Early Parenting Intervention Effects on Brain Responses to Maternal Cues Among High-Risk Children

Abstract

Objective: Early adversity is correlated with increased risk for negative outcomes, including psychopathology and atypical neurodevelopment. The authors aimed to test the causal impact of an early parenting intervention (Attachment and Biobehavioral Catch-Up; ABC) on children's neural processing of parent cues and on psychosocial functioning in a longitudinal randomized clinical trial.

Methods: Participants (N=68, mean age, 10.0 years [SD=0.8 years]) were 46 high-risk children whose parents were randomly assigned to receive either the ABC intervention (N=22) or a control intervention (N=24) while the children were infants, in addition to a comparison sample of low-risk children (N=22). During functional MRI scanning, children viewed pictures of their own mothers and of a stranger.

Results: Children in the ABC condition showed greater maternal cue-related activation than children in the control condition in clusters of brain regions, including the precuneus, the cingulate gyrus, and the hippocampus, regions commonly associated with social cognition. Additionally, greater activity in these regions was associated with fewer total behavior problems. There was an indirect effect of early intervention on middle childhood psychosocial functioning mediated through increased activity in brain regions in response to maternal cues.

Conclusions: These results suggest that early parenting intervention (in this case the ABC intervention) can enhance brain regions supporting children's social cognitive development. In addition, the findings highlight these brain effects as a possible neural pathway through which ABC may prevent future behavior problems among high-risk children, yielding psychosocial benefits that endure through at least middle childhood without the need to intervene with the child directly.

Trial registration: ClinicalTrials.gov NCT02093052.

Keywords: Adversity; Attachment; Parenting; Prevention; Randomized Controlled Trial; fMRI.

Conflict of interest statement

All authors report no financial relationships with commercial interests.

Figures

Figure 1.

Grand average Mother > Stranger contrast. Positive Z-values indicate Mother > Stranger. All ps < .05. Montreal Neurological Institute coordinates X = −25, Y = −6, Z = 13.

Figure 2.

(a) Randomized clinical trial (RCT) group differences in Mother > Stranger contrast from whole-brain analysis after adjusting for multiple group comparisons. Colored regions indicate areas where experimental intervention > control intervention (there were no significant differences where control intervention > experimental intervention). Montreal Neurological Institute coordinates X = 4, Y = −2, Z = 27. (b) Cluster-masked mean voxel-wise statistics from the voxels highlighted in the panel above. Note that these parameter estimates were extracted from voxels that were already identified (via whole-brain analysis) to reflect an ABC > DEF group difference and are plotted here to illustrate the group means at these voxels. Error bars show +/− 1 SD. ABC = Attachment and Biobehavioral Catch-up (experimental intervention). DEF = Developmental Education for Families (control intervention).

Figure 3.

Scatterplots depicting relationships between neural activation during the parent/stranger task and the Child Behavior Checklist (CBCL) The solid red regression line indicates a significant correlation (p < .05) whereas dashed black regression lines indicate non-significant correlations.