Assessing Changes in Parent Sensitivity in Telehealth and Hybrid Implementation of Attachment and Biobehavioral Catch-Up During the COVID-19 Pandemic.

During the COVID-19 pandemic, home visiting services for families with young children pivoted to continue providing services virtually. One such service was Attachment and Biobehavioral Catch-up (ABC), a brief prevention/intervention program targeting increased parental sensitivity. 70 families participated in a sensitivity assessment before and after receiving ABC. Forty-three families received the program fully through telehealth, and 27 families received the program through an in-person/telehealth hybrid format. Parent sensitivity was assessed pre- and post-intervention, and results suggested that when ABC was delivered through a telehealth or hybrid format, parents showed increased following the lead and decreased intrusiveness from pre- to post-intervention, with moderate effect sizes. Ongoing supervision in the model, weekly fidelity maintenance checks, and the flexibility of families and parent coaches likely contributed to the maintenance of significant change in parental sensitivity from pre- to post-intervention during the move from face-to-face home visiting to the provision of virtual services.

Parent Coaching Fidelity Trajectories of In-Person and Telehealth Sessions during the COVID-19 Pandemic.

The COVID-19 pandemic has posed significant challenges to delivery of preventive and mental health services, and providers have rapidly transitioned to telehealth service provision. Factors such as sudden isolation, financial strain, and physical and mental health stress presented unique challenges for providers and families and highlight the need for accessible and effective services. Thus, providers' fidelity of implementation during the pandemic is an important area for research. The current observational study compared providers' fidelity across in-person and telehealth-delivered sessions before and during the COVID-19 pandemic in Attachment and Biobehavioral Catch-up (ABC), a preventive parent coaching intervention for infants and toddlers. Participants included 24 providers (95% female, 42% White, M age = 37) who participated in ABC training and consultation during the COVID-19 pandemic. Providers' fidelity data (N = 593 sessions) were modeled longitudinally using hierarchical linear modeling, and separate intercepts and slopes were estimated for in-person and telehealth-delivered sessions. When data were modeled across all available sessions, results indicated that providers demonstrated improving fidelity over the course of training. When in-person and telehealth-delivered sessions were compared, providers' fidelity in telehealth-delivered ABC sessions was not significantly different from their fidelity in in-person sessions. Providers demonstrated improving fidelity over time in telehealth-delivered sessions. Thus, providers were able to maintain and improve ABC fidelity during the COVID-19 pandemic when provided with implementation support. Rapid transition to telehealth delivery can be successful when ongoing support such as consultation is provided.

Transitioning to telehealth due to COVID-19: Maintaining model fidelity in a home visiting program for parents of vulnerable infants.

Maintaining treatment fidelity when implementing evidence-based interventions is a significant challenge. The inability to deliver in-person services due to the COVID-19 pandemic critically challenged the foundation of implementation fidelity for home visiting programs across the globe. The Attachment and Biobehavioral Catch-Up (ABC) program is an evidence-based home visiting intervention designed to increase sensitivity in parents of infants who have experienced early adversity. ABC's community effectiveness is due to rigorous fidelity monitoring and supervision. Fidelity is measured by microanalytic coding of parenting opportunities and "in-the-moment" commenting, the active ingredient of ABC. In this study, we examined intervention fidelity among parent coaches implementing ABC through telehealth. Random 5-min clips from 510 telehealth ABC session videos conducted by 91 parent coaches at 48 agencies were coded for their frequency and quality of in-the-moment comments. On average, parent coaches were able to exceed in-person commenting fidelity standards when implementing ABC through the telehealth format. The active fidelity monitoring and supervision inherent to ABC's dissemination afforded a smooth transition to implementing ABC through telehealth while adhering to fidelity standards. Procedural and clinical challenges to telehealth implementation are discussed, along with future directions for telehealth program effectiveness.

Mantener la fidelidad al tratamiento cuando se implementan intervenciones con base en la evidencia es un reto significativo. La inhabilidad de ofrecer servicios en persona debido a la pandemia del COVID-19 representó un reto crítico a la base de la fidelidad de implementación para los programas de visitas a casa en el mundo. El programa de Afectividad y Bio-conducta de Ponerse el Día (ABC) es una intervención de visitas a casa con base en la evidencia diseñada para aumentar la sensibilidad en los progenitores de infantes que han experimentado temprana adversidad. La eficacia comunitaria de ABC se debe a la rigurosa inspección y supervisión de la fidelidad (Caron et al., 2016). La fidelidad se mide por medio de codificación micro analítica de las oportunidades de crianza y por el comentario " en el momento," ingrediente activo de ABC. En este estudio, examinamos la fidelidad de intervención entre progenitores entrenadores que implementaban ABC a través de salud a distancia. Segmentos de video de 5 minutos de 510 sesiones de salud a distancia ABC al azar, llevadas a cabo por 91 progenitores entrenadores en 48 agencias se codificaron en cuanto a su frecuencia y calidad de los comentarios del momento. En promedio, los progenitores entrenadores pudieron exceder los estándares de fidelidad de comentarios en persona cuando implementaban ABC a través del formato de salud a distancia. La activa inspección y supervisión de la fidelidad inherente a la divulgación de ABC permitió una transición fluida a la implementación de ABC a través de salud a distancia, manteniendo la adhesión a los estándares de fidelidad. Se discuten los retos de procedimiento y clínicos a la implementación de salud a distancia, junto con futuras directrices para la eficacia de programas de salud a distancia.

Le maintien de la fidélité au traitement en mettant en place des interventions basées sur des données factuelles est un défi important. L'incapacité à offrir des services en personne du fait de la pandémie du Covid19 a présenté un défi critique pour la fondation de la mise en place de la fidélité pour les programmes de visite domicile dans le monde entier. Le programme ABC (selon l'anglais Attachment and Biobehavioral Catch-Up, soit Rattrapage de l'Attachement et Rattrapage Biocomportemental) est une intervention de visites à domicile basée sur des données factuelles conçue pour augmenter la sensibilité chez les parents de bébés ayant fait l'expérience d'une adversité précoce. L'efficacité de la communauté de l'ABC est attribuable à un contrôle rigoureux de la fidélité et de la supervision (Caron et al., 2016). La fidélité est mesurée par un codage micro-analytique des opportunités de parentage et des commentaires "au moment", l'ingrédient actif de l'ABC. Dans cette étude nous avons examiné la fidélité de l'intervention chez les entraîneurs de parents mettant en place l'ABC au travers de la télésanté. Des clips de 5-minute randomisés de 510 sessions vidéos de télésanté ABC faites avec 91 entraîneurs de parents de 48 agences ont été codé pour leur fréquence et la qualité des commentaires "au moment". En moyenne les entraîneurs de parent étaient capables d'excéder les standards de fidélité de commentaire en personne en mettant en place l'ABC au travers du format de télésanté. Le contrôle actif de fidélité et de la supervision propre ã la dissémination de l'ABC a permis une transition facile à la mise en place de l'ABC au travers de la télésanté tout en adhérant aux standards de fidélité. Les défis de procédure et les défis cliniques à la mise en place par télésanté sont discutés ainsi que les directions futures pour l'efficacité du programme par télésanté.

Attractiveness bias: A cognitive explanation.

According to cognitive averaging theory, preferences for attractive faces result from their similarity to facial prototypes, the categorical central tendencies of a population of faces. Prototypical faces are processed more fluently, resulting in increased positive affect in the viewer.

Unattractive infant faces elicit negative affect from adults.

We examined the relationship between infant attractiveness and adult affect by investigating whether differing levels of infant facial attractiveness elicit facial muscle movement correlated with positive and negative affect from adults (N=87) using electromyography. Unattractive infant faces evoked significantly more corrugator supercilii and levator labii superioris movement (physiological correlates of negative affect) than attractive infant faces. These results suggest that unattractive infants may be at risk for negative affective responses from adults, though the relationship between those responses and caregiving behavior remains elusive.

Individual differences in children's production of scale errors.

Individual differences in the production and persistence of committing scale errors were examined in children (age range 18-29 months) attending a laboratory preschool. Miniature replica toys were placed in the classrooms during three 20-min observation periods for 10 weeks. The majority of the children (88%, n=24) performed scale errors providing confirmation in a different setting (than presented in previous research) that most young children commit these behaviors. Large individual differences were found in the frequency and persistence of committing scale errors. Extended exposure to the replica items increased the number of scale errors, though the frequency of scale errors decreased over the entire observation period.

Parental reports of children's scale errors in everyday life.

Scale errors refer to behaviors where young children attempt to perform an action on an object that is too small to effectively accommodate the behavior. The goal of this study was to examine the frequency and characteristics of scale errors in everyday life. To do so, the researchers collected parental reports of children's (age range = 13-21 months at onset) scale errors over a 6-month period. All but 1 of the parents (N = 30) reported at least 1 scale error with an average of 3.2 scale errors per child. These results suggest that most, if not all, children commit scale errors during early childhood.

A method for eliciting scale errors in preschool classrooms.

Six preschool classrooms, containing children between the ages of 4.0 and 40.0 months, were seeded with miniature items to examine how easily scale errors could be elicited. Observations occurred over a period of 3 months, with a total of 280 min of observations per classroom. A concealed observer documented all interactions with the miniature items. A total of 93 scale errors occurred, with a higher frequency committed by the younger children. These results confirm findings from previous research and suggest that scale errors can be effectively elicited in a preschool classroom. Our approach may provide a useful method for systematically studying the factors that influence scale errors.