Testing the limits: Extending attachment-based intervention effects to infant cognitive outcome and parental stress

Abstract

Using a sample of 41 infants and toddlers (21 interventions, 20 controls) who were neglected or at serious risk for neglect, this randomized clinical trial examined the efficacy of a parent-child attachment-based video-feedback intervention on parental sensitivity, parental stress, and child mental/psychomotor development. Results showed that following the 8-week intervention, scores for maternal sensitivity and child mental and psychomotor development were higher in the intervention group than in the control group. The intervention appears to have no effect on self-reports of stress. All parents report lower levels of stress postintervention; however, when defensive responding is not considered (i.e., extremely low score of parental stress), parents in the control group report somewhat lower scores, raising questions as to the significance of this finding. Considering the small nature of our sample, replication of the present results is needed. Nevertheless, the present findings contribute to the burgeoning literature suggesting that the early attachment relationship provides an important context that influences developmental outcome in different spheres and raises questions as to how such intervention strategies may or may not affect the subjective experience of parenting.

Attachment in the context of atypical caregiving

“…The research featured in this Special Issue clearly pushes the boundaries of the status quo of attachment-based intervention in a number of potentially generative ways. Three of the reports find efficacy of attachment-related intervention not merely for interpersonal outcomes (as might be expected) but for improving aspects of cognitive development (Cassidy et al, 2017;Dubois-Comtois et al, 2017;Lind, Raby, Caron, Roben, & Dozier, 2017). Another interesting report based on a French sample hones in on some of the specific interpersonal behavioral change mechanisms (i.e., improvements in disrupted maternal communication) by which attachmentinformed home visitations offset risk for disorganized attachment (Tereno et al, 2017).…”

“…First, even the largest interventions reported in this Special Issue (e.g., Cassidy et al, 2017;Humphreys et al, 2017;Lind et al, 2017) consisted of fewer than 200 participants, with adequate power to detect only medium or larger population effects. In contrast, many of the studies reported here included approximately 100 participants, and a handful of "proof of concept" reports were based on fewer than 50 individuals (e.g., Dubois-Comtois et al, 2017;Schact et al, 2017;Swain et al, 2017). Intervention research presents inherent challenges and is immensely expensive and time consuming, but the point remains that only large sample trials are capable of detecting the kinds of small (though ideally enduring) differences between intervention and control groups that might be reasonably expected in this area.…”

“…Nonetheless, in the course of coediting the excellent papers in this Special Issue, several themes emerged repeatedly, which we believe merit some attention at the outset. As elaborated on below, these themes included the following: the value of studies of attachment in the context of atypical caregiving for producing methodological insights (e.g., Bailey, Tarabulsy, Moran, Pederson, & Bento, 2017; Kobak et al, 2017; Martin, Bureau, et al, 2017; Martin, Sturge-Apple, Davies, Romero, & Buckholz, 2017; Poehlmann-Tynan et al, 2017; Raby, Labella, et al, 2017; Raby, Yarger, et al, 2017); the continued search for biological mechanisms capable of explaining the origins and potentially enduring consequences of variation in early attachment experiences (Blaze & Roth, 2017; Fearon et al, 2017; Mulder et al, 2017; Quevedo et al, 2017; Thijssen et al, 2017); and the notable diversity of current attachment-related intervention efforts (Cassidy et al, 2017; Dubois-Comtois et al, 2017; Guild, Toth, Handley, Rogosch, & Cicchetti, 2017; Handley, Michl-Petzing, Rogosch, Cicchetti, & Toth, 2017; Humphreys, Nelson, Fox, & Zeanah, 2017; Schact et al, 2017; Suchman et al, 2017; Swain et al, 2017; Tereno et al, 2017). …”

A case study illustrating the use of an attachment video‐feedback intervention strategy

“…Our work with adolescent mothers and other high‐risk mother–infant dyads, as well as randomized clinical trials conducted with children receiving child protection services, either with foster or biological families has shown that a positive, warm, and supporting mentoring relationship with parents, using a structured and encouraging approach to modifying parent–child interaction, can lead to improvements in maternal interactive behavior, the emerging parent–child relationship, and child outcomes. Benefits of AVI include improvements in maternal sensitivity (the specific target of the intervention), attachment, child cognitive and motor development for infants and toddlers, and a reduction in parental perceptions of preschooler externalized behavior (Dubois‐Comtois et al., ; Moss et al., ; Moss et al., ). Recent work with child protection agencies show reduced levels of child placement when dyads are exposed to AVI (Tarabulsy, Baudry, Pearson, & Turgeon, ).…”

Improving parent–child interactions in maltreating families with the Attachment Video-feedback Intervention: Parental childhood trauma as a moderator of treatment effects

“…intervention studies have shown to be effective in improving child attachment (i.e., fewer children with a disorganized attachment and more children with a secure attachment post-intervention), child mental and motor development (Dubois-Comtois et al, 2017) and parent-child interactive quality, and in reducing emotional and behavioural problems (Bernard et al, 2012;Moss et al, 2011;Negrao et al, 2014).…”