Implementing Attachment and Biobehavioral Catch-Up (ABC) -Infant

Attachment and Biobehavioral Catch-Up–Infant (ABC-Infant) is based on attachment theory and stress neurobiology.*

* ABC-Infant was originally called the ABC Intervention. The developer renamed the model ABC-Infant after creating a version of the model for toddlers (described under Adaptations and enhancements).

ABC-Infant was developed by Mary Dozier, Ph.D., and the Infant Caregiver Project at the University of Delaware. Implementation support is available through the program development team, which is composed of certified ABC supervisors employed by the University of Delaware and supervised by the model developer.

The program development team provides ongoing technical assistance.

ABC-Infant is a training program for caregivers of infants between the ages of 6 and 24 months, including high-risk birth parents and caregivers of young children in foster care, kinship care (for example, a grandparent raising a grandchild), and adoptive care.

ABC-Infant aims to help caregivers provide:

• Nurturing, even when children do not appear to need it;
• Mutually responsive interactions in which caregivers follow children’s lead; and
• Care that is not frightening or overwhelming to children, such as refraining from verbal threats.

ABC-Infant is a training program for caregivers. It is delivered in the family’s home by a parent coach. The curriculum outlines the focus for each session. Sessions 1 and 2 are designed to help caregivers reinterpret children’s behavioral signals, providing nurturing even when it is not elicited. Sessions 3 and 4 are designed to help caregivers learn to follow their children’s lead. Sessions 5 and 6 are designed to help caregivers recognize their own overwhelming or frightening behaviors and develop alternative responses. Sessions 7 and 8 are designed to help caregivers overcome automatic responses to their children that are based on their own experiences and could interfere with providing nurturing, sensitive care. Sessions 9 and 10 are designed to reinforce knowledge gained during previous sessions.

Per the program development team, the most crucial aspect of the intervention is the parent coach’s use of immediate feedback (referred to as "in the moment" comments) on the caregiver’s interaction with the child. Throughout the home visiting session, the parent coach comments on the caregiver’s interactions to help the caregiver attend to the target behaviors, including following the child’s lead with delight, using nurturing behaviors, and avoiding frightening behaviors. During the session, the parent coach and caregiver also watch a video of the caregiver interacting with the child. The parent coach highlights the caregiver’s strengths, celebrates changes in behavior, and identifies areas for improvement. The model also incorporates homework to give caregivers the opportunity to practice the skills they are learning and record their observations about their own behavior and the child’s behavior.

ABC-Infant includes 10 weekly sessions lasting about 60 minutes each.

Two versions of the model have been developed: (1) ABC-Toddler and (2) Modified ABC. ABC-Toddler is for children between the ages of 24 and 48 months and aims to help caregivers provide calming behaviors when young children are angry and/or unable to regulate their emotions. Modified ABC is designed for mothers with opioid dependence.

No information is available on the process, if any, for considering modifications to the model.

There are no requirements about the type or characteristics of organizations that can implement ABC-Infant. Currently, the model is primarily implemented by agencies that conduct home visits with foster parents, adoptive parents, and high-risk birth parents.

ABC-Infant requires parent coaches to meet ongoing fidelity guidelines. Please contact the model developer for additional information about these guidelines.

ABC-Infant is implemented by parent coaches who conduct home visits.

There are no education or experience requirements for the parent coaches. However, all prospective parent coaches are required to pass a screening process that involves a 45-minute video interview with the program development team to assess the parent coach candidates’ openness to attachment theory, ability to provide in-the-moment comments about caregiver-child behavior, and their agencies’ readiness for implementation.

Parent coaches are considered trainees until they become certified after a year-long supervision process and assessment of their adherence and fidelity to the model. Each week for one year, parent coach trainees must participate in two videoconferences with a supervisor from the program development team. These meetings are explained below:

• Group clinical supervision. A one-hour meeting of two or three trainees with a supervisor; the meeting includes a review of videos from home visit sessions.
• “In the moment” commenting supervision. A 30-minute one-on-one meeting between a supervisor and trainee. Before each supervision meeting, the trainee and supervisor code the trainee’s use of commenting in a 5-minute videotaped segment from the trainee’s home visit sessions. The goal of the supervision is to enhance comment quality and frequency by supporting trainees’ assessment of their own commenting.

Ongoing supervision is recommended but not required after parent coaches complete the certification process. The program development team offers training to program sites on how to provide ongoing supervision for their parent coaches after the supervision from the program development team ends.

Parent coach trainees must attend a two-day pre-service training. The program development team offers the training for small groups three times annually in Newark, Delaware. For larger groups, the program development team conducts training at program sites. Please contact the model developer for additional information about the pre-service training requirement.

ABC-Infant does not require that parent coaches or supervisors participate in ongoing professional development.