2-126 - Randomized Interventions in Early Childhood: Exploring Multilevel Mechanisms Mediating Change

Session Type: Paper Symposium

Integrative Statement

RCT’s have shown that a variety of intervention models focused on improving parent-child interaction are successful in improving child outcomes. However, surprisingly few studies have carefully assessed the mechanisms underlying these improved outcomes. For example, while several studies have assessed maternal sensitivity as a likely change mechanism, the only study to assess mediation statistically found no mediation (Cicchetti et al., 2006). Thus, more work is needed to test our assumptions regarding how interventions cause change in child development.
The current symposium brings together three state of the art RCT’s to improve parent-child interaction and child outcomes during the first five years of life, with a focus on exploring questions of mechanism. All three interventions used video-feedback techniques as an essential element of intervention. However, each looks at a different aspect of mechanism of effect. In the first presentation, reductions in frightened, frightening, or atypical maternal behavior are assessed as a mediator of reductions in infant disorganized attachment behavior, using recent statistical improvements in evaluating mediation. In the second presentation, intervention-related changes in maternal behavior are assessed as one mediator of change in maternal neurobiological responses in the inferior frontal gyrus, part of the neural network mediating inhibitory control. The final presentation focusses on mechanism at the level of the clinician’s activity, with clinicians’ ‘in the moment’ comments on mother-child interaction evaluated as a critical component producing change in maternal sensitivity.
Discussion will focus on future directions for increasing our understanding of the multilevel causal processes involved in intervention.

Sub Unit

• Prevention and Interventions

Chair

• Karlen Lyons-Ruth, Harvard Medical School

Discussant

• Pasco Fearon, Research Department of Clinical, Educational and Health Psychology, University College London

Individual Presentations

• Assessing Change Mechanism in an Infant RCT: Does Reduction in Maternal Disrupted Communication Reduce Infant Disorganization? - Presenting Author: Susana Tereno, Institut de Psychologie, Université Paris Descartes, Sorbonne Paris Cité; Sheri Madigan, University of Calgary; Karlen Lyons-Ruth, Harvard Medical School; Andre Plamondon, Département des fondements et pratiques en éducation, Université Laval, Quebec City, Canada; Leslie Atkinson, Department of Psychology, Ryerson University, Toronto, Canada; Nicole Guedeney, Université Paris Diderot, Sorbonne Paris Cité; Tim Greacen, Laboratoire de Recherche, Etablissement public de santé Maison Blanche; Romain Dugravier, Institut de Puériculture de Paris Université Paris Diderot, Sorbonne Paris Cité; Thomas Saias, Département de Psychologie, Université du Québec, Montréal, Canada; Florence Tubach, Unité de Recherche Clinique Paris-Nord, Hôpital Bichat Claude-Bernard, Paris, France; Antoine Guedeney, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France Université Denis Diderot, Sorbonne Paris Cité

• Inhibitory Control Mechanisms of a Nurturing Parenting Intervention - Presenting Author: Nicole Giuliani, Department of Psychology University of Oregon; Kathryn G Beauchamp, University of Oregon; Philip A. Fisher, University of Oregon

• Identifying the Mechanism of an Early Intervention and Ensuring Model Fidelity - Presenting Author: Mary Dozier, University of Delaware