Mental Health Services for Toddlers in Foster Care

Study Overview
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Brief Summary
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Toddlers (2- to 3-year-old children) in foster care often have difficulty regulating behavior and biology, and are at risk for a host of mental health problems. Critical issues for toddlers straddle the challenges of infancy and preschool years. In particular, toddlers in foster care face significant challenges in forming new attachment relationships and developing behavioral and biological regulatory capabilities. This project will assess the effectiveness of an intervention that targets these issues. Attachment and Biobehavioral Catch-up for Toddlers in Foster Care (ABC-T) was developed to help parents: provide nurturing care so that children develop secure, trusting relationships; and supporting children when they become overwhelmed that enhance children's ability to regulate behavior and biology. This intervention's effectiveness will be assessed in a randomized clinical trial.

Detailed Description
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This study assesses the efficacy of a 10-session intervention for young children in the foster care system. Children are randomly assigned to the experimental condition (ABC-T) or to a treatment control (DEF). In the Attachment and Biobehavioral Catch-up for Toddlers (ABC-T) condition, children's foster parents receive an intervention that focuses on nurturance, following children's lead, and helping children settle when they become overwhelmed. In the Developmental Education for Families (DEF) intervention, children's foster parents receive an intervention that focuses on enhancing children's cognitive and motor skills. Both of the interventions are provided in families' homes for 10 sessions of about 60 minutes duration. Outcomes include attachment (assessed in the Preschool Strange Situation), cortisol production (assessed diurnally), child behavior problems (assessed through laboratory procedures that stress children), and through psychiatric interviews.

Official Title
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Mental Health Services for Toddlers in Foster Care

Conditions
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Behavior Problems

Intervention / Treatment
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* Behavioral: Attachment and Biobehavioral Catch-up
* Behavioral: Developmental Education for Families


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 2 -3 years of age, in foster care Exclusion Criteria: Not in foster care

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 3 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Attachment and Biobehavioral Catch-up<br>Attachment and Biobehavioral Catch-up: 10 session intervention in foster families' homes designed to enhance parental nurturance, synchrony, and provide skills such that parents can help children calm down when overwhelmed. | Behavioral: Attachment and Biobehavioral Catch-up<br>* Enhances nurturance, following the lead, and calming behaviors<br>* Other names: Attachment and Biobehavioral Catch-up for Foster Toddlers;|
| Active Comparator: Developmental Education for Families<br>10 session intervention in foster families' homes that targets cognitive and motor skills of children | Behavioral: Developmental Education for Families<br>* Attention control: Enhances parents understanding of developmental milestones<br>* Other names: Occupational Therapy/Physical Therapy;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Problem behaviors | Assessed through laboratory measures of child behavior problems. (Disruptive Behavior Diagnostic Observation Schedule) | Annual | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Attachment | Assessed through Preschool Strange Situation | Once at post-intervention |