Attachment-Based Intervention for Child Health Outcomes

Overseen By Roderick Rose, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Maryland, Baltimore

Disqualifiers: Premature birth, Heart conditions, Autoimmune, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 10

260 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines how an attachment-based program can improve health outcomes in young Latino children, such as reducing common illnesses and enhancing sleep. It compares two groups: one participating in the Attachment Biobehavioral Catch-Up (ABC) program with home-based sessions, and another receiving weekly children's books through the Home Book-of-the-Week (HBOW) program. Mothers who identify as Latina, speak English or Spanish, and have a 9-month-old child on Medicaid are suitable candidates for this study. As an unphased trial, this study provides a unique opportunity to contribute to research that could enhance children's health and development.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this intervention is safe for children?

Research has shown that the Attachment and Biobehavioral Catch-Up (ABC) program is safe for young children. The program consists of 10 home visits where a trained coach assists the parent and child. Studies have found that families in the ABC program typically experience positive results without major side effects. The program emphasizes supporting the child's emotional and behavioral growth. Since ABC has been used elsewhere without reports of harm, it is generally well-accepted. This evidence supports its safety for children in the trial. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Attachment and Biobehavioral Catch-Up (ABC) program because it offers a novel approach to improving child health outcomes by focusing directly on enhancing the parent-child relationship. Unlike traditional methods that might emphasize medication or standalone educational resources, the ABC program involves personalized, home-based coaching sessions that help caregivers better respond to their children's needs. This hands-on, interactive approach fosters stronger emotional bonds and can lead to more positive developmental outcomes. Meanwhile, the Home-Based Book-of-the-Week (HBOW) program is unique in its dual-language support and weekly book delivery, which not only encourages literacy but also provides regular opportunities to monitor and support family well-being. Both programs bring innovation to child development interventions by integrating practical, family-centered strategies directly into the home environment.

What evidence suggests that this trial's treatments could be effective for improving child health outcomes?

Research shows that the Attachment and Biobehavioral Catch-Up (ABC) program, one of the interventions in this trial, improves children's well-being by enhancing parenting practices. Studies have found that children participating in ABC manage their emotions better and exhibit healthier physical responses, both crucial for overall health. The program helps parents support their children in managing emotions and behaviors more effectively. This approach has been particularly beneficial for children in child welfare, suggesting positive effects on broader health outcomes. Although this study focuses on Latino children, the general findings indicate that ABC can promote healthier development for all children. ^{1 2 3 6 7}

Who Is on the Research Team?

Lisa Berlin, PhD

Principal Investigator

University of Maryland

Natalie Slopen, PhD

Principal Investigator

Harvard School of Public Health (HSPH)

Cathi Propper, PhD

Principal Investigator

Department of Psychology and Neuroscience at UNC Chapel Hill

Are You a Good Fit for This Trial?

This trial is for Latina mothers with a 9-month-old child enrolled in Medicaid. The child must be born at full term without major complex medical conditions like heart or autoimmune diseases that could affect participation.

Inclusion Criteria

My 9-month-old child is enrolled in Medicaid.

Women who are having their first baby and women who have had more than one baby.

I am a biological mother.

Exclusion Criteria

My child has a serious health condition that could affect their participation in the study.

I was born before 37 weeks of pregnancy.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive either the ABC program or the HBOW program over 10 weeks

10 weeks

10 home-based sessions

Post-Intervention Assessment

Two post-intervention assessments are conducted to evaluate outcomes

Approximately 12 months

Follow-up

Participants are monitored for health outcomes such as sleep, BMI, and common childhood illnesses

3 months

What Are the Treatments Tested in This Trial?

Interventions

• Attachment and Biobehavioral Catch-Up
• Home-Based Book-of-the-Week

Trial Overview The study tests an attachment-based intervention (ABC) against a Home Book-of-the-Week program, focusing on health outcomes such as illnesses, body mass index, and sleep in low-income Latino children.

How Is the Trial Designed?

Group I: Attachment and Biobehavioral Catch-up (ABC) program Experimental Treatment 1 Intervention

The ABC program consists of 10 1 -hour home-based sessions delivered by a trained parent coach. Each session includes the mother and her child together and addresses a specific topic.

Group II: Home-Based Book-of-the-Week (HBOW) program Active Control 1 Intervention

The HBOW program consists of 10 English/Spanish developmentally appropriate books hand-delivered weekly to the mothers. A trained RA will utilize a standard set of questions to ask about the mother's and child's well-being.

Who Is Running the Clinical Trial?

University of Maryland, Baltimore

Lead Sponsor

Trials

729

Recruited

540,000+

Harvard School of Public Health (HSPH)

Collaborator

Trials

283

Recruited

17,030,000+

Johns Hopkins University

Collaborator

Trials

2,366

Recruited

15,160,000+

Published Research Related to This Trial

The Attachment and Biobehavioural Catch-Up (ABC) program, a 10-session home visiting intervention, has shown a significant small to medium effect on improving attachment-related outcomes for parents with psychosocial risk factors, based on a review of 11 controlled trials.

The program particularly enhanced parental sensitivity, indicating that ABC can positively influence caregiver behaviors that are crucial for child development, although further research is needed to identify the most effective target populations and compare it with other interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of the "Attachment and Biobehavioural Catch-Up" program on attachment related parent behavior-A systematic review. O'Byrne, E., McCusker, C., McSweeney, S.[2023]

Attachment-based interventions for caregivers of toddlers (12-24 months) can lead to improved attachment security, with Child-Parent Psychotherapy and Attachment and Biobehavioral Catch-Up showing the strongest evidence for effectiveness.

Most of the evidence supporting these interventions comes from single studies, often lacking randomized controlled trials, highlighting the need for more rigorous research to confirm their efficacy across diverse populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attachment-Based Parenting Interventions and Evidence of Changes in Toddler Attachment Patterns: An Overview. Kohlhoff, J., Lieneman, C., Cibralic, S., et al.[2022]

The Attachment and Biobehavioral Catch-up (ABC) intervention significantly reduced disorganized attachment rates to 32% and increased secure attachment rates to 52% among 120 young children at risk for neglect, compared to control groups.

This randomized clinical trial demonstrates the effectiveness of the ABC intervention in improving attachment quality in children aged 11.7 to 31.9 months, highlighting its potential as a valuable tool for parents at risk of maltreatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhancing attachment organization among maltreated children: results of a randomized clinical trial. Bernard, K., Dozier, M., Bick, J., et al.[2021]

The Attachment Biobehavioral Catch-up (ABC) intervention is effective in improving emotional regulation, behavior, and attachment quality in children aged 6 months to 2 years, particularly those involved with child welfare, based on a systematic review of 10 randomized control trials.

ABC is recognized as a Level 1 evidence-based practice, highlighting its strong support in the field of child welfare and mental health interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

ATTACHMENT AND BIOBEHAVIORAL CATCH-UP: A SYSTEMATIC REVIEW. Grube, WA., Liming, KW.[2019]

The Attachment and Biobehavioral Catch-up (ABC) intervention, consisting of 10 sessions, effectively improved self-regulation in children exposed to early adversity, as evidenced by lower negative affect in children during challenging tasks.

In a randomized clinical trial involving 117 parent-child dyads referred to Child Protective Services, children who received the ABC intervention (n=56) showed better emotional regulation compared to those in the control group (n=61).

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intervention effects on negative affect of CPS-referred children: results of a randomized clinical trial. Lind, T., Bernard, K., Ross, E., et al.[2021]

The Attachment and Biobehavioral Catch-up (ABC) program effectively enhances parental sensitivity in families facing early adversity, showing results comparable to those seen in controlled clinical trials.

By implementing a microanalytic fidelity assessment during training and supervision, the program was successfully delivered to 108 families, achieving significant improvements in parent sensitivity, which suggests a promising approach for scaling evidence-based interventions in community settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Moving an Evidence-Based Parenting Program Into the Community. Roben, CKP., Dozier, M., Caron, EB., et al.[2018]

The Attachment and Biobehavioral Catch-up (ABC) intervention significantly improved parental sensitivity and reduced depression symptoms among parents of infants aged 5 to 21 months in a community setting, based on a study involving 200 parents.

The effectiveness of the ABC intervention was consistent regardless of sociodemographic risk factors, suggesting it can be broadly applied to diverse populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changing parental depression and sensitivity: Randomized clinical trial of ABC's effectiveness in the community. Perrone, L., Imrisek, SD., Dash, A., et al.[2022]

The Attachment and Biobehavioral Catch-Up (ABC) intervention, provided during infancy, significantly improved perceived attachment security in middle childhood for children referred by Child Protective Services, as measured by the Kerns Security Scale at age nine.

This study, involving 100 children, highlights the long-term efficacy of a brief 10-session intervention in enhancing caregiving quality and attachment security, demonstrating benefits that persisted for eight years post-intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sustained effects on attachment security in middle childhood: results from a randomized clinical trial of the Attachment and Biobehavioral Catch-up (ABC) intervention. Zajac, L., Raby, KL., Dozier, M.[2021]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5477793/

Attachment and Biobehavioral Catch-up - PubMed Central - NIH Attachment and Biobehavioral Catch-up (ABC) was designed to target three parenting behaviors that are key to child regulation of behavior and physiology. First, ...

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/39028289/

Child Welfare Outcomes After Attachment and ... This study employed a multi-tiered analytic approach to examine child welfare outcomes after participation in Attachment and Biobehavioral Catch-up (ABC).

3. researchgate.net researchgate.net/publication/328545291_ATTACHMENT_AND_BIOBEHAVIORAL_CATCH-UP_A_SYSTEMATIC_REVIEW_ABS_A_Systematic_Review

(PDF) ATTACHMENT AND BIOBEHAVIORAL CATCH-UP Findings indicate that ABC is effective, when implemented with child-welfare-involved children, at improving emotion regulation, improving ...

4. journals.sagepub.com journals.sagepub.com/doi/10.1177/10775595241265968

Child Welfare Outcomes After Attachment and ... Limited research is available examining distal child welfare outcomes after participation in evidence-based parenting interventions.

5. nctsn.org nctsn.org/sites/default/files/interventions/attachment-and-biobehavioral-catch-up-072025.pdf

Attachment and Biobehavioral Catch-up (ABC) Attachment and Biobehavioral Catch-up (ABC) is a 10-session home visiting program designed for parents of children from birth through 48 months.

6. massaimh.org massaimh.org/wp-content/uploads/2020/02/Chapter31AttachmentAndBiobehavior.pdf

Attachment and Biobehavioral Catch-Up ABC focuses on three specific tar- gets: nurturing the distressed child, following the child's lead with delight, and avoiding harsh or frightening behavior.

7. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1111/cfs.70015?af=R

Exploring the Impact of Attachment and Biobehavioral ... Specifically, this study describes the impact the ABC had on well-being outcomes of infants deemed at risk for experiencing adversities or toxic ...