BERLIN – A short-term video feedback intervention in early childhood can enhance parent-child relationships in adoptive families and minimize later child psychopathology associated with attachment problems, Femmie Juffer, Ph.D., said at the 16th World Congress of the International Association for Child and Adolescent Psychiatry and Allied Professions.
Previous studies have found that adopted children present more behavior problems and are overrepresented in clinical and mental health services, possibly as a consequence of disorganized infant attachment, Dr. Juffer noted.
To assess the effect that family interventions based on attachment theory can have on adopted child mental health, Dr. Juffer and her colleagues at Leiden (the Netherlands) University tested two intervention programs on 130 families with 6-month-old infants adopted from Sri Lanka, South Korea, and Colombia.
Two samples of families participated in the prospective longitudinal study: 90 families with a first-adopted child only and 40 families with birth children and a first-adopted child. All families were randomly assigned to one of three conditions. In the first condition, 30 families were given a personal book that included suggestions and advice on how to parent a child in a sensitive way. In the second condition, 50 families received the same book combined with three home-based sessions offering video feedback. The remaining 50 families were assigned to the control condition and received no intervention.
Both intervention programs “aimed at enhancing parental sensitive responsiveness, with the ultimate goal of promoting secure infant-parent attachment relationships and infant competence,” Dr. Juffer said.
Post-test assessments conducted 3 months after the end of the intervention period showed that the video feedback/personal book intervention resulted in statistically significant enhanced maternal sensitive responsiveness.
Additionally, the children of mothers who received this intervention were less likely to be classified as having disorganized attachment at the age of 12 months, compared with infants in the control group, while the book-only intervention had no effect on the number of infants with disorganized attachment classifications, Dr. Juffer reported.
A long-term follow-up study when the children were 7 years old showed positive effects of the video-feedback intervention among the children who were adopted into families with birth children. “Adopted children in 'mixed' adoptive families presented fewer internalizing behavior problems,” Dr. Juffer said.
Also, adopted girls who were in the video-intervention group scored higher on ego resiliency and social competence, compared with controls at age 7, according to Dr. Juffer.
In the total sample, “early parent-child relationship and parental sensitivity predicted adopted children's socioemotional and cognitive development and rate of behavior problems in middle childhood,” Dr. Juffer stated.
In a separate metaanalysis of adoptive family interventions, Dr. Juffer and her colleagues concluded that effective interventions focused on sensitivity, began at or after 6 months, and were implemented by intervention professionals. The most effective interventions used a moderate number of sessions and a clear-cut behavioral focus. “The video-feedback intervention matches this description well,” she said.
Interventions that were more effective in enhancing parental sensitivity were also more effective in enhancing attachment security, “which supports the notion of a causal role of sensitivity in shaping attachment,” Dr. Juffer said.
“The effectiveness of the [video] intervention in the sample of adoptive parents and their genetically unrelated children documents the importance of parenting in the developing of infant attachment disorganization,” she concluded.