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Authors: Paul Tough

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11. Minnesota

But Ainsworth’s contention that early attachment had long-term consequences was, at that point, just a theory. No one had figured out a reliable way to test it. And then in 1972, one of Ainsworth’s research assistants, Everett Waters, graduated from Johns Hopkins and entered the PhD program in child development at the University of Minnesota. There he met Alan Sroufe, a rising young star at the university’s Institute of Child Development. Sroufe was intrigued by what Waters told him about Ainsworth’s work, and he quickly embraced her ideas and her methods, setting up a lab with Waters where they could perform the Strange Situation test with mothers and children. Before long, the institute had become a leading center of attachment research.

Sroufe joined forces with Byron Egeland, a psychologist at the university who had received a grant from the federal government to conduct a long-term study on low-income mothers and their children. From the local public-health clinic in Minneapolis, they recruited 267 pregnant women, all about to become first-time mothers, all with incomes below the poverty line. Eighty percent of the mothers were white, two-thirds were unmarried, and half were teenagers. Egeland and Sroufe began tracking this group
of children at birth, and they have been studying them ever since. (The subjects are now in their late thirties; both Egeland and Sroufe recently retired.) The evidence the study produced, which Egeland and Sroufe and two coauthors summarized most completely in their 2005 book
The Development of the Person,
stands as the fullest evaluation to date of the long-lasting effects of early parental relationships on a child’s development.

Attachment classification, the Minnesota researchers found, was not absolute destiny—sometimes attachment relationships changed in the course of childhood, and some children with anxious attachments went on to thrive. But for most children, attachment status at one year of age, as measured by the Strange Situation and other tests, was highly predictive of a wide range of outcomes later in life. Children with secure attachment early on were more socially competent throughout their lives: better able to engage with preschool peers, better able to form close friendships in middle childhood, better able to negotiate the complex dynamics of adolescent social networks.

In preschool, two-thirds of children in the Minnesota study
who had been securely attached in infancy were categorized by their teachers as “effective” in terms of their behavior, meaning they were attentive and engaged and rarely acted out in class. Among children who had been observed to be anxiously attached a few years earlier, only one in eight was placed in the effective category; the large majority of those children were classified by their teachers as having one or more behavior problems. (The teachers didn’t know how the kids had done on the Strange Situation.) Children whose parents had been judged disengaged or emotionally unavailable in early assessments of their parenting style did the worst in preschool, and teachers recommended special education or grade retention for two-thirds of them. When teachers ranked students on indicators of dependency,
90 percent of the children with an anxious-attachment history fell in the more dependent half of the class, compared with just 12 percent of children with secure histories. When teachers and other children were surveyed,
the anxiously attached children were more often labeled mean, antisocial, and immature.

When the children in the study were ten, researchers invited a randomly selected group of forty-eight students to four-week-long sessions at a summer camp, where they were closely observed and discreetly studied. Counselors (again, unaware of the students’ attachment classifications at one year) rated campers who had had secure attachment in infancy as more self-confident, more curious,
and better able to deal with setbacks. The ones with anxious-attachment histories spent less time with peers, more time with the counselors, and more time alone.

Finally, the researchers followed the children through high school, where they found that early parental care predicted which students would graduate
even more reliably than IQ or achievement-test scores. Using measures of early parenting only and ignoring the students’ own characteristics and abilities, the researchers found they could have predicted with 77 percent accuracy,
when the children were not yet four years old, which ones would later drop out of high school.

It is easy to see parallels between what Michael Meaney’s researchers found in their rat pups in Montreal and what Alan Sroufe and Byron Egeland found in the children they studied in Minnesota. In both cases, certain mothers performed certain specific idiosyncratic parenting behaviors in the earliest days of their children’s lives. And those behaviors—licking and grooming in the rats, responding sensitively to infants’ cues in the humans—seem to have had a powerful and long-lasting effect on the children’s outcomes in a variety of similar ways: the human and rat babies who received the extra dose of early care were, later on, more curious, more self-reliant, calmer, and better able to deal with obstacles. The early nurturing attention from their mothers had fostered in them a resilience that acted as a protective buffer against stress. When the regular challenges of life emerged, even years later—an open-field test, a disagreement among strong-willed kindergartners—they were able, rats and humans alike, to assert themselves, draw on reserves of self-confidence, and make their way forward.

12. Parenting Interventions

There is a direct link between Mary Ainsworth’s research on attachment and Nadine Burke Harris’s clinic in Bayview−Hunters Point, and that link is a San Francisco psychologist named Alicia Lieberman. In the mid-1970s, Lieberman studied with Ainsworth at Johns Hopkins University in Baltimore. It was the era when Ainsworth was conducting her first big study of parenting and attachment, and under Ainsworth’s direction, Lieberman, then a graduate student, spent long hours watching and coding videotape of new mothers interacting with their babies, looking for the small, specific examples of sensitive and responsive maternal behavior that promoted secure attachment for the infants. Today, Lieberman runs the Child Trauma Research Program at the University of California at San Francisco, where she has become, in recent years, a close collaborator with Nadine Burke Harris.

Lieberman told me that while she admires the study that Sroufe and Egeland did in Minnesota, she feels there are two important ideas missing from their analysis. The first is an explicit recognition of how plainly difficult it is for many parents in neighborhoods like Bayview−Hunters Point to form secure attachments with their children. “Often, the circumstances of a mother’s life overwhelm her natural coping capacity,” Lieberman told me when I visited one of the clinics where she works in San Francisco. “When you are bombarded by poverty, uncertainty, and fear, it takes a superhuman quality to provide the conditions for a secure attachment.” In addition, a mother’s own attachment history can make her parenting challenge even greater: research from the Minnesota study and elsewhere shows that if a new mother experienced insecure attachment with her parents as a child (no matter what her class background), then it will be exponentially more difficult for her to provide a secure, nurturing environment for her own children.

The other thing that is underemphasized in the Minnesota study, Lieberman said, is the fact that parents can
overcome
histories of trauma and poor attachment; that they can change their approach to their children from one that produces anxious attachment to one that promotes secure attachment and healthy functioning. Some parents can accomplish this transformation on their own, Lieberman said, but most need help. And that is what she has spent most of her career doing: figuring out how best to provide that help. In the years after she left Johns Hopkins, she developed a treatment, called child-parent psychotherapy, that combines Ainsworth’s theories on attachment with more recent research on traumatic stress. In child-parent psychotherapy, therapists work with at-risk parents and their infant children simultaneously to improve attachment relationships and protect both parents and children from the effects of trauma. Two therapists in Lieberman’s program now work on site at Burke Harris’s clinic, providing the treatment to dozens of patients.

Lieberman’s treatment is relatively intensive, administered in weekly sessions that can continue for as long as a year. But the principle behind it—improving children’s outcomes by promoting stronger relationships between children and their parents—is increasingly in use across the country in a wide variety of interventions. And the results, when these interventions are evaluated, are often powerful.

In one study, Dante Cicchetti, a psychologist at the University of Minnesota
, tracked a group of 137 families with documented histories of previous child maltreatment; these were families, in other words, where children were at very high risk. Each family had a one-year-old child who was the focus of the intervention. At the beginning of the study, all the infants were evaluated in the Strange Situation procedure, and the results were predictably awful: just one of the 137 infants demonstrated secure attachment, and 90 percent of them were classified as having disorganized attachment, the most problematic type of anxious attachment. Then the families were divided randomly into a treatment group and a control group. The treatment group was given a year of Lieberman’s child-parent psychotherapy, and the control group received the standard community services provided to families reported for maltreatment. When the children were two years old, 61 percent of the ones in the treatment group had formed a secure attachment with their mothers, while in the control group, only 2 percent of the children were securely attached. Attachment-promoting parenting, Cicchetti had shown, can be nurtured in even the most troubled parents, and the benefit to both them and their children can be profound.

Other studies have shown an effect on not only children’s attachment classification but also the health of their stress-response systems, and researchers have demonstrated this effect with interventions that are less intensive than Lieberman’s treatment. An intervention called Multidimensional
Treatment Foster Care for Preschoolers, run by a psychologist in Eugene, Oregon, named Philip Fisher, gives foster parents six months of training and consultation in techniques to manage confrontation and difficult situations in the home. Children in foster care often have trouble regulating their stress-response systems (just as Monisha Sullivan did), but in one experiment, after six months of treatment, the kids in Fisher’s program not only showed increased evidence of secure attachment; they also had cortisol patterns that had shifted from dysfunctional to entirely normal.

Another intervention for foster parents of young children, called Attachment and Biobehavioral Catch-up,
or ABC, was developed by Mary Dozier, a psychologist at the University of Delaware. ABC encourages foster parents to respond to their infants’ cues more attentively and warmly and calmly. After just ten home visits,
children in ABC show higher rates of secure attachment, and their cortisol levels are indistinguishable from those of typical, well-functioning, non-foster-care children. What is perhaps most remarkable about Dozier’s intervention is that only the parents receive the treatment, not the children in their care—and yet it has a profound effect on the HPA-axis functioning of the children.

13. Visiting Makayla

I saw the attachment-promotion approach in action one recent spring afternoon on the South Side of Chicago when I visited a sixteen-year-old girl named Jacqui and her eight-month-old baby, Makayla, at the house where they lived with Jacqui’s mother. I wasn’t the only visitor—an older African American woman named Anita Stewart-Montgomery was there too, an employee of Catholic Charities who regularly visited at-risk parents (usually single mothers) and their children through a program run by the Ounce of Prevention Fund, a Chicago-based philanthropy. After the visit, I spoke to Nick Wechsler, an infant specialist who has overseen the Ounce’s home-visiting programs for more than two decades. He explained that while he and his staff do care about the traditional issues that home visitors discuss with new parents—infant nutrition and smoking cessation and vocabulary growth—they are convinced by the research that improving attachment is the most powerful lever they have for improving child outcomes. And so attachment is what they emphasize.

In fact, Wechsler said, he often has to remind home visitors in the program that it is not their job to try to fix all the many problems they see in the lives of the young parents they visit—just this one. “It’s a tremendous challenge for home visitors, because your instinct is that you want to do more,” Wechsler told me. “But even if you can’t always take away bad housing or bad schooling, you can build in the parent an inner strength and resilience, so they can be the best parent they can be.”

It was true that there was plenty to fix in Makayla’s world. As I watched her and Jacqui and Stewart-Montgomery playing and talking on the living-room rug, I found myself wishing that the house were quieter and the furniture had fewer sharp corners, that she and her mom and grandmother didn’t live next to an abandoned lot on a rough-looking block, and that we couldn’t smell the cigarette smoke from next door. But Stewart-Montgomery, to her credit, focused on Jacqui, watching her watch Makayla, making encouraging comments, expressing to Jacqui exactly the kind of warm and nurturing support that she hoped Jacqui would pass on to Makayla.

A previous generation of early-childhood interventions, developed under the influence of Hart and Risley’s research on the importance of early language skills, focused primarily on encouraging the parents to take steps to expand their children’s vocabulary. The frustrating reality about those interventions, though, is that if you are a parent and you have a limited vocabulary, which many low-income parents do, it is very hard for you to nurture in your children a rich vocabulary. Reading to them more is certainly helpful, but infants absorb language from their parents not just in dedicated vocabulary-building moments but at every moment. This is why vocabulary deficits are often handed down from one generation to the next—a cycle that a great preschool and a great kindergarten can do a lot to interrupt but that is hard to break with a parent-based intervention alone.

BOOK: How Children Succeed: Grit, Curiosity, and the Hidden Power of Character
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