Bridging Disciplinary Boundaries (January 11 - 14, 2007)


Seacliff A (Hyatt Regency San Francisco)

Case Study of Eight Year-Old Fraternal Twins with Histories of Maltreatment Using an Attachment-Based Narrative Method

Timothy F. Page, PhD, Louisiana State University at Baton Rouge.

Purpose: This presentation will demonstrate the use of a narrative methodology to assess the perceptions of family relationships of two eight year-old fraternal twins, Bobby and Claire, with histories of attachment disorder. The twins first came into foster care at age 18 months due to severe neglect, at which time they were diagnosed with attachment disorders. Within a 20-month period they were moved twelve times, placed in a total of five different foster homes, and eventually adopted by a maternal aunt and uncle at age 30 months. Assessments at 18 and 36 months showed developmental delays in both children. The 36-month assessment indicated controlling, role-reversed behavior in Claire, and self-endangering behavior in Bobby, but also preferred attachment behavior toward their adoptive parents. This presentation focuses on one measure used in a follow-up assessment at age 8 that indicates several problematic areas of functioning. Methods: The Narrative Story Stem Technique (NSST) is a representational measure of children's attachments and other perceptions of qualities of close relationships. Children are presented with up to 10 brief story stems, each of which depicts some familiar, mildly stressful situation. The story-stems are enacted with the aid of family figures and props, to facilitate the children's comprehension of the story-stem and self-expression. After the presentation of the story stem, the child is asked to show and tell what happens next in the story. The child's response is then coded for themes of interest. The content of the two children's narrative responses were evaluated for interaction qualities between story characters, autonomous or negative depictions of individuals, enactment of attachment behavior in children, parenting nurturance and discipline, and the presence of distorted or bizarre elements. In addition, overall story coherence was rated. The author coded the NSST unaware of any previous data or the histories of the children. Videotape excerpts of these assessments will be shown. Results: Bobby's stories reveal a sense of disconnection and detachment in family relationships, and repeated injuries occur in several stories. Almost always, however, the injuries are responded to in some way with reparation. The story structures are, for the most part, fairly coherent. Claire enacted few representations of children's attachment behavior, and there are several unusual enactments of very frightening images and of deceit. Story structures are mostly not coherent with frequent, very abrupt plot changes that are typically accompanied by highly emotionally charged themes. Both children also created several positive images in their stories, notably of the mother in authoritative and nurturing roles. Other assessment data (Child Behavior Checklist – parent report) indicate Bobby functioning normally with respect to social behavior, while Claire was functioning in the clinical range of delinquent behavior. Implications for Practice: The NSST holds great promise as an assessment instrument capable of revealing young children's perceptions of close family relationships, notably their expectations with respect to attachment. The use of this narrative method appears to enable children to express themselves in short periods of time in a way that is enjoyable yet clinically meaningful.