Attachment and Biobehavioral Catch-Up (ABC) -Infant

Model effectiveness research report last updated: 2020

Effects shown in research & outcome measure details

Child development and school readiness

Findings rated high

Yarger, H. A. (2018). Investigating longitudinal pathways to dysregulation: The role of anomalous parenting behavior (Publication No. 2130944494) [Doctoral dissertation, University of Delaware]. ProQuest Dissertations and Theses.

Attachment and Biobehavioral Catch-Up (ABC) -Toddler

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Strange Situation Procedure - Disorganized attachment	FavorableUnfavorable or ambiguousNo Effect	7 months post-intervention	ABC-I vs. DEF; Large mid-Atlantic city	109 children	Unadjusted proportion = 0.33 Unadjusted proportion	Unadjusted proportion = 0.45 Unadjusted proportion	Mean difference = -0.12	HomeVEE calculated = -0.31	Not statistically significant, p= 0.17	Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.

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Outcome measure	Outcome measure description	Collection method	Properties
Strange Situation Procedure - Disorganized attachment	The Strange Situation procedure involves separating the child from the parent briefly to assess child's attachment to his or her caregiver upon reunification; results in classification of child as secure, avoidant, disorganized, or resistant. This study collapsed the categories into disorganized versus all others.	Videotaped interactions between mother and child.	Interrater agreement on disorganized attachment was 89%.

Findings rated moderate

Bernard, K., Frost, A., Jelinek, C., & Dozier, M. (2019). Secure attachment predicts lower body mass index in young children with histories of child protective services involvement. Pediatric Obesity, 14(7), e12510. https://doi.org/10.1111/ijpo.12510

Attachment and Biobehavioral Catch-Up (ABC) -Toddler

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Strange Situation Procedure - Secure attachment	FavorableUnfavorable or ambiguousNo Effect	First post-intervention visit where child was at least 1-year old (range 11.8 to 31.9 months old)	ABC-Infant vs. DEF; Delaware	105 children	Adjusted proportion = 0.52	Adjusted proportion = 0.32	Mean difference = 0.20	HomeVEE calculated = 0.43	Statistically significant, p= 0.03	Model controls for child gender and cumulative social risk index.

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Outcome measure	Outcome measure description	Collection method	Properties
Strange Situation Procedure - Secure attachment	The Strange Situation Procedure is a laboratory assessment of children's reliance on a parent when they are distressed.	Parent-child assessment	Not reported

Lind, T. (2017). Intervening to enhance emotion regulation: Early childhood adversity, parent-child mutual positive affect, and later child regulation capabilities (Publication No. 1972774602) [Doctoral dissertation, University of Delaware]. ProQuest Dissertations and Theses.

Attachment and Biobehavioral Catch-Up (ABC) -Toddler

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Emotion Regulation Checklist - Child emotion lability/negativity	FavorableUnfavorable or ambiguousNo Effect	Age 8	ABC-Infant vs. DEF; Philadelphia	80 children	Not reported	Not reported	Not reported	= -0.10	Not statistically significant, p= 0.67	Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. Model does not include statistical controls.
Emotion Regulation Checklist - Child emotion lability/negativity	FavorableUnfavorable or ambiguousNo Effect	Age 8	ABC-Infant vs. DEF; Philadelphia	80 children	Not reported	Not reported	Not reported	= -0.04	Not statistically significant, p= 0.87	Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. Model controls for mutual positive affect at 24 months.
Emotion Regulation Checklist - Child emotion lability/negativity	FavorableUnfavorable or ambiguousNo Effect	Age 8	ABC-Infant vs. DEF; Philadelphia	80 children	Not reported	Not reported	Not reported	= -0.08	Not statistically significant, p= 0.73	Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. Model controls for mutual positive affect at 24 months, child risk, parent risk (0 to 24 months), and instability risk (0 to 24 months).
Emotion Regulation Checklist - Child emotion lability/negativity	FavorableUnfavorable or ambiguousNo Effect	Age 8	ABC-Infant vs. DEF; Philadelphia	80 children	Not reported	Not reported	Not reported	= -0.04	Not statistically significant, p= 0.85	Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. Model controls for mutual positive affect at 24 months, child risk, parent risk (0 to 24 months), parent risk (8 to 10 years), instability risk (0 to 24 months), and instability risk (8 to 10 years).
Emotion Regulation Checklist - Child positive emotion regulation	FavorableUnfavorable or ambiguousNo Effect	Age 8	ABC-Infant vs. DEF; Philadelphia	80 children	Not reported	Not reported	Not reported	= 0.07	Not statistically significant, p= 0.75	Model does not include statistical controls.
Emotion Regulation Checklist - Child positive emotion regulation	FavorableUnfavorable or ambiguousNo Effect	Age 8	ABC-Infant vs. DEF; Philadelphia	80 children	Not reported	Not reported	Not reported	= -0.05	Not statistically significant, p= 0.83	Model controls for mutual positive affect at 24 months.
Emotion Regulation Checklist - Child positive emotion regulation	FavorableUnfavorable or ambiguousNo Effect	Age 8	ABC-Infant vs. DEF; Philadelphia	80 children	Not reported	Not reported	Not reported	= -0.16	Not statistically significant, p= 0.48	Model controls for mutual positive affect at 24 months, child risk, parent risk (0 to 24 months), and instability risk (0 to 24 months).
Emotion Regulation Checklist - Child positive emotion regulation	FavorableUnfavorable or ambiguousNo Effect	Age 8	ABC-Infant vs. DEF; Philadelphia	80 children	Not reported	Not reported	Not reported	= -0.13	Not statistically significant, p= 0.55	Model controls for mutual positive affect at 24 months, child risk, parent risk (0 to 24 months), parent risk (8 to 10 years), instability risk (0 to 24 months), and instability risk (8 to 10 years).

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Outcome measure	Outcome measure description	Collection method	Properties
Emotion Regulation Checklist - Child emotion lability/negativity	The Emotional Regulation Checklist (cited in Shields & Cicchetti, 1997) is a 24-item checklist that measures emotion lability/negativity and positive emotion regulation in children. Items about emotion lability/negativity focus on child's quick or exaggered changes in mood (lability), reactive anger, and intensity of negative emotions.	Parent report	Not reported by author.
Emotion Regulation Checklist - Child positive emotion regulation	The Emotional Regulation Checklist (cited in Shields & Cicchetti, 1997) is a 24-item checklist that measures emotion lability/negativity and positive emotion regulation in children. Items about positive emotion regulation focus on child's emotion understanding and empathy.	Parent report	Not reported by author.

Lind, T., Bernard, K., Yarger, H. A., & Dozier, M. (2019). Promoting compliance in children referred to child protective services: A randomized clinical trial. Child Development. Advance online publication. https://doi.org/10.1111/cdev.13207

Attachment and Biobehavioral Catch-Up (ABC) -Toddler

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Child compliance composite	FavorableUnfavorable or ambiguousNo Effect	36 months of age	ABC-Infant vs. DEF; Large mid-Atlantic city	101 mother/child dyads	Unadjusted mean = 0.26	Unadjusted mean = -0.21	Mean difference = 0.47	Study reported = 0.53	Statistically significant, p= 0.01	Authors used ANOVA to estimate the difference between the ABC and DEF groups; effect size is Cohen's D.
Child compliance: child touched toys	FavorableUnfavorable or ambiguousNo Effect	36 months of age	ABC-Infant vs. DEF; Large mid-Atlantic city	101 mother/child dyads	Unadjusted proportion = 0.33	Unadjusted proportion = 0.54	Mean difference = -0.21	= -0.52	Statistically significant, p <.05	Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. Authors used Chi-Square Test of significance to estimate the difference between the ABC and DEF groups.
Child compliance: duration of child touching toys (seconds)	FavorableUnfavorable or ambiguousNo Effect	36 months of age	ABC-Infant vs. DEF; Large mid-Atlantic city	101 mother/child dyads	Unadjusted mean = 4.35	Unadjusted mean = 11.78	Mean difference = -7.43	Study reported = -0.42	Statistically significant, p= 0.04	Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention. Authors used ANOVA to estimate the difference between the ABC and DEF groups; effect size is Cohen's D.
Child compliance: latency to child touching toys (seconds)	FavorableUnfavorable or ambiguousNo Effect	36 months of age	ABC-Infant vs. DEF; Large mid-Atlantic city	101 mother/child dyads	Unadjusted mean = 263.47	Unadjusted mean = 199.89	Mean difference = 63.58	Study reported = 0.68	Statistically significant, p= 0.00	Authors used ANOVA to estimate the difference between the ABC and DEF groups; effect size is Cohen's D.

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Outcome measure	Outcome measure description	Collection method	Properties
Child compliance composite	Child compliance was coded using the Noldus Observer XT 11 and assessed using the 5-minute waiting task drawn from the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). The measure was constructed by taking the mean, standardized to a z-score, of the three other reported child compliance findings, with the time spent touching toys reversed coded so that a positive finding was favorable to the intervention.	Video recorded play interactions	Interrater reliability k=.85
Child compliance: child touched toys	Child compliance was coded using the Noldus Observer XT 11 and assessed using the 5-minute waiting task drawn from the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). A categorical variable of whether or not the child touched the toy was coded.	Video recorded play interactions	Interrater reliability k=.85
Child compliance: duration of child touching toys (seconds)	Child compliance was coded using the Noldus Observer XT 11 and assessed using the 5-minute waiting task drawn from the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). A total duration (seconds) of child touching toys was coded.	Video recorded play interactions	Interrater reliability k=.85
Child compliance: latency to child touching toys (seconds)	Child compliance was coded using the Noldus Observer XT 11 and assessed using the 5-minute waiting task drawn from the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). Latency of child touching toys in seconds was coded.	Video recorded play interactions	Interrater reliability k=.85

Yarger, H. A., Bronfman, E., Carlson, E., & Dozier, M. (2019). Intervening with Attachment and Biobehavioral Catch-up to decrease disrupted parenting behavior and attachment disorganization: The role of parental withdrawal. Development and Psychopathology. Advance online publication. https://doi.org/10.1017/S0954579419000786

Attachment and Biobehavioral Catch-Up (ABC) -Toddler

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Strange Situation Procedure - Disorganized attachment	FavorableUnfavorable or ambiguousNo Effect	7 months after enrollment (1 month post-intervention)	ABC-Infant vs. DEF; Large mid-Atlantic city	105 children	Unadjusted proportion = 0.32	Unadjusted proportion = 0.46	Mean difference = -0.14	HomeVEE calculated = -0.34	Not statistically significant, p= 0.16	Negative effect is favorable Submitted by user on Fri, 03/15/2019 - 14:29 Negative effect is favorable to the intervention.

Show outcome measure summary

Outcome measure	Outcome measure description	Collection method	Properties
Strange Situation Procedure - Disorganized attachment	The Strange Situation is a laboratory assessment of children's reliance on the parent when they are distressed.	Parent-child assessment	Interrater reliability=.89

Zajac, L., Raby, K. L., & Dozier, M. (2019). Sustained effects on attachment security in middle childhood: Results from a randomized clinical trial of the Attachment and Biobehavioral Catch‐up (ABC) intervention. Journal of Child Psychology and Psychiatry, 61(4), 417–424. https://doi:10.1111/jcpp.13146

Attachment and Biobehavioral Catch-Up (ABC) -Toddler

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Kerns Security Scale - Attachment security	FavorableUnfavorable or ambiguousNo Effect	Age 9	ABC-Infant vs. DEF; Large mid-Atlantic city	100 children	Unadjusted mean = 3.49 Unadjusted mean	Unadjusted mean = 3.28 Unadjusted mean	Mean difference = 0.21	HomeVEE calculated = 0.46	Statistically significant, p= 0.02	Model does not include statistical controls.
Kerns Security Scale - Attachment security	FavorableUnfavorable or ambiguousNo Effect	Age 9	ABC-Infant vs. DEF; Large mid-Atlantic city	100 children	Adjusted mean = 3.49 Adjusted mean	Adjusted mean = 3.28 Adjusted mean	Mean difference = 0.21	HomeVEE calculated = 0.48	Statistically significant, p= 0.02	Model controls for receipt of financial assistance from the government.

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Outcome measure	Outcome measure description	Collection method	Properties
Kerns Security Scale - Attachment security	Attachment security was measured using the Kerns Security Scale, a 15-item, self-report questionnaire. Responses were averaged across the four-point scale for each item. Higher scores indicate higher levels of perceived attachment security to primary caregiver.	Child questionnaire administered by interviewer.	Internal consistency, a=.71

Bernard, K., Dozier, M., Bick, J., Lewis-Morrarty, E., Lindhiem, O., & & Carlson, E. (2012). Enhancing attachment organization among maltreated children: Results of a randomized clinical trial. Child Development, 83(2), 623–636.

Attachment and Biobehavioral Catch-Up (ABC) -Toddler

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Strange Situation Procedure - Disorganized Attachment	FavorableUnfavorable or ambiguousNo Effect	Approximately 1 month after program end, or longer if child not yet old enough to measure outcome.	Full analytic sample	120 children	Unadjusted proportion = 0.32	Unadjusted proportion = 0.57	Mean difference = -0.25	HomeVEE calculated = 0.67	Statistically significant, p = 0.01²	footnote162 Submitted by user on Fri, 03/15/2019 - 14:29 Negative value is favorable to the intervention.
Strange Situation Procedure - Secure Attachment	FavorableUnfavorable or ambiguousNo Effect	Approximately 1 month after program end, or longer if child not yet old enough to measure outcome.	Full analytic sample	120 children	Unadjusted proportion = 0.52	Unadjusted proportion = 0.33	Mean difference = 0.19	HomeVEE calculated = 0.46	Not statistically significant, p = 0.08²	footnote254 Submitted by user on Fri, 03/15/2019 - 14:29 Effect size and significance based on adjusted odds ratio provided to <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr> by the authors.

Show outcome measure summary

Outcome measure	Outcome measure description	Collection method	Properties
Disorganized attachment	Strange Situation, a laboratory assessment of children's reliance on the parent when they are distressed.	Parent-child assessment	Videotapes were double coded, and coders agreed on 87% of organized-disorganized classifications.
Secure attachment	Strange Situation, a laboratory assessment of children's reliance on the parent when they are distressed.	Parent-child assessment	Videotapes were double coded, and coders agreed on 92% of secure-insecure classifications.

Raby, K. L., Freedman, E., Yarger, H. A., Lind, T., & Dozier, M. (2018). Enhancing the language development of toddlers in foster care by promoting foster parents’ sensitivity: Results from a randomized controlled trial. Developmental Science, 22(2), e12753. https://doi.org/10.1111/desc.12753

Attachment and Biobehavioral Catch-Up (ABC) -Toddler

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance
Peabody Picture Vocabulary Test (PPVT) - Receptive Vocabulary	FavorableUnfavorable or ambiguousNo Effect	36 months of age	ABC-Toddler vs. DEF; Delaware	32 children	Unadjusted mean = 93.60	Unadjusted mean = 80.30	Mean difference = 13.30	HomeVEE calculated = 0.86	Statistically significant, p= 0.02
Peabody Picture Vocabulary Test (PPVT) - Receptive Vocabulary	FavorableUnfavorable or ambiguousNo Effect	48 months of age	ABC-Toddler vs. DEF; Delaware	53 children	Unadjusted mean = 99.60	Unadjusted mean = 97.00	Mean difference = 2.60	HomeVEE calculated = 0.17	Not statistically significant, p= 0.52
Peabody Picture Vocabulary Test (PPVT) - Receptive Vocabulary	FavorableUnfavorable or ambiguousNo Effect	60 months of age	ABC-Toddler vs. DEF; Delaware	58 children	Unadjusted mean = 105.10	Unadjusted mean = 95.50	Mean difference = 9.60	HomeVEE calculated = 0.60	Statistically significant, p= 0.03

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Outcome measure	Outcome measure description	Collection method	Properties
Peabody Picture Vocabulary Test (PPVT) - Receptive Vocabulary	Peabody Picture Vocabulary Test–Third Edition (PPVT; Dunn & Dunn, 1997) measures child's receptive vocabulary.	Researcher-administered test	Not reported by author

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