Adapting the ABC Intervention for Children Adopted Internationally and Toddlers in Foster Care

Introduction: Given strong evidence that the ABC intervention is effective for infants living with their neglecting birth parents, we aimed to adapt the ABC model for other populations of children who face early adversity. Specifically, we designed a version of ABC for children adopted internationally (ABC-CAI) and a version for toddlers in foster care (ABC-T). Although adopted children and foster children face similar challenges to infants living with their neglecting birth parents, there are also unique issues. For example, children adopted internationally are likely to show indiscriminate friendliness - behaving towards strangers in ways typically reserved for primary caregivers. Toddlers in foster care are likely to show behavioral dysregulation - having difficulty calming down when angry or upset. Thus, parents of these children need additional parenting strategies to address these issues. 

Adoptive parents and foster parents also bring unique issues. For example, adoptive parents sometimes behave in overly instructive ways, struggling to follow their children’s lead during interactions. These non-synchronous behaviors may reflect a sense of urgency to help their children catch up developmentally. Foster parents sometimes struggle to show delight in their foster children, which may reflect low levels of commitment due to viewing their role as temporary. 

Methods: We designed adapted ABC protocols for children adopted internationally (ABC-CAI) and toddlers in foster care (ABC-T). Although the main targets of the intervention remain the same, additional components target indiscriminate friendliness for adopted children and behavioral regulation for toddlers in foster care. We tested these adapted versions of the ABC intervention in two randomized control trials. 

Results: We found that the ABC intervention could be successfully adapted for other populations of children who faced early adversity. In addition to describing the process of adapting the ABC intervention, we will report on evidence from the RCTs demonstrating effects on maternal sensitivity, child attachment security, and child executive functioning.  

Conclusions: When adapting an evidence-based intervention, such as ABC, to new populations, it is critical that modifications are grounded in strong developmental research and then tested in rigorous studies.