Sensitivity and attachment interventions in early childhood: A systematic review and meta-analysis

- Secure attachment, reduced rates of disorganized attachment and improved maternal sensitivity are actualised by early intervention programmes.
- Review findings support those of a previous review which found that early interventions improved attachment security and maternal sensitivity.
- It is postulated that critical to all these intervention studies is relationship based working acting as a key agent of change.
- Further research is warranted in relation to the efficacy of early interventions.

A systematic review and meta-analysis of randomized controlled trials (RCT) was conducted to determine whether early interventions are effective in improving attachment security and parental sensitivity. Electronic databases were searched 2002-2015 onwards, All RCTs delivered to mothers, fathers or carers, before their child's mean age was 36 months, via 1:1 support, group work or guided self-help were included. The search was restricted to English Language publications. Study Selection, data extraction and quality appraisal were independently undertaken by two authors. With regard to analysis, where appropriate, dichotomous data were pooled using the Mantel- Haenszel odds ratio method and for continuous data descriptive statistics were collected in order to calculate standardized mean differences and effect sizes.Four studies met inclusion criteria and were divided into two groups: North American & Canadian and South African based studies. Combining data from both groups indicates that early interventions improve attachment security and improves rates of disorganized attachment. One study provided extractable data on the outcome of parental sensitivity which shows that early interventions were effective in improving maternal sensitivity at 6 and 12 months. Study results generally support the findings of a previous review (Bakermans-Kranenburg et al., 2003) which found that early interventions improved attachment security and maternal sensitivity.