Poster #166 - Effectiveness of an Attachment-Based Intervention on Children's Socioemotional Well-being

• In Event: 2-163 - Poster Session 08
  In Poster Session: PS 08 Section - Prevention and Interventions

Integrative Statement

Children who experience early life adversity, including experiences of maltreatment, neglect, and unstable care, are at risk for the development of socioemotional problems (Maughan & Cicchetti, 2002). As a result, these issues may lead to maladaptive outcomes later in life, such as internalizing and externalizing problems, poor academic functioning, and peer relational issues. Research suggests that the development of secure, organized attachment relationships between child and caregiver early in life are central in supporting healthy socioemotional regulatory capabilities.

Attachment and Biobehavioral Catch-up (ABC) is a preventative intervention aimed at promoting the development of secure attachments between child and caregiver by enhancing caregiver sensitivity. Due to strong evidence of efficacy (Bernard et al., 2012; Bernard, Hostinar, Dozier, 2015; Lind et al., 2017), ABC is now being disseminated in many communities throughout the United States and internationally. Given that interventions are often less effective when moved from efficacy to effectiveness contexts (Durlak & Dupre, 2008), it is critical to examine ABC’s effectiveness as it scaled. The current study aimed to examine (1) whether ABC influenced children’s socioemotional functioning in the context of community-based implementation, and (2) whether changes in children’s socioemotional functioning were mediated by the purported intervention mechanism: enhanced parental sensitivity.

A total of 200 parents and their infants were enrolled in a randomized clinical trial being implemented in a high-risk community characterized by concentrated poverty. Dyads were randomly assigned to ABC or a waitlist condition [data for a subsample of 78 participants were available for current analyses]. Parent sensitivity was assessed pre- and post-intervention through video-recorded play interactions (NICHD ECCRN, 1999, 2003). Residualized changes scores were computed that reflected change in parental sensitivity from pre- to post-intervention. Parents completed the Ages and Stages Questionnaire- Social-Emotional, 2nd edition (ASQ-SE:2), and children were classified as low-risk, sub-threshold risk, and at-risk based on age-based norms. For analyses, risk level was dichotomized as low-risk versus any risk.

Mediation analyses were conducted using PROCESS 2.041 in SPSS (Hayes, 2013). Full model results are presented in Table 1. ABC was a significant predictor of change in parental sensitivity (see Figure 1), with parents randomly assigned to ABC demonstrating higher sensitivity at post-intervention than parents randomly assigned to the control group. Increased parental sensitivity, in turn, predicted reduced likelihood of children being classified as at-risk for socioemotional problems. The indirect (i.e., mediating) effect of ABC on children’s risk for socioemotional problems via change in parental sensitivity was significant, b = -.35 [95% CI: -1.09, -.02].

These results suggest that, when implemented in the community, ABC continues to show evidence of effectiveness via the purported intervention mechanism. Although a limitation of the study is the reliance on parental report of children’s socioemotional risk, identifying valid yet scalable assessment tools, like the ASQ-SE that capture intervention effects on children's well-being is important for ongoing monitoring of successful dissemination.

Authors

• Aline Szenczy, Stony Brook University
  Presenting Author

• Melanie Rodriguez, Stony Brook University
  Non-Presenting Author

• Allison Dash, Power of Two
  Non-Presenting Author

• Steven Imrisek, Stony Brook University
  Non-Presenting Author

• Kristin Bernard, Stony Brook University
  Non-Presenting Author