The ABC Manual
What are we trying to gain in each activity?
Activities are included for dedicated practice of ABC targets. With pop-out books, blocks, pudding, stickers, and lotion activities, we are trying to encourage following the lead. With the puppet activity, we are helping parents override their urge to be intrusive and frightening. The puppet activity tends to bring out these behaviors in even very sensitive caregivers, providing coaches with opportunities to comment. During these activities we expect coaches to have a higher rate of commenting (about 2 comments a minute, often more), because there is no expectation to be covering other content during the play as well. The coach’s goal is to help the parent be a success during the activity. Comment frequently and descriptively when the coach is succeeding, and scaffold when the parent needs help.
What are some strategies for working with multiple caregivers?
Working with multiple caregivers or multiple children in the home can be overwhelming, but it is helpful for the caregiver to learn ABC in his or her natural home setting, which often includes other children and caregivers. If a second caregiver is present, encourage him or her to join in the activities and conversation. Commenting on both of the caregivers behaviors will keep them engaged, help each feel successful, and perhaps help them learn from each other. Encourage the second caregiver to join activities, and make sure you have enough supplies for them as well, for example having an extra spoon for the pudding activity. You may feel challenged by needing to comment on multiple parent behaviors, but one benefit is that you will never feel that it is too quiet, or that you do not have opportunities for comments! As you become more comfortable in multiple caregiver situations, also try and think about the balance of comments you are giving to each. For instance, are you positively commenting on one but mainly scaffolding the other? If so, try to find opportunities to scaffold the first parent and make a positive comment on the second.
Does ABC work with babies with medical conditions or developmental delays? What’s different?
We have not specifically tested whether or not ABC is effective in these populations, but we have anecdotally seen success at dissemination sites and in some University of Delaware cases. The child should be developmentally between 6 months and 2 years. For instance, do not do the intervention with a child who is 6 months of age, but developmentally only 3. One of our ITM supervisors noted that she has found caregivers to be more teachy or overprotective when they have babies with medical conditions or developmental delays, making the skills of appropriate following the lead and nurturance important and relevant.
What do I do for session 7 if a parent is really good at all of the targets?
There is always something to work on! Even if the coach is generally skilled at all ABC targets try to help the caregiver determine when the targets are the most challenging. Perhaps the caregiver is less likely to nurture when she is overwhelmed or stressed. What makes that challenging and how can she override the automatic response to avoid nurturing/ignore/etc.?
What do I do for Session 7 if a parent struggles with multiple targets?
It is not uncommon for caregivers to have challenges with nurturance, following the lead, delight, and frightening behaviors. If this is the case, prior to Session 7 you should be working hard to prioritize which targets are the most concerning and to directly address those in Sessions 7 and 8. You might not be able to come up with a “voice” for each challenging target, and that’s ok.