Enhancing diurnal cortisol regulation among young children adopted internationally: A randomized controlled trial of a parenting-based intervention

Abstract

Children who have been adopted internationally commonly experience institutional care and other forms of adversity prior to adoption that can alter the functioning of the hypothalamic–pituitary–adrenal (HPA) axis. In particular, internationally adopted children tend to have blunted diurnal declines compared to children raised in their birth families. The Attachment and Biobehavioral Catch-Up (ABC) intervention was developed to enhance young children's biological and behavioral regulation by promoting sensitive parenting. The current study used a randomized controlled trial to assess whether ABC improved the diurnal functioning of the HPA axis among 85 children who had been adopted internationally when they were between the ages of 4 and 33 months (M = 16.12). Prior to the intervention, there were no significant differences in diurnal cortisol production between children whose parents were randomly assigned to receive ABC and children whose parents were randomly assigned to receive a control intervention. After the intervention, children whose parents had received the ABC intervention exhibited steeper declines in cortisol levels throughout the day than children whose parents had received the control intervention. These results indicate that the ABC intervention is effective in enhancing a healthy pattern of diurnal HPA axis regulation for young children who have been adopted internationally.

Caregiving quality modulates neuroendocrine and immunological markers in young children in foster care who have experienced early adversity

“…At the same time, it seems plausible that, under improved caregiving conditions following foster care placement, some of the effects of early childhood adversity on the HPA axis may be reduced. While an increasing number of cross‐sectional and, in particular, intervention studies support the occurrence of such recovery (e.g., DePasquale, Raby, Hoye, & Dozier, 2018; Fisher, Stoolmiller, Gunnar, & Burraston, 2007; Flannery et al., 2017; Raby, Bernard, Gordon, & Dozier, 2020), other studies indicate that alterations are highly persistent (Kumsta et al., 2017). Research examining longitudinal changes in stress hormone levels after placement in foster/adoption care is, however, limited.…”

Socioeconomic changes predict genome-wide DNA methylation in childhood

“…At the householdlevel, parent-child interventions that promote supportive parenting styles or social cohesion during times of instability and/or heightened parental stress may help to foster resiliency in children 78,79 . In fact, parenting interventions that focus on maternal responsiveness have revealed measurable biological impacts on children's genome-wide DNAm profiles 80 and on other biomarkers [81][82][83] . At the neighborhood-level, after-school programs, community recreational centers, or other community-based interventions 65 that provide added support/routine to children's environments might be particularly beneficial to children whose families are experiencing socioeconomic instability.…”

The persistent associations between early institutional care and diurnal cortisol outcomes among children adopted internationally

“…Indeed, the Attachment and Biobehavioral Catch‐Up (ABC) intervention has been shown to promote sensitive parenting and to enhance children's diurnal cortisol regulation among families referred to Child Protective Services due to risk for maltreatment (Bernard, Dozier, et al., 2015; Bernard et al., 2015; Garnett et al., 2020). In addition, the ABC intervention had effects on internationally adopted children's diurnal cortisol outcomes shortly after families completed the intervention (Raby et al., in press). Significant effects of the ABC intervention on children's diurnal cortisol regulation 3 years post adoption were not observed in this study, which may suggest that the effects of the intervention weaken with time and require booster sessions in order to have sustained effects on cortisol regulation outcomes for this group of families.…”