Hostname: page-component-745bb68f8f-f46jp Total loading time: 0 Render date: 2025-01-11T21:02:28.628Z Has data issue: false hasContentIssue false
  • English
  • Français

Efficacy of a home-visiting intervention aimed at improving maternal sensitivity, child attachment, and behavioral outcomes for maltreated children: A randomized control trial

Published online by Cambridge University Press:  24 January 2011

Ellen Moss ,
Karine Dubois-Comtois ,
Chantal Cyr ,
George M. Tarabulsy ,
Diane St-Laurent  and
Annie Bernier
Ellen Moss*
Affiliation:
Université du Québec à Montréal
Karine Dubois-Comtois
Affiliation:
Université du Québec à Trois-Rivières
Chantal Cyr
Affiliation:
Université du Québec à Montréal
George M. Tarabulsy
Affiliation:
Université Laval
Diane St-Laurent
Affiliation:
Université du Québec à Trois-Rivières
Annie Bernier
Affiliation:
Université de Montréal
*
Address correspondence and reprint requests to: Ellen Moss, Department of Psychology, Université du Québec à Montréal, C.P. 8888, Succursale Centreville, Montreal, QC H3C 3P8, Canada; E-mail: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

The efficacy of a short-term attachment-based intervention for changing risk outcomes for children of maltreating families was examined using a randomized control trial. Sixty-seven primary caregivers reported for maltreatment and their children (1–5 years) were randomly assigned to an intervention or control group. The intervention group received 8 weekly home visits directed at the caregiver–child dyad and focused on improving caregiver sensitivity. Intervention sessions included brief discussions of attachment–emotion regulation-related themes and video feedback of parent–child interaction. Comparison of pre- and posttest scores revealed significant improvements for the intervention group in parental sensitivity and child attachment security, and a reduction in child disorganization. Older children in the intervention group also showed lower levels of internalizing and externalizing problems following intervention. This is the first study to demonstrate the efficacy of short-term attachment-based intervention in enhancing parental sensitivity, improving child security, and reducing disorganization for children in the early childhood period.

Type
Regular Articles
Information
Development and Psychopathology , Volume 23 , Issue 1 , February 2011 , pp. 195 - 210
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA Preschool Forms and Profiles. Burlington, VT: University of Vermont, Department of Psychiatry.Google Scholar
Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Erlbaum.Google Scholar
Bakermans-Kranenburg, M. J., Juffer, F., & van IJzendoorn, M. H. (1998). Interventions with video feedback and attachment discussions: Does type of maternal insecurity make a difference? Infant Mental Health Journal, 19, 202–219.3.0.CO;2-P>CrossRefGoogle Scholar
Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., & Juffer, F. (2003). Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bulletin, 129, 195–215.CrossRefGoogle ScholarPubMed
Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., & Juffer, F. (2005). Disorganized infant attachment and preventive interventions: A review and meta-analysis. Infant Mental Health Journal, 26, 191–216.CrossRefGoogle Scholar
Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., Pijlman, F. T., Mesman, J., & Juffer, F., (2008). Experimental evidence for differential susceptibility: Dopamine D4 receptor polymorphism (DRD4 VNTR) moderates intervention effects on toddlers’ externalizing behavior in a randomized controlled trial. Developmental Psychology, 44, 293–300.CrossRefGoogle ScholarPubMed
Barnett, D., Ganiban, J., & Cicchetti, D. (1999). Maltreatment, negative expressivity, and the development of Type D attachments from 12- to 24-months of age. Monographs of the Society for Research in Child Development, 64, 97–118.CrossRefGoogle ScholarPubMed
Belsky, J., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2007). For better and for worse: Differential susceptibility to environmental influences, Science, 16, 300–304.Google Scholar
Bretherton, I. (1985). Attachment theory: Retrospect and prospect. In Bretherton, I. & Waters, E. (Eds.), Growing points of attachment theory and research. Monographs of the Society for Research in Child Development, 50, 3–35.Google Scholar
Carlson, E. A. (1998). A prospective longitudinal study of disorganized/disoriented attachment. Child Development, 69, 1970–1979.CrossRefGoogle Scholar
Cassidy, J., Marvin, R. S., & the MacArthur Working Group on Attachment. (1992). Attachment organization in 2 1/2 to 4 1/2 year olds: Coding manual. Unpublished manuscript, University of Virginia.Google Scholar
Chaffin, M., Silovsky, J., Funderbunk, B.,Valle, L., Brestan, E., Balachova, T., et al. (2004). Parent–child interaction therapy with physically abusive parents. Efficacy for reducing future abuse reports. Journal of Consulting and Clinical Psychology, 72, 500–510.CrossRefGoogle ScholarPubMed
Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2006). Fostering secure attachment in infants in maltreating families through preventive interventions. Development and Psychopathology, 18, 623–649.CrossRefGoogle ScholarPubMed
Cicchetti, D., Toth, S. L., & Lynch, M. (1995). Bowlby's dream comes full circle: The application of attachment theory to risk and psychopathology. Advances in Clinical Child Psychology, 17, 1–75.Google Scholar
Cicchetti, D., & Valentino, K. (2006). An ecological–transactional perspective on child maltreatment: Failure of the average expectable environment and its influence on child development. In Cicchetti, D. & Cohen, D. J. (Eds.), Developmental psychopathology: Vol. 3. Risk, disorder, and adaptation (2nd ed., pp. 129–201). Hoboken, NJ: Wiley.Google Scholar
Daro, D. (1988). Confronting child abuse: Research for effective program design. New York: Free Press.Google Scholar
De Klyen, M., & Greenberg, M. T. (2008). Attachment and psychopathology in childhood. In Cassidy, J. & Shaver, P. R. (Eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 637–665). New York: Guilford Press.Google Scholar
Dozier, M., Peloso, E., Lindhiem, O., Gordon, M. K., Manni, M., Sepulveda, S., et al. (2006). Developing evidence-based interventions for foster children: An example of a randomized clinical trial with infants and toddlers. Journal of Social Issues, 62, 767–785.CrossRefGoogle Scholar
Drew, A., Baird, G., Baron-Cohen, S., Cox, A., Slonims, V., Wheelwright, S., et al. (2002). A pilot randomised control trial of a parent training intervention for pre-school children with autism. Preliminary findings and methodological challenges. European Child and Adolescent Psychiatry, 11, 266–272.CrossRefGoogle ScholarPubMed
Egeland, B., & Erickson, M. F. (1993). Attachment theory and findings: Implications for prevention and intervention. In Kramer, S. & Parens, H. (Eds.), Prevention in mental health: Now, tomorrow, ever? (pp. 21–50). Northvale, NJ: Aronson.Google Scholar
Egeland, B., Jacobvitz, D., & Sroufe, A. (1988). Breaking the cycle of child abuse. Child Development, 59, 1080–1088.CrossRefGoogle Scholar
Gliner, J. A., Morgan, G. A., & Harmon, R. J. (2003). Pretest–posttest comparison group designs: Analysis and interpretation. Journal of the American Academy of Child & Adolescent Psychiatry, 42, 500–503.CrossRefGoogle ScholarPubMed
Grossmann, K. E., Grossmann, K., & Waters, E. (2005). Attachment from Infancy to Adulthood. New York: Guilford Press.Google Scholar
Hane, A. A., & Fox, N. A. (2006). Ordinary variations in maternal caregiving of human infants influence stress reactivity. Psychological Science, 17, 550–556.CrossRefGoogle ScholarPubMed
Heinicke, C. M., Fineman, N. R., Ruth, G., Recchia, S. L., Guthrie, D., & Rodning, C. (1999). Relationship-based intervention with at-risk mothers: Outcome in the first year of life. Infant Mental Health Journal, 20, 349–374.3.0.CO;2-X>CrossRefGoogle Scholar
Hesse, E., & Main, M. (2006). Frightened, threatening, and dissociative parental behavior in low-risk samples: Description, discussion, and interpretations. Development and Psychopathology, 18, 309–343.CrossRefGoogle ScholarPubMed
Hoffman, K. T., Marvin, R. S., Cooper, G., & Powell, B. (2006). Changing toddlers’ and preschoolers’ attachment classifications: The circle of security intervention. Journal of Consulting and Clinical Psychology, 74, 1017–1026.CrossRefGoogle ScholarPubMed
Juffer, F., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2008). Promoting positive parenting: An attachment-based intervention. New York: Taylor & Francis.Google Scholar
Klein Velderman, M., Bakermans-Kranenburg, M. J., Juffer, F., van IJzendoorn, M. H., Mangelsdorf, S. C., & Zevalking, J. (2006). Preventing preschool externalizing behavior problems through video-feedback intervention in infancy. Infant Mental Health Journal, 27, 466–493.CrossRefGoogle ScholarPubMed
Larin, S., St-Georges, R., Jacques, C., Otis, N., & Desaulniers, R. (2006). Programme en intervention relationnelle: Guide d'intervention. Unpublished manuscript, Les Centres jeunesse de Lanaudière, Quebec.Google Scholar
Lemelin, J. P., Tarabulsy, G. M., & Provost, M. (2006). Predicting preschool cognitive development from infant temperament, maternal sensitivity, and psychosocial risk. Merrill–Palmer Quarterly, 52, 779–806.CrossRefGoogle Scholar
Lieberman, A. F., Ghosh Ippen, C., & Van Horn, P. (2006). Child–parent psychotherapy: 6-month follow-up of a randomized control trial. Journal of the American Academy of Child & Adolescent Psychiatry, 45, 913–918.CrossRefGoogle Scholar
Lieberman, A. F., Van Horn, P., & Ghosh Ippen, C. (2005). Towards evidence-based treatment: Child–parent psychotherapy with preschoolers exposed to marital violence. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 1241–1248.CrossRefGoogle Scholar
Lyons-Ruth, K., Bronfman, E., & Parsons, E. (1999). Maternal frightened, frightening, or atypical behavior and disorganized infant attachment patterns. Monographs of the Society for Research in Child Development, 64, 67–96.CrossRefGoogle ScholarPubMed
Lyons-Ruth, K., Connell, D. B., Grunebaum, H. U., & Botein, S. (1990). Infants at social risk: Maternal depression and family support services as mediators of infant development and security of attachment. Child Development, 61, 85–98.CrossRefGoogle ScholarPubMed
Lyons-Ruth, K., & Jacobvitz, D. (2008). Attachment disorganization: Genetic factors, parenting contexts, and developmental transformation from infancy to adulthood. In Cassidy, J. & Shaver, P. R. (Eds.), Handbook of attachment second edition: Theory, research, and clinical applications (pp. 666–697). New York: Guilford Press.Google Scholar
MacLeod, J., & Nelson, G. (2000). Programs for the promotion of family wellness and the prevention of child maltreatment: A meta-analytic review. Child Abuse & Neglect, 24, 1127–1149.CrossRefGoogle ScholarPubMed
MacMillan, H. L., Wathen, C. N., Barlow, J., Fergusson, D. M., Leventhal, J. M., & Taussig, H. N. (2009). Interventions to prevent child maltreatment and associated impairment. Lancet, 373, 250–266.CrossRefGoogle ScholarPubMed
Madigan, S., Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., Moran, G., Pederson, D. R., & Benoit, D. (2006). Unresolved states of mind, anomalous parental behavior, and disorganized attachment: A review and meta-analysis of transmission gap. Attachment and Human Development, 8, 89–111.CrossRefGoogle ScholarPubMed
Main, M., & Cassidy, J. (1988). Categories of response to reunion with the parent at age 6: Predictable from infant attachment classifications and stable over a 1-month period. Developmental Psychology, 24, 415–426.CrossRefGoogle Scholar
Main, M., & Solomon, J. (1990). Procedures for identifying infants as disorganized/disoriented during the Ainsworth Strange Situation. In Greenberg, M. T., Cicchetti, D., & Cummings, M. (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 121–160). Chicago: University of Chicago Press.Google Scholar
Marvin, R. S. (1977). Ethological and general systems perspectives on child–parent attachment during the toddler and preschool years. In Segal, N., Weisfeld, G., & Weisfeld, C. (Eds.), Uniting psychology and biology: Integrative perspectives on human development (pp. 189–216). Washington, DC: American Psychological Association.Google Scholar
Meaney, M. (2001). Maternal care, gene expression, and the transmission of individual differences in stress reactivity across generations. Annual Reviews in Neuroscience, 24, 1161–1192.CrossRefGoogle Scholar
Moran, G., Pederson, D. R., & Krupka, A. (2005). Maternal unresolved attachment status impedes the effectiveness of interventions with adolescent mothers. Infant Mental Health Journal, 26, 231–249.CrossRefGoogle ScholarPubMed
Moss, E., Bureau, J.-F., Cyr, C., Mongeau, C., & St-Laurent, D. (2004). Correlates of attachment at age 3: Construct validity of the Preschool Attachment Classification System. Developmental Psychology, 40, 323–334.CrossRefGoogle ScholarPubMed
Moss, E., Cyr, C., Bureau, J.-F., Tarabulsy, G. M., & Dubois-Comtois, K. (2005). Stability of attachment during the preschool period. Developmental Psychology, 41, 773–783.CrossRefGoogle ScholarPubMed
Moss, E., Cyr, C., & Dubois-Comtois, K. (2004). Attachment at early school age and developmental risk: Examining trajectories of controlling–caregiving, controlling–punitive and behaviorally-disorganized children. Developmental Psychology, 40, 519–532.CrossRefGoogle ScholarPubMed
Moss, E., Smolla, N., Cyr, C., Dubois-Comtois, K., Mazzarello, T., & Berthiaume, C. (2006). Attachment and behavior problems in middle childhood as reported by adult and child informants. Development and Psychopathology, 18, 425–444.CrossRefGoogle ScholarPubMed
Moss, E., & St-Laurent, D. (2001). Attachment at school age and academic performance. Developmental Psychology, 37, 863–874.CrossRefGoogle ScholarPubMed
Moss, E., St. Laurent, D., & Parent, S. (1999). Disorganized attachment and developmental risk at school-age. In George, C. & Solomon, G. (Eds.), Attachment disorganization (pp. 160–186). New York: Guilford Press.Google Scholar
NICHD Early Child Care Research Network. (2001). Child-care and family predictors of preschool attachment and stability from infancy. Developmental Psychology, 37, 847–862.CrossRefGoogle Scholar
NICHD Early Child Care Research Network. (2005). Predicting individual differences in attention, memory, and planning in first graders from experiences at home, child care, and school. Developmental Psychology, 41, 99–114.CrossRefGoogle Scholar
Olds, D., Eckenrode, J., Henderson, C., Kitzman, H., Powers, J., Cole, R., et al. (1997). Long-terms effects of home visitation on maternal life course and child abuse and neglect. Journal of the American Medical Association, 278, 637–643.CrossRefGoogle Scholar
Olds, D., Henderson, C., Cole, R., Eckenrode, J., Kitzman, H., Luckey, et al. (1998). Long-terms effects of home visitation on children's criminal and antisocial behaviour. Journal of the American Medical Association, 280, 1238–1244.CrossRefGoogle Scholar
Olds, D., Sadler, L., & Kitzman, H. (2007). Programs for parents of infants and toddlers: Recent evidence from randomized trials. Journal of Child Psychiatry and Psychology, 48, 355–391.CrossRefGoogle ScholarPubMed
Osofsky, J. D., Kronenberg, M., Hammer, J. H., Lederman, J. C., Katz, L., Adams, S., et al. (2007). The development and evaluation of the intervention model for the Florida Infant Mental Health Pilot Program. Infant Mental Health Journal, 28, 259–280.CrossRefGoogle ScholarPubMed
Pederson, D. R., Gleason, K. E., Moran, G., & Bento, S. (1998). Maternal attachment representations, maternal sensitivity, and the infant–mother attachment relationship. Developmental Psychology, 34, 925–933.CrossRefGoogle ScholarPubMed
Pederson, D. R., & Moran, G. (1995). A categorical description of attachment relationships in the home and its relation to q-sort measures of infant–mother interaction. Monographs of the Society for Research in Child Development, 60, 247–254.Google Scholar
Reynolds, H. T. (1984). Analysis of nominal data. Beverly Hills, CA: Sage.CrossRefGoogle Scholar
Salzinger, S., Feldman, R. S., Hammer, M., & Rosario, M. (1993). The effects of physical abuse on children's social relationships. Child Development, 64, 169–187.CrossRefGoogle ScholarPubMed
Schonkoff, J. P., & Philips, D. (2000). From neurons to neighborhoods: The science of early child development. Washington, DC: National Academies Press.Google Scholar
Schore, A. N. (2001). Effects of a secure attachment relationship on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22, 7–66.3.0.CO;2-N>CrossRefGoogle Scholar
Schuengel, C., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (1999). Frightening maternal behavior linking unresolved loss and disorganized infant attachment. Journal of Consulting and Clinical Psychology, 67, 54–63.CrossRefGoogle ScholarPubMed
Shonk, S. M., & Cicchetti, D. (2001). Maltreatment, competency deficits, and risk for academic and behavioral maladjustment. Developmental Psychology, 37, 3–17.CrossRefGoogle ScholarPubMed
Slade, A., Sadler, L. S., & Mayes, L. C. (2005). Minding the baby: Enhancing parental reflective functioning in a nursing/mental health home visiting program. In Berlin, L. J., Ziv, Y., Amaya-Jackson, L., & Greenberg, M. T. (Eds.), Enhancing early attachments: Theory, research, intervention, and policy (pp. 152–177). New York: Guilford Press.Google Scholar
Statistics Canada. (2008). Les seuils de faible revenu de 2007 et les mesures de faible revenu de 2006. Ottawa, Canada: Ministre de l'Industrie.Google Scholar
Tarabulsy, G. M., Bernier, A., Provost, M. A., Maranda, J., Larose, S., Moss, E., et al. (2005). Another look inside the gap: Ecological contributions to the transmission of attachment in a sample of adolescent mother–infant dyads. Developmental Psychology, 41, 212–224.CrossRefGoogle Scholar
Tarabulsy, G. M., Provost, M. A., Larose, S., Moss, E., Lemelin, J.-P., Moran, G., et al. (2008). Similarities and differences in mothers’ and observers’ ratings of infant security on the Attachment Q-sort. Infant Behavior and Development, 31, 10–22.CrossRefGoogle ScholarPubMed
Toth, S. L., Cicchetti, D., & Kim, J. (2002). Relations among children's perceptions of maternal behavior, attributional styles, and behavioral symptomatology in maltreated children. Journal of Abnormal Child Psychology, 30, 487–501.CrossRefGoogle ScholarPubMed
Toth, S. L., Cicchetti, D., Macfie, J., Rogosch, F. A., & Maughan, A. (2000). Narrative representations of moral-affiliative and conflictual themes and behavioral problems in maltreated preschoolers. Journal of Clinical Child Psychology, 29, 307–318.CrossRefGoogle ScholarPubMed
Toth, S. L., Maughan, A., Manly, J. T., Spagnola, M., & Cichetti, D. (2002). The relative efficacy of two interventions in altering maltreated preschool children's representational models: Implications for attachment theory. Development and Psychopathology, 14, 877–908.CrossRefGoogle ScholarPubMed
Trocmé, N., Fallon, B., MacLaurin, B., Daciuk, J., Felstiner, C., Black, T., et al. (2005). Canadian incidence study of reported child abuse and neglect—2003: Major findings. Ottawa, Canada: Minister of Public Works and Government Services Canada.Google Scholar
Van Doesum, K. T. M., Riksen-Walraven, J. M., Hosman, C. M. H., & Hoefnagels, C. (2008). A randomized controlled trial of a home-visiting intervention aimed at preventing relationship problems in depressed mothers and their infants. Child Development, 79, 547–561.CrossRefGoogle ScholarPubMed
Van IJzendoorn, M. H., Schuengel, C., & Bakermans-Kranenburg, M. J. (1999). Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae. Development and Psychopathology, 11, 225–249.CrossRefGoogle ScholarPubMed
Van Zeijl, J., Koot, H., Mesman, J., van IJzendoorn, M. H., Bakermans-Kranenburg, M. J., Juffer, F., et al. (2006). Attachment-based intervention for enhancing sensitive discipline in mothers of 1- to 3-year-old children at risk for externalizing behavior problems: A randomized controlled trial. Journal of Consulting Psychology, 74, 994–1005.CrossRefGoogle ScholarPubMed