Enhancing Attachment Organization Among Maltreated Children: Results of a Randomized Clinical Trial




Kristin Bernard, Mary Dozier, Johanna Bick, Erin Lewis-Morrarty, Oliver Lindhiem, and Elizabeth Carlson

Brief Type

Journal Publication


  • Attachment and Biobehavioral Catch-Up (ABC)


Young children who have experienced early adversity are at risk for developing disorganized attachments. An intervention, Attachment and Biobehavioral Catch-up (ABC), was developed that very specifically targets nurturing, sensitive care among the parents identified as being at risk for neglecting their young children, with the aim of decreasing disorganized attachment. The ABC intervention consists of 10 parent-child sessions conducted in families’ homes. The present study assessed the efficacy of this intervention through a randomized clinical trial in which parents with Child Protective Services involvement were assigned to the experimental intervention or to a control intervention (DEF). Attachment quality was assessed for 120 children in the Strange Situation. Children in the ABC intervention showed significantly lower rates of disorganized attachment (32%) and higher rates of secure attachment (52%) relative to the control intervention (57% and 33%, respectively). These results support the efficacy of the ABC intervention in enhancing attachment quality among parents at high risk for maltreatment. (author abstract)

Data Collection Methods

  • Fidelity observations
  • Home Visit Observations
  • Parent-child observations


Findings Available

For More Information

Bernard, K., Dozier, M., Bick, J., Lewis-Morrarty, E., Lindhiem, O., & Carlson, E. (2012). Enhancing attachment organization among maltreated children: Results of a randomized clinical trial. Child Development, 83, 2, 623.
Author contact information:
Kristin Bernard


  • Participant, Family, and Program Outcomes