Research Watch

Effects of the ABC intervention on foster children's receptive vocabulary: Follow-up results from a randomized clinical trial

Year of Publication
Date Reviewed
Reviewed By
Nico Trocmé

Bernard, K., Lee, A. H., & Dozier, M. (2017). Effects of the ABC intervention on foster children's receptive vocabulary: Follow-up results from a randomized clinical trial. Child Maltreatment, 22(2), 174-179.


Children with a history of maltreatment or maltreatment related adversities are at high risk of cognitive, social and emotional delays. The Attachment and Biobehavioral Catch-up (ABC) is a 10-session intervention developed by one of the authors, Mary Dozier, to enhance sensitive caregiving for child welfare involved parents.  Using structured activities and video feedback, coaches help parents learn how to (1) follow the child’s lead, (2) provide nurturance in response to distress, and (3) avoid overly intrusive responses. The efficacy of ABC has been shown in previous randomized controlled trials to improve attachment and executive functioning.  This study extends these results by examining the impact of ABC on early language development, an important indicator of school readiness.

Fifty-two infants who had been placed in foster care were randomly assigned to either the ABC intervention or a control intervention, a Development Education for Families (DEF) program that did not target parent sensitivity. At the two-year follow-up time, half of the children had been adopted, 10 were in non-relative foster care, 8 in kinship care and 9 were living with their birth parent.  Using the Peabody Picture Vocabulary Test to measure receptive language, the study found that infants who received the ABC intervention scored significantly higher at age 36 months than infants who received the DEF control intervention. These results provide further evidence of the importance of providing caregivers of maltreated children with structured evidence-based interventions targeting parental responsiveness.

Methodological Notes

This is a well-designed randomized controlled trial conducted in the United States by the research group that developed the ABC intervention. The use of a control intervention minimizes the risk of a placebo effect and provides further evidence of the importance of targeting parental responsiveness with this population. The major draw back with this study, however, is that it is limited to 22.5% of the original sample; the remaining 77.5% were not available for the 2-year follow-up assessment. The follow-up group appears to have been an atypically stable group, with half having been adopted, and two-thirds having experienced one stable out-of-home placement. As a result, while very promising, the findings cannot be generalized to all infants in foster care.