Skip Navigation

Attachment and Biobehavioral Catch-Up (ABC) Intervention

Meets HHS criteria for an evidenced based model

In Brief

Last Updated

April 2017

Top

Evidence of Model Effectiveness

This model meets the criteria established by the Department of Health and Human Services (HHS) for an “evidence-based early childhood home visiting service delivery model” for the general population, but does not meet the criteria for tribal populations.

Top

Model Description

The Attachment and Biobehavioral Catch-Up (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. The original ABC Intervention included both infants and toddlers. The model has since been organized into two versions: (1) ABC-Infant for children 6 to 24 months old, and (2) ABC-Toddler for children 24 to 48 months old. (The studies HomVEE reviewed for this report were based on the original ABC Intervention and included both infants and toddlers. The ABC-Infant and ABC-Toddler versions of the model have not been reviewed.) Parent coaches conduct 10 weekly home visits, approximately 60 minutes each. The model 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, and nonfrightening care. Parent coaches provide immediate feedback (referred to as “in the moment” comments) on the caregivers’ interaction with the child to help the caregivers attend to the target behaviors. The model also incorporates homework and video feedback. For more information, please read the Model Overview.

Top

Extent of Evidence

Results of Research and ReviewNumber of Studies for ABC
Released from 1979 to 2015 29
Eligible for review 17
     Rated high 1
     Rated moderate 3
     Rated low 12
     Additional sources1 1

1Additional sources overlap with another study and are not rated.

For more information, see the study database. For more information on the criteria used to determine the study ratings, please read Producing Study Ratings.

Top

Summary of Findings



ABC
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness

Favorable: 1
No effect: 1
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Child Health

Favorable: 1
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health Not measured Not measured
Positive Parenting Practices

Favorable: 4
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured
Table Help
CLOSE

This table summarizes the effects found in research across outcome domains. Outcomes with a favorable impact are listed in green and outcomes with an unfavorable or ambiguous impact are listed in red. Outcomes that have high attrition or lack of baseline equivalence are excluded from this report.

Favorable Impact: A statistically significant impact on an outcome measure in a direction that is beneficial for children and parents. This impact could statistically be positive or negative, and is determined “favorable” based on the end result. For example, a favorable impact could be an increase in children’s vocabulary or daily reading to children by parents, or a reduction in harsh parenting practices or maternal depression.

Unfavorable or Ambiguous Impact: A statistically significant impact on an outcome measure in a direction that may indicate potential harm to children and/or parents. This impact could statistically be positive or negative, and is determined “unfavorable or ambiguous” based on the end result. NOTE: While some outcomes are clearly unfavorable, for other outcomes it is not as clear which direction is desirable. For example, an increase in children’s behavior problems is clearly unfavorable, while an increase in number of days mothers are hospitalized is more ambiguous. This may be viewed as an unfavorable impact because it indicates that mothers have more health problems, but it could also indicate that mothers have increased access to needed health care due to their participation in a home visiting program.

Primary Outcome Measure: For the HomVEE review, an outcome measured through direct observation, direct assessment, or administrative data; or self-reported data collected using a standardized (normed) instrument.

Secondary Outcome Measure: For the HomVEE review, most self-reported data, excluding self-reports based on a standardized (normed) instrument.

Please read Describing Effects for more information on these categories. Only results from studies that meet the standards for the high or moderate ratings are included above.

Top

Criteria Established by the Department of Health and Human Services

Information Based on Comprehensive Review of All High- and Moderate-Impact Studies for this Model
High- or moderate-quality impact study? Yes
Across high- or moderate-quality studies, favorable impacts in…
 
   at least two outcome domains within one sample
 
   OR
 
   the same domain for at least two non-overlapping samples?
Yes
Favorable impacts on full sample? Yes
Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?1 Yes
One or more favorable, statistically significant impact reported in a peer-reviewed journal?1 Yes

1This information is reported for all models, but the requirements for sustained findings and inclusion in a peer-reviewed journal only apply to models for which all findings are from randomized controlled trials.

Please read the HHS Criteria for Evidence-Based Models for more information.

Top