Assessing attachment in school-age children.

The School-age Assessment of Attachment (SAA) is a newly developed clinical tool to identify pattern of attachment using the Dynamic-Maturational Model of attachment and adaptation (DMM). Seven picture cards were used to elicit fantasy stories and recalled episodes. The transcribed discourse was analyzed to yield one of 13 DMM attachment classifications, together with possible unresolved traumas and losses, and modifiers (depression and intrusions). In this article, we outline the steps necessary to validate an assessment tool, describe the development of the SAA, and report data from a preliminary clinical study testing the SAA's reliability, validity, and utility. Concurrent construct, familial, and discriminant validity were evaluated in terms of mental health status and exposure to danger on a sample of 5-12-year-old children, drawn from clinical ( n = 51) and normative (n = 40) populations. The SAA (a) differentiated children referred for psychiatric diagnosis from those in the normative population; (b) accounted for 31% of the variance (46% when family variables were added); (c) identified risk children in the normative sample; and (d) suggested risk factors associated with children's psychiatric disorder.