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

Model implementation summary last updated: 2020

The information in this implementation report 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 manuscripts 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. Please see the Effectiveness button on the left for more information about any research on the effectiveness of the model, including any version(s) of the model with effectiveness research. Versions of the model that are described in the Adaptations and enhancements section of this implementation report may include (1) versions that were identified by the model’s developer and (2) versions that have been implemented by researchers and have manuscripts that HomVEE rated high or moderate, but that are not supported by the model’s developer.

Model overview

Theoretical approach

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).

View Revisions

Implementation support

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.

View Revisions

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.
View Revisions

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.
View Revisions

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.

View Revisions

Model intensity and length

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


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

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.

View Revisions

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 in April 2020. HomVEE reserves the right to edit the profile for clarity and consistency.

View Revisions