|dc.description.abstract||Background: Maltreated children, including those who are looked after away from
home, are amongst the most vulnerable members of society. Due to the relational
trauma that most looked after children have experienced they are at increased risk of
attachment and mental health difficulties, which can impede their ability to form
close relationships with new carers. Indeed, many such children behave in ways that
fail to elicit caregiving or even as if they do not need caregivers, and providing
sensitive, therapeutic care to these vulnerable children can be a considerable
Aims: The aims of this thesis were threefold: to review the impact of maltreatment
experiences on children’s executive functioning, to investigate the prevalence of
attachment and trauma-related difficulties in children in foster care, and their impact
on the parenting task of foster carers.
Methods: Aims are addressed in two journal articles. To address the first aim, a
systematic review of research regarding the association between maltreatment and
executive function in children and adolescents is presented in journal article one.
Subsequent aims are addressed in journal article two, a cross-sectional study with
foster carers of children in care aged 3-12 years who completed self-report measures
investigating the emotional, behavioural, attachment and trauma related difficulties
of their foster child, the perceived quality of the relationship, and levels of parenting
stress and sense of competence.
Results: The systematic review revealed that the majority of studies demonstrated a
significant impairment in one or more areas of executive ability in maltreated
children, with particular support for impairments in inhibitory control, executive
working memory and decision making. However, there was only limited support for
impairments in cognitive flexibility, planning/problem solving, and fluency.
Furthermore, there was considerable variability between studies in the specific
deficits reported. Results from the empirical study highlight the prevalence of
attachment and trauma-related difficulties in children in foster care. Hierarchical
regression analyses revealed that levels of foster carer-rated inhibited attachment
behaviour was a significant predictor of quality of the foster carer-child relationship
and parenting stress. The level of emotional and behavioural difficulties also
emerged as a significant predictor of quality of the foster carer-child relationship, and
parenting sense of competence.
Conclusions: This thesis highlights the pervasive impact of relational trauma on
children. Results of the systematic review indicate its impact on children’s executive
ability. The empirical study reveals the high prevalence of attachment and trauma-related
difficulties in children in foster care, and provides insight into factors related
to quality of the foster carer-child relationship, and the stress and sense of
competence of foster carers. Implications for interventions and service provision
regarding maltreated children who become looked after away from home, and their
carers, are discussed.||en