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Relationships and Learning: A Review and Investigation of Narrative Coherence in Looked-After Children in Primary School

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Title: Relationships and Learning: A Review and Investigation of Narrative Coherence in Looked-After Children in Primary School
Language: English
Authors: Greig, Anne, Minnis, Helen, Millward, Reuben, Sinclair, Claire, Kennedy, Eilis, Towlson, Kate, Reid, Warren, Hill, Jonathan
Source: Educational Psychology in Practice. Mar 2008 24(1):13-27.
Availability: Routledge. Available from: Taylor & Francis, Ltd. 325 Chestnut Street Suite 800, Philadelphia, PA 19106. Tel: 800-354-1420; Fax: 215-625-2940; Web site: http://www.tandf.co.uk/journals/default.html
Peer Reviewed: Y
Page Count: 15
Publication Date: 2008
Document Type: Journal Articles
Reports - Evaluative
Education Level: Elementary Education
Descriptors: Experimental Groups, Control Groups, Investigations, Personal Narratives, Attachment Behavior, Caregiver Child Relationship, Emotional Development, Early Experience, Metacognition, Foster Care, Mainstreaming, Developmental Psychology, Foreign Countries, Educational Psychology
Geographic Terms: United Kingdom (Scotland)
DOI: 10.1080/02667360701841189
ISSN: 0266-7363
Abstract: This review and investigation draws on principles from attachment theory regarding the importance of early relationships and their impact on the coherence and organisation of psychological functions. Comparisons are made between the narrative coherence scores of an experimental group of 17 looked-after children with problematic relationship histories in mainstream school and a matched control group of 17 of their peers. There were significant differences between the groups in the coherence of children's narratives, denial and avoidance in story play themes and in their use of intentionality. The paper considers the theory and discusses the results in terms of the implications for teaching, learning and intervention. (Contains 2 figures and 3 tables.)
Abstractor: Author
Number of References: 74
Entry Date: 2008
Accession Number: EJ786670
Database: ERIC
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  Value: <anid>AN0030049775;b8g01mar.08;2019Feb26.13:17;v2.2.500</anid> <title id="AN0030049775-1">Relationships and learning: a review and investigation of narrative coherence in looked-after children in primary school. </title> <sbt id="AN0030049775-2">Introduction</sbt> <p>This review and investigation draws on principles from attachment theory regarding the importance of early relationships and their impact on the coherence and organisation of psychological functions. Comparisons are made between the narrative coherence scores of an experimental group of 17 looked‐after children with problematic relationship histories in mainstream school and a matched control group of 17 of their peers. There were significant differences between the groups in the coherence of children's narratives, denial and avoidance in story play themes and in their use of intentionality. The paper considers the theory and discusses the results in terms of the implications for teaching, learning and intervention.</p> <p>People have internal relationships that affect thinking. Moreover, these relationships are rooted in the early months and years of a person's life. What happens between an infant and her caregiver is vitally important ... for the way the infant will relate to herself and to other people, but also for her developing capacity to think. (Hobson, [<reflink idref="bib38" id="ref1">38</reflink>], pp. 180–181)</p> <p>In his "thinking and relationships" approach to the development of thought, Hobson drew on numerous studies across a range of disciplines that, in recent times, have begun to define the links between the child's inner (nature) and outer (nurture) worlds. Hobson cited accomplished works in developmental and interpersonal psychology, developmental neuro‐psychology and from psychoanalysis and, specifically, his own work with people habitually involved in stormy relationships. He concluded that people with troubled and traumatic early relationships are unable, in certain contexts, to reflect and communicate in a coherent narrative. This involves cognitive abilities that, presently reviewed, are at the very core of learning and thinking.</p> <p>It is perhaps not surprising that investigations into the personal and learning outcomes for children who are in care, who have almost universally experienced early relationship difficulties, have indicated consistently that they are a high‐risk population with mixed personal and academic outcomes (see McCann, James, Wilson, & Dunn, [<reflink idref="bib45" id="ref2">45</reflink>]; Schofield, [<reflink idref="bib58" id="ref3">58</reflink>]). The UK Joint Working Party on Foster Care ([<reflink idref="bib68" id="ref4">68</reflink>]) noted that, compared with children in general, those who need the care of public authorities are up to 10 times more likely to be excluded from school; 12 times more likely to leave school with no qualifications; 60 times more likely to be sent to prison; and four times more likely to be unemployed and suffer from mental health problems (Meltzer, Gatward, Corbin, Goodman, & Ford, [<reflink idref="bib48" id="ref5">48</reflink>]) and will have an almost universal history of maltreatment (Minnis, Pelosi, Knapp, & Dunn, [<reflink idref="bib50" id="ref6">50</reflink>]). Many children and young people who have a known history of very troubled early relationships are supported in society as "looked‐after children". From an Internet search of government statististics, it can be seen that, in England in 2004, there were 35,000 children of school age who were looked after by the authorities. By Year 11, only 9% of this group attained five GCEs compared with 54% of all children. In a Scottish survey of 355 children in care, it was found that they experienced higher levels of mental health problems than their peers and that 45% of 5‐ to 17‐year‐olds were assessed as having a mental disorder (Meltzer <emph>et al.</emph>, [<reflink idref="bib48" id="ref7">48</reflink>]). In the younger group of 5‐ to 10‐year‐olds, the looked‐after population is six times more likely to have a mental disorder than those living within families in the community (52% and 8%, respectively) (Meltzer <emph>et al.</emph>, [<reflink idref="bib48" id="ref8">48</reflink>]).</p> <p>The majority of looked‐after children attend mainstream schools. There are additionally at these schools an unknown number of children who have been in troubled relationships for all their lives and remain so for they have not been referred to the authorities (Ladd, Birch, & Buhs, [<reflink idref="bib40" id="ref9">40</reflink>]). Hence, children with troubled histories and their teachers have extensive exposure to each other yet have little or no information to facilitate understanding and intervention.</p> <hd id="AN0030049775-3">Review of theory and research</hd> <p></p> <hd id="AN0030049775-4">Early emotional attachment and internal representation</hd> <p>Current understanding of the importance of relationships on psychological development and adaptation began with Bowlby's ([<reflink idref="bib8" id="ref10">8</reflink>]) and Ainsworth, Blehar, Walters and Wall's ([<reflink idref="bib1" id="ref11">1</reflink>]) ethological research into the development of emotional attachments between infants and their caregivers. Attachment behaviour is elicited from the infant when there is distress or danger and includes, in the very young for example, following, clinging and crying. Initially, the process is emotional and behavioural, but as the child matures the attachment response becomes increasingly motivated by internal (mental) "working" models – a small scale, mentally internal world that is constructed from the child's experiences with the caregiver. Within close relationships children acquire representations, or internal models, of themselves and their worthiness based on the availability, ability and willingness of the caregiver to provide care and protection. The child of an attuned, emotionally available and supportive caregiver will be secure and have a model of self as valued and competent. However, the child of a neglectful or maltreating caregiver will be insecure and have a model of self as worthless and incompetent.</p> <p>It is important to note that Bowlby thought that all learning in all children occurred in this way and that, in effect, all children will have attachment and learning styles based on either security or a form of insecurity. The work of Ainsworth <emph>et al.</emph> ([<reflink idref="bib1" id="ref12">1</reflink>]) showed that secure children explore, play and think freely. Insecure children, however, have developed a response (albeit an adaptive response) that is avoidant (restricted, flat and defensive play or learning) or ambivalent (anxious, attention‐seeking, coercive play or learning). Insecure children with very poor relationship histories may fail to form an adaptive response and will then have a disorganised approach to play and learning (Crittenden, [<reflink idref="bib23" id="ref13">23</reflink>]; van Ijzendoorn, Schuengel, & Bakermans‐Kranenburg, [<reflink idref="bib70" id="ref14">70</reflink>]; Main, Kaplan, & Cassidy, [<reflink idref="bib44" id="ref15">44</reflink>]). An overview of these types of secure and insecure attachment and learning styles is depicted in Figure 1.</p> <p>Graph: Figure 1 Attachment and learning styles across the school years.</p> <p>Lyons‐Ruth and Jacobvitz ([<reflink idref="bib43" id="ref16">43</reflink>]) reported that 55–65% of all children are secure, 20–30% are insecure‐avoidant, 5–15% are insecure‐ambivalent, and 20–40% are insecure‐disorganised. Within the disorganised group, 80% of the children are at a high risk of poor developmental outcomes.</p> <hd id="AN0030049775-5">Infant inter‐subjectivity and cultural learning</hd> <p>Trevarthen and Aitken ([<reflink idref="bib67" id="ref17">67</reflink>]) described how the newborn human infant has "emotional and communicative precocity", a natural sociability indicating that the quality of the interactions between infants and caregivers must play a crucial role in early brain development. The intricate mother–infant interactions were described as "proto‐conversations". These are the very early pre‐verbal, emotional exchanges between an infant and caregiver. The quality of these exchanges has characteristic rhythmic timing and vocal registers that are easily identifiable and function to motivate social engagement, cooperation, and the empathic connections of confiding and confidence.</p> <p>Trevarthen and Aitken drew on the theory of internalisation (Vygotsky, [<reflink idref="bib71" id="ref18">71</reflink>]), in that children construct their own internal mentalisation as a result of social interaction. Being a uniquely human feature, this early communicative pattern is the basis of cultural learning, including later language learning. The first very early exchanges between the infant and caregiver have been called "primary inter‐subjectivity" an essentially intensive face to face, body to body, soul to soul "meta‐communicative" engagement. As the child develops physically and perceptually, joint attention around the environment or objects leads to "secondary inter‐subjectivity". The authors also noted that the meta‐communicative comes before the meta‐cognitive (reflective, thinking about thinking) and that the newborn's abilities for the expression of coherent emotions and social behaviour are likely to regulate early brain developments in the higher cortex. This will include the refinement of important cognitive abilities such as perceptual discrimination, cognitive processing, memory, voluntary deployment of attention to environmental objects and executive functioning or problem‐solving (see Schore, [<reflink idref="bib59" id="ref19">59</reflink>], [<reflink idref="bib60" id="ref20">60</reflink>], [<reflink idref="bib61" id="ref21">61</reflink>], [<reflink idref="bib62" id="ref22">62</reflink>]). Hence, what children learn (and the adaptability of that learning) about themselves and others in the process of social interaction, is mediated by the cultural tool of language, preverbal, nonverbal, and verbal (Vygotsky, [<reflink idref="bib71" id="ref23">71</reflink>]). Indeed, Trevarthen and Aitken conclude that:</p> <p>The narrative awareness that is so central to the passing on of human concepts, ideas, fantasies and beliefs, including its symbolic formulation in language, results from coordinated action of all ...cerebral systems ... (Trevarthen & Aitken, [<reflink idref="bib67" id="ref24">67</reflink>], p. 23)</p> <hd id="AN0030049775-6">Metacognition or "thinking about thinking"</hd> <p>Since the concept was first introduced by Premack and Woodruff ([<reflink idref="bib53" id="ref25">53</reflink>]), "thinking about thinking", or the ability to openly reflect about the content of one's own and others' cognitions, including thoughts, beliefs, intentions, and feelings has become known as "theory of mind" and has been extensively researched by developmental psychologists. There is now an impressive body of research evidence on the development of this mental faculty and, in particular, the impact of interpersonal experiences on this emerging ability in infants. These include the impact of relationships in the home (Dunn & Brown, [<reflink idref="bib26" id="ref26">26</reflink>], [<reflink idref="bib27" id="ref27">27</reflink>]; Dunn, Brown, & Beardsall, [<reflink idref="bib28" id="ref28">28</reflink>]), in the extended family (Lewis, Freeman, Kyriakidou, Maridaki‐Kassotaki, & Berridge, [<reflink idref="bib42" id="ref29">42</reflink>]), in the school (Lalonde & Chandler, [<reflink idref="bib41" id="ref30">41</reflink>]), the number and closeness in age between siblings (Perner, Ruffman, & Leekham, [<reflink idref="bib52" id="ref31">52</reflink>]) and the frequency and complexity of pretend play with carers (Youngblade & Dunn, [<reflink idref="bib74" id="ref32">74</reflink>]). These studies support the view that the child's ability to understand the thoughts and feelings of oneself and those of others is related to the quality of interactions and communications and the frequency and extent of play with carers and siblings.</p> <p>Increasing numbers of studies are looking at the issue of attachment and parental sensitivity. It has been suggested that, in a learning task, the mothers of secure children were more sensitively attuned to their child's "zone of proximal development" and that these children were more able to adapt their play to maternal suggestions than were insecure children (Meins, [<reflink idref="bib46" id="ref33">46</reflink>]). A related longitudinal study found that children assessed as secure in infancy were, compared with insecure children, more skilled at "mentalising" and social understanding tasks at age five and had mothers who treated them as a mental agent at an early age (Meins, Fernyhough, Russell, & Clark‐Carter, [<reflink idref="bib47" id="ref34">47</reflink>]). Fonagy, Redfern and Charman ([<reflink idref="bib31" id="ref35">31</reflink>]) found a similar link between attachment security and performance on a "theory of mind" task and explain the association as one in which the interaction with the attachment figure provides the infant with a model of the relationship and sets up an internal "reflective self" – an executive – that constructs representations based on experience: a secure child will have a reflective ability that is more coherent and flexible than an insecure child.</p> <p>These studies in general provide accumulating evidence on the importance of the quality of early social relationships and the role they play in the development of the executive functions in young children.</p> <hd id="AN0030049775-7">Learning and relationships</hd> <p>The processes in learning have the demand characteristics of a stressful situation – the task is unfamiliar, and the uncertain child may be fearful of error or failure. Consequently, the learning situation can trigger insecure behaviour patterns in children (Bretherton, [<reflink idref="bib10" id="ref36">10</reflink>]). Sensitively attuned guides (parents, carers or teachers) are alert to the child's signs of anxiety or curiosity. As the review so far indicates, those children who are generally insecure, with a poor relationship history, would be less able to trust those who teach them.</p> <p>Since Bowlby's classic study of the impact of care‐giving in orphanages, researchers have been interested in the role of institutions, notably schools and teachers, in promoting resilience in children who may otherwise be vulnerable because of early care giving experiences (Bowlby, [<reflink idref="bib5" id="ref37">5</reflink>], [<reflink idref="bib6" id="ref38">6</reflink>], [<reflink idref="bib7" id="ref39">7</reflink>]). Rutter and Quinton ([<reflink idref="bib57" id="ref40">57</reflink>]) identified the qualities of schools that supported resilient girls who were in the care system. The importance of the school in supporting children in times of stress, such as transition, in providing a sense of mastery and success, in providing teachers as a secure base, and in the creation of warm, secure learning social environments has been demonstrated in many studies (DeMulder, Denham, Schmidt, & Mitchell, [<reflink idref="bib24" id="ref41">24</reflink>]; Cabello & Terrell, [<reflink idref="bib22" id="ref42">22</reflink>]; Dunn, [<reflink idref="bib25" id="ref43">25</reflink>]; Moss, Gosselin, Parent, Rousseau, & Dumont, [<reflink idref="bib51" id="ref44">51</reflink>]) but it is arguable that teachers may be unaware of the implications of this work for their own practice.</p> <p>Early relationships are now believed to be of central importance in the organisation of the neuronal growth of prefrontal executive functions. These include memory, narrative, emotion, representation and states of mind (see Balbernie, [<reflink idref="bib3" id="ref45">3</reflink>]; Glaser, [<reflink idref="bib35" id="ref46">35</reflink>]), all of which are crucial for scholastic achievement and social adjustment. Deficits in these executive functions are linked to underachievement at school, attention deficits, autism, specific language impairments and auditory processing (reviewed by Trevarthen & Aitken, [<reflink idref="bib67" id="ref47">67</reflink>]). A secure, reflective internal working model of oneself and the reliability of others is important for the development of self‐esteem and motivation in scholastic achievement and learning environments. Whilst IQ has been found to be the best general predictor of achievement, in some cases, early attachment is nearly as good (see Granot & Mayseless, [<reflink idref="bib36" id="ref48">36</reflink>]; Teo, Carlson, & Sroufe, [<reflink idref="bib66" id="ref49">66</reflink>]), and, as noted in the introduction, the general scholastic and life outcomes for children in the care system are not good.</p> <hd id="AN0030049775-8">Relationships and literacy</hd> <p>The interpersonal basis of literacy acquisition is an area that has been subjected to extensive research in recent times. Early book reading is a social process. The child's ability to read before school predicts achievement; language growth, early literacy and reading ability (see van Ijzendoorn, Dijkstra, & Bus, [<reflink idref="bib69" id="ref50">69</reflink>]; van Ijzendoorn <emph>et al.</emph>, [<reflink idref="bib70" id="ref51">70</reflink>]; Wells, [<reflink idref="bib73" id="ref52">73</reflink>]). Children with poor relationship histories are more likely to be insecure, to have had unhappy experiences of reading, including potentially damaging lack of attunement to the child's ability or needs, and to have had little exposure to books.</p> <p>Bus ([<reflink idref="bib14" id="ref53">14</reflink>], [<reflink idref="bib15" id="ref54">15</reflink>]) and Bus and van Ijzendoorn ([<reflink idref="bib18" id="ref55">18</reflink>], [<reflink idref="bib19" id="ref56">19</reflink>], [<reflink idref="bib20" id="ref57">20</reflink>], [<reflink idref="bib21" id="ref58">21</reflink>]) studied the interpersonal dimensions of early reading and literacy in a series of empirical studies. Many of the studies have suggested links between parent behaviour in the reading situation, infant insecurity and the quality of the experience. Insecure dyads (mother–3‐year‐old child pairs) read less frequently and actual engagement tended to be disrupted with irrelevant interactions such as disciplining (Bus & van Ijzendoorn, [<reflink idref="bib18" id="ref59">18</reflink>]). A larger scale study of picture book reading between mothers of children about 1‐year‐of‐age found that basic learning/instruction processes of picture book reading depend on the affective quality of the relationship, again with insecurity related to distraction and disciplining rather than joint attention (Bus & van Ijzendoorn, [<reflink idref="bib19" id="ref60">19</reflink>]).</p> <p>Another study of parental sensitivity, involving 138 families rearing first‐born sons, suggested that insecure avoidant dyads had mothers that were more inclined than secure mothers to read the verbal text rather than to initiate interactions around the pictures, and that insecure resistant mothers were over‐controlling and over‐stimulating with their ambivalent infants. This study assessed attachment security status at 12 and 18 months (mother–child) and at 13 and 20 months (father–child). The dyads were then observed and videotaped in a prescribed book reading task. The significant results related only to mother–child dyads (Bus, Belsky, van Ijzendoorn, & Keultjes, [<reflink idref="bib16" id="ref61">16</reflink>]). Another study of Dutch ethnic groups revealed that when reading is less important for the parents personally, they are less inclined to deviate from the text to negotiate meaning (Bus, Leseman, & Keultjes, [<reflink idref="bib17" id="ref62">17</reflink>]).</p> <p>Roy and Rutter ([<reflink idref="bib56" id="ref63">56</reflink>]) compared groups of children in institutional care (<emph>N</emph> = 19) and children in continuous family foster care (<emph>N</emph> = 19) with a group of matched mainstream control children, with respect to measures of inattention and early reading performance. They found that reading delay was significantly associated with the institutionalised group of children and they had lower reading scores than either the foster care group or the control group. Although IQ was related to performance in all groups, it was also found that inattention, specifically to high demand cognitive teacher led tasks, was also significantly associated with institutional care. The authors are rightly cautious about explanations given the limitations of the study, and call for further research. However, such results would be consistent with the role of quality of relationship history as having an impact on the ability of young children to regulate stress in demanding and potentially threatening, socially mediated learning contexts.</p> <p>In general these studies highlight early reading and literacy as a social process that is crucially dependent on the sensitivity to the parent in flexibly adjusting input to meet the child's ability and interests. During typical reading the adult reads and the child listens, but in <emph>dialogic</emph> reading, the adult becomes an active listener, questioner, informer and prompter of the child to increase the sophistication of the descriptions of the pictures in the book, and this may be seen as an ability to bridge the gap between the child's world and the book with careful use of images and language. In this kind of process, the child is learning to narrate, to become a storyteller.</p> <hd id="AN0030049775-9">Narrative coherence</hd> <p>One of the most helpful research discoveries for the assessment of psychological constructs, such as narrative coherence, has been a methodology that obtains an index of the nature and organisational state of an individual's internal representational models. A coherent narrative, or verbal account of memories, is one that has four pragmatic features that are important for meaningful, reciprocal social communication: relevance; appropriate quantity (e.g., informative only as is required); quality (truth and evidence); and manner (brief, orderly and unambiguous) (Grice, [<reflink idref="bib37" id="ref64">37</reflink>]). The methodology is also a form of discourse analysis that has been successfully used to access the internal representational states of adults (George, Kaplan, & Main, [<reflink idref="bib34" id="ref65">34</reflink>]). There continues to be a growing body of evidence to support the view that children's ability to communicate openly and coherently about interpersonal topics is linked to their security and to the prenatal, narrative state of mind of their caregiver (see Bretherton & Mullholland, [<reflink idref="bib12" id="ref66">12</reflink>]; Steele et al., [<reflink idref="bib64" id="ref67">64</reflink>]). The qualitative features of a spontaneous narrative are thought to reflect the state of mind of the narrator at the time of talking and will either facilitate or impede the four qualities above. Hence a coherent narrative will flow logically and naturally between participants, it will be free from contradictions, and memories will be freely selected and reflected upon.</p> <p>Doll play and pictorial story completion tasks have become established as a reliable index of narrative coherence and psychological security with very young and preschool aged children (Bretherton, [<reflink idref="bib11" id="ref68">11</reflink>]; Buchsbaum, Toth, Clayman, Cicchetti, & Emde, [<reflink idref="bib13" id="ref69">13</reflink>]; Jacobsen, Edelstein, & Hofmann, [<reflink idref="bib39" id="ref70">39</reflink>]; Main et al., [<reflink idref="bib44" id="ref71">44</reflink>]; Solomon & George, [<reflink idref="bib63" id="ref72">63</reflink>]; Warren, Emde, & Sroufe, [<reflink idref="bib72" id="ref73">72</reflink>]). In this technique, the task administrator begins the story using pictures or toys and then asks the child to complete the story by saying "tell me/show me what happens next". The story stems or "beginnings" are evocative of a distressing situation, one in which there would be a need for felt security, such as a child being hurt (a burnt hand), frightened (scary dog), abandoned (parents leave the child with a sitter) or getting into trouble (losing something of value to parents). They are referred to as story stems because only the start of the story is presented, with the aim to have the child complete it. There are numerous studies using techniques that assess narrative coherence, among other things, in adults and younger children, usually between the ages of four and eight, but there are relatively few studies on the internal representations of middle childhood. Methodologically, these children are too mature for the projective doll play, where the child plays with dolls and imagines their actions and thoughts, yet not sophisticated enough for interview techniques such as the adult attachment interview (George et al., [<reflink idref="bib34" id="ref74">34</reflink>]).</p> <p>Minnis et al. ([<reflink idref="bib49" id="ref75">49</reflink>]) have produced a computer adaptation of one of these doll play approaches, based on the MacArthur Story Stem Battery or MSSB (see Emde, Wolfe, & Oppenheim, [<reflink idref="bib30" id="ref76">30</reflink>]) which they refer to as the CMSSB. This would potentially appeal to and engage a wider age range of pupils and could be economically administered. Ordinarily, the administrator interacts directly with the child, initially in a neutral warm‐up story and then in 8 to 12 stories which are videotaped and subjected to detailed analysis. This involves rating numerous subscales (those for which significant results were obtained * are defined in Figure 2, below): narrative coherence*; affect regulation/dysregulation; denial/avoidance*; interpersonal themes; aggression; danger; conflict; events without agent; intentionality* and quality of parental response. The computerised version (CMSSB) has only two key players, the child and the computer. The role of the administrator is to introduce and train the child on the use of the computer and to be on hand to help out if the child becomes stuck. The stems are presented on the computer with animated figures and prompts that facilitate the child in beginning, maintaining and completing a series of animated stories.</p> <p>Graph: Figure 2 Definitions of significant CMSSB subscales.</p> <p>The following study reports on the findings of using the computer story completion methodology described above with a group of vulnerable looked‐after children and a control group, having a particular interest in the skills involved in narrative coherence and its implications for the children and those who work with them in an educational context. It was hypothesised that the looked‐after children would have more difficulties with narrative coherence and associated verbal skills than the control group of children.</p> <hd id="AN0030049775-10">Method</hd> <p></p> <hd id="AN0030049775-11">Participants</hd> <p>The target group of looked‐after children in foster care, aged 4‐ to 9‐years‐old, were approached through a Scottish Social Work Department and 63% (<emph>n</emph> = 17) of their parents, or social worker if <emph>in loco parentis,</emph> gave consent for their participation. All participants were in mainstream education. The parents of 17 children from a local primary school volunteered their child to participate. The school was chosen, in so far as is possible, to find a comparison group where the school children were from similar social backgrounds to the looked‐after children. Group composition is summarised below.</p> <p></p> <ulist> <item> • Experimental group: 17 looked after fostered children.</item> <p></p> <item> • Control group: 17 non‐looked after, non‐fostered children.</item> </ulist> <hd id="AN0030049775-12">Measures</hd> <p></p> <hd id="AN0030049775-13">Computerised MacArthur Story Stem Battery (CMSSB)</hd> <p>Participants completed a specially devised computerised story stem assessment based on the established MacArthur Story Stem Battery. The MacArthur group advised an economic approach by using only those story stems that had proved the most replicable and reliable in other studies (Minnis et al., [<reflink idref="bib49" id="ref77">49</reflink>]). These included the following six story stems: "The lost keys", "The burnt hand", "The scary dog", "The sweet shop", "Fight with a friend" and "Mum's headache". A prototype CMSSB was piloted for acceptability with 10 volunteer children who had no psychiatric involvement.</p> <p>This test has two warm‐up sections lasting approximately 10 minutes: one to familiarise the child with the equipment and image manipulation and another where the child completes a neutral story stem (a birthday party). The actual testing of the six CMSSB story stems is done by the child interacting only with the computer (via a series of prompts) although an administrator is close by to deal with difficulties.</p> <p>At the computer, the child sees an animated story beginning that involves simple drawings on the computer screen. A computerised voice asks the child to continue the story by saying "show me and tell me what happens next". A character called Mr Query pops up after a pre‐specified time and asks whether the child is finished telling the story. The child then has the option of clicking for "yes" or "no" or to ignore Mr Query completely. Where the story has a scripted response, it occurs only after the child has opted to finish or after a further time lapse. The child's vocal responses and the way s/he manipulates the screen characters are recorded and downloaded onto a CD. Rating is then carried out as for the doll‐play version. The CMSSB stories were transcribed and rated by co‐authors (RM, CS, AG and EK) for a range of indices including coherence of narrative, intentionality and avoidance of the dilemma presented in the story. Avoidance is a feature noted in various measures of attachment where the child does not refer to the emotional content of the situation. Intentionality refers to the extent to which the child provides an account that is portrayed or told in terms of the participants' motives, emotions or beliefs. See Figure 2 for a description of the subscales.</p> <p>Raters were blind to the care status of the child. A random sample of 10 percent of stories was allocated to a second rater who was blind to the first rating. Inter‐rater reliabilities are reported in Table 1 in the result section below.</p> <p>Table 1. Inter‐rater reliability using limits of agreement method.</p> <p> <ephtml> <table><thead valign="bottom"><tr><td>Rating Scale</td><td>Mean difference between ratings (95% confidence interval)</td><td>Range of composite scale (sum of 6 stories)</td><td>% of total scale range</td></tr></thead><tbody><tr><td>Coherence</td><td char=".">0.73 (−5.62–1.52)</td><td char=".">1–72</td><td char=".">0.01</td></tr><tr><td>Denial/Avoidance</td><td char=".">1.13 (0.0035–2.22)</td><td char=".">1–72</td><td char=".">0.016</td></tr><tr><td>Intentionality of action</td><td char=".">0.19 (−0.8–1.22)</td><td char=".">1–72</td><td char=".">0.003</td></tr><tr><td>Minnis, H., Millward, R., Sinclair, C., Kennedy, E., Greig, A., Towlson, K., Read, W., & Hill, J. (<xref ref-type="bibr" rid="bibr49">2006</xref>). Copyright John Wiley & Sons Limited. Reproduced with permission.</td></tr></tbody></table> </ephtml> </p> <hd id="AN0030049775-14">Verbal measures</hd> <p>The British Picture Vocabulary Scale and the Renfrew Bus Story (see below) were used in order to assess children's ability to tell stories. This allowed the researchers to check that the differences found between the experimental and the control children on the CMSSB were not simply due to basic story‐telling abilities.</p> <hd id="AN0030049775-15">The British Picture Vocabulary Scale (BPVS)(Dunn et al., 1982)</hd> <p>The BPVS is a well validated test of a child's ability of naming vocabulary or verbal comprehension (Atkinson, [<reflink idref="bib2" id="ref78">2</reflink>]). It is often used in studies as an index of verbal mental age, although it cannot be exactly equated with IQ. The child is shown a booklet about A4 size with four black and white drawings on each page. The child is given a prompt by the administrator – for example, "show me the ball" – which the child can then point to in preference to the other three pictures.</p> <hd id="AN0030049775-16">The Renfrew Bus Story (RBT) (Renfrew, 1991)</hd> <p>This test measures general language development between three and eight years. It involves listening to a short story which begins, "Once upon a time there was a naughty bus ...". The story is told with the aid of a picture book, and the child is asked to retell the story as the tester turns the pages of the book. A composite score is obtained by summing dimensions that rate the quality of information, the average sentence length, and the number of subordinate clauses.</p> <hd id="AN0030049775-17">Data analysis approach</hd> <p>The scores for individual stories on continuous scales were summed to form composite scales: for example, the coherence score for "Scary dog" story described above (where a story stem begins with a child being frightened by a large unfriendly dog when out in the park with his parents, who are momentarily distracted) has a potential range of 1–12, and the composite coherence scores for all six scales has a potential range of 1–72. The Limits of Agreement Method (Bland & Altman, [<reflink idref="bib4" id="ref79">4</reflink>]) was used to assess inter‐rater reliability. Between‐group comparisons were made using <emph>t</emph>‐tests and adjusting for potential confounders (age, gender and BPVS score), using multiple regression. Analyses were done using SPSS version 1.</p> <hd id="AN0030049775-18">Results</hd> <p></p> <hd id="AN0030049775-19">Inter‐rater reliability</hd> <p>There was good statistical power for inter‐rater reliability and the agreement between raters was good on all subscales, the mean difference between raters was very small at only 0.02% of the total scale (see Table 1).</p> <hd id="AN0030049775-20">Group comparisons of key measures and characteristics</hd> <p>Table 2 shows that there were no significant differences between the experimental and the control group with respect to age, gender, verbal comprehension (BPVS), language information and sentence length (RBT) but the control group had fewer boys than the looked after group.</p> <p>Table 2. Group comparisons for looked‐after vs control children on verbal comprehension (British Picture Vocabulary Scales – BPVS) and verbal information and sentence length (Renfrew Bus Test – RBT).</p> <p> <ephtml> <table><thead valign="bottom"><tr><td>Variable</td><td>Control children (<italic>N</italic> = 17)Mean (sd) or %</td><td>Looked‐after children (<italic>N</italic> = 17)Mean (sd) or %</td><td><italic>p</italic>‐value</td></tr></thead><tbody><tr><td>Age</td><td char=".">8.94 (2.66)</td><td char=".">7.47 (2.09)</td><td char=".">0.061</td></tr><tr><td>Gender (% boys)</td><td char=".">40.0 % (<italic>N</italic> = 7)</td><td char=".">62.5% (<italic>N</italic> = 10)</td><td char=".">0.029</td></tr><tr><td>BPVS score: verbal comprehension</td><td char=".">7.40 (3.26)</td><td char=".">7.41 (2.55)</td><td char=".">0.987</td></tr><tr><td>RBT scores: information</td><td char=".">30.56 (13.55)</td><td char=".">25.59 (12.45)</td><td char=".">0.280</td></tr><tr><td>Sentence length</td><td char=".">11.38 (5.07)</td><td char=".">10.48 (4.29)</td><td char=".">0.254</td></tr><tr><td>Minnis, H., Millward, R., Sinclair, C., Kennedy, E., Greig, A., Towlson, K., Read, W., & Hill, J. (<xref ref-type="bibr" rid="bibr49">2006</xref>). Copyright John Wiley & Sons Limited. Reproduced with permission.</td></tr></tbody></table> </ephtml> </p> <hd id="AN0030049775-21">Group comparisons of story stem scales</hd> <p>The purpose of the regression analysis was to examine the association between being a looked after child and the various subscales of the CMSSB, while taking into account factors which could interfere with this association because of a strong correlation with one of the other factors. These factors were gender, age, scores on the BPVS and scores on the Renfrew Bus Test. However, only the BPVS scores were strongly associated with the subscale scores, i.e., BPVS and narrative coherence were significantly associated (<emph>p</emph> < 0.001) and this was the only additional factor entered into the regression analysis. The control group achieved significantly better scores on coherence, avoidance and intentionality than the experimental group of children (see Table 3).</p> <p>Table 3. Group means for coherence and avoidance and intentionality (total of 6 stories; possible range 0–72).</p> <p> <ephtml> <table><thead valign="bottom"><tr><td>Scale</td><td>Control childrenMean (sd)<italic>N</italic> = 15</td><td>looked‐after childrenMean (sd)<italic>N</italic> = 16</td><td>Adjusted difference in score*</td><td>95% CI</td><td><italic>p</italic>‐value</td></tr></thead><tbody><tr><td>Mean coherence</td><td char=".">6.33 (2.53)</td><td char=".">4.42 (2.61)</td><td char=".">−1.89</td><td char=".">0.20 – 3.57</td><td char=".">0.029</td></tr><tr><td>Mean avoidance</td><td char=".">6.44 (2.85)</td><td char=".">8.60 (3.14)</td><td char=".">−2.50</td><td char=".">−4.68 – 0.33</td><td char=".">0.025</td></tr><tr><td>Mean intentionality</td><td char=".">6.13 (2.23)</td><td char=".">4.60 (2.27)</td><td char=".">1.87</td><td char=".">0.32 – 3.42</td><td char=".">0.020</td></tr><tr><td>Note: *adjusted for age, gender and BPVS score.Minnis, H., Millward, R., Sinclair, C., Kennedy, E., Greig, A., Towlson, K., Read, W., & Hill, J. (<xref ref-type="bibr" rid="bibr49">2006</xref>). Copyright John Wiley & Sons Limited. Reproduced with permission.</td></tr></tbody></table> </ephtml> </p> <hd id="AN0030049775-22">Discussion</hd> <p>The results of this study showed that children in foster care were out‐performed by their school‐aged peers on tests of narrative coherence, intentionality and avoidance, controlling for age and verbal comprehension. Such tests tap into the type of literacy skills that are usually not apparent in standard reading accuracy and comprehension tests. Coherence, intentionality and avoidance relate to forms of verbal performance such as story sequencing and structure, quantity and quality of narrative and the ability to imagine freely a variety of relevant perspectives and satisfactory outcomes in a given scenario.</p> <p>The story stems used in this study also invoked distressing scenarios around such themes as fear, loss, hurt and safety. Foster children typically have early traumatic relationship histories and it is perhaps not surprising that they performed less well than their peers on such salient scenarios for which they may lack a consistent internal narrative or actual, consistent or established satisfactory experiences. The explicit working through of salient and difficult memories could reasonably lead to confusion and avoidance in the face of anxiety (Price, [<reflink idref="bib54" id="ref80">54</reflink>]).</p> <p>As noted in the review above, the attachment quality of relationships has been linked to cognitive skill development (Fonagy et al., [<reflink idref="bib33" id="ref81">33</reflink>], [<reflink idref="bib31" id="ref82">31</reflink>], [<reflink idref="bib32" id="ref83">32</reflink>]) and institutional care to critical attentional skills as well as motivational and engagement processes involving the cultural learning of literacy tasks (Roy & Rutter, [<reflink idref="bib56" id="ref84">56</reflink>]).</p> <p>This study hints at how other, more subtle, skills required for literacy learning, such as narrative organisation both in written and verbal forms, perspective taking and story resolution may be implicated in early educational failure and underachievement in literacy in this group of children. Implicit in this study is the importance of the nature of the assessment material both in terms of complexity of demand and content. Situational content in some learning tasks for these children may act as triggers for specific distressing memories. Van Ijzendoorn et al's ([<reflink idref="bib69" id="ref85">69</reflink>]) meta‐analysis of studies on language, intelligence and attachment indicated that some language based assessments of insecure children are likely to be impaired due to attachment related anxiety and diversion of attention rather than their cognitive ability. It is perhaps also worth returning to the point that attachment security status has been found to be nearly as good a predictor of scholastic achievement outcomes as IQ.</p> <hd id="AN0030049775-23">Implications</hd> <p>It is of concern that difficulties originating in infancy persist over a number of years that are especially critical for children in terms of cognitive and emotional development. Learning materials and contexts that involve emotional content or that are unfamiliar or distressing to these children may result in impaired information processes, comprehension, written and verbal performance and pragmatic awareness as well as a generally lower quality of the learning experience. This suggests that, regardless of superficial or technical ability, these children need to be sensitively monitored and targeted for the earliest possible interventions available. Additionally, as noted by Trevarthen and Aitken ([<reflink idref="bib67" id="ref86">67</reflink>]), these children may present with all the signs of an attention deficit or hyperactive disorder which, although not tested here, may really indicate an inability to focus on the task due to anxiety and perceived threats.</p> <p>Psychologists and other professionals involved in the assessment of, and intervention with, children need to be aware of the theoretical and practical issues involved in this relatively subtle difficulty that impedes learning potential. Schools need to be aware of the impact of early traumatic relationships on learning potential and know how to tap into a variety of levels of suitable intervention. Severely affected children and foster families may be able to access intensive therapeutic programmes in clinics or settings outside school. As well as training school staff and foster parents on the impact of early trauma on learning potential and behavioural and emotional adjustment, psychologists can assist schools in accessing systemic level interventions for creating warm, secure learning environments and the setting up of nurture groups (Boxall, 2002). Children will need to be emotionally ready to learn and therefore perhaps also to benefit from established forms of early intervention. Additionally, psychologists could expand their therapeutic role by securing training in a range of individual therapeutic techniques such as cognitive behaviour therapy (CBT) and narrative therapies that are known to be an effective treatment for trauma (see Sutton, [<reflink idref="bib65" id="ref87">65</reflink>], for a discussion). There is still much to be researched and discovered both theoretically and in terms of efficacy and efficiency of such interventions in the field.</p> <hd id="AN0030049775-24">Limitations</hd> <p>There are numerous limitations to this study and explanations of the significant findings remain necessarily tenuous. Firstly, the study has a relatively small group size that affects the power of analyses. Secondly, whilst the study used classic methods of attachment classification (story stem completion), it was being applied in an innovative form using computerised story batteries. No attempt was made in this study, therefore, to use the assessment and analysis in terms of attachment security status. Further reliability and validity testing would be required in order to come to firmer conclusions about attachment status and its role in the outcomes of this study. Rather, the focus of the study was on the narrative skills involved in the computerised task itself. Thirdly, due to time constraints, actual data relating to quality of early relationship histories was not available. Similarly, the inclusion of data on the children's achievement scores on a range of standardised literacy tasks and other indices of school adjustment would perhaps have further supported the findings and conclusions of this small scale study. However, this study does draw attention to the wider range of scholastic skills that are mediated interpersonally and that are critical for motivation and achievement in literacy in its fullest sense.</p> <p>Finally, it should be noted that this study showed that the control group of children <emph>specifically</emph> out‐performed the experimental children in measures that were already loaded with factors likely to highlight known differences between the groups (i.e., the story themes being designed to invoke distress, etc). Whether or not a significant result would be obtained for the comparison of more <emph>general</emph> literacy indices needs to be evidenced in the existing review and by further research.</p> <p>Balbernie ([<reflink idref="bib3" id="ref88">3</reflink>]) summarised the three main and important conclusions from recent developments in brain research: children's capacity to learn and thrive in any setting depends on the interaction of both genes and the care they receive; the human brain is culturally adaptive and is therefore constructed to benefit from social interaction, from good teaching, especially in the early years; and, although opportunities and risks are greatest in the early years, humans do go on learning throughout life (Schore, [<reflink idref="bib61" id="ref89">61</reflink>]). 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  Data: Relationships and Learning: A Review and Investigation of Narrative Coherence in Looked-After Children in Primary School
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  Data: <searchLink fieldCode="AR" term="%22Greig%2C+Anne%22">Greig, Anne</searchLink><br /><searchLink fieldCode="AR" term="%22Minnis%2C+Helen%22">Minnis, Helen</searchLink><br /><searchLink fieldCode="AR" term="%22Millward%2C+Reuben%22">Millward, Reuben</searchLink><br /><searchLink fieldCode="AR" term="%22Sinclair%2C+Claire%22">Sinclair, Claire</searchLink><br /><searchLink fieldCode="AR" term="%22Kennedy%2C+Eilis%22">Kennedy, Eilis</searchLink><br /><searchLink fieldCode="AR" term="%22Towlson%2C+Kate%22">Towlson, Kate</searchLink><br /><searchLink fieldCode="AR" term="%22Reid%2C+Warren%22">Reid, Warren</searchLink><br /><searchLink fieldCode="AR" term="%22Hill%2C+Jonathan%22">Hill, Jonathan</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Educational+Psychology+in+Practice%22"><i>Educational Psychology in Practice</i></searchLink>. Mar 2008 24(1):13-27.
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  Data: Routledge. Available from: Taylor & Francis, Ltd. 325 Chestnut Street Suite 800, Philadelphia, PA 19106. Tel: 800-354-1420; Fax: 215-625-2940; Web site: http://www.tandf.co.uk/journals/default.html
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  Data: 15
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  Data: 2008
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  Data: Journal Articles<br />Reports - Evaluative
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  Label: Education Level
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  Data: <searchLink fieldCode="EL" term="%22Elementary+Education%22">Elementary Education</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Experimental+Groups%22">Experimental Groups</searchLink><br /><searchLink fieldCode="DE" term="%22Control+Groups%22">Control Groups</searchLink><br /><searchLink fieldCode="DE" term="%22Investigations%22">Investigations</searchLink><br /><searchLink fieldCode="DE" term="%22Personal+Narratives%22">Personal Narratives</searchLink><br /><searchLink fieldCode="DE" term="%22Attachment+Behavior%22">Attachment Behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Caregiver+Child+Relationship%22">Caregiver Child Relationship</searchLink><br /><searchLink fieldCode="DE" term="%22Emotional+Development%22">Emotional Development</searchLink><br /><searchLink fieldCode="DE" term="%22Early+Experience%22">Early Experience</searchLink><br /><searchLink fieldCode="DE" term="%22Metacognition%22">Metacognition</searchLink><br /><searchLink fieldCode="DE" term="%22Foster+Care%22">Foster Care</searchLink><br /><searchLink fieldCode="DE" term="%22Mainstreaming%22">Mainstreaming</searchLink><br /><searchLink fieldCode="DE" term="%22Developmental+Psychology%22">Developmental Psychology</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Educational+Psychology%22">Educational Psychology</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22United+Kingdom+%28Scotland%29%22">United Kingdom (Scotland)</searchLink>
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  Data: 10.1080/02667360701841189
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  Data: 0266-7363
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  Data: This review and investigation draws on principles from attachment theory regarding the importance of early relationships and their impact on the coherence and organisation of psychological functions. Comparisons are made between the narrative coherence scores of an experimental group of 17 looked-after children with problematic relationship histories in mainstream school and a matched control group of 17 of their peers. There were significant differences between the groups in the coherence of children's narratives, denial and avoidance in story play themes and in their use of intentionality. The paper considers the theory and discusses the results in terms of the implications for teaching, learning and intervention. (Contains 2 figures and 3 tables.)
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  Data: 2008
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  Data: EJ786670
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        Value: 10.1080/02667360701841189
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      – Text: English
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        PageCount: 15
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      – SubjectFull: Experimental Groups
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      – SubjectFull: Investigations
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      – SubjectFull: Personal Narratives
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      – SubjectFull: Attachment Behavior
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      – SubjectFull: Caregiver Child Relationship
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      – SubjectFull: Foster Care
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      – SubjectFull: United Kingdom (Scotland)
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      – TitleFull: Relationships and Learning: A Review and Investigation of Narrative Coherence in Looked-After Children in Primary School
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