Effectiveness of a Parent Training Program for Parents of Children Adopted Internationally
Condition: Attachment Disorders
Study type: Interventional

Summary: 
      This study will test the effectiveness of a parent training program aimed at helping children
      who are adopted internationally to develop secure, organized attachments to their parents.
    

Detailed description: 
      Children adopted internationally by parents in the United States often experience
      institutional care prior to adoption. Early institutional care may lead to inattention,
      deficits in inhibitory control, and insecure attachments in children. Many of these problems
      persist even after the child is adopted. This study will test the effectiveness of a parent
      training program called Attachment and Biobehavioral Catch-up for Children Adopted
      Internationally (ABC-I). This program is designed to enhance children's ability to regulate
      their attention, behavior, and physiology and to develop secure, organized attachments to
      their parents.

      Participation in this study will begin when the child participant is between 12 and 20 months
      old, and it will end when the child is 4 years old. Participants, who will include parents
      and their adopted child, will meet with the study researchers 3 times before receiving the
      training program intervention, twice in their home and once at the research site. During
      these visits, the background and medical history of the child participant will be reviewed.
      Participants will then be randomly assigned to receive 1 of 2 parent training programs: ABC-I
      or Developmental Education for Families (DEF). Both programs will involve 10 weekly sessions,
      each lasting 60 to 90 minutes and occurring in the parents' homes. The DEF training program
      will focus on enhancing the intellectual and language development of the child participant,
      but it will not train parents to pay attention to and interpret their children's cues. The
      ABC-I training program will involve videotaping parents while they interact with their
      children, reviewing the videotapes, discussing strategies for interacting with children, and
      completing homework assignments.

      Participants will undergo assessments before and after the training programs and at follow-up
      visits when each child turns 2, 3, and 4 years old. Assessments will be made of sensitivity
      in parents and of inattention, inhibitory control, attachment quality, and cortisol
      production in children. Parent sensitivity will be measured by observing parent-child
      interactions and coding them according to a pre-existing scale. Child inattention and
      inhibitory control will be measured through observing each child's behaviors on various
      structured tasks, such as watching a video with a distracter present or being told to wait to
      open a wrapped gift. Attachment will be measured through observation of child behavior and
      through parent ratings and diaries. Cortisol production will be measured through a saliva
      sample, collected via cotton swab. When children are 4 years old, they will also be evaluated
      for diagnosable behavioral disorders. For a subset of children, cheek swabs will be collected
      at age 5-6 for the assessment of telomere length.
    

Intervention name(s): ABC for Children Adopted Internationally; DEF for Children Adopted Internationally
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Participants will participate in 10 weekly in-home intervention sessions aimed at enhancing the ability of children to regulate their attention, behavior, and physiology and to develop secure, organized attachments to their parents.; Participants will participate in 10 weekly in-home intervention sessions aimed at enhancing the intellectual and language development of children.
Other intervention name(s): Attachment and Biobehavioral Catch-up; ABC; ABC-I; DEF; PT/OT; Physical Therapy/Occupational Therapy
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: Internationally Adopted Children; Adoption; Attachment; Inattention; Prevention