Enhancing executive functioning among toddlers in foster care with an attachment-based intervention

Abstract

Young children in foster care often experience adversity, such as maltreatment and lack of stability in early caregiving relationships. As a result, these children are at risk for a range of problems, including deficits in executive functioning. The Attachment and Biobehavioral Catch-up for Toddlers (ABC-T) intervention was designed to help foster parents behave in ways that promote the development of young children's emerging self-regulatory capabilities. Participants included 173 parent-toddler dyads in three groups: foster families that were randomly assigned to receive either the ABC-T intervention (n = 63) or a control intervention (n = 58), as well as low-risk parent-toddler dyads from intact families (n = 52). At a follow-up conducted when children were approximately 48 months old, children's executive functioning abilities were assessed with the attention problems scale of the Child Behavior Checklist (Achenbach & Rescorla, 2000) and a graded version of the Dimensional Change Card Sort developed for preschoolers (Beck, Schaefer, Pang, & Carlson, 2011). Results showed that foster children whose parents received the ABC-T intervention and low-risk children never placed in foster care had fewer parent-reported attention problems and demonstrated greater cognitive flexibility during the Dimensional Change Card Sort than foster children whose parents received the control intervention. These results indicate that an attachment-based intervention implemented among toddlers in foster care is effective in enhancing children's executive functioning capabilities.Children in foster care are at risk for negative developmental outcomes as the result of experiences of abuse, neglect, and unstable attachment relationships (Jackson, Gabrielli, Fleming, Tunno, & Makanui, 2014). In addition to the initial removal from their birth parents, children in foster care often experience repeated disruptions in their attachment relationships as they transition between multiple caregivers and placements (Dozier & Lindhiem, 2006;Sanchirico & Jablonka, 2000). As a result, foster children often struggle with effectively regulating their cognitions (Bernedo, Salas, Fuentes, & García-Martín, 2014;Tarren-Sweeney, 2008), emotions (Pears, Kim, Buchanan, & Fisher, 2015), behaviors (Clausen, Landsverk, Ganger, Chadwick, & Litrownik, 1998;Keller et al., 2001), and Address correspondence and reprint requests to: Mary Dozier, Department of Brain and Psychological Sciences, University of Delaware, 108 Wolf Hall, Newark, DE 19716; mdozier@udel.edu. (Bernard, Butzin-Dozier, Rittenhouse, & Dozier, 2010;Bruce, Fisher, Pears, & Levine, 2009). HHS Public AccessIn the United States, about 20% of children in foster care are between the ages of 1 and 3 years old (US Department of Health and Human Services, 2015). Children in this age group face several critical developmental tasks: establishing attachment relationships with caregivers (Sroufe, 2005), using attachment relationships to coregulate difficult emotions (Cassidy, 1994), and developi...

Sustained effects on attachment security in middle childhood: results from a randomized clinical trial of the Attachment and Biobehavioral Catch‐up (ABC) intervention

“…These findings are consistent with a larger body of work demonstrating positive effects of ABC on child outcomes across a range of domains (e.g., Bernard et al, ; Bick et al, ; Dozier & Bernard, ; Grube & Liming, ; Lind, Raby, Caron, Roben, & Dozier, ; Raby et al, ; Tabachnick, Raby, Goldstein, Zajac, & Dozier, ). In addition to promoting secure and organized attachments during infancy (Bernard et al, ), ABC is effective in reducing children's expression of negative affect (Lind, Bernard, Ross, & Dozier, ) and enhancing executive functioning (Lind et al, ), physiological regulation (Bernard, Hostinar, & Dozier, ), and receptive vocabulary (Raby et al, ) in early childhood for children involved in the child welfare system. During middle childhood, ABC has been shown to positively affect physiological regulation (Tabachnick et al, ) and brain development (Bick et al, ).…”

Circle of Security–Parenting: A randomized controlled trial in Head Start

“…Not incidentally, the three key caregiving dimensions linked to children’s EF (sensitivity, mind–mindedness, and autonomy–support; Carlson, 2003) have also been linked to secure attachment (Ainsworth, Blehar, Waters, & Wall, 1978; Bernier & Dozier, 2003; Whipple, Bernier, & Mageau, 2011). Further, a recent study found that children of parents who participated in the Attachment and Biobehavioral Catchup for Toddlers program showed improved EF skills following the intervention, including reduced attention problems and enhanced cognitive flexibility (Lind, Raby, Caron, Roben, & Dozier, 2017 [this issue]).…”

Attachment and Biobehavioral Catch-up: addressing the needs of infants and toddlers exposed to inadequate or problematic caregiving

“…As toddlers, children in the ABC intervention showed lower anger during a frustrating problem-solving task than children in the control group [41]. Finally, children in the ABC group also showed more optimal inhibitory control and cognitive flexibility several years after the intervention than children in the control group [42,43]. …”

“…Similar to ABC for infants, ABC-T coaches provide frequent in the moment comments to celebrate, reinforce, and scaffold parents’ behaviors with regard to each of the targets. In a randomized clinical trial, ABC-T has been found to improve foster children’s cognitive flexibility and reduce foster children’s attention problems [43]. In ongoing research, it will be critical to examine whether ABC-T reduces externalizing behaviors, such as aggression and non-compliance, in addition to the related constructs of cognitive self-control.…”