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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.

Model(s) Reviewed: Attachment and Biobehavioral Catch-Up (ABC) -Infant
Manuscript screening details
Screening decision Screening conclusion
Passes screens Eligible for review
Study design details
Rating Design Attrition Baseline equivalence Reassignment Confounding factors
Moderate Randomized controlled trial High Established on race/ethnicity and SES; outcome(s) not feasible to assess at baseline None None
Notes:

footnote252

Submitted by user on Fri, 03/15/2019 - 14:29

Information on baseline equivalence for race/ethnicity and SES, attrition, and effect size and significance was based on correspondence with the author.

Study characteristics
Study participants Parents/caregivers of children younger than 2 with protective services involvement were randomly assigned to the treatment and comparison groups. If the parent or caregiver had two children, both were placed in the parent/caregiver's assigned group. Most of the parents belonged to a minority racial/ethnic group (80 percent), were living in poverty (80 percent), and had less than a high school education (88 percent). 58 percent of the children were male, and 93 percent belonged to minority racial/ethnic groups.
Setting The study was conducted in a large city in the Mid-Atlantic.
Intervention services The intervention, Attachment and Biobehavioral Catch-Up (ABC), consisted of 10 hour-long sessions conducted weekly in participants' homes with parents and their children.
Comparison conditions Comparison families received Developmental Education for Families (DEF) in home visits that were the same duration (10 hour-long sessions) and frequency (weekly) as ABC. DEF was designed to enhance cognitive and linguistic development.
Staff characteristics and training Parent trainers who administered the programs were hired based on experience with children and strong interpersonal skills. The parent trainers conducted program sessions with parents according to a structured training manual.
Funding sources NIMH grants R01 MH052135, R01 MH074374, and R01 MH084135
Author affiliation When the research was conducted, the authors were affiliated with the University of Delaware and the University of Minnesota.
Study Registration:
Clinicaltrials.gov Identifier: NCT02093052. Study registration was assessed by HomVEE beginning with the 2014 review.

Findings details

Child development and school readiness
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Moderate Strange Situation Procedure - Disorganized Attachment
FavorableUnfavorable or ambiguousNo Effect
 Full analytic sample Approximately 1 month after program end, or longer if child not yet old enough to measure outcome. 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.
Moderate Strange Situation Procedure - Secure Attachment
FavorableUnfavorable or ambiguousNo Effect
 Full analytic sample Approximately 1 month after program end, or longer if child not yet old enough to measure outcome. 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.

Outcome measure summary

Child development and school readiness
Outcome measure Description of measure Data collection method Properties of measure

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.