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Implementing Attachment and Biobehavioral Catch-Up (ABC) Intervention

Meets HHS criteria for an evidenced based model

Model Overview

Last Updated

April 2018


The information in this profile reflects feedback, if provided, from this model’s developer as of the above date. The description of the implementation of the model here, including any adaptations, may differ from how it was implemented in the studies reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the HHS criteria for evidence of effectiveness.


Implementation Support

The Attachment and Biobehavioral Catch-Up (ABC) Intervention was developed by Dr. Mary Dozier, Ph.D., and the Infant Caregiver Project at the University of Delaware. The original ABC Intervention included both infants and toddlers. The model has since been organized into two versions:* (1) ABC-Infant and (2) ABC-Toddler

No state systems that provide infrastructure support exist. Implementation support is available through the developer.

*The information in the profile applies to both ABC-Infant and ABC-Toddler unless specified otherwise.


Theoretical Model

The intervention is based on attachment theory and stress neurobiology.


Target Population

The ABC Intervention is a training program for caregivers of infants and young children 6 to 48 months old, including high-risk birth parents and caregivers of young children in foster care, kinship care (such as a grandparent raising a grandchild), and adoptive care. ABC-Infant is for children 6 to 24 months old and (2) ABC-Toddler is for children 24 to 48 months old.


Targeted Outcomes

The ABC Intervention is designed to help caregivers provide:

  • Nurturance even when children do not appear to need it
  • Mutually responsive interactions in which caregivers follow children’s lead
  • Care that is not frightening or overwhelming to children, such as refraining from verbal threats
  • Calming behaviors when young children are angry and/or unable to regulate their emotions (ABC-Toddler)


Model Components

The ABC Intervention is a training program for caregivers that a parent coach delivers in the family’s home. Sessions 1 and 2 are designed to help caregivers reinterpret children’s behavioral signals, providing nurturance even when it is not elicited. Sessions 3 and 4 are designed to help caregivers learn to follow their children’s lead. Sessions 5 and 6 are designed to help caregivers recognize their own overwhelming or frightening behaviors and develop alternative responses. Sessions 7 and 8 are designed to help caregivers overcome automatic responses to their children that are based on their past experiences and could interfere with providing nurturing, sensitive care. Sessions 9 and 10 are designed to reinforce knowledge gained during previous sessions.

The most crucial aspect of the intervention is the parent coach’s use of immediate feedback (referred to as "in the moment" comments) on the caregiver’s interaction with the child. Throughout the home visiting session, the parent coach comments on the caregiver’s interactions to help the caregiver attend to the target behaviors, including following the child’s lead with delight, using nurturing behaviors, and avoiding frightening behaviors. The model also incorporates homework and video feedback.


Model Intensity and Length

The ABC Intervention includes 10 weekly sessions, approximately 60 minutes each.



The intervention is being implemented in 15 U.S. states and several international locations, including Australia, Germany, and Russia.


Adaptations and Enhancements

No information is available.



The information contained on this page was last updated in April 2018. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by Dr. Caroline Roben on January 16, 2018. HomVEE reserves the right to edit the profile for clarity and consistency.