Implementing Attachment and Biobehavioral Catch-Up (ABC) -Infant Meets HHS Criteria

Model implementation summary last updated: 2020

The information in this profile reflects feedback, if provided, from this model’s developer as of the above date. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the research reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the HHS criteria for evidence of effectiveness. Similarly, models described here may not all have impact studies, and those with impact studies may vary in their effectiveness. Please see the Effectiveness button on the left for more information about research on the effectiveness of the models discussed here.

Model overview

Theoretical approach

The intervention is based on attachment theory and stress neurobiology.
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Implementation support

Attachment and Biobehavioral Catch-Up–Infant (ABC-Infant) was developed by Dr. 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.

* 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).

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Intended population

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.
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Targeted outcomes

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.
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Model services

ABC-Infant is a training program for caregivers. It is delivered in the family’s home by a parent coach. 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.

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Model intensity and length

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

The intervention is being implemented in 20 U.S. states and several international locations, including Australia, Germany, Norway, Russia, South Africa, Sweden, and Taiwan.
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Adaptations and enhancements

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.

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Implementation notes

The information contained on this page was last updated in July 2020. Recommended further reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by Dr. Caroline Roben on April 9, 2020. HomVEE reserves the right to edit the profile for clarity and consistency.

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