Attachment-facilitating interactions in non-kin foster families

Depósito de Investigación de la Universidad de Sevilla https://idus.us.es/ This is the peer reviewed version of the following article: Molano, N., León, E., Jiménez-Morago, J. M., Román, M., & Murillo, C. (2021). Attachment-facilitating interactions in non-kin foster families. Child & Family Social Work, 26(1), 70–78, which has been published in final form at https://doi.org/10.1111/cfs.12790. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. 1 Attachment-facilitating interactions in non-kin foster families Nuria Molano, Graduate Teacher Assistant; Esperanza León, Associate Professor; Jesús M. Jiménez-Morago, Associate Professor; Maite Román, Associate Professor; & Cristina Murillo, Research Assistant Department of Developmental and Educational Psychology, University of Seville, Spain Correspondence Nuria Molano Department of Developmental and Educational Psychology, University of Seville, Spain Address: Camilo José Cela, no number, Seville 41018, Spain Phone: +34 954557861 Email: [email protected] The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. 2 Abstract This study aims to analyze the interaction between children in foster care and their main caregivers during a micro-coded co-construction task, focusing on the verbal and non-verbal behaviors that the adults use to promote a secure attachment in the child. It also examines how children and caregivers’ socio-demographic variables relate to the interaction. The sample is made up of 28 Spanish children between 4 and 9 years old in long-term non-kin foster care and their foster families. The building task was administered to 28 dyads, composed of the child and the main caregiver in each family. Our results showed that the caregivers’ use of attachment-facilitating behaviors was frequent during the interaction. Moreover, children tended to display a positive attitude when adults used these attachment-facilitating behaviors. We also found some differences in the interaction according to the caregivers and children’s age, the child’s gender and the caregivers’ satisfaction with the child’s development. These results offer us a better understanding of the functioning of the adult-child relationships in foster families, which helps us make more efficient interventions to improve the caregivers’ sensitivity toward the children’s needs and difficulties. Keywords: caregiver-child interactions, non-kin foster families, long-term foster care, Co-Construction Task, attachment-facilitating behavior. 3 Introduction Family foster care is the main alternative that the Spanish Child Protection System offers to those children who suffered from early adverse experiences, such as maltreatment or abuse (Jiménez-Morago & Palacios, 2008). To that extent, children are separated from their birth families and are placed into kin or non-kin families that take care of their development (Amorós & Palacios, 2004). The Spanish Law 26/2015 on the Modification of the Child Protection System includes three types of family foster care according to their purpose: emergency foster care, where the child can stay with the foster family up to six months; temporary foster care—up to two years—; and longterm—up to legal age. In the latter modality, children are not expected to go back to their families of origin. Recent official data from the Spanish Government show that there are 36,531 children under the assistance of the Spanish Child Welfare System: 17,527 in residential care; 12,748 in kin foster care; and 6,256 in non-kin foster care (Observatorio de la Infancia, 2018). These children suffered a series of physical, psychological or sexual abuse experiences that led them to be separated from their parents (Jiménez-Morago & Palacios, 2008). As many of them did not have the opportunity to grow up in a family that provided them with the unconditional affection and care that every child needs (Ainsworth, 1979; Bowlby, 1973; Schofield & Beek, 2006), their placement within a new family is preferred to the institutional alternative (Carrera et al., 2016; Nowacki & Schoelmerich, 2010). In contrast to family care, it is difficult to build secure and stable relationships in residential care due to the absence of a main caregiver (Jiménez-Morago & Palacios, 2008). There is national and international evidence of the larger presence of physical, cognitive, emotional and psychosocial problems in institutionalized children, in comparison to those in family foster care (see Berens & Nelson, 2015; Fernández- Molina et al., 2011; Jiménez-Morago et al., 2015; Lionetti et al., 2015; Nowacki & Schoelmerich, 2010; Pollak et al., 2010; van IJzendoorn et al., 2011). Thus, foster families offer children a better and faster chance at recovery by providing them with stable and individualized care, affection, security and stimulation (López et al., 2010). Notwithstanding, among the children that are placed into family-based alternatives, those in non-kin foster care tend to be older, have more previous placement transitions and present more behavioral problems, which may hinder the adaptation to a new family context (Jiménez & Palacios, 2008; Jiménez-Morago et al., 2015). In contrast, children fostered by their relatives tend to be younger, present less disruptive behaviors, and have no more than one transition (Montserrat, 2014). On the other hand, non-kin foster parents usually have more positive psychosocial profiles than kinship carers: higher educational level, more stimulating homes, larger social support networks and better strategies to cope with stress (Jiménez & Palacios, 2008; Montserrat, 2014). All caregivers must pass a suitability assessment and they are trained by professionals before taking any child into their homes. Later on, they require protocolized monitoring (Amorós et al., 2003; Palacios, 2014). Bringing together the families’ initial resources, the specialized training for the fostering task and the latter supervision, there is an 4 attempt to ensure as much as possible that non-kin caregivers will be able to cope with the child’s potential difficulties. Unfortunately, breakdowns in non-kin foster care are more frequent than in other alternatives, especially in the long-term modality. Some factors are especially associated with these unsuccessful placements: difficulty in emotional bonding, behavioral problems and family violence (Palacios et al., 2015), along with insufficient monitoring and long-term support (Palacios et al., 2015; Tonheim & Iversen, 2018). In order to avoid future breakdowns, it is necessary to gain insight into foster families’ dynamics (Carrera et al., 2016; Jiménez-Morago et al., 2018; Ottaway & Selwyn, 2016) and Spain is a particularly suitable context for such a study, as some fields are still unexplored, such as the relationship between the caregiver and the child. As mentioned above, one of the cornerstones of a successful placement is a good bonding between the child and the caregiver. This positive, healthy and close relationship is created from the daily interactions between them, but it is sometimes difficult to establish due to the child’s past experiences. From what is known from the study of interactions in normative families, a sensitive, stable, coordinated and positive pattern of interaction between the adult and the child at an early stage promotes a secure attachment representation in the latter, once the child is able to internalize these experiences (Beebe, 2005; Beebe et al., 2010; Beebe & Steele, 2013; Jaffe et al., 2001). Unfortunately, most of the children in protection contexts missed this positive pattern of interaction within their family of origin and consequently developed an insecure attachment pattern (Amorós et al., 2003; Ponciano, 2010; Schofield & Beek, 2006), which limits the establishment of new, positive and secure relationships with their caregivers (Carrera et al., 2016; Dallos et al., 2015; Dozier & Bernard, 2017). This is frequently reflected in a rejection of the caregiver or when the children behave as if they do not need their new carer (Bovenschen et al., 2016). Despite the difficulties of overcoming insecure patterns of attachment, especially on the representational level (Bovenschen et al., 2016), some national and international studies with adoptive families show that the new family context can instigate some secure attachment indicators in these children thanks to better quality interactions (Hodges et al., 2003; Palacios et al., 2014; Román et al., 2012; Steele et al., 2007). Other international studies offer the same evidence with foster care families. Some authors point out that internal working models are not completely rigid but can turn into a more secure pattern, provided that new caregivers interact sensitively with their foster children (Ponciano, 2010), even when they start living together at older ages or when they have complex emotional needs (Dallos et al., 2015; Joseph et al., 2016; Nowacki & Schoelmerich, 2010). Since the information regarding caregivers’ influence on their foster children comes from international research, we need to explore this aspect in depth with national samples (Carrera, et al., 2016). In this study, we chose a micro-analytic methodology to analyze the interactions between children in long-term non-kin foster care and their main caregivers. This methodology seeks to record behavior in small time segments to 5 carry out a detailed quantitative analysis. In particular, we based on previous studies with adoptive families that followed this kind of analysis, which consists of observing and recording a series of behaviors in 10-second segments from a videotaped joint construction task between the adult and the child (León et al., 2013; León et al., 2018; Steele et al., 2007). It was found that adoptive parents frequently use behaviors that facilitate a secure attachment in their children, such as a positive voice tone or a supportive touch. Also, some of their results revealed that displaying these behaviors was higher in adoptive dyads than in a community comparison group (Cáceres et al., 2016). The variables they selected as attachment-facilitating behaviors were based on the previously mentioned studies of Beebe, Jaffe and colleagues. Given that long-term foster care is the most similar measure to adoption in terms of length, and that foster parents are prepared to be consciously proactive, responsive and sensitive to the children’s needs (Berrick & Skivenes, 2012), we expect to find similar results in our research. Nevertheless, the results obtained from the study of parent-child interactions in adoption samples (Beijersbergen et al., 2012; Cáceres et al., 2015; Rueter et al., 2009; Stams et al., 2002) cannot be completely generalized to foster care. Even though in both alternatives the child and the new caregivers are biologically unrelated, these two measures do not share the same nature: in foster care, caregivers do not become the child’s parents—they do not even share a legal bond—and many of these children maintain contact with their family of origin. Those aspects, in addition to foster children’s difficulties, like psychosocial adjustment problems, can negatively influence the establishment of optimal relationships and interactions within the foster family (Dallos et al., 2015). In light of the relevance of exploring the adult-child interactions in foster families, our aims in the present study were: a) to examine the presence of attachmentfacilitating behaviors in the caregivers during a joint construction task with the children, as well as the relationship between these variables and other behaviors shown by the caregivers during the interaction; b) to observe the interaction between caregivers’ attachment-facilitating behaviors and the children’s verbal, non-verbal and global codes; and c) to analyze how the quality of the interaction could be related to the caregivers and children’s socio-demographic characteristics, to the families’ satisfaction with the children’s development under their care, and to some of the children’s protection record variables. Method Participants A total of 28 dyads from Seville (Andalusia, Spain) participated in the study, which were composed of a child in non-kin long-term foster care and his or her main caregiver. In terms of gender, 17 girls made up 60.71% of the sample, whereas 11 boys made up the remaining 39.29%. Their ages ranged from 4 to 9 years old, with an average age of almost 8 years old (M = 93.96 months; SD = 15.96). The mean time they 6 had been in the current placement was around three years (M = 37.50 months; SD = 28.45), where they arrived when they were, on average, 4 and a half years old (M = 54.64 months; SD = 30.55). There was a large variety in the age of arrival, from 2 months to 8 years old. Moreover, 50% of the children had only been in a previous placement, 25% had been in two and 10.71% in three, whereas for the remaining 14.29% this was their first foster placement. The majority had been in family foster care (41.66%) and the rest had been in residential care (29.17%) or in both kinds of placements (29.17%). Main caregivers’ age ranged from 31 to 55 years old (M = 43.86; SD = 6.63) and they were mostly women (75%). The highest percentage of them (42.85%) had a medium educational level—high school or vocational training—and many (35.71%) had a high educational level—university studies. Regarding the families’ structure and composition, six of them were singleparent families (21.42%) and 22 were two-parent (78.58%). The second caregiver from the two-parent families was 42.73 years old on average (SD = 5.15) and the majority had medium (36.36%) and high (40.91%) educational level. Almost half of the families (53.57%) did not have any biological children and the rest (46.43%) had from one to three. Instruments Different assessment instruments were used for this study, which adopted a cross-sectional approach. Sociodemographic and protection record variables The information about children and caregivers’ sociodemographic aspects was assessed through a starting questionnaire that was completed by the caseworkers who collaborated with the families at foster care organizations. Furthermore, it collects information about the characteristics of the foster care placement and the child’s experience in the Child Protection System. Other variables, such as the child’s adaptation and development within the family or the foster family’s motivation, needs and satisfaction, were assessed through a semi-structured interview, which was administered to the caregivers. This interview contained open questions as well as Likert-scale items. Caregiver-child interaction The interaction between the caregiver and the child was observed through Co- Construction Task (Steele et al., 2005; Steele et al., 2007). In this task, the adult and the child are given a series of wooden building blocks with different shapes, sizes and colors. Next, the experimenter gives the following instruction: “I would like you to build something using as many of these blocks as you can. I am going to leave you alone to build for five minutes.” Then, the building task is videotaped and the children and caregivers’ verbal and non-verbal contents are coded dichotomously—presence or absence—in 10-second segments (Steele & Steele, 2007). 7 For each adult and child, 17 codes are assessed: nine are verbal and eight are non-verbal. Verbal codes include, for example, vocal expressions, responses to questions or using the child’s name. Non-verbal codes refer to patterns of touch, gestures or facial expressions, among others. Apart from these, some global ratings— seven from the caregivers, six from the children and four from the dyad—are also coded through a Likert scale from 0 (none) to 3 (almost always). For instance, some global codes are the caregiver’s controlling behavior or the child’s attention to the task. The dyad’s variables are the child and carer’s rhythmicity and coordination during the task, their level of creativity, the global quality of the interaction, as well as the way they do the task—together or separately—. These verbal, non-verbal and global behaviors can also be divided into positive and negative codes. Among positive behaviors, we can find the use of a positive voice tone or some supportive patterns of touch. On the contrary, negative variables are those which reflect tension or annoyance, for example, negative facial expressions or a controlling attitude. In a further classification, some positive behaviors can also be related to the promotion of a secure attachment, so that they reflect the adult’s sensitivity toward the child and facilitate the establishment of a positive and secure bond between them (Cáceres et al., 2016; Oropesa, 2015; Rueter et al., 2009; Steele et al., 2007). Following previous studies, eight adult behaviors during the interaction will be identified as attachment-facilitating: (1) positive facial expression—e.g. smiling; (2) supportive patterns of touch—e.g. stroking; (3) positive vocal expression—e.g. upward intonation; (4) use of the child’s name; (5) asking questions/making suggestions; (6) use of the pronoun we or us; (7) use of positive reinforcement; and (8) reference to shared experiences—e.g. references to other family members. Finally, two coders were trained by two researchers who got accredited on this instrument at The Center for Attachment Research (University of New York). Inter-rater agreement was measured by Cohen’s kappa coefficient, which was high in most of the contents—between 0.73 and 1 in caregivers and children’s verbal and non-verbal codes—and over 0.5 for global codes and the dyad’s ratings. Procedure This study belongs to a larger research project entitled “Socio-emotional and cognitive development of children in foster care. Adversity, family processes and adaptation”. It aims to analyze, for the first time in Spain, foster children’s cognitive and emotional development, foster families’ profile and functioning, and the relationships between these foster children and their caregivers. It was carried out under the regional authorities, foster care associations and foster families’ permission. First, an informed consent, the authorization from the Andalusian Biomedical Research Ethics Coordinating Committee and the permission from the Andalusian Child Protection authorities were necessary to access the families’ information. Once obtained, the Andalusian Child Protection authorities requested the collaboration of two family foster care organizations: Márgenes y Vínculos Foundation and APRONI Foundation. 8 In the earliest stage of the project, we selected the instruments and the sample that was going to be used. The criteria for selecting the sample was the following: children between 4 and 9 years old, without severe disability, who had already been living with their current foster family for at least five months. However, due to the difficulties in finding this kind of sample, we exceptionally decided to include a family that was close to five months of living with the foster child. For this work, we used two sources of information: foster care professionals and family home visits, which lasted from two to three hours on average. Caseworkers from the two participating foster care organizations provided us with some information about the foster placements. After contacting each family by phone call, two trained psychologists administered the battery of instruments at the family’s home, including the Co-Construction Task. Afterwards, data codification and analysis were carried out. Data analysis All the statistical analyses were done by SPSS-24. After obtaining the frequency and the descriptive statistics of central tendency and variability from the Co- Construction Task codes, bivariate Pearson correlations, Student’s t-tests and Cohen’s d were used to analyze their relationship with the rest of the explored caregivers and children’s variables. Results Caregivers’ attachment-facilitating behaviors The first objective of this study was to examine the presence of attachmentfacilitating behaviors in the main caregiver during the interaction with the child in care. Descriptive statistics of central tendency and variability can be observed in Table 1. [TABLE 1] After analyzing the relationship between the eight variables by Pearson Correlation Coefficient, we observed that all the variables had a significant positive relationship with at least one of the other included variables, and that the effect size was medium or large in all the cases (r = ≥ .24 and r = ≥ .37, respectively, according to Cohen, 1988, 1992) (Table 2). [TABLE 2] We also wanted to explore the correlation between these behaviors and the caregiver’s variables that are related to a negative attitude during the interaction: avoidance of physical proximity; negative facial expression; non-supportive patterns of touch; negative quality of demeanor; and control. We found that the variable 15 References Ainsworth, M.D.S (1979). Infant-Mother Attachment. American Psychologist, 34(10), 932-937. http://dx.doi.org/10.1037/0003-066X.34.10.932 Amorós, P., Palacios, J., Fuentes, N., León, E., & Mesas, A. (2003). Familias canguro: una experiencia de protección a la infancia [in Spanish]. Barcelona: Fundación “la Caixa”. Amorós, P. & Palacios, J. (2004). Acogimiento familiar [in Spanish]. Madrid: Alianza Editorial. Beebe, B. & Steele, M. (2013). How Does Microanalysis of Mother-Infant Communication Inform Maternal Sensitivity and Infant Attachment?. Attachment & Human Development, 15(0), 1-18. https://doi.org/10.1080/14616734.2013.841050 Beebe, B., Jaffe, J., Markese, S., Buck, K., Chen, H., Cohen, P., … & Feldstein, S. (2010). The Origins of 12-Month Attachment: A Microanalysis of 4-Month Mother- Infant Interaction. Attachment & Human Development, 12(0), 3-141. https://doi.org/10.1080/14616730903338985 Beebe, B. (2005). Mother-infant research informs mother-infant treatment. Psychoanalytic Study of the Child, 60, 7-46. http://dx.doi.org/10.1080/00797308.2005.11800745 Beijersbergen, M.D., Juffer, F., Bakermans-Kranenburg, M., & van IJzendoorn, M.H. (2012). Remaining or becoming secure: Parental sensitive support predicts attachment continuity from infancy to adolescence in a longitudinal adoption study. Developmental Psychology, 48, 1277-1282. http://doi.org/10.1037/a0027442 Berens, A.E. & Nelson, C.A. (2015). The science of early adversity: is there a role for large institutions in the care of vulnerable children? Lancet, 386, 388-398. https://doi.org/10.1016/S0140-6736(14)61131-4 Bernard, K., Dozier, M., Bick, J., Lewis-Morrarty, E., Lindhiem, O., & Carlson, E. (2012). Enhancing Attachment Organization Among Maltreated Children: Results of a Randomized Clinical Trial. Child Development, 83(2), 623-636. https://doi.org/10.1111/j.1467-8624.2011.01712.x Berrick, J.D. & Skivenes, M. (2012). Dimensions of high quality foster care: Parenting Plus. Children and Youth Services Review, 34, 1956-1965. https://doi.org/10.1016/j.childyouth.2012.05.026 Bick, J. & Dozier, M. (2013). The effectiveness of an attachment-based intervention in promoting foster mothers’ sensitivity toward foster infants. Infant Mental Health Journal, 34(2), 95-103. https://doi.org/10.1002/imhj.21373 Bornstein, M.H. & Manian, N. (2013). Maternal responsiveness and sensitivity reconsidered: Some is more. Development and Psychopathology, 25, 957-971. https://doi.org/10.1017/S0954579413000308 16 Bovenschen, I., Lang, K., Zimmermann, J., Förthner, J., Nowacki, K., Roland, I., & Spangler, G. (2016). Foster children’s attachment behaviour and representation: Influence of children’s pre-placement experiences and foster caregiver’s sensitivity. Child Abuse & Neglect, 51, 323-335. https://doi.org/10.1016/j.chiabu.2015.08.016 Bowlby, J. (1973). Attachment and loss: Vol. 2. Separation: Anxiety and anger. Nueva York: Basic Books. Cáceres, I., León, E., Marín, C., Román, M., & Palacios, J. (2016). Conductas facilitadoras del apego en las interacciones parento-filiales y función reflexiva parental en familias adoptivas [in Spanish]. Apuntes de Psicología, 34(2-3), 311-320. Carrera, P., Jiménez-Morago, J.M., León, E., & Viedma, I. (2016). La investigación en acogimiento familiar: de la descripción a los procesos de adaptación y desarrollo [in Spanish]. Apuntes de Psicología, 34, (2-3), 77-86. Cohen, J. (1988). Statistical power analysis for the behavioural sciences (2nd ed.). Hillsdale, NJ: Erlbaum. Cohen, J. (1922). A power primer. Psychological Bulletin, 112, 155-159. http://10.1037/0033-2909.112.1.155 Cohn, J.F. & Tronick, E. (1988). Mother-Infant Face-to-Face Interaction: Influence is Bidirectional and Unrelated to Periodic Cycles in Either Partner’s Behavior. Developmental Pyschology, 24(3), 386-392. http://doi.org/10.1037//0012- 1649.24.3.386 Cyr, C., Dubois-Comtois, K., Geneviève, M., Poulin, C., Pascuzzo, K., Losier, V., … & Moss, E. (2012). Attachment Theory in the Assessment and Promotion of Parental Competency in Child Protection Cases. In A. Muela (Ed.), Child Abuse and Neglect – A Multidimensional Approach. http://doi.org/10.5772/48771 Dallos, R., Morgan-West, K., & Denman, K. (2014). Changes in attachment representations for young people in long-term therapeutic foster care. Clinical Child Psychology and Psychiatry, 20, 589-599. https://doi.org/10.1177/1359104514543956 Dozier, M. & Bernard, K. (2017). Attachment and Biobehavioural Catch-up: addressing the needs of infants and toddlers exposed to inadequate or problematic caregiving. Current Opinion in Psychology, 15, 111-117. https://doi.org/10.1016/j.copsyc.2017.03.003 Feldman, R. (2007). Parent-infant synchrony and the construction of shared timing; physiological precursors, developmental outcomes, and risk conditions. Journal of Child Psychology and Psychiatry, 48(3-4), 329-354. http://doi.org/10.1111/j.1469- 7610.2006.01701.x Fernández-Molina, M., del Valle, J., Fuentes, M.J., Bernedo, I.M., & Bravo, A. (2011). Problemas de conducta de los adolescentes en acogimiento preadoptivo, residencial y con familia extensa [in Spanish]. Psicothema, 23(1), 1-8. 17 Hodges, J., Steele, M., Hillman, S., Henderson, K., & Kaniuk, J. (2003). Changes in attachment representations over the first year of adoptive placement: Narratives of maltreated children. Clinical Child Psychology and Psychiatry, 8, 351-367. https://doi.org/10.1177/1359104503008003006 Jaffe, J., Beebe, B., Feldstein, S., Crown, C., & Jasnow, M. (2001). Rhythms of dialogue in early infancy. Monographs of the Society for Research in Child Development, Series 264, 66(2), 1-132. Jiménez-Morago, J.M. & Palacios, J. (2008). El acogimiento familiar en Andalucía. Procesos familiares, perfiles personales [in Spanish]. Junta de Andalucía: Consejería para la Igualdad y Bienestar Social. Jiménez-Morago, J.M., León, E., & Román, M. (2015). Adversity and adjustment in children in institutions, family foster care and adoption. The Spanish Journal of Psychology, 18(45), 1-10. https://doi.org/10.1017/sjp.2015.49 Jiménez-Morago, J.M., León, E., & Algeciras, C. (2018). Parental sense of competence among non-kin foster carers from Spain. Children and Youth Services Review, 94, 437-445. https://doi.org/10.1016/j.childyouth.2018.07.030 Joseph, M.A., O’Connor, T.G., Briskman, J.A., Maughan, B., & Scott, S. (2013). The formation of secure new attachments by children who were maltreated: An observational study of adolescents in foster care. Development and Psychopathology, 26, 67-80. https://doi.org/10.1017/S0954579413000540 León, E., Steele, M., Palacios, J., Román, M., & Moreno, C. (2018). Parenting adoptive children: Reflective functioning and parent-child interactions. A comparative, relational and predictive study. Children and Youth Services Review, 95, 352-360. https://doi.org/10.1016/j.childyouth.2018.11.009 León, E., Román, M., Marín, C., Moreno-Maldonado, C., & Palacios, J. (2013, July). Co-construction task: a comparative and longitudinal analysis of parent-child interactions in adoptive families. Paper presented at Fourth International Conference on Adoption Research, Bilbao, Spain. León, E. (2012). La reunificación familiar tras el acogimiento: Una aproximación psicosocial desde la perspectiva de niños y niñas, familias biológicas y familias de acogida [in Spanish]. Madrid: Editorial Académica Española. Ley 26/2015, de 28 de julio, de Modificación del Sistema de Protección a la Infancia y a la Adolescencia. Boletín Oficial del Estado, núm. 180, de 29 de julio de 2015, pp. 64544 a 64612 [in Spanish]. Lionetti, F., Pastore, M., & Barone, L. (2015). Attachment in institutionalized children: a review and meta-analysis. Child Abuse & Neglect, 42, 135-145. https://doi.org/10.1016/j.chiabu.2015.02.013 18 López, M., Montserrat, C., del Valle, J.F., & Bravo, A. (2010). El acogimiento en familia ajena en España. Una evaluación de la práctica y sus resultados [in Spanish]. Infancia y Aprendizaje, 33(2), 269-280. Montserrat, C. (2014). Kinship care in Spain: messages from research. Child & Family Social Work, 19(3), 367-376. http://doi.org/10.1111/cfs.12028 Nowacki, K. & Schoelmerich, A. (2010). Growing up in foster families or institutions: Attachment representation and psychological adjustment of young adults. Attachment & Human Development, 12, 551-566. https://doi.org/10.1080/14616734.2010.504547 Observatorio de la Infancia (2018). Boletín de datos estadísticos de medidas de protección a la infancia. Boletín número 20. Datos 2017. Ministerio de Sanidad, Servicios Sociales e Igualdad [in Spanish]. Oropesa, N.F. (2015). Análisis del contexto familiar en la adopción: características psicológicas de los padres y madres y procesos de relación entre padres e hijos [in Spanish]. Unpublished dissertation. University of Seville, Spain. Ottaway, H. & Selwyn, J. (2016). ‘No-one told us it was to be like this’: Compassion fatigue and foster carers. Bristol: Fostering Attachments. University of Bristol. http://doi.org/10.13140/RG.2.2.33955.45606 Palacios, J., Jiménez-Morago, J.M., & Paniagua, C. (2015). Rupturas en adopción y acogimiento familiar en Andalucía [in Spanish]. Unpublished manuscript. University of Seville, Spain. Palacios, J. (2014). Valoración de idoneidad para el acogimiento familiar [in Spanish]. Junta de Andalucía: Consejería de Igualdad, Salud y Políticas Sociales. Palacios, J., Román, M., Moreno, C., León, E., & Peñarrubia, M. (2014). Differential plasticity in the recovery of adopted children after early adversity. Child Development Perspectives, 3(8), 169-174. http://dx.doi.org/10.1111/cdep.12083 Pollak, S.D., Nelson, C.A., Schlaak, M.F., Roeber, B.J., Wewerka, S.S., Wiik, K.L., … & Gunnar, M.R. (2010). Neurodevelopmental effects of early deprivation in postinstitutionalized children. Child Development, 81(1), 224- 236. https://doi.org/10.1111/j.1467-8624.2009.01391.x Ponciano, L. (2010). Attachment in Foster Care: The Role of Maternal Sensitivity, Adoption, and Foster Mother Experience. Child and Adolescent Social Work Journal, 27, 97-114. http://doi.org/10.1007/s10560-010-0192-y Ponciano, L. (2012). The Influence of Perception on Maternal Sensitivity in Foster Care. Child & Youth Services, 33(1), 70-85. http://dx.doi.org/10.1080/0145935X.2012.665325 19 Román, M., Palacios, J., Moreno, C., & López, A. (2012). Attachment representations in internationally adopted children. Attachment and Human Development, 14(6), 585-600. https://doi.org/10.1080/14616734.2012.727257 Rueter, M.A., Keyes, M.A., Iacono, W.G., & McGue, M. (2009). Family interactions in adoptive compared to nonadoptive families. Journal of Family Psychology, 23(1), 58-66. http://doi.org/10.1037/a0014091 Schofield, G. & Beek, M. (2006). Attachment Handbook for Foster Care and Adoption. London: British Association for Adoption and Fostering. Stams, G.J., Juffer, F., & van IJzendoorn, M.H. (2002). Maternal sensitivity, infant attachment, and temperament in early childhood predict adjustment in middle childhood: The case of adopted children and their biologically unrelated parents. Developmental Psychology, 38, 806-821. http://doi.org/10.1037//0012-1649.38.5.806 Steele, M., D’Agostino, D., & Blom, I. (2005). The Co-Construction coding manual: Verbal and non-verbal behaviour. Unpublished manuscript. Steele, M., Hodges, J., Kaniuk, J., Steele, H., D’Agostino, D., Blom, I., … & Henderson, K. (2007). Intervening with Maltreated Children and Their Adoptive Families. In D. Oppenheim & D. Goldsmith (Eds.), Attachment Theory in Clinical Work with Children: Bridging the Gap between Research and Practice (pp. 58-89). New York: The Guildford Press. Steele, M. & Steele, H. (2007). Co-Construction Coding Scheme Manual. Nueva York: The Center for Attachment Research. Tonheim, M. & Iversen, A.C. (2018). “We felt completely left to ourselves.” Foster parents' views on placement disruption. Child & Family Social Work, 24, 90-97. http://doi.org/10.1111/cfs.12585 van IJzendoorn, M.H., Palacios, J., Sonuga-Barke, E.J.S., Gunnar, M.R., Vorria, P., McCall, R.B., … & Juffer, F. (2011). Children in Institutional Care: Delayed Development and Resilience. Monographs of the Society for Research in Child Development, 76(4), 8-30. https://doi.org/10.1111/j.1540-5834.2011.00626.x Yarger, H.A., Bernard, K., Caron, E.B., Wallin, A., & Dozier, M. (2019). Enhancing Parenting Quality for Young Children Adopted Internationally: Results of a Randomized Controlled Trial. Journal of Clinical Child & Adolescent Psychology, 00(00), 1–13. https://doi.org/10.1080/15374416.2018.1547972 20 Table 1 Descriptive statistics of caregivers’ attachment-facilitating behaviors N Minimum Maximum M SD Positive facial expression 28 1 26 9.96 7.1 Supportive patterns of touch 28 0 3 0.64 1.1 Positive vocal expression 28 4 30 21.18 7.42 Use of the child's name 28 0 8 2.32 2.44 Asking questions/making suggestions 28 6 25 16.68 5.06 Use of the pronoun we or us 28 1 22 10.50 5.67 Use of positive reinforcement 28 0 11 3.68 3.02 Reference to shared experiences 28 0 5 0.61 1.17 Table 2 Correlation between attachment-facilitating behaviors 2 3 4 5 6 7 8 1.Positive facial expression .30 .38* .18 -.21 -.14 .09 .03 2.Supportive patterns of touch - .51** .56** .06 .34 .51** .09 3.Positive vocal expression - - .27 .07 .26 .38* -.12 4.Use of the child’s name - - - .02 .23 .40* -.07 5.Asking questions/making suggestions - - - - .63** .31 .50** 6.Use of the pronoun we or us - - - - - .36 .40* 7.Use of positive reinforcement - - - - - - .32 8.Reference to shared experiences - - - - - - - Note. *p < .05; **p < .01 Table 3 Contrast analysis and effect size between boys and girls Boys Girls M SD M SD Cohen’s d Student’s t Caregiver’s variables Positive facial expression 5.91 2.63 12.59 7.94 1.12 3.21** Negative facial expression 2.27 1.95 0.65 1.22 0.99 2.72* Supportive touch 0.18 0.60 0.94 1.25 0.77 2.15* Positive vocal expression 15.64 8.09 24.76 4.16 1.41 3.46** Negative vocal expression 4.73 5.12 0.82 1.07 1.05 2.49* Positive global behavior 2.18 0.75 2.82 0.39 1.07 2.61* Negative global behavior 0.82 0.60 0.12 0.33 1.44 3.97** Child’s variables Positive facial expression 10.36 4.78 15.71 6.81 0.91 2.26* Dyad’s variables Rhythmicity 2.45 0.93 3.29 0.77 0.98 2.59* Quality 2.36 0.81 3.24 0.56 1.26 3.37** Note. *p < .05; **p < .01