The Buffering Toxic Stress (BTS) Consortium: Testing Parenting Interventions in Early Head Start (EHS) Sponsored by the Office of Planning, Research & Evaluation (OPRE) within the Administration for Children & Families (ACF)

Goals O Each site must: O Work to empirically validate the assessment of toxic stress O Test a promising intervention(s) O Evaluate intervention implementation O Include assessments of the hormone cortisol

Research Sites & Principal Investigators O New York University: Clancy Blair & C. Cybele Raver O University of Colorado: Michelle Sarche & Misty Boyd O University of Delaware: Rena Hallam, Myae Han, Jason Hustedt, & Jennifer A. Vu O University of Denver: Sarah Enos Watamura O University of Maryland: Lisa Berlin & Brenda Jones Hardin O Washington University: John N. Constantino

Intervention Required Components O Each site selected their own intervention based on their sites specific needs and resources, and their estimation of the research body behind each O All interventions target parents as the first critical support for infants and toddlers – and the barrier between what is tolerable and what is toxic O Families served must be attending Early Head Start programming of some type (home visitation, center care etc.)

Interventions by Site O New York University: Play and Learning Strategies (Pals) O University of Colorado Anschutz Medical Campus: Parent-Child Interaction Therapy (PCIT) & Mindfulness-Based Emotional Availability Intervention O University of Delaware: Promoting First Relationships (PFR) O University of Denver: Filming Interactions to Nurture Development (FIND), and FIND+ Parent Focused Support O University of Maryland: Attachment & Biobehavioral Catch-up (ABC) O Washington University: Incredible Years Toddler Basic Parenting Program (IYT)

New York University O Intervention Name: Play and Learning Strategies (PLAY) O Intervention Developer: Landry O Population: primarily low income Latina mothers and children O Location: New York City O Intervention components: O Family coaches deliver the intervention by visiting families on a weekly basis over the course of three months O Each session includes a discussion of the parent's practice during the preceding week; introduction of the new topic; viewing of educational videos demonstrating the skill; guided, videotaped practice using the skill with her own child; review of the videotaped practice; and planning for practice during the upcoming week.

University of Colorado Anschutz Medical Campus O Intervention Name: Parent-Child Interaction Therapy (PCIT), and Mindfulness Based Emotional Availability Intervention (MEAI) O Intervention Developers: PCIT - Eyberg; MEAI – Beringen O Population: American Indian O Location: A mid-western state (not Colorado) O Intervention components: O PCIT first mastery is obtained with following the child’s lead in play; then behavioral management strategies are taught O MEAI is a 4-session group format parent training in stress management and being in the moment to support emotional availability to children

University of Delaware O Intervention Name: Promoting First Relationships (PFR) O Intervention Developers: Kelly, Zuckerman, Sandoval, Buehlman) O Population: 45% African American; 35% Hispanic/Latino; 15% White O Location: Delaware O Intervention components: O 10 sessions, videotaped feedback, strengths based, focused on 5 components (offering love and attention every day; responding with empathy and understanding; providing comfort when upset; offering a predictable world; and promoting play and exploration

University of Denver O Intervention Name: Filming Interactions to Nurture Development O Intervention Developer: Phillip Fisher O Population: 60% immigrant families; majority Hispanic families O Location: Denver metro area O Intervention components: O Video-coaching method; 10 sessions; strengths- based; uses micro interactions and very short clips to illustrate them; works on 5 building competencies (sharing the focus of attention; supporting and encouraging; naming; back and forth; endings and beginning)

University of Maryland O Intervention Name: Attachment & Biobehavioral Catch-up (ABC) O Intervention Developer: Dozier O Population: O Location: Maryland O Intervention components: O Videotaped, uses highly trained coaches, near continuous “in-the-moment” coaching feedback, focuses on nurturance, following the child’s lead, and non-frightening caregiving behavior

University of Washington O Intervention Name: Incredible Years Toddler Basic Parenting Program (IYT) O Intervention Developer: Webster-Stratton, Reinke, & Herman O Population: O Location: Youth in Need sample drawn from urban, suburban, & rural Missouri O Intervention components: O 4-8 sessions depending on child age; emphasis on child-directed play, emotion “coaching,” praise and encouragement, management of common early childhood tasks, and parental self-control

Shared Intervention Components O Careful assessment of family characteristics O Attachment/positive parenting focus O Theoretically grounded O Most are relatively short interventions (4-16 weeks) O Most include videotaping O Most involve coaching

Differing Intervention Components O Strengths based only vs. strengths based and corrective O Who delivers the intervention (EHS providers, outside coaches etc.) O Level of training needed for interventionists O Sample sizes and populations served O Type of control or comparison group O Study location

BTS Consortium Timeframe O $12,000,000 awarded in September, 2011 O Study length: 5 years O Expected conclusion date: August 2016 O First data available: 2014 O Complete data available: 2017