Assessing changes in the internal worlds of early- and late-adopted children using the Story Stem Assessment Profile (SSAP)

Abstract

A growing body of literature has consistently shown how adopted children often have previous history of trauma and neglect, and in turn develop negative representations of the self and others. This study assesses the internal representations of three groups of children, as measured by the Story Stem Assessment Profile (SSAP). These were: (1) a maltreated, late-adopted (MLA) sample (n = 63); (2) a non-maltreated, early-adopted (EA) sample (n = 48); and (3) a non-maltreated community sample (COMM) (n = 80). In addition, it examined whether MLA and EA adopted children’s attachment and internal representations changed over time. Results showed that children in the MLA sample significantly displayed more disorganised, avoidant and negative representations and fewer representations characteristic of ‘secure’ attachment when compared with EA and, especially, COMM children. Longitudinal follow-up of both MLA and EA samples demonstrated significant changes over a two-year period in SSAP representation; secure representations increased while the avoidant and disorganised ones diminished. These findings are discussed and the limitations and implications of the study presented.

Attachment representations in 7‐year‐old children at familial high risk of schizophrenia or bipolar disorder: Associations with mental disorders and daily functioning

“…The seven-story SSAP version is a shortened instrument based on the original 13-story version. It elicits results consistent with those of the original version (Hillman, 2011). The seven-story version consists of three story stems based on clinical experience with maltreated children and four story stems adapted from the MacArthur Story Stem Battery (Bretherton, Ridgeway & Cassidy, 1990;Hodges et al, 2014).…”

“…The internal consistency of the SSAP was acceptable in the current study, yet thorough evaluation of its psychometric properties is lacking. Results on the SSAP attachment constructs have, to our knowledge, been reported in only a few other studies, overall showing that maltreated and institutionalized children show more insecure and disorganized attachment and less security than controls (Hillman et al ., 2020; Hillman, Cross & Anderson, 2020; Román, Palacios, Moreno & López, 2012). Residual confounding from factors not examined in the current study, such as child maltreatment, is possible, and, as described, severity of parental mental illness may also affect child outcomes.…”

Holding a foster child’s mind in mind: study protocol for a cluster-randomized controlled trial of mentalization-based therapy (MBT) for foster families

“…The Story Stem Assessment Profile (SSAP) is a narrative-based measure to assess internal representations in 4-to-11-year-old children [ 25 , 64 ]. Using a standard doll family and play materials, the interviewer enacts the beginning of a story (a story stem) and asks the child to complete the story using the provided play materials.…”

“…It "allows an assessment of the child's expectations and perceptions of family roles without asking the child direct questions about their own family, which might cause the child undue conflict or anxiety. A shortened version of the SSAP consisting of seven stories, which has demonstrated robust psychometric properties and has been validated with looked-after children in the UK, will be used in the trial [ 25 , 64 ]. Attachment will be coded by reliable coders blind to treatment allocation.…”

An innovative approach to working with children who have experienced developmental trauma: An introduction to the Building Underdeveloped Sensorimotor Systems (BUSS®) model

“…Much of the emphasis of post-adoption support is on the parent–child relationship, assuming that if a child can be supported to engage in a relationship with an adoptive parent or carer who is emotionally attuned and available to the child, this enables the development of new internal working models. It is hoped that that this will be the path to their recovery from earlier abuse and relational trauma (Hillman et al., 2020). While not disputing the value of this for the ongoing health and wellbeing of the child, this article seeks to highlight to the importance of an appreciation of motor development and the relational context necessary for it to grow.…”