Attachment and Biobehavioral Catch-up Intervention (ABC) - a pilot study of home-based intervention for families with young children in the Child Welfare Services

The purpose of the project is to carry out a pilot study of a promising American intervention T"he Attachment and Biobehavioral Catch-up Intervention (ABC)". ABC is a parental supervision intervention that aims to reduce the parents' frightening behaviour, increase sensitive and loving care and thus contribute to helping the child to emotional, behavioral and physiological regulation. The intervention has been shown to increase the parenting skills of parents with young children under the age of 3 and is used as an early intervention to prevent abnormal development in children as a result of neglect. Two evaluations of the method have now been carried out in the USA (The California Evidence-Based Clearinghouse for Child Welfare, 2016; U.S. Department of Health & Human Services, 2017), and ABC is now recommended as an effective method for parents with young children who have need for help within child welfare.

The main objectives of the pilot are to investigate the experiences of the child welfare staff and parents who receive the ABC intervention as a support measure, and how the ABC intervention fits into a Norwegian child welfare context. Another key objective is to work in parallel with carrying out a knowledge summary of published articles, where we critically assess, based on available empirical evidence, already tested and evaluated national and international home-based interventions aimed at infants and toddlers in Child Welfare Services (CWS). Such a summary of knowledge will contribute with knowledge about which core components seem to be important in interventions that are particularly aimed at families who receive support measures in CWS. We will thus gain knowledge of whether ABC has already included these components and/or whether ABC has other important components that are absent in comparable interventions. There are thus a number of sub-goals for this pilot: 1. Investigate experiences with recruiting child welfare services to participate in the pilot study. 2. Investigate the child welfare staff's experience with the training process in the ABC intervention. 3. Investigate children's care staff's experience of working with families based on the content of the ABC manual and assess any needs for further development/adaptation to Norwegian conditions.4. Investigate the parents' experience of receiving the ABC intervention as a relief measure and assess any need for further development/adaptation to Norwegian conditions. 5. Investigate whether the child protection staff carry out the ABC intervention in accordance with the training and the manual. 6. Investigate goal attainment using outcomes on the child, the parents, and the parent-child relationship Investigate service managers' experience with the ABC intervention in the service. 7. Investigate unique and common core components in the ABC intervention and other home-based measures for this target group.

In this pilot study, video observation, questionnaires and interviews will be used. Selection: The target population for the pilot will be parents with children between 6 and 24 months who are under follow-up by Child Welfare Services  and assessed as being able to benefit from a support measure in the form of ABC. If necessary, children up to the age of 3 may be included later in the project. The parent who is the primary carer and lives with the child will be asked to participate. If both parents live with the child, and both consider themselves to be primary carers, it is the parent who can be present at all 10 home visits that is included. Both parents can be present during the home visits. If the CWS has registered that the child of possible participants has been placed in a foster home or where foster home placement has already been decided, they will not be included. Parents with serious mental health problems or an ongoing substance abuse, but who receive help from the child welfare services, will also be excluded from participation. In addition, the parents must be Norwegian-speaking. Selection procedure: The families are recruited with the help of CWS in Eastern Norway. Managers in the child welfare service will be asked to participate and relevant employees in the same services will be interviewed and recruited and receive training in ABC on the basis of this interview and assessment of four short American video recordings. They will also be included in the study. If they are relevant for training, they will receive oral and written information. When a collaboration contract has been written with the head of the CWS and the employee, the future parent coaches will contact relevant participants. These will be informed orally and in writing by the parent coach. Once they have been recruited, the project manager/assistant will contact the family. The aim is to recruit four to five child welfare services and their managers, 12 employees who will be trained in ABC and approx. 40 families. As this is a pilot study, it is appropriate to limit the number of participants. Only one child per family aged 6 to 24 months will be included.