Can Parenting Intervention Prevent Cascading Effects From Placement Instability to Insecure Attachment to Externalizing Problems in Maltreated Toddlers?

Abstract

Multiple placement changes disrupt continuity in caregiving and undermine well-being in children in child welfare. This study conducted secondary data analysis of a randomized controlled trial to examine whether a relationship-based intervention, Promoting First Relationships^© (PFR), reduced risk for a maladaptive cascade from placement instability to less secure attachment to elevated externalizing problems. Participants included caregivers (birth or foster/kin) of toddlers (10–24 months) recently transitioned to their care because of child welfare placement decisions. Although main effects of PFR on security and externalizing problems were not previously observed, this study’s results revealed that PFR attenuated the association between multiple placement changes (baseline) and less security (postintervention) and that the indirect effect of placement instability on greater externalizing problems (6-month follow-up) via less security was evident only in toddlers in the comparison condition. These findings shed light on how a history of multiple caregiver changes may influence toddlers’ risk for poor adjustment in subsequent placements, and the promise of supporting caregivers through a parenting intervention to prevent such risk.

Keywords

child welfare toddlers placement changes externalizing prevention

Get full access to this article

View all access options for this article.

References

Achenbach

T. M.

Rescorla

L. A.

(2000). Child behavior checklist for ages 1 1/2–5. Burlington: University of Vermont.

Baron

R. M.

Kenny

D. A.

(1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.

Bovenschen

Lang

Zimmermann

Förthner

Nowacki

Roland

Spangler

(2016). Foster children’s attachment behavior and representation: Influence of children’s pre-placement experiences and foster caregiver’s sensitivity. Child Abuse & Neglect, 51, 323–335.

Bowlby

(1982). Attachment and loss. Vol. 1: Attachment (2nd ed.). New York, NY: Basic Books. (Original work published 1969)

Briggs-Gowan

M. J.

Carter

A. S.

(2002). Brief Infant–Toddler Social and Emotional Assessment (BITSEA) manual, version 2.0. New Haven, CT: Yale University.

Briggs-Gowan

M. J.

Carter

A. S.

Irwin

J. R.

Wachtel

Cicchetti

D. V.

(2004). The brief infant–toddler social and emotional assessment: Screening for social–emotional problems and delays in competence. Journal of Pediatric Psychology, 29, 143–155.

Brock

R. L.

Kochanska

(2015). Toward a developmentally informed approach to parenting interventions: Seeking hidden effects. Development and Psychopathology, 28, 583–593.

Cassidy

Woodhouse

S. S.

Sherman

L. J.

Stupica

Lejuez

C. W.

(2011). Enhancing infant attachment security: An examination of treatment efficacy and differential susceptibility. Development and Psychopathology, 23, 131–148.

Cicchetti

Rogosch

F. A.

(2001). The impact of child maltreatment and psychopathology on neuroendocrine functioning. Development and Psychopathology, 13, 783–804.

10.

Dishion

T. J.

Shaw

Connell

Gardner

Weaver

Wilson

(2008). The family check-up with high-risk indigent families: Preventing problem behavior by increasing parents’ positive behavior support in early childhood. Child Development, 79, 1395–1414.

11.

Dozier

Zeanah

C. H.

Bernard

(2013). Infants and toddlers in foster care. Child Development Perspectives, 7, 166–171.

12.

Fearon

R. P.

Bakermans-Kranenburg

M. J.

van Ijzendoorn

M. H.

Lapsley

A.-M.

Roisman

G. I.

(2010). The significance of insecure attachment and disorganization in the development of children’s externalizing behavior: A meta-analytic study. Child Development, 81, 435–456.

13.

Fisher

P. A.

Mannering

A. M.

Van Scoyoc

Graham

A. M.

(2013). A translational neuroscience perspective on the importance of reducing placement instability among foster children. Child Welfare, 92, 9–36.

14.

Fisher

P. A.

Van Ryzin

M. J.

Gunnar

M. R.

(2011). Mitigating HPA axis dysregulation associated with placement changes in foster care. Psychoneuroendocrinology, 36, 531–539.

15.

Ford

Vostanis

Meltzer

Goodman

(2007). Psychiatric disorder among British children looked after by local authorities: Comparison with children living in private households. The British Journal of Psychiatry, 190, 319–325.

16.

Gabler

Bovenschen

Lang

Zimmermann

Nowacki

Kliewer

Spangler

(2014). Foster children’s attachment security and behavior problems in the first six months of placement: Associations with foster parents’ stress and sensitivity. Attachment & Human Development, 16, 479–498.

17.

Hayes

A. F.

(2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York, NY: Guilford Press.

18.

Bentler

P. M.

(1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1–55.

19.

Jonkman

C. S.

Oosterman

Schuengel

Bolle

E. A.

Boer

Lindauer

R. J. L.

(2014). Disturbances in attachment: Inhibited and disinhibited symptoms in foster children. Child and Adolescent Psychiatry and Mental Health, 8, 21–21.

20.

Kelly

Sandoval

Zuckerman

T. G.

Buehlman

(2008). Promoting first relationships: A program for service providers to help parents and other caregivers nurture young children’s social and emotional development (2nd ed.). Seattle, WA: NCAST Programs.

21.

Kirkland

Bimler

Drawneek

McKim

Schölmerich

(2004). An alternative approach for the analyses and interpretation of attachment sort items. Early Child Development and Care, 174, 701–719.

22.

Kochanska

Kim

(2012). Toward a new understanding of legacy of early attachments for future antisocial trajectories: Evidence from two longitudinal studies. Development and Psychopathology, 24, 783–806.

23.

Lewis

E. E.

Dozier

Ackerman

Sepulveda-Kozakowski

(2007). The effect of placement instability on adopted children’s inhibitory control abilities and oppositional behavior. Developmental Psychology, 43, 1415–1427.

24.

Luijk

M. P. C. M.

Saridjan

Tharner

van IJzendoorn

M. H.

Bakermans-Kranenburg

M. J.

Jaddoe

V. W. V.

Tiemeier

(2010). Attachment, depression, and cortisol: Deviant patterns in insecure-resistant and disorganized infants. Developmental Psychobiology, 52, 441–452.

25.

MacKinnon

D. P.

(2008). Introduction to statistical mediation analyses. Mahwah, NJ: Lawrence Erlbaum.

26.

Muthen

L. K.

Muthen

B. O.

(1998–2012). Mplus user’s guide (7th ed.). Los Angeles, CA: Author.

27.

Newton

R. R.

Litrownik

A. J.

Landsverk

J. A.

(2000). Children and youth in foster care: disentangling the relationship between problem behaviors and number of placements. Child Abuse & Neglect, 24, 1363–1374.

28.

Oosterman

Schuengel

(2008). Attachment in foster children associated with caregivers’ sensitivity and behavioral problems. Infant Mental Health Journal, 29, 609–623.

29.

Pears

K. C.

Fisher

P. A.

Bruce

Kim

H. K.

Yoerger

(2010). Early elementary school adjustment of maltreated children in foster care: The roles of inhibitory control and caregiver involvement. Child Development, 81, 1550–1564.

30.

Rubin

D. M.

O’Reilly

Luan

Localio

A. R.

(2007). The impact of placement stability on behavioral well-being for children in foster care. Pediatrics, 119, 336–344.

31.

Spieker

S. J.

Nelson

E. M.

Condon

M.-C.

(2011). Validity of the TAS-45 as a measure of toddler–parent attachment: Preliminary evidence from early head start families. Attachment & Human Development, 13, 69–90.

32.

Spieker

S. J.

Oxford

M. L.

Kelly

J. F.

Nelson

E. M.

Fleming

C. B.

(2012). Promoting First Relationships: Randomized trial of a relationship-based intervention for toddlers in child welfare. Child Maltreatment, 17, 271–286.

33.

Stovall

K. C.

Dozier

(1998). Infants in foster care. Adoption Quarterly, 2, 55–88.

34.

Stovall-McClough

K. C.

Dozier

(2004). Forming attachments in foster care: Infant attachment behaviors during the first 2 months of placement. Development and Psychopathology, 16, 253–271.

35.

Strijker

Knorth

E. J.

Knot-Dickscheit

(2008). Placement history of foster children: A study of placement history and outcomes in long-term family foster care. Child Welfare, 87, 107–124.

36.

Toth

S. L.

Gravener-Davis

J. A.

Guild

D. J.

Cicchetti

(2013). Relational interventions for child maltreatment: Past, present, and future perspectives. Development and Psychopathology, 25, 1601–1617.

37.

U.S. Department of Health and Human Services. (2012). Child welfare outcomes 2009–2012: Report to congress. Retrieved from http://www.acf.hhs.gov/programs/cb/resource/cwo-09-12

38.

Villodas

M. T.

Litrownik

A. J.

Newton

R. R.

Davis

I. P.

(2015). Long-term placement trajectories of children who were maltreated and entered the child welfare system at an early age: Consequences for physical and behavioral well-being. Journal of Pediatric Psychology, 41, 46–54.

39.

Waters

(1987). Attachment Behavior Q-sort (version 3.0) (Unpublished manuscript). State University of New York, Stony Brook, NY.

40.

Zeanah

C. H.

Berlin

L. J.

Boris

N. W.

(2011). Practitioner review: Clinical applications of attachment theory and research for infants and young children. Journal of Child Psychology and Psychiatry, 52, 819–833.