Help for Vulnerable Infants and Toddlers:

The ABC Pilot ProjectPatria Weston-Lee, LCSW

Consuelo FoundationHonolulu, Hawaii

Consuelo FoundationMission: To

operate or support programs in the Philippines and Hawai`i that prevent and treat abuse, neglect, and exploitation of children, women and families.

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

Supporting vulnerable infants & toddlers

Philippines HawaiiHealthy Start exampleAdapted for environment

and culture

Attachment and Biobehavioral Catch-up Intervention (ABC) pilot

Attachment & Biobehavioral Catch-up Intervention

Mary Dozier, PhD. University of DelawareEvidence based

Consuelo Foundation Pilot 2009-2011

Community Pilot 2012-2013

AttachmentChildren develop

within context of relationships

Need a relationship with at least one primary caregiver

Sensitivity and responsiveness in social interactions

Attachment PatternsSecureInsecure

AvoidantResistant Disorganized

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

Cortisol AM and PM LevelsMary Dozier PhD data

What is ABC?

Attachment is crucial to child’s healthy developmentGeared for ages 0-2 years with history of neglect 10 sessions

Providing nurturanceFollowing child’s leadNot frightening

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

ABC Targets

Powerful tools:Video tapingBreaking down

interactions and their effects

ScaffoldingManualized

Strengths Based InterventionUses gentle suggestionsIn-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

Use of VideotapingEnsure fidelity to

model and clinical supervision

Videotaped observations extremely helpful in providing parents with feedback they need to develop strengths as parents

Enhancing Cultural RelevanceProvide food/meals

where appropriateProvide referrals or

other assistance when needed

Adjust modes of communication (texting)

Offer to compile footage into home movie DVD

Overall FindingsABC 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

ABC Trainees in Hawai`i1 Keiki O Ka `Aina, Kalihi 1 Catholic Charities – Mary Jane Home

transitional shelter for new mothers in Kailua1 Queen Lili’uokalani Children’s Center on

Kaua`i Enhanced Healthy Start Clinical Specialists:

Family Support Services, Kona Catholic Charities, Oahu PACT, Oahu Child and Family Service, Ewa Beach

Community pilot

33 families have completed session 10

25 in progress10 dropped out or cannot classifyPilot ends in June 2013Exploring future sustainability or

expansion

SENSITIVITY

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INTRUSIVENESS

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DETACHMENT

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POSITIVE REGARD

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MAHALO!

Patria Weston-LeeConsuelo Foundation

pwestonlee@consuelo.org