The efficacy of a short-term attachment-based intervention for changing risk outcomes for children of maltreating families was examined using a randomized control trial. Sixty-seven primary caregivers reported for maltreatment and their children (1-5 years) were randomly assigned to an intervention or control group. The intervention group received 8 weekly home visits directed at the caregiver-child dyad and focused on improving caregiver sensitivity. Intervention sessions included brief discussions of attachment-emotion regulation-related themes and video feedback of parent-child interaction. Comparison of pre- and posttest scores revealed significant improvements for the intervention group in parental sensitivity and child attachment security, and a reduction in child disorganization. Older children in the intervention group also showed lower levels of internalizing and externalizing problems following intervention. This is the first study to demonstrate the efficacy of short-term attachment-based intervention in enhancing parental sensitivity, improving child security, and reducing disorganization for children in the early childhood period.

The contribution of attachment, maternal reported stress, and mother-child interaction to the prediction of teacher-reported behavior problems was examined for a French-Canadian sample of 121 school-age children. Attachment classifications were assigned on the basis of reunion behavior with mother when the children were between 5 and 7 years of age. Maternal reported stress and mother-child interaction patterns were assessed concurrent to the attachment measure, whereas behavior problems were evaluated both at ages 5 to 7 and 7 to 9 years. Security of attachment significantly predicted the likelihood of school-age behavior problems: Controlling/other children were most at risk for both externalizing and internalizing problems across both age periods. Younger ambivalent children presented clinical cut-off levels of externalizing problems, and older avoidant boys had higher internalizing scores. Patterns of maternal-reported stress and mother-child interaction differed across attachment groups and contributed to prediction of school-age behavior problems, partially mediating the relation between attachment and adaptation. Results support the importance of attachment in explaining school-age adaptation and validity of attachment coding for children of this age.

Preschool to school-age trajectories of 242 children, including 37 with insecure-disorganized and 66 with insecure-organized attachment patterns, were examined. Child attachment and stressful life events (the latter retrospectively) were measured at ages 5-7, and mother-child interactive quality, parenting stress, marital satisfaction, and teacher-reported behavior problems were evaluated concurrently and 2 years earlier. Results indicated that all three disorganized subgroups had poorer mother-child interactive patterns and more difficult family climates than secure or insecure-organized children. The controlling-punitive group showed significant increases in maternal reports of child-related stress between preschool and school age. The controlling-caregiving group showed greater likelihood of loss of a close family member, and mothers of the insecure-other group reported lower marital satisfaction and greater likelihood of their own or a spouse's hospitalization. Controlling-punitive children had higher externalizing scores, and controlling-caregiving children higher internalizing scores, than secure children.

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The association between attachment and school-related cognitive functioning was longitudinally examined for a French Canadian sample of 108 school-age children. The affective quality of mother-child interaction patterns, child cognitive engagement, and quality of child attachment to mother were evaluated during a laboratory visit that included a separation-reunion procedure occurring when the children were approximately 6 years of age. Children's mastery motivation and academic performance were assessed 2 years later (at age 8). Analyses indicated that secure children had higher scores than their insecure peers on communication, cognitive engagement, and mastery motivation. Controlling children were at greatest risk for school underachievement, with the poorest performance on all measures except mastery motivation. Avoidant and ambivalent children were lowest on mastery motivation. Results of mediational analyses support the salience of mother-child interactional processes and child cognitive engagement at school age in explaining relations between attachment and cognitive functioning in school.