Behavioral Parent Training in Infancy: What About the Parent-Infant Relationship?

Abstract

Behavioral parent training (BPT) and attachment interventions have demonstrated efficacy in improving outcomes for young children. Despite theoretical overlap in these approaches, the literature has evolved separately, particularly with respect to outcome measurement in BPT. We examined the impact of the Infant Behavior Program (IBP), a brief home-based adaptation of Parent-Child Interaction Therapy, on changes in attachment-based caregiving behaviors (sensitivity, warmth, and intrusiveness) at postintervention and 3- and 6-month follow-ups during a videotaped infant-led play. Sixty mother-infant dyads were randomly assigned to receive the IBP (n = 28) or standard care (n = 30). Infants were an average age of 13.52 months and predominately from ethnic or racial minority backgrounds (98%). We used bivariate correlations to examine the association between attachment-based caregiving behaviors and behaviorally based parenting do and don't skills and structural equation modeling to examine the direct effect of the IBP on attachment-based caregiving behaviors and the indirect effect of behaviorally based parenting skills on the relation between intervention group and attachment-based caregiving behaviors. Behaviorally based parenting do and don't skills were moderately correlated with attachment-based caregiving behaviors. Results demonstrated a direct effect of the IBP on warmth and sensitivity at postintervention and 3- and 6-month follow-ups. The direct effect of the IBP on warmth and sensitivity at the 3- and 6-month follow-ups was mediated by increases in parenting do skills at postintervention. Findings suggest that behaviorally based parenting skills targeted in BPT programs have a broader impact on important attachment-based caregiving behaviors during the critical developmental transition from infancy to toddlerhood.

FIGURE 1

Indirect effects of parenting skills on relation between Infant Behavior Program and responsive caregiving at 3-month follow-up. Note: Values outside parentheses represent standardized regression weights and values inside parentheses represent unstandardized regression weights; dotted line represents indirect effect. Model fit indices: CMIN χ² = 2.77, p = .964; root mean square error of approximation < .001, PCLOSE p value = .93; comparative fit index = 1.00, Tucker-Lewis index = 1.00. Regression weights for nonsignificant covariates: maternal education, β = 0.03 (0.24); infant age in months, β = −0.10 (−0.08); infant ethnicity, β = 0.004 (0.02); baseline maternal warmth/positive affect, β = 0.14 (0.14); baseline maternal sensitivity/responsivity, β = .009 (.010); and baseline parenting do skills, β = 0.09 (0.02). *p < .05. ***p < .001.

FIGURE 2

Indirect effects of parenting skills on relation between Infant Behavior Program and responsive caregiving at 6-month follow-up. Note: Values outside the parentheses represent standardized regression weights and values inside the parentheses represent unstandardized regression weights; dotted line represents indirect effect. Model fit indices: CMIN χ² = 2.58, p = .784; root mean square error of approximation < .001, PCLOSE: p = .845; comparative fit index = 1.00, Tucker-Lewis index = 1.00. Regression weights for covariates: maternal education, β = −0.10 (−0.08); infant age in months, β = −0.13 (−0.10); infant ethnicity, β = 0.08 (0.41); baseline maternal warmth/positive affect, β = 0.10 (0.09); baseline maternal sensitivity/responsivity, β = .014 (.015); and baseline parenting do skills β = 0.15 (0.036). ***p < .001.