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This study will assess early and middle childhood outcomes of an intervention for neglecting parents that was implemented in the children's infancy. We expect that parents who received the Attachment and Biobehavioral Catch-up Intervention in infancy will be more nurturing and will follow children's lead more than parents who received a control intervention, and that children will show better outcomes in attachment, inhibitory control, emotion regulation, and peer relations than children of parents who received the control intervention.
Children were randomly assigned to receive the ABC intervention or a control intervention (DEF) in infancy. These two groups, plus a group of low-risk children, will be studied in early and middle childhood. Of interest will be differences in parent and child outcomes that result from the intervention.
Hypothesis 1: Neglected children whose parents received the ABC intervention and low-risk comparison children will show better inhibitory control than neglected children whose parents received the DEF intervention.
Hypothesis 2: Children in the ABC intervention condition and low-risk comparison children will show better emotion regulation than children in the DEF condition.
Hypothesis 3: Children in the ABC intervention condition and comparison children will show less reactive aggression and less hostile attributional bias than children in the DEF condition.
Hypothesis 4: Children in the ABC condition and comparison children will show more normative cortisol production than children in the DEF condition.
Although we expect that sustained changes in parenting are critical for sustained changes in child behaviors, several alternative models will be tested. First, it is possible that when parents change as a result of the intervention in a child's infancy, there are positive outcomes for children regardless of whether the changes in parenting are sustained. If this is the case, early parenting will mediate the effects of the intervention when controlling for later parenting. Second, if concurrent parenting is what is critical to child functioning, current parenting will mediate intervention effects on child outcomes when controlling for early parenting. Third, longitudinal modeling of both parent and child behaviors allows for analysis of cross-lagged associations using structural equation modeling. Such modeling can examine concurrent and transactional associations between parent and child. We can also examine associations between change at behavioral and biological levels.
Longitudinal modeling will be used to examine models of change in parenting behaviors and how those influence child outcomes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Attachment and Biobehavioral Catch-up | Experimental | Attachment and Biobehavioral Catch-up - 10 session intervention to enhance nurturance and following the lead |
|
| Developmental Education for Families | Active Comparator | Developmental Education for Families - 10 session intervention that targets cognitive development |
|
| Low-risk | No Intervention | Low-risk comparison group |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Attachment and Biobehavioral Catch-up | Behavioral | Enhance nurturance and following the lead among parents. In-home intervention with parents and children present. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Inhibitory control | DB-DOS- children who successfully do not touch forbidden toys | Child age of 36 months |
| Emotion regulation | Children will complete emotion regulation tasks (Perfect Circle and Disappointing Gift) | Child age of 36 months |
| Peer relations | Social information processing will be assessed through children's responses to videos of peer provocations. | Child age of 10 years |
| Child diagnosis | Parents will complete diagnostic interview. | Child age of 10 |
| Child aggression | Children will complete video game that will allow assessment of reactive and proactive aggression. | Child age of 10 |
| Cortisol production | Salivary cortisol levels collected at wake-up and bedtime | Child age of 24 months |
| Cortisol production | Salivary cortisol levels collected at wake-up and bedtime | Child age of 8 |
| Cortisol production | Salivary cortisol levels collected at wake-up and bedtime |
| Measure | Description | Time Frame |
|---|---|---|
| Parental sensitivity | Parental sensitivity will be assessed through parent-child interactions. | Child age of infancy (12-24 months child age) |
| Child attachment security (narrative measure) | Children's score on Attachment Script Assessment, a narrative technique |
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Inclusion Criteria:
Exclusion Criteria:
-
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| Name | Affiliation | Role |
|---|---|---|
| Mary Dozier, Ph.D. | University of Delaware | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Delaware | Newark | Delaware | 19711 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37385583 | Derived | Valadez EA, Tottenham N, Korom M, Tabachnick AR, Pine DS, Dozier M. A Randomized Controlled Trial of a Parenting Intervention During Infancy Alters Amygdala-Prefrontal Circuitry in Middle Childhood. J Am Acad Child Adolesc Psychiatry. 2024 Jan;63(1):29-38. doi: 10.1016/j.jaac.2023.06.015. Epub 2023 Jun 27. | |
| 36548042 | Derived |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Oct 5, 2013 | Feb 4, 2019 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D019955 | Conduct Disorder |
| D001289 | Attention Deficit Disorder with Hyperactivity |
| D003863 | Depression |
| ID | Term |
|---|---|
| D019958 | Attention Deficit and Disruptive Behavior Disorders |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
| D001526 | Behavioral Symptoms |
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| Developmental Education for Families | Behavioral | Enhance children's cognitive development. In-home intervention with parents and children present. |
|
| Child age of 10 |
| Attachment | Attachment assessed through Strange Situation | Age 18 months |
| Child age 9 |
| Child inhibitory control in middle childhood | Delay task (Flanker). ERP data will be collected. | Child age 8 |
| Autonomic nervous system activity | Child heart rate and respiratory sinus arrhythmia | Child age 8 |
| Child brain activity | Child brain activation assessed in fMRI | Child age 9 |
| Parent Attachment Script Knowledge | Parents' score on Attachment Script Assessment, a narrative technique | Child age of 9 |
| Parental sensitivity using Parent-Child Interaction Coding System | Extent to which parent is responsive and attuned in support discussion (coded behaviorally) | Child age 9 |
| Autonomic nervous system activity | Child Respiratory Sinus Arrhythmia (RSA) | Child age 10 |
| Alpha and theta wave | Alpha and theta wave activity in resting state EEG | Child age 9 |
| Round Robin Assessment of Peer Rejection | Play groups of unknown peers constituted and video recorded; videos coded at microanalytic level for indices of peer rejection | Child age 9 |
| Parent neural activity assessed through event related potentials | Negative 170 ms. (N170: negative deflection 170 ms. after onset of stimulus) in task discriminating infant affect | Child age 4 |
| Parent neural activity assessed through event related potentials | Late positive potential - 350-600 ms after onset of stimulus (LPP) in task discriminating infant affect | Child age 4 |
| Child attachment security (self-reported on Kerns' Attachment Inventory) | Self-report from child of extent to which he or she can rely on parent | Child age 9 |
| Child attachment security (self-reported on Kerns' Attachment Inventory) | Self-report from child of extent to which he or she can rely on parent | Child age 10 |
| Body mass index | Proportion of height to weight | Age 3 |
| Body mass index | Proportion of height to weight | Age 4 |
| Hubbard JA, Bookhout MK, Zajac L, Moore CC, Dozier M. Children's social information processing predicts both their own and peers' conversational remarks. Dev Psychol. 2023 Jun;59(6):1153-1165. doi: 10.1037/dev0001510. Epub 2022 Dec 22. |
| 32781397 | Derived | Garnett M, Bernard K, Hoye J, Zajac L, Dozier M. Parental sensitivity mediates the sustained effect of Attachment and Biobehavioral Catch-up on cortisol in middle childhood: A randomized clinical trial. Psychoneuroendocrinology. 2020 Nov;121:104809. doi: 10.1016/j.psyneuen.2020.104809. Epub 2020 Jul 24. |
| 32731812 | Derived | Valadez EA, Tottenham N, Tabachnick AR, Dozier M. Early Parenting Intervention Effects on Brain Responses to Maternal Cues Among High-Risk Children. Am J Psychiatry. 2020 Sep 1;177(9):818-826. doi: 10.1176/appi.ajp.2020.20010011. Epub 2020 Jul 31. |
| 31677152 | Derived | Zajac L, Raby KL, Dozier M. Sustained effects on attachment security in middle childhood: results from a randomized clinical trial of the Attachment and Biobehavioral Catch-up (ABC) intervention. J Child Psychol Psychiatry. 2020 Apr;61(4):417-424. doi: 10.1111/jcpp.13146. Epub 2019 Nov 1. |
| 30659782 | Derived | Bernard K, Frost A, Jelinek C, Dozier M. Secure attachment predicts lower body mass index in young children with histories of child protective services involvement. Pediatr Obes. 2019 Jul;14(7):e12510. doi: 10.1111/ijpo.12510. Epub 2019 Jan 18. |
| 25436448 | Derived | Bernard K, Hostinar CE, Dozier M. Intervention effects on diurnal cortisol rhythms of Child Protective Services-referred infants in early childhood: preschool follow-up results of a randomized clinical trial. JAMA Pediatr. 2015 Feb;169(2):112-9. doi: 10.1001/jamapediatrics.2014.2369. |
| D001519 | Behavior |