Intellectual Disabilities: An exploration into attachment assessments and adoptive mothers’ experiences

Systematic Literature Review:

Twenty-three studies evaluating the psychometric properties of twelve attachment measures were systematically reviewed to examine their reliability and validity for adults and children with intellectual disabilities (ID). The COSMIN appraisal tool was used to evaluate methodological quality of the studies and to evaluate psychometric properties. Evidence was found of good internal consistency and test-retest reliability but inconsistent inter-rater reliability and construct validity. Methodological quality of the studies ranged from ‘inadequate’ to ‘very good’. The findings of a small but growing evidence base were promising, however highlighted the importance of clinicians using attachment measures with people with ID with caution. Limitations were raised in relation to validity and reliability of observational measures with people with ID and in particular the Strange Situation Procedure. Further research is needed in relation to all psychometric properties and particularly test-retest reliability and construct validity.

Research Paper:

Interpretative Phenomenological Analysis was used to explore adoptive mothers’ experiences of their child being diagnosed with an intellectual disability post-adoption. Three Group Experiential Themes were developed: ‘Trauma of Intellectual Disability: something is ‘not quite right’ highlighted experiences of loss and betrayal; ‘isolation and marginalisation: ‘your world becomes smaller’ captured experiences of isolation from social networks and feelings of powerlessness; and ‘growth and resilience’ illustrated mothers advocating for their child and holding on to hope for the future. Themes were discussed in relation to existing literature and highlighted the importance of professionals acknowledging experiences of loss and grief and offering more post-diagnostic support to families of children with intellectual disabilities. Mothers’ experiences of gravitating towards people with shared experiences illustrated that it may be helpful for adoption and learning disability services to connect families to peer workers with lived experiences.