Promoting Attachment Security among Internationally Adopted Children with Histories of Early Adversity
Infants and young children adopted internationally into the United States often experience preadoptive conditions poorly suited to their developmental needs. Most especially, children often experience a lack of consistent attachment figures who are responsive to their cues. Although adoption represents a profound change in children’s environments with children moving from starkly depriving settings to enriched ones, children with histories of preadoptive adversity at risk for forming insecure attachments. Attachment and Biobehavioral Catch-up (ABC) was designed to promote secure attachment in young children by enhancing parents’ sensitive responsiveness. ABC consists of 10 parent-child sessions conducted in families’ homes and has been shown to enhance attachment security in other high-risk populations. The present study used a randomized clinical trial to evaluate the efficacy of the ABC intervention at increasing secure attachments among children adopted internationally.
Families of 106 children adopted internationally between the ages of 5 and 38 months (average age was 15.1 months) participated in the study. At the time of enrollment, adoptive parents provided information about six commonly studied indicators of pre-adoptive deprivation: late age of adoption, long duration of institutional care, adoption from Russia or Eastern Europe, stunted physical growth, poor pre-adoptive caregiving quality, and pre-adoptive social neglect. A principal components analysis supported the creation of a single measure of preadoptive adversity. Families were randomized to receive the ABC intervention or a control intervention. Afterward, children’s attachment security was assessed using the infant and the preschool versions of the Strange Situation Procedure (average ages at the time of assessments were 24.7 months and 50.3 months, respectively). At both assessments, children were classified as having formed a secure or an insecure (avoidant, resistant, or disorganized) attachment to their adoptive parent. Information from the two assessments was combined by calculating the proportion of times children were classified as being securely attached at these two ages.
Results indicated that the positive effects of ABC were conditional on children’s preadoptive histories. Among children who experienced high adversity prior to adoption (based on a median split), those who received the ABC intervention showed higher rates of secure attachment (67%) than children in the control intervention (54%). In contrast, there was not a significant difference in the rates of secure attachment for children in the ABC intervention (69%) and children in the control intervention (67%) among children who experienced low preadoptive adversity. These findings indicate that the parenting-focused ABC intervention can help promote secure attachments among the internationally adopted children who are most at risk for problematic development.