Group Attachment Based Intervention (GABI) Targeting Young Child Maltreatment: Improvement in Developmental Outcomes

• In Event: Poster Session 04
  In Poster Session: PS 04 Topic - Prevention and Interventions

Abstract

BACKGROUND: Children who are maltreated or live with parents with a history of maltreatment, are at significant risk for impairments in biological, cognitive, and social-emotional functioning. Recently, interventions aimed at improving the mother-child relationships have been extended to include reports on infant/toddler cognitive outcomes, not central to the intervention, but an understandable corollary of social-emotional development (Dubois-Comtois, et al, 2017). GABI is a multifamily maltreatment prevention program for families with children 0 to 3. Systematic Training for Effective Parenting (STEP) is a parent training program to prevent maltreatment and was Treatment as Usual (TAU) for families in the Bronx, NY, where GABI was tested in a RCT in comparison to STEP. Importantly, STEP treats only parents, while GABI treats both children and parents.
OBJECTIVE: To assess the differential impact upon children’s cognitive development in the RCT comparing GABI to STEP.
DESIGN/METHOD: A randomized control trial was conducted at an urban university affiliated multidisciplinary center in the Bronx, NY, with families with children 0 to 3 at-risk for maltreatment. Families were randomly assigned to either GABI or STEP. The Bayley Scales of Infant and Toddler Development Screening Test, 3rd Edition was administered to children at intake and end-of-treatment. Statistical analysis included McNemar-Bowker test, chi-square (see separate PDF with Table)
RESULTS: Seventy-eight families completed treatment (GABI n=43; STEP n= 35), with 43% of children over 18 months but under 3 years of age; ethnically diverse sample, with >90% Black, Hispanic, or biracial; >70% reported >4 ACEs; and nearly 20% had previously lost custody of a child. Comparisons across treatment time for GABI on a cross-tabulations for Bayley-III categorizations (At-Risk, Emerging, and Competent) as shown in Table 1, indicate that 35% (n=15) showed improvement from At Risk/Emerging to Competent and 40% (n=17) maintained Competent categorization from intake; only 25% (n=11) showed decreased competence. Only 37% (n=16) of GABI children were Competent at intake; by end-of-treatment, 53% (n=23) were Competent. STEP performed no better than chance, with as many children, 23% improving (n=8) as decreasing scores (n=8); the remaining 54% (n=19) maintained baseline categorization. The number of STEP children in the Competent category held at 51% (n=18) over the course of treatment. Finally, 71% (n=5) of GABI children in the At-Risk group at intake shifted to Competent by end-of-treatment (p<.05); this was only true for 40% (n=2) of STEP children (p=.51).
CONCLUSION: In this population a significant improvement in developmental competence was seen in GABI. No difference was noted in STEP. Discussion will focus on the import of treating both child and mother in early preventive interventions.

Authors

• Romina Barros, Montefiore Medical Center
  Presenting Author

• Miriam Steele, New School for Social Research
  Non-Presenting Author

• Howard Steele, New School for Social Research
  Non-Presenting Author

• Christina Panas, New School for Social Research
  Non-Presenting Author

• Grace Drylewski, The New School for Social Research
  Non-Presenting Author

• Anne Murphy, Montefiore Medical Center
  Non-Presenting Author