Using video feedback as a tool in training parent coaches: promising results from a single-subject design.

The Attachment and Biobehavioral Catch-up (ABC) parenting program focuses on three intervention targets: increasing parental nurturance, increasing parental synchrony, and decreasing parental frightening behavior. Parent coaches are expected to comment "in the moment" when behaviors relevant to these three targets are observed in sessions. Making in the moment comments is a challenging aspect of intervention, and parent coaches have struggled with their fidelity to this critical intervention component. Thus, we developed a system for coding the frequency and quality of comments from video-recorded session clips on a statement-by-statement level. To help parent coaches refine and maintain their skills in making such comments, they are taught to code segments of their own video-recorded sessions, with the expectation that gains would be seen in comments after learning to code. In this paper, we describe the fidelity coding system and present initial results from a year-long, single-subject design examining the effects of video feedback coding for a parent coach who was learning the intervention. We observed an increase in frequency of in the moment comments during the period of video feedback coding, consistent with a training effect.

Predictors of detection of alcohol use episodes using a transdermal alcohol sensor.

The objective of this investigation was to establish the ability of the Secure Continuous Remote Alcohol Monitoring (SCRAM) alcohol sensor to detect different levels of self-reported alcohol consumption, and to determine whether gender and body mass index, alcohol dependence, bracelet version, and age of bracelet influenced detection of alcohol use. Heavy drinking adults (N = 66, 46% female) wore the SCRAM for 1-28 days and reported their alcohol use in daily Web-based surveys. Participant reports of alcohol use were matched with drinking episodes identified from bracelet readings. On days when bracelets were functional, 690 drinking episodes were reported and 502 of those episodes (72.8%) were detected using sensor data. Using generalized estimating equations, we found no gender differences in detection of reported drinking episodes (77% for women, 69% for men). In univariate analyses, at the level of fewer than 5 drinks, women's episodes were more likely to be detected, likely because of the significantly higher transdermal alcohol concentration levels of these episodes, whereas at the level of 5 or more drinks, there was no gender difference in detection (92.6% for women, 93.4% for men). In multivariable analyses, no variables other than number of drinks significantly predicted alcohol detection. In summary, the SCRAM sensor is very good at detecting 5 or more drinks; performance of the monitor below this level was better among women because of their higher transdermal alcohol concentration levels. Individual person characteristics and bracelet features were not related to detection after number of drinks was included. Minimal bracelet malfunctions were noted.

Parental synchrony and nurturance as targets in an attachment based intervention: building upon Mary Ainsworth's insights about mother-infant interaction.

As an astute observer of parent-infant interaction, Mary Ainsworth described and assessed facets of maternal sensitivity, including responsiveness to conditions of infant distress and non-distress. This paper considers the importance of distinguishing between parental sensitivity to children's distress cues (which we refer to as nurturance) and parental sensitivity to children's non-distress cues (which we refer to as synchrony). Observations of parents in our intervention, Attachment and Biobehavioral Catch-up (ABC), have led us to believe that distress and non-distress represent distinct contexts in which parents can be differentially sensitive or insensitive in responding. Thus, we have conceptualized nurturance and synchrony as distinct targets of the ABC intervention and, in deciding how to assess parental sensitivity, we have chosen measures that distinguish between nurturance and synchrony. This paper describes the strengths and weaknesses of different approaches we have taken to assess parental sensitivity, including diary methodology that we developed for assessing parental nurturance and global measures that we have used for assessing parental synchrony. Finally, a frequency-based coding system is described that we developed for assessing parental nurturance and synchrony from videotaped intervention sessions.