KU part of program that successfully reduces toxic stress in families
LAWRENCE — Doctors regularly ask adults about stress as part of an overall assessment of their health. But stress in infants and toddlers is not as commonly considered, even though high levels can cause lifelong problems. Research from the University of Kansas has shown that a program aimed at reducing toxic stress in infants is effective, not only in helping children, but in aiding parents, communities and the early childhood service system.
KU researchers have been part of the Kansas ABC Early Childhood Initiative, an effort to implement an intervention called Attachment and Bio-behavioral Catchup, or ABC, since 2018. The intervention is an evidence-based, 10-week program designed to reduce stress levels in infants that can lead to developmental, health and behavior problems. Evaluation showed that while the intervention helped improve the well-being of young children, it also benefited parents and other family members.
“As a whole, we found this initiative resulted in improvements in four main areas: the child, the parent/caregiver, the family or household, and service systems and settings,” said Amy Mendenhall, professor of social welfare at KU and principal investigator of the project’s evaluation. “We found it had a positive result at all four levels, including healthier kids, more confident parents and better services from agencies.”
The initiative trained early childhood service providers at five agencies serving 36 counties in Kansas to implement ABC in 10-week sessions. The intervention utilizes play-based strategies to help parents develop secure attachment with their children through nurturance and positive regard. Sessions are videotaped and provided to parents to highlight strengths and areas for growth and document progress made. By building stronger bonds between parents and children, the goal is to reduce levels of cortisol, known as the stress hormone, in children. The hormone, present in all people, is generally at its highest in the morning and decreases throughout the day. But in children who have experienced high levels of stress, levels stay high, as though they are on alert for something negative to happen regularly, which can lead to long-term problems in memory and learning, depression, anxiety, lower immune function and other health concerns.
Evaluation of the more than 400 families who took part in the initiative showed that cortisol levels in the children normalized over the course of the intervention, though not at a statistically significant level. However, parents taking part reported improvements in their caregiver knowledge and higher confidence in their parenting ability, which can help reduce situations that cause stress in their children, Mendenhall said. Additionally, benefits were shown at the household level, with families showing significant improvements in household environment, family interactions, safety, social life, self-sufficiency and health.
“Through this evaluation, we’ve also learned a lot about implementation of the intervention, which is as important as the outcomes. You have to understand it to know why an intervention is successful or not,” she said.
The onset of the pandemic forced part of the implementation to take place virtually. Preliminary evaluation results suggest the effects are as positive in virtual settings as in-person. That is especially valuable in rural settings, Mendenhall said. Additionally, about half of the population that received services did so in Spanish, and positive outcomes held across both language groups, indicating ABC is adaptable. Results also showed that the intervention can be successfully implemented in varying geographic areas, including urban and rural settings, as well as in different types of agencies, such as mental health centers and child development centers.
The ABC intervention’s success in Phase 1 showed that child well-being and functioning can be improved while also benefiting parents by boosting their skills, strengthening households and expanding the capacity of early childhood services to help ensure healthy families, Mendenhall said. Ongoing research will determine if those same benefits hold for toddlers and how the program could be improved or delivered in expanded settings.
Phase 2 of the initiative, which began last year and will continue through 2023, continues delivery and evaluation of ABC’s effectiveness expanding to toddlers but with a subset of the original agencies.
“One of the things we heard from parents during Phase 1 was that the intervention reduced parents’ stress and allowed them to advocate for their children more,” Mendenhall said. “We weren’t able to quantify that in the data in the first phase, but we’ve added measures to see if that result holds up in Phase 2.
“Phase 2 is about expanding service capacity and further exploring the impact of the intervention on caregiver outcomes and school readiness,” she said. “We’re trying to get more parent coaches trained and sustain the program by helping agencies be able to bill insurance, secure funding and to increase awareness and education about the importance of early childhood services. It’s historically been an area that’s underfunded. Effective services can really make a difference in the life trajectory of young people.”
Top image credit: KU School of Social Welfare.
Inset image: Pexels.com.