Can the family drawing be a useful tool for assessing attachment representations in children? A systematic review and meta-analysis

A systematic review and meta-analysis were conducted to evaluate the quality and validity of Family Drawings (FD) with an Attachment-Based Coding System in assessing attachment representations among pre-school and school-age children. A literature search in notable databases identified 645 records, of which 20 were eligible after screening and quality assessment. Results showed: 1) ABCD attachment distribution in community children was: 48% secure, 20% avoidant, 21% ambivalent, 11% disorganized. Security prevailed both in classifications and Fury et al.’ scales. 2) No significant differences according to the cultural background; 3) At-risk/clinical children showed higher insecurity than community ones using scales; 4) Girls were more secure than boys. In conclusion, FD may be a culture-fair method to assess attachment representations in children. Global scales seem more reliable than ABCD classifications for discriminating at-risk and clinical children, but further studies on these groups are needed.