Objectives: The current study employs a randomized clinical trial to investigate changes in child attachment behaviors after a parent-mediated intervention designed to increase responsive maternal behaviors.
Methods: Seventy preschoolers with autism (chronological age: M = 57.1 months, SD = 12.3) were randomly assigned to either the experimental group (twelve in-home parent-education sessions), or the control group (four in-home training sessions on advocacy). Data on children’s attachment behaviors were only available for 41 children: 6 children did not participate in exit assessments; for 11 children, the strange situation was not administered due to time constraints; in 12 instances, the separation was ended early because of child distress. Preliminary analyses indicate that participants with incomplete attachment data did not differ from participants with complete data on any baseline measure. Children’s responses to a reunion with their mothers during an abbreviated “strange situation” were evaluated during intake and exit assessments. Observational coding consisted of qualitative ratings of two interactive behavior variables first described by Ainsworth, Blehar, Waters, and Wall (1978). The Proximity and Contact Seeking Behaviors (PCSB) variable deals with the intensity of a child’s effort to regain contact with, or proximity to, their mother. Higher PCSB scores indicate that the child took initiative in achieving contact. The Avoidant Behaviors (AB) variable deals with the intensity and duration of the child’s avoidance toward their mother. Highest AB scores indicate that the child did not greet his/her mother upon reunion. Excellent inter-observer reliability was established for both variables (ICC = .86-.89).
Results: To determine if the groups were similar at intake, they were compared on several child characteristics including chronological age, mental age and IQ. There were no significant differences between the treatments groups on these variables. Gains scores were computed from intake and exit assessment attachment behavior variables. Results from independent samples t tests showed a significant difference in gain scores for the PCSB: t(39) = 2.157, p < .05, where children in the experimental condition had a larger gain in PCSB scores (M = .10, SD = 1.29) than children in the control group (M = -.81, SD = 1.40). The test for change in AB was also significant, t(39) = -2.205, p < .05, where children in the experimental condition had a larger decrease in AB scores (M = -.90, SD = 1.86) than children in the control group (M = .71, SD = 2.72).
Conclusions: This research suggests that children who participate in a parent-mediated intervention that enhances maternal responsiveness exhibit more positive attachment behaviors after the treatment than children who do not receive the treatment.