Projects

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Promoting First Relationships (PFR): Research and Training Efforts with Early Childhood Populations: Promoting First Relationships is an evidence-based prevention program dedicated to promoting children's social and emotional development through responsive, nurturing caregiver-child relationships. For over a decade, we have trained service providers in countless agencies across Washington State and increasingly in other parts of the country and the world in the use of practical, effective strategies for promoting secure and healthy relationships between caregivers and young children (birth to 3 years).

The efficacy of Promoting First Relationships has been evaluated via a number of studies. Currently, two NIH funded research projects, The Fostering Families Project and Early Detection and Intervention for Infants at Risk for Autism are occurring. The Fostering Families Project is described in further detail below, and the autism project is described on the PFR link. Washington State DSHS funding is on-going to provide PFR services for families referred to Child Protective Services.

For more information regarding Promoting First Relationships, visit www.pfrprogram.org.
The Fostering Families Project (FFP): The Fostering Families Project (FFP) is a federally-funded, longitudinal, randomized controlled trial, involving over 200 toddlers in child welfare dependency and their caregivers. The project is a comparative effectiveness study of the Promoting First Relationships intervention (PFR) and the Early Education and Support (EES) intervention. Participant children are between 11 and 24 months of age who have recently experienced a change of care provider through actions of the child welfare/foster care system. PFR and EES interventionists work with foster, kin, and birth care providers. PFR focuses on understanding child's cues, attachment needs, and developmental level, with the goal of minimizing the impact that the experience of separations and caregiver transitions will have on developing attachment strategies and emotional regulation. EES provides caregiver resource and referral, education and support, but does not have an attachment focus.

This project is possible because of the strong support and collaboration of administrators and social workers at Washington State's Department of Social & Health Services Children's Administration. This project is unique in that we intervene as early as possible after a young child with a developed attachment relationship has experienced the loss of that caregiver, and try to follow the children and maintain the interventions even if children are moved from caregiver to caregiver several times over the course of the study. Our goal is to determine the impact that an attachment-focused intervention can have on this vulnerable population, during an extremely stressful time, and at a crucial period in development.
Stress Regulation in Foster Infants: This research looks at the development of the HPA axis, or “stress response system” in children who are child welfare dependency.

A sub-group of 50 children in the Fostering Families Project (FFP) described above will be enrolled in this study as well. We measure the children's production of cortisol, a by-product of the stress response, both pre-and post-intervention. Most infants develop a regulated stress response during their first year of life through predictable, soothing interactions with their caregivers. Normal stressors, like a diaper change or a doctor's visit, occur daily in the lives of infants and toddlers. When their stress response system is activated, interactions with their caregivers allow them to become calm and return to a normal baseline level of cortisol production. After the first year, their stress response system begins to achieve this response with less interaction, resulting in a regulated response to stressors. Extreme or repeated stress without the consistent support of a caregiver may leave a child with a stress response system that is either hyper-responsive or under-responsive. Our hypothesis is that an intervention that focuses on attachment will help the stress response of foster children to become better regulated, and that improved HPA functioning will be related to improved developmental, behavioral, and emotional outcomes.
Your Baby and You: This project evolved from CIMHD co-director Jean Kelly's discussions with nurses and other home-visitors about the difficulty and importance of discussing attachment with new parents.

The goal of this project is to produce a 15 minute DVD that introduces 4 real families with diverse early parenting experiences, and allows them to provide examples of the process of forming an attachment relationship with their new infant over their first year. The DVD will include home footage, interviews and laboratory tasks filmed at the Birth to Three Lab, and professional narration to highlight the important points that first-time parents need to know about attachment. We completed our first year of filming in February 2009 with the support of the Russell Foundation and have begun our second year. View a trailer of the DVD project and meet our first three families. {video will be emailed - embed}
Evaluating Educare in the White Center Early Learning Initiative: In partnership with Thrive by Five and the Puget Sound Educational School District (PSESD), CIMHD was selected by the Bill and Melinda Gates Foundation to evaluate the Educare program located within the White Center Early Learning Initiative.

Educare is a model of center-based early childhood care and education developed by the Ounce of Prevention Fund and implemented in high poverty neighborhoods across the country. Key features of Educare include a public-private funding partnership, a place specifically designed for early care and education, and a program to serve children from birth to five. The program seeks to promote and sustain best practices in early childhood education to benefit children and families living in poverty. Program characteristics include the use of research-based strategies, reflective supervision and practice, intensive staff development, and small class sizes with high staff/child ratios. In addition, Educare programming aims to increase children's school readiness skills by emphasizing social-emotional development, language and literacy skills, and family involvement.

CIMHD provides evaluation and technical support to PSESD in regard to implementing Educare in a racially, ethnically, and linguistically diverse, low-income population in the White Center area. As local evaluation partner, CIMHD has joined a consortium of 7 sites across the country implementing the Educare model, all under the leadership of a national evaluator, Donna Bryant, at the Frank Porter Graham Center at the University of North Carolina.
TAS-45: Secure attachment is associated with a variety of indices of child wellbeing and healthy development. Promoting child-parent attachment security is a frequently cited goal of early intervention programs such as nurse home visiting, but measurement of attachment in the context of home visiting research and practice has rarely occurred, primarily because the two observational ‘gold standards,' the Strange Situation Procedure (SSP) and the Attachment Q-Sort (AQS), are both costly and difficult-to-use research tools.

Dr. Susan Spieker and her colleagues have been studying an alternative to these measures. It is called the Toddler Attachment Sort-45 items (TAS-45). The TAS-45 was developed for the birth cohort of the Early Childhood Longitudinal Study (ECLS-B) . In a recent grant, Dr. Spieker and her colleagues piloted the TAS-45 in two Early Head Start programs. As part of the dissemination aims of that grant, the researchers initiated a process whereby NCAST Programs, the dissemination arm of the CIMHD, has been collaborating with the original developers of the TAS-45 to make the scoring software, training, and monitoring widely available. In the future, Dr. Spieker's team hopes to conduct validation studies comparing the TAS-45 with the gold standards in the field as well as theoretically important correlates of attachment, such as parenting sensitivity and child emotional regulation.