Course of disinhibited social engagement behavior in clinically referred home‐reared preschool children

Abstract

Background Evidence supporting clinical relevance and persistence of disinhibited social engagement behavior (DSEB) pertains mostly to children reared in institutions and foster care. This study examined the course of DSEB in clinically referred home‐reared children from early into middle childhood, and associations with neglect/emotional maltreatment, effortful control, Attention Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, and Autism Spectrum Disorder. Methods Disinhibited social engagement behavior was examined in 124 children (82% boys, M = 4.06 years, SD = 0.89), referred for treatment of emotional and behavioral problems, by use of the Disturbances of Attachment Interview (DAI) with biological parents. Neglect and emotional maltreatment were assessed from case records and effortful control by use of the Child Behavior Questionnaire. At follow‐up, on average 4 years later, DSEB was examined by use of DAI as well as two observational ratings: the Stranger at the Door procedure (SatD) and a structured home observation of stranger approach. Psychiatric disorders were assessed by means of the Kiddie‐Schedule for Affective Disorders and Schizophrenia. Results Persistence of parent‐reported DSEB was found in 57% (n = 27) of the children with DSEB at baseline (n = 47). Parent‐reported DSEB at follow‐up was significantly related to DSEB observed in the SatD (rpb = .31, p = .001) and to observed stranger approach (rs = .41, p < .001), but only stranger approach was associated with baseline DSEB. The course of DSEB was not related to neglect/emotional maltreatment, nor to the level of effortful control. There was no association between DSEB and Autism Spectrum Disorder, but course of DSEB was associated with Attention Deficit/Hyperactivity Disorder/Oppositional Defiant Disorder at follow‐up (χ2 = 13.08, p = .004). Conclusions Although explanations for the onset and course of DSEB in home‐reared children remain elusive, findings suggest that DSEB is part of a complex of clinically significant problem behaviors in referred home‐reared preschool children.

Differentiating “Attachment Difficulties” From Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder: Qualitative Interviews With Experienced Health Care Professionals

“…Yet research from developmental psychology also overwhelmingly indicates that a complex network of social, psychological, and genetic factors shapes attachment bonds. Further, there are significant gaps in the current understanding of the intergenerational transmission of attachment (Scheper et al, 2019). The practice challenge was identifying to what degree did contextual factors influence the child's presenting behaviors.…”

Attachment disorders diagnosed by community practitioners: a replication and extension

“…It is unlikely that this limitation explains the difference between community and in‐clinic prevalence, because standardized, research‐informed assessment procedures are rarely implemented in community mental health settings. However, given the low (Bruce, Tarullo, & Gunnar, ) to moderate (Giltaij, Sterkenburg, & Schuengel, ; Scheper et al., ) associations between interview and observation‐based assessment, actual prevalence of RAD and DSED may be higher than reflected by the in‐clinic results. Furthermore, only a limited number of factors potentially associated with community diagnosis could be explored, using data collected in‐clinic.…”

Indiscriminate friendliness in foster children: Associations with attachment security, foster parents’ sensitivity, and child inhibitory control

“…The original coding system developed by Zeanah, Smyke, and Koga (2005) coded whether or not the child left with the stranger. To obtain more variance in the measurement of IF, we developed a more elaborate coding system similar to the coding system used by Scheper et al (2019). In addition to coding whether or not a child was willing to leave with a stranger (Gleason et al, 2011, 2014; Zeanah, Smyke, & Koga, 2005), we also coded whether the child hesitated and/or displayed social referencing, for example when the child sought proximity to the foster parent.…”

“…Specifically parental sensitivity seems to be predictive of a decrease in IF (Dobrova-Krol et al, 2010; Love et al, 2015). Nevertheless, other studies suggest that IF is not related to attachment security or caregiver sensitivity (Oosterman & Schuengel, 2008) but remains relatively persistent over time despite improved caregiving quality (Guyon-Harris et al, 2018; Lawler et al, 2016; Scheper et al, 2019; Smyke et al, 2012).…”