Help for Vulnerable Infants and Toddlers: The ABC Pilot Project

1. Help for Vulnerable Infants and Toddlers: The ABC Pilot Project Patria Weston-Lee, LCSW Consuelo Foundation Honolulu, Hawaii

2. Consuelo Foundation • Mission: To operate or support programs in the Philippines and Hawai`i that prevent and treat abuse, neglect, and exploitation of children, women and families.

3. Foundation Role in the Community of Service Providers • Bring innovative ideas to the community in areas of identified need • Demonstrate efficacy of services in a given community • Educate decision makers • Support community providers in developing successful services

4. Supporting vulnerable infants & toddlers Philippines Hawaii • Healthy Start example • Adapted for environment and culture • Attachment and Biobehavioral Catch-up Intervention (ABC) pilot

5. Attachment & Biobehavioral Catch-up Intervention Mary Dozier, PhD. University of Delaware Evidence based Consuelo Foundation Pilot 2009-2011 Community Pilot 2012-2013

6. Attachment • Children develop within context of relationships • Need a relationship with at least one primary caregiver • Sensitivity and responsiveness in social interactions

7. Attachment Patterns • Secure • Insecure • Avoidant • Resistant • Disorganized

8. 3 Key Issues Identified for Children who Experienced Adversity: • Tendency to push caregivers away • Need for nurturing care • Often dysregulated at behavioral and biobehavioral levels

9. Cortisol AM and PM LevelsMary Dozier PhD data

10. What is ABC? • Attachment is crucial to child’s healthy development • Geared for ages 0-2 years with history of neglect • 10 sessions • Providing nurturance • Following child’s lead • Not frightening

11. ABC Targets • Providing Nurturance when distress: Examples: discomfort with child crying, bottle propping, fear of spoiling, time outs for crying • Following Lead with Delight: Examples: emphasis on teaching child, struggle with expressing delight • Not Frightening Child: Examples: threatening the child when s/he misbehaves, scaring the child as a game

12. Powerful tools: • Video taping • Breaking down interactions and their effects • Scaffolding • Manualized

13. Strengths Based Intervention • Uses gentle suggestions • In-the-moment comments are done in a natural, conversational fashion • Quickly builds rapport through positive comments • Does not focus on what parent is doing “wrong” but highlights the small positives

14. Use of Videotaping • Ensure fidelity to model and clinical supervision • Videotaped observations extremely helpful in providing parents with feedback they need to develop strengths as parents

15. Enhancing Cultural Relevance • Provide food/meals where appropriate • Provide referrals or other assistance when needed • Adjust modes of communication (texting) • Offer to compile footage into home movie DVD

16. Overall Findings • ABC model well accepted by targeted families • Possible to deliver the model with high fidelity in Hawai`i • Positive data trends for ABC group • Demand created for intervention to be made available in community

18. ABC Trainees in Hawai`i • 1 Keiki O Ka `Aina, Kalihi • 1 Catholic Charities – Mary Jane Home transitional shelter for new mothers in Kailua • 1 Queen Lili’uokalaniChildren’s Center on Kaua`i • Enhanced Healthy Start Clinical Specialists: Family Support Services, Kona Catholic Charities, Oahu PACT, Oahu Child and Family Service, EwaBeach

19. Community pilot • 33 families have completed session 10 • 25 in progress • 10 dropped out or cannot classify • Pilot ends in June 2013 • Exploring future sustainability or expansion

20. SENSITIVITY

21. INTRUSIVENESS

22. DETACHMENT

23. POSITIVE REGARD

24. MAHALO! Patria Weston-Lee Consuelo Foundation pwestonlee@consuelo.org