An attachment-focused parent–child intervention for biting behaviour in a child with intellectual disability

Abstract

Attachment and attachment-related psychopathology has increasingly gained focus since Bowlby introduced the concept into the clinical repertoire. However, little has been done to explore attachment, or attachment-based interventions, within the context of intellectual disability. Clinical experience, however, has demonstrated significant attachment-related problems in children with intellectual disability. This article explores one such case of a 13-year-old girl with moderate intellectual disability and severe and persistent externalizing behavioural difficulties - biting, in particular. Once the severity of the behaviour was formulated within the framework of attachment, a structured attachment-focused parent-child intervention was designed in order to repair the damaged attachment between mother and daughter as a way of addressing the problematic behaviour. Outcomes demonstrated a sustained - immediately, at 3- and 6-month follow-up - positive impact of the intervention not only on the presenting problem but also on the quality of the relationship between mother and daughter. Research and clinical implications are discussed.

Developmental Delays in Socio-Emotional Brain Functions in Persons with an Intellectual Disability: Impact on Treatment and Support

“…With regard to treatment and care, aspects such as the level of socio-emotional functioning and the associated mental competencies and possibilities for reflection may support the decision for or against a certain therapeutic approach. Well-developed perspective-taking skills, for example, may increase the probability of the individual deriving benefit from cognitive behavioral therapy or mentalization-based treatment, while individuals with limited stress regulation abilities may be more likely to respond to bodily and experience-based treatment methods, such as attachment-based behavioral therapy or dance and movement therapy [ 48 , 70 , 71 , 72 ]. Targeting evidence-based treatment programs that are personalized and in line with the individual’s abilities and goals is particularly vital in persons with developmental disabilities [ 49 , 73 ].…”

O cuidado do agressor familiar frequente: revisão integrativa da literatura

“…(21) A case study with parents of an adolescent participant with intellectual disabilities and long term highly aggressive behavior towards her family showed a positive short term impact (between three and six months) of the use of attachment-based therapy. (22) In this case, parents and family members were approached at first, and the adolescent was included later on in the process. Approaching the family as a whole allowed for the identification of the needs and potentials of each member individually, in order to maintain family homeostasis, removing their sole focus from the adolescent's individual behavior and transferring it to the various forms family wound up producing a hostile conduct.…”

Therapeutic Supports for Neurodiverse Children Who Have Experienced Interpersonal Trauma: a Scoping Review

“…Eight of the studies that implemented a therapeutic support used nonverbal, sensory, and/or play-based therapeutic techniques (Guest & Ohrt, 2018;Harley et al, 2014;Horovitz, 1981;Kildahl et al, 2021;Mevissen et al, 2011Mevissen et al, , 2017Mevissen et al, , 2020Mohamed & Mkabile, 2015), and an additional study made an explicit attempt to integrate their participant's interests and preferred activities into the intervention process (Gerhardt & Smith, 2020). Efforts to modify language and match the communication abilities of participants were reported across five studies, which included the provision of clear instructions (Mevissen et al, 2011(Mevissen et al, , 2017(Mevissen et al, , 2020, simplified communication (Guest & Ohrt, 2018;Ooms-Evers et al, 2021), and the use of positive language (Harley et al, 2014).…”

“…A separate study employed an exclusively behavioural intervention that involved highly individualised strategies (i.e., reinforcement, arousal modulation, physical activity, and routine; Kildahl et al, 2021), whereas another implemented a blended behaviour-attachment focussed support that aimed to cultivate sensitive and responsive child-caregiver interactions and increase adaptive behaviour (Sterkenburg et al, 2008). A further two studies delivered established attachment interventions that included child parent psychotherapy (CPP; Harley et al, 2014) and Theraplay (Mohamed & Mkabile, 2015), and two others implemented non-directive therapeutic supports that drew upon art and symbolic play (Guest & Ohrt, 2018;Horovitz, 1981). Finally, the two studies remaining implemented "psychotherapy" without mention of a specific therapeutic modality or support target, both of which mentioned parental involvement (Cook et al, 1993;de Pilar Trelles Thorne et al, 2015).…”