The Earlier We Start, the Better We Can Do for Our Children

An early childhood intervention that spells out the parenting ABCs

Pam Page knew her daughter Phoenix was struggling when she went from being a playful baby to a toddler who didn’t talk or make eye contact. Pam also realized she did not have the parenting tools she needed to help her daughter thrive.

Pam was able to get the support she needed from CCFH’s prevention services, which offered her in-home therapeutic support in the form of two evidence-based interventions – Attachment and Biobehavioral Catch-Up (ABC) and Child Parent Psychotherapy (CPP).

“One of the most important things you learn from ABC is how to be the parent that you imagined you could be. And the earlier we start, the better we can do for our children,”  Pam said. “It has shifted our whole family dynamic. We are happier together. We communicate how we are feeling.”

ABC, a 10-week in-home intervention, will soon be offered to a growing number of caregivers with infants and toddlers who have experienced trauma or face other risk factors. Thanks to a new research grant from the Duke Endowment and a partnership with University of North Carolina’s Psychiatry Department, about 150 families will receive the intervention over the next three years with the aim of advancing tools to determine how the effects of attachment can be shown in children. Additionally, ongoing support from a five-year federal grant will allow CCFH to expand training opportunities to 20 child-serving providers  across North Carolina – with a specific focus on rural communities, Spanish-speaking families and high-risk families referred from child welfare and residential drug treatment centers.

This means the support Pam experienced will soon expand to hundreds of new families across North Carolina. 

With the guidance of a trained coach, ABC helps caregivers build attachment and connection with their very young children. Coaches videotape regular, every-day interactions between a child and their caregivers, showing clips of positive exchanges from every session. This real-time video feedback gives parents a chance to reflect on and choose reactions that best fit their unique child’s relationship needs and influence positive social-emotional development.

ABC coaches learn to adapt these sessions to the unique needs of individual families and work with these families to uplift their culture, beliefs and values. ABC emphasizes healthy relationships, and it rests on this bedrock principle: Children need to feel safe if they are going to connect to their caregiver. When a parent can reduce confusing or fear-inducing behaviors and respond consistently to a child’s bid for closeness, that builds trust.

While the intervention is brief, longitudinal research demonstrates that the positive effects can last for years, said Dina Gerber, a CCFH clinician and ABC trainer.

Children learn they can rely on that parent even when the child’s feelings and behaviors are intense or upsetting (to themselves or others),” Dina said. “And really, that’s what all of us want at any age – someone who will stick with us even when we are not at our best and we feel scared or hurt. Many parents are already doing things that are great, we just don’t have many avenues for parents to know what they are doing well.

Even at a very young age, children can internalize trauma in ways that disrupt how they behave, respond to difficult circumstances and interact with others. Parents who are confused or overwhelmed by their children’s behaviors learn what  reactions  to emphasize  to connect positively during both peaceful playtime moments and high-stress situations. ABC coaches also are quick to praise caregivers when they see those loving, trusting moments during their videotaped sessions.

“It was amazing to hear all the things we were doing right…the things that would help us understand and deal with our son’s behaviors much better,” said Tiffany Solomon, a Durham mom of three who said the ABC coaching was so valuable for her family that she is considering ABC parent coach training so she could support other area families like hers.

At the time, she was at a loss dealing with her son’s behaviors–screaming, banging his head on the floor, slapping his face. Her instinct was to face her son and hold him tightly and she learned through these family sessions that this physical connection and eye contact was calming her son, even though it didn’t feel like it was in the moment.  “(Our parent coach) would show me in the video…and it would totally reinforce those little things that made the difference.”

Her youngest child, King, was born in 2017 with significant developmental delays, including visual and hearing impairments. He was later diagnosed with a level of autism requiring significant, one-on-one support. The financial demands of his care were so profound that the family ended up in a homeless shelter,  and it was at that point that they were offered the support of an ABC coach trained by CCFH clinicians.

The ABC experience allowed the entire family to relax more while playing with King and appreciate his emerging personality as a toddler.

“He was funny, and he loved to laugh and giggle. There was a trust in him, and we learned to follow his lead.”  King is now 6 and attending a special therapeutic school. He cannot use words, but he has learned how to get what he needs from his family, grabbing a parent or a sibling’s hand and leading them to the door when he wants to go outside. “He’s such a great problem solver. And he loves to learn.”

Pam also works as an advocate for ABC and other early childhood programs in the Durham community, spreading the word at events and encouraging other parents–especially those who themselves are recovering from trauma– to access this parenting support.

Because these practices have become so ingrained in her parenting approach, Pam can now relax and revel in all the things she loves about her now 4-year-old Phoenix – all her energy and creativity, the random facts she knows about dinosaurs, the structures she loves to build, the tea parties she loves to throw for her mom and teenage sister. She lets Phoenix help her in the kitchen – baking cornbread and cake – and not worry about whether she is making a mess.

“ABC lets you drop that anxiety as a parent about whether you are doing the right thing. It taught me to step back, to just let her do her thing.“