to suit a variety of maternal education levels and child disabilities, we developed the Attachment Memories Interview for the purpose of the present study.
Mothers were interviewed about their memories of their children behaviors regarding three events that typically promote attachment behaviors: entrance to a new educational setting, entrance to new place, and remaining with a new/strange person. They were also asked to describe their own feelings during each of the three events.
The coding focused on the separation and reunion behaviors of the children, as classified according to the four common attachment patterns. The use of memories was supported by the Adult Attachment Interview developed by Main (1985), which used adults' memories to classify their attachment patterns.
Mother's feelings were coded according to three affective groups: positive feelings (for example: happiness, pride), negative feelings (for example: sadness, fear), and mixed feelings (for example: wonder, embarrassment).
Attachment research has underscored several factors as contributing to individual differences in attachment patterns, such as the child's temperament, the caregiver's quality of care, the mother's distress, etc. However, most of the research that has explored at-risk and clinical samples has focused on abused children, premature infants, children from disadvantaged environments, and children with psychiatric problems or physical illness, rather than focusing on children with mild disabilities or children at risk for developing learning disabilities.
Therefore, unique value may be attributed to the current exploration of the role of attachment in explaining adaptation and behavior problems among children with developmental delays.
Sense of coherence:
"Sense of coherence" is the main variable within the salutogenic model developed by Antonovsky (1979, 1987), which suggested a complementary approach to the pathological model. The salutogenic model sought to explain successful coping with stressors.
"Sense of coherence" is a global orientation or enduring tendency to see the world as more or less comprehensible, manageable, and meaningful (Antonovsky, 1987). According to the salutogenic model, individuals' "sense of coherence" (SOC) has implications for their response to various types of stressful situations. Studies have indicated that individuals with a high level of SOC are less likely to perceive stressful situations as threatening and will be more likely to appraise such situations as manageable. Persons with a high level of coherence are also less likely to perceive stressful situations as provoking anxiety and anger.
Research hypothesis
According to the present study's multidimensional model of risk factors, the hypothesis examined the interaction between the different components of the model and estimated the contribution of each.
The children's adaptation levels (in other words andogenic/latent variables in the model) were assessed utilizing six measures based on three information sources:
Risk factors comprised the exogenic and the mediating variables in the model. These constituted the child's gender and developmental status, as well as mothers' evaluations of the child's temperament, attachment style as remembered by the mother, and two ecological variables: maternal reports of their own sense of coherence and of family cohesion measures.
Analysis of the results
The analysis was conducted in two stages:
I shall focus my discussion on the second stage of the analysis the Estimation of the model
This study indicated a high fit between the theoretical model and the empirical findings (GFI=.98; CFI=1; REMSA=.02), as well as a different pattern of relations between the model's components for the two populations studied (see Figures 2 and 3).
As can be seen in Figure 2, in the model modified to the developmentally delayed children (GFI=.97; CFI=1; RMSEA=.00), the child's gender and temperamental characteristics contributed significantly to the explanation of the three mediating variables: attachment style, maternal coherence, and family cohesion. Children's difficult temperament was related to an insecure pattern of attachment, low maternal sense of coherence, and a low level of family cohesion. An important contribution of this study lies in its examination of the temperament component, which, for the children with developmental delays, contributed directly to these three mediating factors. The temperament also contributed indirectly to children's loneliness and coherence (through the attachment style mediator) and to teacher-evaluated child adjustment (through the family cohesion mediator).
The gender and the family cohesion variables explained differences in these developmentally delayed children's adaptation according to teacher evaluations, whereas differences in the children's adaptation according to self-reports (loneliness and sense of coherence) were explained by the attachment style (see Figure 2). In this group, teachers evaluated the girls and the children whose mothers had reported high family cohesion as demonstrated high level of adaptive functioning. In this group of children, secure attachment contributed to High level sense of coherence and low level of loneliness.
As demonstrated in Figure 3, an examination of the model modified to children without developmental delays (GFI=.97; CFI=1; RMSEA=.00) yielded a different pattern of relations between the components. The child's characteristics - gender and temperament - were found to contribute less to the explanation of these children's adaptation. The child's gender contributed only to differences in teacher-evaluated adaptive functioning and in the children's self-reported sense of coherence. Similarly to the group with development delays, the normally developing girls were evaluated by their teachers as better adjusted than were boys. In contrast to the group with development delays, girls in the control group reported a high sense of coherence than did boys.
The temperament component was related only to family cohesion in the same direction as found for the children with developmental delays (in other words difficult temperament was related to low family cohesion). With regard to temperament, family cohesion was found to be a mediating factor contributing to the child's coherence. Family cohesion was also related to maternal coherence. In this group, the role of attachment style as a factor predicting adaptation was not substantiated (see Figure 3).
This study's results support the multidimensional risk model as explaining the adaptation of young children with developmental delays.
The results of the study have theoretical and practical implications. The theoretical implications focus on three major issues:
The practical implications of the present research are threefold: First, this study developed and evaluated the maternal interview on attachment memories. Second, the study calls attention to the need to identify children at risk for developing behavioral and adaptation problems. Third, the present findings highlighted the need to incorporate maternal and ecological components and early intervention into treatment planning.
These findings emphasize the importance of early identification of difficulties and the design of treatment and intervention methods that will assist these children in learning behavioral and emotional regulation as they approach the transition to school. The critical importance found within the model regarding the maternal and familial ecological components and the attachment style calls for the inclusion of these components for consideration in intervention planning.
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