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My preschool son chewed on a wad of cotton for science. The wad went straight from his mouth into the specially prepared and labeled vial, which we stored in our kitchen freezer, later to be collected by intrepid researchers from the University of Delaware. This frozen saliva sample then joined hundreds of other samples from adopted children being studied as part of the Infant Caregiver Project (ICP) spearheaded by Professor Mary Dozier at Delaware. In an ongoing research program focused on interventions for at-risk children, the ICP researchers aim to understand how parent training can affect the development of cognitive abilities, attachment, behavior, and stress physiology among adopted children.
My son’s spit-soaked cotton wads, along with those collected from dozens of other children, were later assayed for the stress hormone cortisol. Cortisol is a steroid hormone produced by the adrenal glands as part of the body’s natural stress response. Because it is measurable in simple saliva samples without any invasive procedures, cortisol has become a useful marker for researchers interested in how early adversity and family experiences affect children’s responses to stress. In typical children and adults, cortisol shows a characteristic daily rhythm, with levels highest in the morning and lowest late in the day, around bedtime. Prior research has found that life stress, including early adversity such as neglect or institutionalization, results in an atypically blunted cortisol rhythm. This blunted cortisol pattern is taken as a marker of a poorly regulated stress-response system, which is thought to result from the absence of responsive caregiving early in life. The Delaware researchers aim to determine whether subsequent nurturing parenting can help to normalize these aberrant patterns of stress response as well as enhancing aspects of cognition, emotion, and behavior.
Our participation in the research project went well beyond providing spit samples, though. Like other research participants, our son completed a battery of cognitive tasks over several sessions, assessing skills such as vocabulary development and flexible thinking. In a task intended to assess the ability to delay gratification, I watched through a one-way mirror as my son was instructed to color (for him, a very boring activity) while also knowing that a jar full of Skittles was in reach but that he was not supposed to touch them. (Proudly, I can report that he did not grab the Skittles, though his eyes remained fixated on the Skittles jar rather than on the coloring page where his hand moved the crayon dutifully back and forth.) Our relationship was also tested, as researchers videotaped how my son reacted to my departure from the testing room and my subsequent re-entry, in a classic paradigm used to study the strength of attachment bonds in relationships.
Most interesting, though, was the parent training, which served as the main experimental manipulation in the study. The Delaware group has developed a parent training program referred to as the “ABC intervention”, which stands for Attachment and Biobehavioral Catch-up. Parents who are assigned to this training condition receive multiple sessions of training with a psychologist (or “parent coach”) in their home. The training has several components, but generally it is intended to help parents learn to be responsive to their child’s needs and to engage in nurturing behavior. During play sessions in the home, the psychologist-trainers give parents real-time, in-the-moment feedback about how to engage in nurturing and synchronous interactions with their child. Anecdotally, I can attest to the persistence of the training; even now, several years later, I occasionally hear echoes of our trainer Abby’s cheerful voice in my head: “Follow his lead!” (encouraging parents to allow their children control over play activities) and “Show delight in what he is doing!” (encouraging parents to express enthusiasm and joy in their children). Another critical component of the ABC training is helping parents to understand that at-risk children need nurturance even though, due to adverse early experiences, they may fail to seek nurturance and may even push away parents at times.
Prior findings from the ICP research program have found that numerous outcomes are improved in at-risk children whose families received the ABC training, compared to those who did not. One series of studies examined families identified by child protective services as being at risk based on a history of abuse or neglect. At-risk children whose families received the ABC training subsequently showed more normal patterns of cortisol secretion, as well as fewer behavioral expressions of anger, compared to children whose families did not receive the training. Another series of studies found similar results among children in foster care. Children placed in foster families who received the training subsequently exhibited more normal cortisol rhythms as well as improved flexible thinking and understanding of the mental states of others, compared to the control group. The ICP research group is continuing this line of research with a study of internationally adopted children, the ongoing study in which my family is taking part.
The Delaware research group is at the forefront of family-based interventions that can have genuine benefits for children’s well-being. It is now well-established that early-life stress, such as that typically experienced by children in foster care, in orphanages, or in neglectful or abusive families, can have pervasive consequences for multiple levels of children’s physiology and behavior, from their chromosomes to their stress hormones to their brain anatomy and function. Now, researchers and families are striving to understand how to reverse those negative outcomes so that children can flourish. Of course, prevention is always the best cure; public policy should fully embrace the goal of preventing early neglect from happening in the first place. But when early adversity becomes part of a child’s history, psychological science should be prepared with evidence-based approaches, such as those pioneered by the Delaware group, about how best to overcome the most pernicious consequences of neglect.
