Examining the Effectiveness of a Multiple Antecedent Intervention for Increasing Secure Infant Attachment

One of the most robust theories in the psychology of child development is attachment theory (Svanberg, 1998). A continually growing body of research finds that a secure attachment of a child to his or her mother provides a foundation for resilience to life\u27s stressors and the basis for later psychological adjustment, social competence, and academic and vocational achievement. Studies typically find, however, that only 55% to 65% of infants become securely attached by one year of age. Increasing this proportion would have important benefits for individuals, families, and society. Past interventions designed to promote secure attachments have typically focused on one or two of the antecedent maternal behaviors which are believed to promote secure attachment. The present study focused on promoting five of these maternal behaviors. This study examined the effectiveness of providing attachment information and a psychoeducational intervention on increasing the proportion of securely attached infants in a sample which included 64 infants and their mothers. The intervention was designed to maximize the chances that a secure attachment would develop by promoting a combination of maternal behaviors which have been found in past research to be associated with secure attachment. These five factors included (1) psychological availability or the attention paid to the child by a mother; (2) physical availability or the actual presence of the mother; (3) maternal sensitivity or the prompt and appropriate responding to infant cues; (4) body contact which included breastfeeding, holding, use of a cloth carrier, infant massage, and room sharing; and (5) psychological warmth or the joyful reciprocal play between mothers and infants. Participants were randomly assigned to one of two intervention groups, both of which were designed to promote secure attachment. These included an attachment information plus home visit group and an attachment information-only group with no home visits. The dependent variable in the study was the infants\u27 attachment classification which was measured by the Strange Situation procedure when the infants were 12 months of age. Psychological availability and psychological warmth were measured using the Still-Face procedure, maternal sensitivity was measured using a modified version of the Ainsworth Scale, and physical availability and body contact were measured through mothers\u27 self-report. The results of the study found a 94% rate of secure attachment in the attachment information plus home visit group, and an 81% rate of secure attachment in the attachment information-only group. These appear to be the highest rates of secure attachments found in any research study to date. A logistic regression analysis found that 98.4% of the infants\u27 attachment classifications (rated when the infants were 12 months of age) were correctly classified by a model which included the following predictor variables all measured when the infants were either 3 or 6 months of age: hours spent at work, long-term absences away from one\u27s infant, amount of holding, amount of room sharing (sleeping with the baby in the same room), amount of infant massage, psychological warmth, and maternal sensitivity. Only one insecure infant was not correctly identified through this model. A post-hoc examination of the ability of the antecedent variables to predict the specific attachment classifications (i.e., the avoidant, secure, anxious, and disorganized groups) found that infants in each of these groups tended to experience specific patterns of stress-producing and stress-reducing maternal behaviors