Investigating trajectories of change in attachment and biobehavioral catch-up: a randomized clinical trial

Abstract

Attachment and Biobehavioral Catch-up (ABC) is a manualized, 10-session intervention that was developed at the University of Delaware to improve parenting abilities and subsequently increase the rate of children's secure attachments and self-regulatory capabilities in high-risk populations. The aims of the current randomized clinical trial were two-fold; the first aim was to investigate whether there were significant differences in parental sensitivity, intrusiveness, and positive regard after completion of ABC when compared to a control condition. The second aim was to explore the rate and shape of change in parenting behaviors. Participants were 24 mothers and their biological children who were randomly assigned to ABC ( n = 13) or a control condition (n = 11). A structured play assessment with each mother and her child was video-recorded prior to randomization into the study, prior to each intervention session, and at a follow-up visit. A total of 259 videos were coded for sensitivity, intrusiveness, and positive regard. Hierarchical linear growth models were used to estimate the total change and rate of change in parenting qualities across the 10 intervention sessions when comparing ABC to a control condition. Piecewise hierarchical linear growth models were used to investigate patterns of change across the 10 sessions for mothers within ABC. Results indicated that mothers in the ABC condition showed greater increases in sensitivity and decreases in intrusiveness when compared to mothers in the control condition. No significant differences in positive regard were found. Preliminary evidence for nonlinear patterns of change in parental sensitivity and intrusiveness among mothers in ABC was also indicated. Results contribute to the growing evidence suggesting that the first few sessions of an intervention or therapy generate the most change and provide additional support that this brief parenting intervention is effective in changing parenting behaviors.