Early intervention for children adopted internationally

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DESCRIPTION (provided by applicant): The number of children adopted into the United States internationally has increased dramatically over the last two decades, with many of these children experiencing institutional care prior to adoption. Problems associated with early institutional care include inattention, deficits in inhibitory control, and insecure attachments. Although rapid gains are seen in some areas, many problems persist. It is critical that interventions be developed that address the specific issues faced by these children and their parents. Attachment and Biobehavioral Catch-up for Children Adopted Internationally (ABC-I) is a 10 session parent training program designed to enhance children's ability to regulate attention, behavior, and physiology, and develop secure, organized attachments to their parents. The proposed study will examine the effectiveness of this intervention through a randomized control design. Initially 220 young children who have lived in institutional care prior to adoption will be enrolled in the study. They will be randomly assigned to the ABC-I intervention or to a control intervention. At least 180 children will be assessed in various contexts annually until they are 4-years- old. Children's ability to regulate attention, behavior, and physiology will be assessed throughout the study period. Children in the ABC-I intervention are expected to show fewer problems with inattention, better inhibitory control, more secure attachments, more normative patterns of hormone production, and lower incidence of diagnosed behavior disorders, than children in the control intervention. PUBLIC HEALTH RELEVANCE: Young children who are adopted after living in institutional care are at increased risk for a range of psychiatric and behavioral disorders, but there are few evidence-based treatment programs that address such problems. The preventive intervention assessed in this study targets issues that have been identified as particularly problematic for these children.