Attachment and Biobehavioral Catch-Up

  • Amanda H. CostelloEmail author
  • Caroline K. P. Roben
  • Mary Dozier


This chapter describes Attachment and Biobehavioral Catch-Up (ABC), a short-term (10-week) intervention that focuses on enhancing parents’ capacities for interacting with their young children (up to 24 months); randomized controlled trial (RCT) data support the program’s effectiveness several years post-intervention across social-emotional, biological, and relational indices. ABC consists of 10 weekly 60-min sessions with both the parent and child present. ABC is designed to be implemented in the home where the parent and child are most comfortable, thereby increasing confidence and skill generalization. The focus of the intervention is to increase synchrony (following the lead) and nurturing parenting behaviors, as well as decrease frightening behavior. Parent coaches encourage these behaviors by making frequent, in-the-moment comments. Specific research on the effectiveness of the intervention is discussed as well as expanding ABC in two different ways: adaptation of the intervention for toddlers (24–48 months) and disseminating ABC to national and international sites. Preliminary data from both endeavors, as well as implementation challenges and improving the dissemination and implementation of ABC, are presented, along with the next steps for the intervention.


  1. Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Erlbaum.Google Scholar
  2. Beardslee, W. R., Bemporad, J., Keller, M. B., & Klerman, G. L. (1983). Children of parents with major affective disorder: A review. American Journal of Psychiatry, 140, 825–832. CrossRefPubMedGoogle Scholar
  3. Beidas, R. S., Edmunds, J. M., Marcus, S. C., & Kendall, P. C. (2012). Training and consultation to promote implementation of an empirically supported treatment: A randomized trial. Psychiatric Services, 63(7), 660–665. CrossRefPubMedGoogle Scholar
  4. Berlin, L. J., Shanahan, M., & Appleyard Carmody, K. (2014). Promoting supportive parenting in new mothers with substance-use problems: A pilot randomized trial of residential treatment plus an attachment-based parenting program. Infant Mental Health Journal 35(1), 81–85. doi: 10.1002/imhj.21427CrossRefGoogle Scholar
  5. Bernard, K., Butzin-Dozier, Z., Rittenhouse, J., & Dozier, M. (2010). Young children living with neglecting birth parents show more blunted daytime patterns of cortisol production than children in foster care and comparison children. Archives of Pediatrics and Adolescent Medicine, 164, 438–443. CrossRefPubMedGoogle Scholar
  6. Bernard, K., & Dozier, M. (2010). Examining infants’ cortisol responses to laboratory tasks among children varying in attachment disorganization: Stress reactivity or return to baseline? Developmental Psychology, 46, 1771–1778. CrossRefPubMedPubMedCentralGoogle Scholar
  7. Bernard, K., & Dozier, M. (2011). This is my baby: Foster parents’ feelings of commitment and displays of delight. Infant Mental Health Journal, 32, 251–262. CrossRefPubMedPubMedCentralGoogle Scholar
  8. Bernard, K., Dozier, M., Bick, J., & Gordon, M. K. (2015). Intervening to enhance cortisol regulation among children at risk for neglect: Results of a randomized clinical trial. Development and Psychopathology, 27, 829–841. CrossRefPubMedGoogle Scholar
  9. Bernard, K., Dozier, M., Bick, J., Lewis-Morrarty, E., Lindheim, O., & Carlson, E. (2012). Enhancing attachment organization among maltreated children: Results of a randomized clinical trial. Child Development, 83, 623–636. CrossRefPubMedPubMedCentralGoogle Scholar
  10. Bernard, K., Hostinar, C. E., & Dozier, M. (2015). Intervention effects on diurnal cortisol rhythms of Child Protective Services-referred infants in early childhood: Preschool follow-up results of a randomized clinical trial. JAMA Pediatrics, 169, 112–119. CrossRefPubMedPubMedCentralGoogle Scholar
  11. Bernard, K., Simons, R., & Dozier, M. (2015). Effects of an attachment-based intervention on Child Protective Services-referred mothers’ event-Related potentials to children’s emotions. Child Development 86(6), 1673–1684. CrossRefGoogle Scholar
  12. Bick, J., & Dozier, M. (2013). The effectiveness of an attachment-based intervention in promoting foster mothers’ sensitivity toward foster infants. Infant Mental Health Journal, 34, 95–103. CrossRefPubMedGoogle Scholar
  13. Blair, C., & Raver, C. C. (2012). Child development in the context of adversity: Experiential canalization of brain and behavior. American Psychologist, 67, 309–318. CrossRefPubMedGoogle Scholar
  14. Bousha, D. M., & Twentyman, C. T. (1984). Mother–child interactional style in abuse, neglect, and control groups. Journal of Abnormal Psychology, 93, 106–114. CrossRefPubMedGoogle Scholar
  15. Bowlby, J. (1969/1982). Attachment and loss (Vol. 1). London, UK: Hogarth Press.Google Scholar
  16. Bruce, J., Fisher, P. A., Pears, K. C., & Levine, S. (2009). Morning cortisol levels in preschool-aged foster children: Differential effects of maltreatment type. Developmental Psychobiology, 51, 14–23. CrossRefPubMedPubMedCentralGoogle Scholar
  17. Bruce, J., Kroupina, M., Parker, S., & Gunnar, M. (2000). The relationships between cortisol patterns, growth retardation, and developmental delays in postinstitutionalized children. Paper presented at the International Conference on Infant Studies, Brighton, UK.Google Scholar
  18. California Evidence-Based Clearinghouse rating of ABC. (September, 2014). In CEBC for Child Welfare. Retrieved from
  19. Calkins, S. D., & Dedmon, S. A. (2000). Physiological and behavioral regulation in two-year-old children with aggressive/destructive behavior problems. Journal of Abnormal Child Psychology, 2, 103–118. CrossRefGoogle Scholar
  20. Calkins, S. D., & Johnson, M. C. (1998). Toddler regulation of distress to frustrating events: Temperamental and maternal correlates. Infant Behavior and Development, 21, 379–395. CrossRefGoogle Scholar
  21. Calkins, S. D., & Leerkes, E. M. (2011). Early attachment processes and the development of emotional self-regulation. In K. D. Vohs & R. F. Baumeister (Eds.), Handbook of self-regulation, Research, theory, and applications (2nd ed.). New York, NY: Guilford Press.Google Scholar
  22. Campbell, S. B., & Ewing, L. J. (1990). Follow-up of hard to manage preschoolers: Adjustment at age 9 and predictors of continuing symptoms. Journal of Child Psychology and Psychiatry, 31, 871–889. CrossRefPubMedGoogle Scholar
  23. Carlson, E. A. (1998). A prospective longitudinal study of attachment disorganization/disorientation. Child Development, 69, 1107–1128. CrossRefPubMedGoogle Scholar
  24. Caron, E., Bernard, K., & Dozier, M. (2016). In vivo feedback predicts parent behavior change in the attachment and biobehavioral catch-up intervention. Journal of Clinical Child & Adolescent Psychology, 4, 1–12. CrossRefGoogle Scholar
  25. Cicchetti, D., Ackerman, B. P., & Izard, C. E. (1995). Emotions and emotion regulation in developmental psychopathology. Development and Psychopathology, 7, 1–10. CrossRefGoogle Scholar
  26. Cicchetti, D., & Toth, S. L. (2005). Child maltreatment. Annual Review of Clinical Psychology, 1, 409–438. CrossRefPubMedGoogle Scholar
  27. Cohn, J. F., & Tronick, E. Z. (1989). Specificity of infants’ response to mothers’ affective behavior. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 242–248. CrossRefPubMedGoogle Scholar
  28. Crittenden, P. M. (1981). Abusing, neglecting, problematic and adequate dyads: Differentiating by patterns of interaction. Merrill–Palmer Quarterly, 27, 201–218. CrossRefGoogle Scholar
  29. Cyr, C., Euser, E. M., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2010). Attachment security and disorganization in maltreating and high-risk families: A series of meta-analyses. Development and Psychopathology, 22, 87–108. CrossRefPubMedGoogle Scholar
  30. Dozier, M., Peloso, E., Lewis, E., Laurenceau, J., & Levine, S. (2008). Effects of an attachment-based intervention on the cortisol production of infants and toddlers in foster care. Development and Psychopathology, 20, 845–859. CrossRefPubMedPubMedCentralGoogle Scholar
  31. Dozier, M., Roben, C. K. P., Caron, E., Hoye, J., & Bernard, K. (2018). Attachment and biobehavioral catch-up: An evidence-based intervention for vulnerable infants and their families. Special Issue: Psychotherapy Research, 28(1), 18–29.Google Scholar
  32. Dozier, M., Stovall, K. C., Albus, K. E., & Bates, B. (2001). Attachment for infants in foster care: The role of caregiver state of mind. Child Development, 72, 1467–1477. CrossRefPubMedGoogle Scholar
  33. 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. CrossRefGoogle Scholar
  34. Feldman, R. (2007). Parent-infant synchrony and the construction of shared timing: Physiological precursors, developmental outcomes, and risk conditions. Journal of Child Psychology and Psychiatry, 48, 329–354. CrossRefPubMedGoogle Scholar
  35. Field, T. (1984). Early interactions between infants and their postpartum depressed mothers. Infant Behavior and Development, 7, 527–532. CrossRefGoogle Scholar
  36. Forbes, E. E., Cohn, J. F., Allen, N. B., & Lewinsohn, P. M. (2004). Infant affect during parent-infant interaction at 3 and 6 months: Differences between mothers and fathers and influence of parent history of depression. Infancy, 5, 61–84. CrossRefPubMedPubMedCentralGoogle Scholar
  37. George, C., Kaplan, N., & Main, M. (1985). The adult attachment interview. Unpublished manuscript, University of California, Berkeley.Google Scholar
  38. Gunnar, M. R., & Cheatham, C. L. (2003). Brain and behavior interface: Stress and the developing brain. Infant Mental Health Journal, 24(3), 195–211. CrossRefGoogle Scholar
  39. Herschell, A. D., Kolko, D. J., Baumann, B. L., & Davis, A. C. (2010). The role of therapist training in the implementation of psychosocial treatments: A review and critique with recommendations. Clinical Psychology Review, 30(4), 448–466. CrossRefPubMedPubMedCentralGoogle Scholar
  40. Hertsgaard, L., Gunnar, M., Erickson, M. R., & Nachmias, M. (1995). Adrenocortical responses to the Strange Situation in infants with disorganized/disoriented attachment relationships. Child Development, 66, 1100–1106. CrossRefPubMedGoogle Scholar
  41. Johnson, E. O., Kamilaris, T. C., Chrousos, G. P., & Gold, P. W. (1992). Mechanisms of stress: A dynamic overview of hormonal and behavioral homeostasis. Neuroscience and Biobehavioral Reviews, 16, 115–130. CrossRefPubMedGoogle Scholar
  42. Keenan, K., Shaw, D., Delliquadri, E., Giovannelli, J., & Walsh, B. (1998). Evidence for continuity of early problem behaviors: Application of a developmental model. Journal of Abnormal Child Psychology, 26(6), 441–454. CrossRefPubMedGoogle Scholar
  43. Kim, J., & Cicchetti, D. (2010). Longitudinal pathways linking child maltreatment, emotion regulation, peer relations, and psychopathology. Journal of Psychology & Psychiatry, 51, 706–716. CrossRefGoogle Scholar
  44. Kopp, C. B. (1989). Regulation of distress and negative emotions: A developmental view. Developmental Psychology, 25(3), 343–354. CrossRefGoogle Scholar
  45. Lewis, E. E., Dozier, M., Ackerman, J., & Sepulveda-Kozakowski, S. (2007). The effect of placement instability on adopted children’s inhibitory control abilities and oppositional behavior. Developmental Psychology, 43(6), 1415–1427. CrossRefPubMedGoogle Scholar
  46. Lewis-Morrarty, E., Dozier, M., Bernard, K., Moore, S., & Terraciano, S. (2012). Cognitive flexibility and theory of mind outcomes among foster children: Preschool follow-up results of a randomized clinical trial. Journal of Adolescent Health, 51, 17–22. CrossRefGoogle Scholar
  47. Lind, T., Bernard, K., & Dozier, M. (2016). Enhancing inhibitory control in children referred to child protective services (CPS): Effects of attachment and biobehavioral catch-up. University of Delaware: Unpublished document.Google Scholar
  48. Lind, T., Bernard, K., Ross, E., & Dozier, M. (2014). Intervention effects on negative affect of CPS-referred children: Results of a randomized clinical trial. Child Abuse and Neglect, 38, 1459–1467. CrossRefPubMedGoogle Scholar
  49. Lind, T., Raby, K. L., Caron, E., Roben, C. K. P., & Dozier, M. (2017). Enhancing executive functioning among toddlers in foster care with an attachment-based intervention. Development and Psychopathology, 29, 575–586. CrossRefPubMedPubMedCentralGoogle Scholar
  50. Loman, M. M., & Gunnar, M. R. (2010). Early experience and the development of stress reactivity and regulation in children. Neuroscience & Biobehavioral Reviews, 34(6), 867–876. CrossRefGoogle Scholar
  51. Lupien, S. J., Maheu, F., Tu, M., Fiocco, A., & Schramek, T. E. (2007). The effects of stress and stress hormones on human cognition: Implications for the field of brain and cognition. Brain and Cognition, 65, 209–237. CrossRefPubMedGoogle Scholar
  52. Lyons-Ruth, K., Bronfman, E., & Parsons, E. (1999). Maternal frightened, frightening, or atypical behavior and disorganized infant attachment patterns. Monographs of the Society for Research in Child Development. 258(Serial No. 64), 67–96. Scholar
  53. Lyons-Ruth, K., Easterbrooks, M. A., & Cibelli, C. D. (1997). Infant attachment strategies, infant mental lag, and maternal depressive symptoms: Predictors of internalizing and externalizing problems at age 7. Developmental Psychology, 33, 681–692. CrossRefPubMedGoogle Scholar
  54. Madigan, S., Moran, G., Schuengel, C., Pederson, D. R., & Otten, R. (2007). Unresolved maternal attachment representations, disrupted maternal behavior and disorganized attachment in infancy: Links to toddler behavior problems. Journal of Child Psychology and Psychiatry, 48, 1042–1050. CrossRefGoogle Scholar
  55. Main, M., & Hesse, E. (1990). Parents’ unresolved traumatic experiences are related to infant disorganized attachment status: Is frightened and/or frightening parental behavior the linking mechanism? In M. T. Greenberg, D. Cicchetti, & E. Cummings (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 161–182). Chicago, IL: University of Chicago Press.Google Scholar
  56. Meade, E.B., Blackwell, M., Roben, C.K.P., & Dozier, M. (2013, April). Using screening interviews to predict therapist performance in the Attachment and Biobehavioral Catch-up intervention. Poster presented at the biennial meeting of the Society for Research on Child Development (SRCD), Seattle, WA.Google Scholar
  57. Meade, E. B., Dozier, M., Barksy, D., Lind, T., & Allen, E. (2015, March). Efficacy of Attachment and Biobehavioral Catch-up with toddlers in foster care. Paper presented at the biennial meeting of the Society for Research on Child Development (SRCD), Philadelphia, PA.Google Scholar
  58. Meade, E. B., Dozier, M., & Bernard, K. (2014). Using video feedback as a tool in training parent coaches: Promising results from a single-subject design. Attachment & Human Development, 16, 356–370. CrossRefGoogle Scholar
  59. Meade, E.B., Mondock, C., Roben, C., & Dozier, M. (2015, March). Using screening interviews to predict therapist performance in the ABC intervention: Replication across time and samples. Poster presented at the biennial meeting of the Society for Research on Child Development (SRCD), Philadelphia, PA.Google Scholar
  60. NICHD Early Child Care Research Network. (1996). Characteristics of infant child care: Factors contributing to positive caregiving. Early Childhood Research Quarterly, 11, 269–306. CrossRefGoogle Scholar
  61. Raver, C. C. (1996). Relations between social contingency in mother-child interactions and 2-year-olds’ social competence. Developmental Psychology, 32, 850–859. CrossRefGoogle Scholar
  62. Roben, C. K. P., Dozier, M., Caron, E., & Bernard, K. (2017). Moving an evidence-based parenting program into the community. Child Development, 88(5), 1447–1452.CrossRefGoogle Scholar
  63. Rogosch, F. A., Cicchetti, D., & Aber, J. L. (1995). The role of child maltreatment in early deviations in cognitive and affective processing abilities and later peer relationship problems. Development and Psychopathology, 7, 591–609. Special Issue: Developmental processes in peer relations and psychopathology.CrossRefGoogle Scholar
  64. Sapolsky, R. M., Romero, M., & Munck, A. (2000). How do glucocorticoids influence stress responses? Integrating permissive, suppressive, stimulatory, and preparative actions. Endocrine Reviews, 21, 55–89. CrossRefPubMedGoogle Scholar
  65. Schuengel, C., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (1999). Frightening maternal behavior linking unresolved loss and disorganized infant attachment. Journal of Consulting and Clinical Psychology, 67, 54–63. CrossRefPubMedGoogle Scholar
  66. Southham-Gerow, M. A., Rodriquez, A., Chorpita, B. F., & Daleiden, E. L. (2012). Dissemination and implementation of evidence based treatments for youth: Challenges and recommendations. Professional Psychology: Research and Practice, 43, 527–534. CrossRefGoogle Scholar
  67. Sprang, G. (2009). The efficacy of a relational treatment for maltreated children and their families. Child and Adolescent Mental Health 14(2), 81–88. CrossRefGoogle Scholar
  68. Sroufe, L. A. (1996). Emotional development. New York, NY: Cambridge University Press.CrossRefGoogle Scholar
  69. Stovall-McClough, K. C., & Dozier, M. (2004). Forming attachments in foster care: Infant attachment behaviors during the first 2 months of placement. Development and Psychopathology, 16, 253–271. CrossRefPubMedGoogle Scholar
  70. Toth, S. L., Gravener-Davis, J. A., Guild, D. J., & Cicchetti, D. (2013). Relational interventions for child maltreatment: Past, present, & future perspectives. Development and Psychopathology, 25(4), 1601–1617. CrossRefPubMedPubMedCentralGoogle Scholar
  71. Tronick, E. Z. (1989). Emotions and emotional communication in infants. American Psychologist, 44, 112–119.CrossRefGoogle Scholar
  72. van IJzendoorn, M. H. (1995). Adult attachment representations, parental responsiveness, and infant attachment: A meta-analysis of the predictive validity of the adult attachment interview. Psychological Bulletin, 117, 387–403. CrossRefPubMedGoogle Scholar
  73. van IJzendoorn, M. H., Schuengel, C., & Bakermans-Kranenburg, M. J. (1999). Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae. Development and Psychopathology, 11, 225–249. CrossRefPubMedGoogle Scholar
  74. Vaughn, B. E., Kopp, C. B., & Krakow, J. B. (1984). The emergence and consolidation of self-control from eighteen to thirty months of age: Normative trends and individual differences. Child Development, 55(3), 990–1004. CrossRefPubMedGoogle Scholar
  75. Winberg, J. (2005). Mother and newborn baby: Mutual regulation of physiology and behavior- a selective review. Developmental Psychobiology, 47, 217–229. CrossRefPubMedGoogle Scholar
  76. Yarger, H. A., Hoye, J. R., & Dozier, M. (2016). Trajectories of change in attachment and biobehavioral catch-up among high-risk mothers: A randomized clinical trial. Infant Mental Health Journal, 37(5), 525–536. CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Amanda H. Costello
    • 1
    Email author
  • Caroline K. P. Roben
    • 1
  • Mary Dozier
    • 1
  1. 1.Department of Psychological and Brain SciencesUniversity of DelawareNewarkUSA

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