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

Abstract

Background Interventions have been developed to promote the development of secure and organized attachments during early childhood among children who have experienced early adversity, yet little is known about whether the effects of these early interventions are sustained beyond 12 months postintervention. The current study examined whether receiving the Attachment and Biobehavioral Catch‐Up (ABC) intervention during infancy led to improvements in perceived attachment security in middle childhood among 100 Child Protective Services (CPS)‐referred children. Methods Children and parents were randomized to receive ABC or a control intervention during infancy. Children completed the Kerns Security Scale at age nine (Mage = 9.46, SD = 0.36). (Trial Registry Name: Intervening Early with Neglected Children; Registry ID: NCT02093052; URL for registry: https://clinicaltrials.gov/ct2/show/NCT02093052?term=dozier%26rank=1). Results Children whose parents received ABC reported higher levels of attachment security on the Kerns Security Scale at age nine than children whose parents had received the control intervention, t(98) = 2.31, p = .023, d = 0.49. Conclusions Findings underscore the long‐term benefits of intervening early to promote caregiving quality among at‐risk families and demonstrate the efficacy of a brief 10‐session intervention in promoting attachment security over the span of eight years in a sample of CPS‐referred children.

Increasing secure base script knowledge among parents with Attachment and Biobehavioral Catch-up

“…Because parents’ secure base script knowledge was not assessed prior to completing the intervention, we cannot rule out the possibility that randomization was not successful, meaning that parents who received the ABC and control interventions differed in their secure base script knowledge prior to being randomized to receive one of the two interventions. That said, the parents who received the ABC intervention did not differ from parents who received the control intervention with respect to many key demographic variables, and other analyses with this group of parents have reported a lack of significant differences in parents’ attachment states of mind and parents’ sensitivity assessed prior to receiving the interventions (Zajac et al, 2019).…”

“…There is robust evidence indicating that the ABC intervention promotes sensitive parenting and enhances children's biological and behavioral wellbeing during infancy and early childhood (Dozier & Bernard, 2017; Dozier & Bernard, 2019). Emerging evidence suggests that ABC has sustained effects on children's outcomes during middle childhood, including effects on neural activity, hypothalamic–pituitary–adrenal axis regulation, autonomic nervous system functioning, and perceived attachment security (Bick, Palmwood, Zajac, Simons, & Dozier, 2018; Garnett, Bernard, Hoye, Zajac, & Dozier, 2020; Tabachnick, Raby, Goldstein, Zajac, & Dozier, 2019; Valadez, Tottenham, Tabachnick, & Dozier, 2020; Zajac, Raby, & Dozier, 2019). The results of the current study offer novel evidence that the ABC intervention also has sustained effects on parents.…”

Enhancing diurnal cortisol regulation among young children adopted internationally: A randomized controlled trial of a parenting-based intervention

“…An important question for future research is whether the effects of the ABC intervention on HPA axis regulation are sustained over time for internationally adopted children. ABC has been shown to have fairly long-term effects on the biological outcomes of children from CPS-referred families (Bernard et al, 2015b; Bick, Palmwood, Zajac, Simons, & Dozier, 2019; Tabachnick, Raby, Goldstein, Zajac, & Dozier, 2019; see also Zajac et al, 2020). In addition, ABC's effects on parenting have been observed to persist for at least 2 years for parents who adopted internationally (Yarger et al, 2019a).…”

“…ABC also has positive effects on children's behavioral outcomes. Children who parents received ABC exhibit increased attachment security (Bernard et al, 2012; Zajac, Raby, & Dozier, 2020), less negative affect (Labella, Lind, Sellers, Roben, & Dozier, 2020; Lind, Bernard, Ross, & Dozier, 2014), greater compliance (Lind, Bernard, Yarger, & Dozier, 2019), stronger executive functioning abilities (Lewis-Morrarty, Dozier, Bernard, Moore, & Terraciano, 2012; Lind, Raby, Caron, Roben, & Dozier, 2017), and more advanced receptive language skills (Bernard, Lee, & Dozier, 2017b; Raby et al, 2019) than children whose parents received a control intervention.…”

Editorial: The primacy of parenting

“…Importantly, both animal and human data have established that there are early sensitive periods, representing windows of opportunity, during which optimal caregiving has its most powerful effects (Curley & Champagne, 2016; Nelson et al, 2007). These points are underscored by papers in this volume showing the sustained effects of early parenting interventions focused on enhancing attachment relationship (Zajac, Raby, and Dozier (2019)). Using another parenting program, Brody, Yu, Miller, and Chen (2019) report longitudinal data showing mechanistic pathways by which the effects of enhanced caregiving impact later adaptive functioning in a high risk sample.…”