As a child development scholar with an interest in intergenerational continuities, I am delighted to contribute to this special issue honoring my academic “grandfather,” Dr. Edward Zigler. Although I never worked directly with the venerated scholar known to many as “Ed,” Zigler mentee Lawrence Aber introduced me as an undergraduate to attachment theory and research and to the field of child policy. I have since been fortunate to collaborate with several other Zigler protégés, including child policy expert Brenda Jones Harden. From these esteemed colleagues I learned, and have since aimed to uphold, Zigler's guiding canon, that of the crucial importance of integrating science, practice, and policy development to support vulnerable children and families, reduce poverty, and improve US wellbeing, writ large (e.g., Zigler & Hall, Reference Zigler and Hall2000). This canon undergirded Zigler's far-reaching scholarship that in turn critically shaped developmental science and US policy in areas including but not limited to child poverty, the Head Start and Early Head Start programs, parental leave, child care, prekindergarten education, child maltreatment, child protective services, services for children with disabilities, and home visiting (e.g., Aber & Zigler, Reference Aber and Zigler1981; Kaufman & Zigler, Reference Kaufman, Zigler, Cicchetti and Carlson1989; Ripple & Zigler, Reference Ripple and Zigler2003, Reference Zigler1994; Zigler & Styfco, Reference Zigler and Styfco2002; Zigler, Finn-Stevenson, & Hall, Reference Zigler, Finn-Stevenson and Hall2004; Zigler, Gilliam, & Jones, Reference Zigler, Gilliam and Jones2006; Zigler, Marsland & Lord, Reference Zigler, Marsland and Lord2009).
In this review, I will describe how integrating one major area of developmental science, the field of attachment theory, research, and intervention, with US child care and early childhood education services has advanced science, practice, and policy. Both child care and early childhood education services typically reflect a patchwork of federal mandates, state regulations, and locally interpreted initiatives. Whereas it can be advantageous for services to vary according to community characteristics and needs, it is also the case that inconsistencies in program implementation create confusion and compromise service quality, a major concern of Zigler's.
As I will discuss, child care and early childhood education are especially relevant to early caregiving and thus to child–caregiver attachment. The integration of attachment into these services not only epitomizes Zigler's overarching vision but also reflects two themes running prominently through his body of work: (a) the importance of supporting child development from its earliest days (e.g., Zigler et al., Reference Zigler, Finn-Stevenson and Hall2004); and (b) the importance of promoting children's socioemotional functioning as a crucial aspect of child development and a key pathway to development in other domains (e.g., Raver & Zigler, Reference Raver and Zigler1997; Yoshikawa & Zigler, Reference Yoshikawa and Zigler2000). I will describe how following Zigler's canon has not only improved services and the lives of those served but also advanced attachment theory and research. Throughout, I will suggest next steps for leveraging attachment theory, research, and intervention to improve US child care and early childhood education systems in ways that both reflect and carry forward the legacy of Edward Zigler.
Attachment and Child Care/Early Childhood Education
US child care and early child education consist of four sets of services: (a) family child care; (b) center-based child care, for which families pay out-of-pocket and/or with needs-based vouchers; (c) federally funded Head Start and Early Head Start programs that provide low-income families with comprehensive home- and center-based child and family development services; and (d) state and community prekindergarten (pre-k) programs. As a whole, child care and early childhood education services touch large numbers of US children. For example, in 2016, almost three quarters (73%) of 3- to 5-year-olds and more than half (54%) of 1- to 2-year-olds spent at least one day per week in nonparental care, averaging 21–27 hr of care per week (U.S. Department of Education, 2016). Coordination both within and across service systems is often limited, prompting some to refer to US preschool as a “nonsystem” (Pianta, Barnett, Burchinal, & Thornburg, Reference Pianta, Barnett, Burchinal and Thornburg2009).
Zigler, attachment, and child care
Throughout his career, Zigler advocated vociferously for young children's access to high-quality child care (e.g., Brauner, Gordic, & Zigler, Reference Brauner, Gordic and Zigler2004; Zigler et al., Reference Zigler, Marsland and Lord2009). He was also among a group of scholars carefully questioning the effects of infants’ experiences in day care on their subsequent development, including attachment security (Gamble & Zigler, Reference Gamble and Zigler1986). These questions in turn helped to launch the landmark 10-site NICHD Study of Early Child Care and Youth Development (NICHD SECCYD; N = 1,153; NICHD Early Child Care Research Network [ECCRN], 2005). The first major set of findings from this study definitively indicated no main effects of child care quantity, quality, or stability on infant–mother attachment security assessed with the Strange Situation procedure at age 15 months (NICHD ECCRN, 1997). Additionally, there was no evidence that the Strange Situation was less valid for infants who typically experienced more separations due to more time spent in care. Child care quantity and quality were also unrelated to attachment security assessed when children were 24 and 36 months old. Consistent with the seminal work of Ainsworth and her colleagues (Ainsworth, Blehar, Waters, & Wall, Reference Ainsworth, Blehar, Waters and Wall1978), the NICHD study found that the strongest predictor of attachment security at all ages was observed maternal sensitive parenting behavior. Interestingly, when maternal sensitivity was low, more hours of child care, low child care quality, and less stability of care increased the likelihood of infant attachment insecurity, whereas when maternal sensitivity was higher, neither quantity nor quality of care was associated with attachment (NICHD ECCRN, 1997; 2001).
As well as reassuring both scholars and parents and providing important evidence of the validity of the widely used Strange Situation, these findings fed importantly into the understanding of maternal sensitivity as the key precursor of attachment security and as a set of behaviors valuable in their own right for supporting child development. These findings also helped to define child care providers’ sensitive caregiving behaviors as the linchpin of child care quality (see Burchinal, Reference Burchinal2018, for a review). Child care providers’ responsivity, sharing of positive affect, child-centered facilitation of exploration, and sensitive cognitive stimulation have since been associated with children's socio-emotional, cognitive, and language skills up to 15 years later (e.g., Vandell, Belsky, Burchinal, Steinberg, & Vandergrift, Reference Vandell, Belsky, Burchinal, Steinberg and Vandergrift2010). Given that the NICHD study also found that positive caregiving across child care settings was reported as “very” or “somewhat” uncharacteristic by over half (61%) of parents of 1- to 3-year olds (NICHD ECCRN, 2000), and that a 2011 systematic review similarly characterized US child care quality on the whole as “mediocre” (Phillips & Lowenstein, Reference Phillips and Lowenstein2011), concerns raised by Zigler over 30 years ago about the need to improve US child care quality (e.g., Zigler & Ennis, Reference Zigler and Ennis1989) remain urgent.
Leveraging attachment theory, research, and intervention to improve US child care
Three attachment-based responses to supporting child care providers’ sensitive caregiving may be especially valuable for improving US child care: (a) implementing attachment-based caregiving interventions for child care providers; (b) instituting attachment-based screening and hiring protocol; (c) promoting parent–caregiver partnerships. With respect to attachment-based caregiving interventions for child care providers, two interventions, both originally developed to support child–parent attachment security, have been tested with child care providers. Findings, while preliminary, are noteworthy. First, an 8-week version of the group-based Circle of Security-Parenting (COS-P) program was evaluated in a small quasi-experimental study of family child care providers (N = 51; Gray, Reference Gray2015). The COS approach involves a trained group leader teaching parents or caregivers basic attachment theory and research, and helping them to reflect on their own histories and caregiving behaviors. The centerpiece of the program content is the COS graphic, a simple yet comprehensive pictorial depiction of attachment theory's key constructs concerning (a) children's needs for both intimate connection and autonomy, and (b) caregiving behaviors that support these needs. The COS also focuses on children's cues, emphasizing that children sometimes “miscue” their caregivers about their true needs. Each weekly session includes a review and discussion of archival video recordings of child-parent interactions and of previous COS-P participants describing how the program affected their caregiving behavior.
In Gray's (Reference Gray2015) inquiry, the child care providers who received the intervention showed an increase over time in self-reported efficacy in managing children's challenging behaviors, whereas those in the comparison group showed a decrease. Intervention participants also experienced the COS-P program as extremely positive and reported an increase in their competence in supporting children's socioemotional development. There were no group differences in two other outcomes tested: self-reported depressive symptoms or work-related resources.
The second attachment-based intervention for child care providers, Video-Feedback Intervention to promote Positive Parenting and Sensitive Discipline for Child Care (VIPP-CC) was developed and evaluated in two small randomized trials in the Netherlands, one with family child care providers (N = 48; Groeneveld, Vermeer, van IJzendoorn, & Linting, Reference Groeneveld, Vermeer, van IJzendoorn and Linting2011) and the other with center-based caregivers (N = 64; Werner, Vermeer, Linting, & Van IJzendoorn, Reference Werner, Vermeer, Linting and Van IJzendoorn2018). VIPP-CC consists of six sessions during which trained interveners focus on promoting caregivers’ empathy and sensitivity through the interveners’ presentation and review of video recorded structured play interactions among the providers and the children in their care. Using an approach called “speaking for the children,” interveners aim to help the caregiver notice the child's signals, interpret them accurately, and respond strategically.
The family child care study revealed a main effect on overall quality of care but no intervention effect on caregiver sensitivity, whereas the center-based study found the opposite pattern (a positive intervention effect on observed caregiver sensitivity but no effect on overall quality). Both studies indicated that the intervention improved self-reported caregiving attitudes. Moreover, caregivers in both studies positively appraised the program. Given these generally positive initial results, both the COS-P and the VIPP-CC programs warrant further development and investigation with US child care providers.
Additionally, in response to high rates of depression and stress reported by child care providers (Cumming, Reference Cumming2017; Whitaker, Becker, Herman, & Gooze, Reference Whitaker, Becker, Herman and Gooze2013) and evidence of associations among child care providers’ mental health symptoms and negative caregiving behaviors (Hamre & Pianta, Reference Hamre and Pianta2004; Jeon, Buettner, & Snyder, Reference Jeon, Buettner and Snyder2014; Whitaker, Dearth-Wesley, & Gooze, Reference Whitaker, Dearth-Wesley and Gooze2015), my colleagues and I have discussed another possible attachment-based intervention approach for child care providers. Building on Jennings and Greenberg's (Reference Jennings and Greenberg2009) prosocial classroom model, we have explored a two-pronged intervention strategy addressing providers’ wellbeing and caregiving behavior (Berlin, Shdaimah, Goodman, & Slopen, Reference Berlin, Shdaimah, Goodman and Slopen2020). Although this strategy has yet to be tested, in qualitative interviews and focus groups with child care providers and center directors, many responded positively to the idea of a mindfulness-focused professional development program to support caregivers’ stress management, emotional regulation, and sensitive caregiving (Berlin et al., Reference Berlin, Shdaimah, Goodman and Slopen2020).
A concern with child care providers’ social and emotional capacities also motivates the second attachment-based response to improving US child care considered here: instituting attachment-based screening and hiring protocol. Specifically, given evidence that parents’ own attachment security, reflective functioning, and insightfulness influence their parenting behaviors (Jones, Cassidy, & Shaver, Reference Jones, Cassidy and Shaver2015; Koren-Karie, Oppenheim, Dolev, Sher, & Etzion-Carasso, Reference Koren-Karie, Oppenheim, Dolev, Sher and Etzion-Carasso2002; Slade, Grienenberger, Bernbach, Levy, & Locker, Reference Slade, Grienenberger, Bernbach, Levy and Locker2005), it stands to reason that a child care provider secure in her own state of mind with respect to attachment may be more likely to provide sensitive care than a provider with unresolved trauma and/or insecure “working models” of attachment (Berlin, Reference Berlin, Odom, Pungello and Gardner-Neblett2012). This possibility has not, to my knowledge, been empirically tested. Several studies of early home visiting can, however, be taken to suggest that child care providers’ own attachment orientations may factor into the care they provide.
Two studies have found associations between home visitors’ adult attachment styles and their job performance or tenure (Burrell, McFarlane, Tandon, Fuddy, & Duggan, Reference Burrell, McFarlane, Tandon, Fuddy and Duggan2009; McFarlane et al., Reference McFarlane, Burrell, Fuddy, Tandon, Derauf, Leaf and Duggan2010). In one, home visitors who reported more attachment avoidance were also more likely to respond to mothers’ mental health problems and to domestic violence, whereas home visitors who reported more attachment anxiety were less likely to respond to these concerns (McFarlane et al., Reference McFarlane, Burrell, Fuddy, Tandon, Derauf, Leaf and Duggan2010). In the second study, home visitors’ self-reported attachment anxiety was related to indicators of burnout, whereas attachment avoidance was associated with a shorter tenure as a home visitor (Burrell et al., Reference Burrell, McFarlane, Tandon, Fuddy and Duggan2009). In addition, results from a recent study of the Attachment and Biobehavioral Catch-up (ABC) home visiting program illustrated the value of screening parent coaches on the basis of their self-reported attachment security or related constructs: ABC parent coaches’ scores on a pretraining assessment of “valuing of attachment openness” predicted their ability to provide ABC home visits with high fidelity (Caron, Roben, Yarger, & Dozier, Reference Caron, Roben, Yarger and Dozier2018). Taken together, these studies imply that the use of a similar attachment-based screening for prospective child care providers may facilitate hiring those more capable of sustained sensitive caregiving.
To institute attachment-based screening and hiring protocol, child care programs might explicitly consider the extent to which caregivers can be contingently responsive to the full range of young children's needs (Berlin, Reference Berlin, Odom, Pungello and Gardner-Neblett2012). Given the frequency with which infants cry, and the importance of nurturance in response to distress for the development of attachment security (Leerkes, Reference Leerkes2011), infant caregivers’ capacities to be consistently responsive to distress should be considered especially closely. Hiring procedures might also assess prospective providers’ commitment to the children in their care. For example, to what extent do providers believe they should care for children as if they were their own? Conversely, to what extent do providers refrain from becoming invested because of the short-term nature of the relationship with the children in their care? Hiring procedures might also include prospective providers viewing and responding to video recorded Strange Situation procedures. For example, to what extent do providers believe that an infant classified as insecure-avoidant is strategically avoidant versus happily independent? A secondary level of screening could include actual observations of caregiving behavior in a typical child care setting. These observations could be coded with the same types of scales used to quantify caregiver sensitivity in the NICHD SECCYD and similar studies, with results then applied to hiring decisions.
The third attachment-based avenue for improving US child care considered here concerns promoting parent–caregiver partnerships (Ahnert & Lamb, Reference Ahnert and Lamb2003; Berlin, Reference Berlin, Odom, Pungello and Gardner-Neblett2012; Owen & Frosch, Reference Owen, Frosch, Thompson, Simpson and Berlinin press). Infants typically form attachments to multiple caregivers. Although the quality of these attachments can vary, they are more likely to be concordant than different (e.g., van IJzendoorn & De Wolff, Reference van IJzendoorn and De Wolff1997). This may be due in part to caregivers’ shared childrearing values and practices. In the child care context, parents and providers often have different perspectives. Communicating and coordinating these perspectives stands to facilitates a more harmonious and coherent experience for the child, as some emerging evidence suggests. For example, in a small study of 3-year-olds, parents and providers reported “sharing and seeking of information about the child” was associated with higher ratings of observed caregiving by both (N = 53; Owen, Ware, & Barfoot, Reference Owen, Ware and Barfoot2000). Elicker and colleagues’ Parent–Caregiver Relationship scale (Elicker, Noppe, Noppe, & Fortner-Wood, Reference Elicker, Noppe, Noppe and Fortner-Wood1997) provides a preliminarily validated tool for future studies to assess the parent–caregiver partnership and its role in overall child care quality.
Zigler, attachment, Head Start, and Early Head Start
Among Zigler's best-known accomplishments is his leadership in the design, implementation, and critical evaluation of the federal Head Start program (e.g., Zigler & Muenchow, Reference Zigler and Muenchow1992; Zigler & Styfco, Reference Zigler and Styfco2004). Established in 1965 as part of the Johnson administration's signature War on Poverty initiative, Head Start provides center-based early education, developmental screenings, and family support services, such as assistance with finding stable housing. Since its inception, Head Start has served over 36 million children. The program currently serves over 650,000 3- to 5-year-old children (U.S. Department of Health and Human Services [US DHHS], 2020).
In 1994, Zigler served on the Secretary's Advisory Committee on Services for Families with Infants and Toddlers convened to design Early Head Start, a downward extension of the Head Start program (US DHHS, 1994). The program developers drew explicitly on attachment theory and research to mandate that Early Head Start services, which can be home-based, center-based, or mixed, directly support child–caregiver relationships (US Department of Health and Human Services [US DHHS], 1994). The program currently serves over 160,000 pregnant women and families with infants and toddlers up to age 3 (U.S. DHHS, 2020).
Zigler campaigned tirelessly for Head Start and Early Head Start quality control, arguing for “crystal clear goals, a feasible evaluation plan, and rules to define and monitor program quality” (Zigler & Styfco, Reference Zigler and Styfco2000, p. 69). He once publicly announced that one-third of Head Start centers should be closed due to low quality (Zigler & Styfco, Reference Zigler and Styfco2002). Zigler helped to institute the Head Start Program Performance Standards that were implemented in 1975, although he lamented that it took “a full ten years” (from program inception) for them to take effect (Zigler & Styfco, Reference Zigler and Styfco2002, p. 10). These Performance Standards, which were expanded in 1998 to cover Early Head Start services, continue to be regularly updated and refined (US DHHS, 2020). From an attachment perspective, it is interesting to note that the most recent (2016) Performance Standards require home-based Early Head Start services to “offer opportunities for parents to participate in a research-based parenting curriculum that builds on parents’ knowledge and offers parents the opportunity to practice parenting skills….” (Office of Head Start, Administration for Children and Families, U.S. DHHS, 2016, p. 61428).
Zigler viewed Head Start and Early Head Start as national laboratories for both program evaluation and child development research. In keeping with these views, in 1995, the US Congress mandated the launch of the Early Head Start National Research and Evaluation Project (EHSREP) to evaluate Early Head Start services in 17 of the first 68 programs (Love et al., Reference Love, Kisker, Ross, Raikes, Constantine, Boller and Vogel2005). The EHSREP randomly assigned 3,001 low-income families to receive either Early Head Start or community services as usual. In-depth interview and observational data on child and family development and service implementation, including multiple video recorded infant-mother interactions for each family, were collected through children's fifth year. The study demonstrated numerous positive effects on parenting and child cognitive, language, and behavioral outcomes (Love et al., Reference Love, Kisker, Ross, Raikes, Constantine, Boller and Vogel2005, Reference Love, Chazan-Cohen, Raikes and Brooks-Gunn2013). At the same time, program effects have typically been modest and have varied for participant subgroups, prompting suggestions for program improvements, especially in the areas of parenting and attachment (e.g., Raikes et al., Reference Raikes, Roggman, Peterson, Brooks-Gunn, Chazan-Cohen, Zhang and Schiffman2014). Leaders of the EHSREP called for Early Head Start's increased precision and explicit targeting of “the parenting behaviors that matter for children's development” (Brooks-Gunn, Love, Raikes, & Chazen-Cohen, Reference Brooks-Gunn, Love, Raikes and Chazen-Cohen2013, p. 141).
Leveraging attachment theory, research, and intervention to improve Head Start and Early Head Start
Several studies have tested attachment-based interventions for Head Start and Early Head Start families. Most have supplemented Head Start or Early Head Start services as usual with an intervention targeting the child–parent attachment. Taken together, they preliminarily suggest that such attachment-based interventions can add value.
Two studies have implemented the group-based Circle of Security (COS) program. The first used a pre–post design to evaluate a 20-week version of the program with parents of Head Start or Early Head preschoolers or toddlers (N = 65; Hoffman, Marvin, Cooper, & Powell, Reference Hoffman, Marvin, Cooper and Powell2006). Comparisons of pre- and postintervention Strange Situations revealed significant decreases in insecure and disorganized attachment classifications. The second study, a randomized trial of a 10-week version of COS-P with mothers of 3- to-5-year-old Head Start children, found no main effects for child attachment security but did demonstrate (a) fewer postintervention “unsupportive” (but not more supportive) maternal responses to their children's distress and (b) greater child inhibitory control (Cassidy et al., Reference Cassidy, Brett, Gross, Stern, Martin, Mohr and Woodhouse2017). There were no intervention group differences in two other child outcomes examined: cognitive flexibility or behavior problems. Some intervention effects were moderated by mothers’ attachment style or depressive symptoms. For example, in dyads with mothers who reported more attachment avoidance, the intervention increased the likelihood of child attachment security and attachment organization. The authors speculated the COS-P's “gently challenging” approach was an especially good fit for these mothers (Cassidy et al., Reference Cassidy, Brett, Gross, Stern, Martin, Mohr and Woodhouse2017, p. 666).
The COS is an interesting model for Head Start families because it is both attachment-focused and applicable to supporting child–parent attachment beyond infancy. Its group-based mode of delivery makes it resource efficient. Given some evidence of positive effects with Head Start child-parent dyads, it merits further development and investigation. A not mutually exclusive possibility is the provision of a home-based attachment-focused intervention, such as those tested with Early Head Start families with infants and/or toddlers. Home-based services are often more manageable for low-income families who may not easily be able to access transportation, child care, and other resources required to attend a group meeting. Moreover, home visitors have a unique opportunity to observe and guide child-parent interaction in the environment in which it most often occurs.
Three studies of home-based, attachment-focused interventions implemented in the context of Early Head Start have aimed explicitly to improve Early Head Start's effects. The first two studies came from EHSREP sites where attachment-focused interventions were embedded in Early Head Start programming. Spieker and her colleagues augmented a mixed-approach Early Head Start program with a home-based, attachment-focused intervention consisting of 33 parenting modules (N = 135; Spieker, Nelson, DeKlyen, & Staerkel, Reference Spieker, Nelson, DeKlyen, Staerkel, Berlin, Ziv, Amaya-Jackson and Greenberg2005). No main program effects emerged for observed parenting or infant attachment security. There were moderated program effects on sensitive parenting and infant attachment organization favoring the dyads in which mothers reported more pre-intervention depressive symptoms.
A related effort evaluated an explicitly attachment-informed, “parenting-focused,” home-based Early Head Start services program in which at least 75% of each home visit was devoted to facilitating responsive mother-infant interactions (N = 161; Roggman, Boyce, & Cook, Reference Roggman, Boyce and Cook2009). This study revealed a positive effect on mothers’ ratings of their toddlers’ attachment security according to the Attachment Q-Set. Although these findings supported the researchers’ hypotheses, it is also important to note that they require replication with a more objective outcome assessment.
In the third study, my colleagues and I implemented one of six Early Head Start–University Partnerships comprising the federal Buffering Toxic Stress Research Consortium (Berlin, Martoccio, & Jones Harden, Reference Berlin, Martoccio and Jones Harden2018; Meyer & Fortunato, Reference Meyer and Fortunato2013). Each Consortium study tested a program innovation designed to improve Early Head Start's parenting supports. In keeping with Zigler's vision, Early Head Start–University Partnerships mandate active collaboration between researchers and EHS staff. We conducted a randomized trial with 208 low-income, predominantly Latina mothers and their 6- to 18-month-old infants. Intervention participants received “Early Head Start plus ABC,” home-based Early Head Start supplemented with Dozier's evidence-based Attachment and Biobehavioral Catch-up (ABC) program consisting of 10 home visits provided by a trained parent coach (Dozier & Bernard, Reference Dozier and Bernard2019). Each ABC session includes the mother and her infant together and addresses a specific topic. Principal intervention activities included discussion of basic attachment principles, guided practice of new parenting behaviors, and review of video clips from previous sessions to help reinforce parenting targets. The parent coach promotes three specific components of sensitive caregiving: (a) nurturance, especially in response to distress; (b) following the child's lead with delight; and (c) avoiding frightening caregiving behavior. Throughout all sessions, parent coaches observe mother-infant interactions and make frequent “in-the-moment” comments that connect the mother's behaviors to the intervention targets. Control participants received home-based Early Head Start plus Book-of-the-Week, a light attention control protocol consisting of 10 English/Spanish developmentally appropriate books sent weekly to the mothers by mail.
Findings revealed positive effects on observed maternal sensitivity/responsiveness, (reduced) intrusiveness, and positive regard (Berlin et al., Reference Berlin, Martoccio and Jones Harden2018) as well as nurturance in response to infant distress (Hepworth et al., Reference Hepworth, Berlin, Salas, Pardue-Kim, Martoccio and Jones Harden2020b). Intervention children showed healthier patterns of behavioral regulation and dysregulation (Hepworth et al., Reference Hepworth, Berlin, Martoccio, Cannon, Berger and Jones Harden2020a) and stress-induced cortisol production (Berlin, Martoccio, Bryce, & Jones Harden, Reference Berlin, Martoccio, Bryce and Jones Harden2019). Although we were not able to include assessments of infant attachment, we found a medium-sized effect, reflecting an increase of approximately one half of a standard deviation, on overall maternal sensitivity, an effect size identified as necessary to improve attachment quality (Bakermans-Kranenburg, van IJzendoorn, & Juffer, Reference Bakermans-Kranenburg, van IJzendoorn and Juffer2003).
Our inquiry, which built on important groundwork laid by previous studies of attachment-based interventions for Head Start and Early Head Start families, was the first to add a well-established attachment-based intervention to Early Head Start services as usual. That our multiple positive effects emerged for mothers already receiving comprehensive Early Head Start services (and did not emerge for control group mothers who received Early Head Start plus weekly books) implicates the addition of the 10 ABC visits, per se, as the critical ingredient in our enhanced Early Head Start model. A major strength of the study was the Early Head Start-University Partnership that undergirded all aspects of the research. While requiring replication, our findings tentatively suggest that integrating an evidence-based attachment-focused intervention such as ABC into ongoing Early Head Start services is a worthy endeavor towards improving the program's stated goal of supporting early parent–child relationships.
Zigler, attachment, and pre-k
As with his concerted and influential efforts in the child care and Head Start/Early Head Start domains, Zigler argued persistently for young children's access to preschool education, ultimately urging the development of a universal US pre-k system (Zigler et al., Reference Zigler, Gilliam and Jones2006). Paralleling the emphasis in the child care literature on providers’ sensitive caregiving behaviors, pre-k teachers’ warmth, sensitivity, and support for children's autonomy have been discussed as key features of pre-k quality (Hamre, Reference Hamre2014; Hamre & Williford, Reference Hamre, Williford, Thompson, Simpson and Berlinin press; Verschueren & Koomen, Reference Verschueren and Koomen2012). Like the relationships between young children and their child care providers, teacher–child relationships often have important implications for subsequent child development (e.g., Hamre, Hatfield, Pianta, & Jamil, Reference Hamre, Hatfield, Pianta and Jamil2014). Also paralleling the child care literature, researchers have raised serious concerns about the quality of teacher-child interactions (e.g., Hamre, Reference Hamre2014; Pianta et al., Reference Pianta, Barnett, Burchinal and Thornburg2009). Inadequate quantity and quality of teacher-child interaction may be especially problematic for children with behavioral challenges, those who arguably benefit most from empathic and supportive relationships with their teachers (Hamre, Reference Hamre2014).
Leveraging attachment theory, research, and intervention to improve US pre-k
Similar to the attachment-based caregiving interventions for child care providers described earlier, several programs have been designed to support the quality of the relationships between pre-k teachers and their students. All of these programs are based at least partially on attachment theory. The early evidence of some positive program effects is noteworthy.
The Banking Time program (Pianta & Hamre, Reference Pianta and Hamre2001) is the most singularly attachment-based teacher–child relationship program. Banking Time consists of brief (10- to 15-min) one-on-one teacher–student meetings conducted two or three times weekly during a 7-week period. The meetings are designed to increase teacher supportiveness and the closeness of the teacher–child relationship, especially for children with externalizing behavior problems. They include activities such as child-led play and the teacher's labeling of the child's emotions. A large randomized trial testing Banking Time program with 183 preschool teachers and 470 3- and 4-year-old children found that intervention teachers demonstrated fewer negative postintervention interactions with their students than control teachers (Williford et al., Reference Williford, LoCasale-Crouch, Whittaker, DeCoster, Hartz, Carter and Hatfield2017). Intervention teachers also reported improvements in the students’ problem behaviors. Analysis of diurnal cortisol production in a subsample of participants (N's = 70 teachers and 113 students; Hatfield & Williford, Reference Hatfield and Williford2017) showed a steeper morning decline (healthier pattern) in the Banking Time children. Unexpected findings (e.g., less positive engagement of teacher among intervention students) and some moderated effects also emerged (see also Driscoll, Wang, Mashburn, & Pianta, Reference Driscoll, Wang, Mashburn and Pianta2011 for a related, preliminary study, and Driscoll & Pianta, Reference Driscoll and Pianta2010, for results of a small randomized trial with Head Start teachers and students, both of which showed some positive and some null effects).
Some positive effects have also emerged from studies of related programs such as Playing 2-Gether (Vancraeyveldt et al., Reference Vancraeyveldt, Verschueren, Van Craeyevelt, Wouters and Colpin2015) and the web-based MyTeachingPartner teacher coaching program (Pianta, Mashburn, Downer, Hamre, & Justice, Reference Pianta, Mashburn, Downer, Hamre and Justice2008b). As encapsulated by the findings of a 2016 meta-analysis of interventions implemented to improve caregiver-child interactions among child care providers and/or preschool teachers, such interventions exert improvements, albeit with small to medium effects, on supportive caregiving behaviors (Werner, Linting, Vermeer, & Van IJzendoorn, Reference Werner, Linting, Vermeer and Van IJzendoorn2016). Given the importance of teacher–child relationships to children's preschool experiences as a whole, such interventions should be among the principal tools used to support early childhood education and should also continue to undergo careful development and evaluation.
Several additional attachment-related opportunities in the context of improving US pre-k are important to note. First, in addition to providing ongoing supports for closer and more harmonious teacher–child relationships, Hamre (Reference Hamre2014) recommends preservice trainings to help teachers enter their jobs better prepared to relate empathically and sensitively to the children with whom they work. Second, in the same way that strengthening partnerships between parents and child care providers may improve child care quality, partnerships between parents and preschool teachers have shown some promise for children's functioning in pre-k (e.g., Powell, Son, File, & San Juan, Reference Powell, Son, File and San Juan2010) and merit further consideration. Finally, Quality Rating and Improvement Systems (QRIS) are federally coordinated, and state-level initiatives to regulate the quality of preschools and related programs. As discussed by Hamre and Williford (Reference Hamre, Williford, Thompson, Simpson and Berlinin press), many QRIS to date have fruitfully employed the observational Classroom Assessment Scoring System (CLASS; Pianta, La Paro, & Hamre, Reference Pianta, La Paro and Hamre2008a), which includes an assessment of teachers’ emotional supportiveness, an important attachment-informed aspect of classroom quality. QRIS analyze data and systematically apply findings to program improvements. QRIS thus have the potential to improve pre-k teacher–student relationships and the quality of US pre-k as a whole.
Conclusions and Future Directions
Edward Zigler left oversized footprints on many areas of developmental science and US policy, especially at the intersection of science, practice, and policy, as exemplified by a consideration of attachment theory, research, and intervention in US child care and early childhood education. Reflecting his deep concern for marginalized people, Zigler led the development of the Head Start and Early Head Start programs for low-income families. He crusaded not only to expand families’ access to child care, Head Start, Early Head Start, and pre-k but also to leverage developmental theory and research to define, assess, and improve the quality of these services. Attachment theory, research, and intervention have been applied fruitfully, if incompletely, to the development and improvement of US child care and early childhood education. Attachment-based interventions, in particular, have shown some promise in supporting the caregiving behaviors of child care providers and teachers. Attachment-based interventions have also shown some promise in supporting parenting behavior and/or attachment quality in Head Start and Early Head Start families. These applications have also advanced attachment theory, research, and intervention. For example, the landmark NICHD child care study illustrated that daily extended separations between infants and their parents do not necessarily jeopardize attachment infant-mother attachment security as long as maternal sensitivity is relatively high (NICHD ECCRN, 1997; 2001). Likewise, findings from studies of attachment-based interventions with Head Start and Early Head Start families have shown that targeting maternal sensitivity can improve it, even in the context of comprehensive Early Head Start services (e.g., Berlin et al., Reference Berlin, Martoccio and Jones Harden2018). The recommendations that I have offered throughout this review for improving US child care and early childhood education emphasize increasing the use, evaluation, and continued development of attachments-based interventions for child care providers, teachers, and families. I have also recommended the use of attachment-based screening and hiring protocol, and the promotion of partnerships between parents and both child care providers and teachers.
The ways in which these recommendations are implemented may be as meaningful as the recommendations themselves. Three specific approaches that may be especially valuable include (a) the increased use of research–practice–policy collaborations, (b) attending to what works for whom, and (c) considering racial, ethnic, and cultural group differences in the design and evaluation of child care and early childhood education. First, in addition to conceptually integrating science, practice, and policy development, proactively building research–practice–policy collaborations could accelerate the pace of cross-disciplinary fertilization. This might involve researchers at the outset of a study seeking policy-makers’ input on outcome variables of interest, or an agency director who is providing a new intervention seeking researchers’ help with analyzing implementation processes and outcomes. Components of successful research-practice partnerships outlined by Tseng, Easton, and Supplee (Reference Tseng, Easton and Supplee2017) include trust among partners and jointly defined research agendas. Successful partnerships in turn can simultaneously and synergistically enhance service quality and developmental science in the real world.
Second, with respect to attending to “what works for whom?,” this question is ubiquitous in evaluation research because more often than not, one “size” does not fit all (e.g., Supplee & Duggan, Reference Supplee and Duggan2019). Indeed, much of the literature reviewed here may be less than conclusive in part due to (a) the presence of moderated effects that have yet to be replicated and/or fully understood and (b) an insufficient examination of moderated or subgroup effects. Theoretically and empirically grounded hypotheses of both main and moderated effects along with well-powered studies that permit rigorous analysis of moderation will be important.
A third and related approach pertains to considering racial, ethnic, and cultural group differences. For example, a well-documented but infrequently discussed finding of the seminal Early Head Start evaluation is that the strongest pattern of program impacts emerged for African American families (Raikes, Vogel, & Love, Reference Raikes, Vogel and Love2013). For the outcome of observed maternal supportive parenting, there were no significant program impacts for either white or Latinx families (Raikes et al., Reference Raikes, Vogel and Love2013). These findings deserve further scrutiny in term of both origins of these differential impacts and their implications for future service development. To take another example, before testing our Early Head Start plus ABC model with predominantly Latina mothers, we conducted a pilot study in which we explicitly addressed the cultural fit of the ABC intervention (Aparicio, Denmark, Berlin, & Jones Harden, Reference Aparicio, Denmark, Berlin and Jones Harden2016). In qualitative interviews, mothers attested to a strong overall fit of the intervention with Latinx communities. They also identified following the child's lead as the most difficult, and initially most culturally incongruous, of the three ABC parenting targets, a finding which later facilitated our interpretation of intervention effects (Berlin et al., Reference Berlin, Martoccio and Jones Harden2018). In a related vein, Owen and Frosch (Reference Owen, Frosch, Thompson, Simpson and Berlinin press) have raised the interesting and as yet untested question of whether culturally driven differences in childrearing values might affect parent–caregiver partnerships and, in turn, the quality of care experienced by the child. Careful consideration of the roles of race, ethnicity, and culture in child care and early childhood education services and evaluation stands to add importantly to developmental theory and research and to service quality.
Both Zigler's footprints and the profitable application of attachment theory, research, and intervention are visible in areas beyond child care and early childhood education, in particular in child welfare (Manly, Smith, Toth, & Cicchetti, Reference Manly, Smith, Toth, Cicchetti, Thompson, Simpson and Berlinin press) and early home visiting (Berlin, West, & Jones Harden, Reference Berlin, West, Jones Harden, Thompson, Simpson and Berlinin press). For example, Safe Babies Court Teams are interprofessional initiatives that integrate child protective decision-making with training in attachment and provision of attachment-based interventions (Osofsky & Lieberman, Reference Osofsky and Lieberman2011; Zero to Three, 2020). Likewise, the landmark Affordable Care Act of 2010 established the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program that in turn considerably expanded early home visiting in the US (National Home Visiting Resource Center, 2019). MIECHV funds are competitively awarded to states and territories to provide home visits to pregnant women and parents with young children. MIECHV grantees must spend at least 75% of their funds to implement one of 18 pre-approved “evidence-based” home visiting models, two of which explicitly target infant attachment security (the ABC program and Minding the Baby [Sadler et al., Reference Sadler, Slade, Close, Webb, Simpson, Fennie and Mayes2013; Slade et al., Reference Slade, Holland, Ordway, Carlson, Jeon, Close and Sadler2020]).
At the same time as the many advancements of Zigler's agenda are worth noting and applauding, it is also important to acknowledge that considerable work remains. For example, Head Start and Early Head Start programs serve only 36% and 11% of eligible families, respectively (National Head Start Association, 2020). Wait lists are often so long that children age out of eligibility before slots become available. Prekindergarten programs expel children, with African American children disproportionately ousted (Gilliam, Reference Gilliam2005). Universal pre-k in the United States is still discussed but as yet unrealized. Developmental science can and should continue to be rigorously integrated with the development of US child and family services and policies. In the short term, this task will be laborious and challenging. In the long term, however, carrying forward the legacy of Edward Zigler to provide more and better services for America's most vulnerable citizens promises great returns.
Acknowledgments
This article reflects the generous mentoring and collegiality of Larry Aber, Rick Barth, Jeanne Brooks-Gunn, Dante Cicchetti, and Brenda Jones Harden. I also gratefully acknowledge editorial assistance provided by Morgan Pardue-Kim and Ana Salas.
Funding Statement
This research received no specific grant from any funding agency, commercial or not-for-profit sectors.
Conflicts of Interest
None.
