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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

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; outcomes not feasible to assess at baseline None None
Notes:

This manuscript analyzes findings from the same randomized controlled trial as Bernard et al. (2012). Additional contextual information about the study is from Bernard et al. (2012). Information on attrition for the 1-month post-intervention follow-up was based on correspondence with the author.

Study characteristics
Study participants This randomized controlled trial (RCT) assigned eligible families to either ABC-Infant or a comparison program that also included home visits. Eligible families were participants in a foster care diversion program with children younger than 2 who were referred from Child Protective Services for various issues placing children at risk (for example, domestic violence, parental substance use, homelessness, or neglect). At the 36 month follow-up, the analytic sample consisted of 101 mother-child dyads (45 in the ABC-Infant group and 56 in the comparison group). In the analytic sample, 69 percent of children were African American, 6 percent were White, 11 percent were Hispanic, and 14 percent were biracial. All caregiver participants in the study were biological mothers, 70 percent of whom were African American, 9 percent White, 14 percent Hispanic, and 7 percent biracial. The majority of the caregivers had less than a high school degree (58 percent) and most (64 percent) reported an annual income of less than $10,000.
Setting The study was conducted in a large mid-Atlantic city.
Intervention services ABC-Infant consisted of 10 weekly hour-long home visits. The sessions focused on five topic areas: providing nurturance, following the child’s lead, refraining from frightening behavior, parents recognizing the effect of their own childhood experiences on their parenting behavior, and learning the importance of touch and children’s emotions. Across all sessions, parent trainers engaged parents in structured activities with their children and then provided feedback on observations of participants’ parenting behavior, both in real-time and by playing back video recordings from the sessions. 
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-Infant. DEF was designed to enhance cognitive and linguistic development. For this study, the components related to following children’s cues were removed to distinguish it from ABC-Infant.
Staff characteristics and training The staff in both groups were selected based on their experience in working with children and their interpersonal skills.
Funding sources This research was supported by Award Numbers R01MH052135, R01MH074374, and R01MH084135 from the National Institute of Mental Health.
Author affiliation Mary Dozier, one of the authors of the study, is a developer of the ABC home visiting model.
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

Child compliance composite

FavorableUnfavorable or ambiguousNo Effect

ABC-Infant vs. DEF; Large mid-Atlantic city

36 months of age

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.

Moderate

Child compliance: child touched toys

FavorableUnfavorable or ambiguousNo Effect

ABC-Infant vs. DEF; Large mid-Atlantic city

36 months of age

101 mother/child dyads Unadjusted proportion = 0.33 Unadjusted proportion = 0.54 Mean difference = -0.21 Study reported = -0.52

Statistically significant, p <.05

Authors used Chi-Square Test of significance to estimate the difference between the ABC and DEF groups.

Moderate

Child compliance: duration of child touching toys (seconds)

FavorableUnfavorable or ambiguousNo Effect

ABC-Infant vs. DEF; Large mid-Atlantic city

36 months of age

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

Authors used ANOVA to estimate the difference between the ABC and DEF groups; effect size is Cohen's D.

Moderate

Child compliance: latency to child touching toys (seconds)

FavorableUnfavorable or ambiguousNo Effect

ABC-Infant vs. DEF; Large mid-Atlantic city

36 months of age

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.

Positive parenting practices
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Moderate

Parent sensitivity

FavorableUnfavorable or ambiguousNo Effect

ABC-Infant vs. DEF; Large mid-Atlantic city

1 month post-intervention

89 mother/child dyads Unadjusted mean = 2.49 Unadjusted mean = 1.94 Mean difference = 0.55 Study reported = 0.47

Statistically significant, p= 0.03

Authors used ANOVA to estimate the difference between the ABC and DEF groups; effect size is Cohen's D.

Moderate

Parent sensitivity: duration (seconds)

FavorableUnfavorable or ambiguousNo Effect

ABC-Infant vs. DEF; Large mid-Atlantic city

36 months of age

101 mother/child dyads Unadjusted mean = 31.23 Unadjusted mean = 21.37 Mean difference = 9.86 Study reported = 0.40

Not statistically significant, p= 0.05

Authors used ANOVA to estimate the difference between the ABC and DEF groups; effect size is Cohen's D.

Outcome measure summary

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

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

Positive parenting practices
Outcome measure Description of measure Data collection method Properties of measure

Parent sensitivity

Parent sensitivity was coded using the 5-point scale of sensitivity adapted from the Observational Record of the Caregiving Environment (ORCE) during a free play activity.

Video recorded play interactions

Interrater reliability correlational coefficient at least .75

Parent sensitivity: duration (seconds)

Parent sensitivity was coded using the Noldus Observer XT 11 and conceptualized using the Observational Record of the Caregiving Environment (ORCE). A total duration (seconds) of parent sensitivity was coded. The observation was drawn from the 5-minute waiting task of the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS).

Video recorded play interactions

Interrater reliability k=.79