Attachment and Biobehavioral Catch-up with Child Protective Services-Involved Parents: Testing Effectiveness in the Community

项目摘要/摘要 经历过忽视或虐待的幼儿行为不良的风险增加 和生物学结果。然而，如果他们的父母表现得很敏感，这种风险是可以缓冲的。 方式。依恋和生物行为追赶(ABC)，家访干预，目标 高危婴儿父母的父母敏感性。通过疗效试验，ABC 干预已被证明可以利用干预机制、父母的敏感性和 增强父母的神经活动。此外，父母领取ABC的孩子 干预显示在依恋、皮质醇产生和行为调节方面有更好的结果 而不是父母接受控制干预的孩子。试点工作表明，一些 家长在几次会议内对干预做出了回应，建议使用缩写的 对他们来说，干预可能是最好的。下一个关键步骤是证明ABC 当社区临床医生实施干预时，干预涉及到干预机制 社区背景，并研究一些父母是否可以从缩写的 干预的版本。 这项有效性试验利用了基于社区的 组织和儿童福利系统审查ABC干预是否使 治疗机制，父母的敏感性，当社区临床医生实施时，是否 父母敏感度的变化对儿童结局的干预效果是否起到中介作用 父母的累积风险减缓了不同剂量干预的有效性。 共有360名父母及其年幼的孩子参与了纽约市的儿童福利 系统将作为参与者被包括在内。家长将随机接受筛选和参考 利用已建立的证据基础进行干预(为每个孩子提供安全的环境；寻求)，以 Seek加3节课的ABC(ABC 3)，或Seek加标准的10节ABC 干预(ABC 10)。干预效果将作为父母的变化进行检查 行为和神经层面的敏感性(干预机制)，以及 儿童结局的变化。父母敏感度的变化有望起到调节干预作用 对儿童结局的影响。对治疗剂量的反应将存在个体差异 探索过了。

PROJECT SUMMARY/ ABSTRACT Young children who have experienced neglect or abuse are at increased risk for poor behavioral and biological outcomes. However, this risk can be buffered if their parents behave in sensitive ways. Attachment and Biobehavioral Catch-up (ABC), a home visiting intervention, targets parental sensitivity among parents of high-risk infants. Through efficacy trials, the ABC intervention has been shown to engage the intervention mechanism, parental sensitivity, and enhance parental neural activity. In addition, children whose parents receive the ABC intervention show better outcomes in attachment, cortisol production, and behavioral regulation than children whose parents receive a control intervention. Pilot work suggests that some parents respond to the intervention within several sessions, suggesting that an abbreviated intervention could be optimal for them. The next critical step is demonstrating that the ABC intervention engages the intervention mechanism when implemented by community clinicians in a community context, and examining whether some parents can benefit from an abbreviated version of the intervention. This effectiveness trial leverages an existing partnership between a community-based organization and child welfare system to examine whether the ABC intervention engages the treatment mechanism, parental sensitivity, when implemented by community clinicians, whether changes in parental sensitivity mediate intervention effects on child outcomes, and whether parental cumulative risk moderates the effectiveness of varied dosages of the intervention. A total of 360 parents and their young children involved in the New York City child welfare system will be included as participants. Parents will be randomized to a screen-and-refer intervention with an established evidence base (Safe Environment for Every Kid; SEEK), to SEEK plus a 3-session version of ABC (ABC 3), or to SEEK plus the standard 10-session ABC intervention (ABC 10). Intervention effectiveness will be examined as changes in parental sensitivity (the intervention mechanism) at both behavioral and neural levels, as well as changes in child outcomes. Changes in parental sensitivity are expected to mediate intervention effects on child outcomes. Individual differences in response to treatment dosage will be explored.